Zirconia Dental Implants
Since the 1960s, titanium has been the material of choice for use in dental implants. But as patients become increasingly concerned about the materials going into their bodies, some may worry about the impact titanium or other metals may have on their overall health and safety. Because of this, it is ideal to select a material that is as minimally reactive and toxic as possible. Other considerations include an evaluation of the implant material’s strength, clinical rate of success, manufacturer quality, and design factors.
As the trend shifts away from using metals in the body, alternative materials, like zirconia, are becoming increasingly popular for dental implants. Patients that are health-conscious may wonder if zirconia dental implants are better or safer than their titanium counterparts. To answer this question, this article will examine the possible benefits, limitations, and drawbacks associate with zirconia dental implants.
Zirconia Dental Implants Explained
Dental implants are devices used to replace one or more missing teeth. Titanium has long been the industry standard material choice for dental implants and with decades of innovation and clinical success, long-term success rates range from 94-97%.
A white colored material, zirconia is a ceramic that was developed in the late 1980s. Zirconia dental implants are a non-metal alternative to titanium that have gained in popularity as the demand for Biomimetic and holistic dentistry have increased. Clinical research into the effectiveness of Zirconia implants continues along with design and manufacturing improvements.
While often advertised as a metal-free, many people may be surprised to learn that ceramics actually contain metals. Also called zirconium dioxide, the ceramic zirconia contains oxygen and zirconium. With an atomic number of 40, zirconium is considered a transitional metal. As such, the metallic atoms of zirconium are present in zirconia implants but are not categorized as metal because of the metal oxide structure which changes its behavior, name, and structure.
Is Zirconia Better Than Titanium for Dental Implants?
The answer depends on what the patient prioritizes. Given that it has been used longer and is backed by decades of clinical research, more is understood about the long-term success of titanium in dental implants. The material has proven biocompatibility and has shown to be effective for most patients.
However, zirconia is showing promise as an alternative to titanium dental implant systems. Studies have indicated that zirconia has similar, if not superior, osseointegration properties to titanium. This is a critical consideration as it determines the implant’s success, stability in the mouth, and function.
Additional advantages and disadvantages of zirconia dental implants are discussed below:
Zirconia Dental Implants: Advantages Compared to Titanium
* Esthetics: Because the color of zirconia looks like natural teeth, zirconia implants do not run the risk of dark color being visible through the gums. This is especially beneficial in the esthetic zone as titanium carries the risk of tissue grayness or discoloration appearing through the gums (gingiva). Patients that are most concerned with appearance, may find that zirconia dental implants offer superior results to their titanium counterparts.
* Metal Allergy or Sensitivity: Allergy or sensitivity to titanium or other metals used in titanium implants are common reasons patients opt for metal-free zirconia implant treatments. Despite being very rare, allergic reactions to titanium or other metals in dental implants have been reported. Although most implants contain 89-99% titanium, they do contain varying amounts of other metals including manganese, iron, tin, chromium, molybdenum, vanadium, niobium, tungsten, nickel, zinc, and zirconium. The precise composition of these other metals varies based on the implant design and manufacturer.
* Less Plaque Buildup Around Implants: Some research suggests that plaque formation is inhibited and fewer infections occur with zirconia implants when compared to titanium. As such, gum health could benefit as the implant material retains less plaque than titanium, especially if a single-piece zirconia implant system is used.
* Less Corrosive: Titanium is more corrosive in the dynamic environment of the mouth than zirconia. Studies indicate that titanium can corrode 5-6 times faster than zirconia counterparts.
* Poor Thermal and Electrical Conductor: Zirconia dental implants avoid any galvanic or battery concerns associated with titanium implant systems.
Zirconia Dental Implants: Advantages Compared to Titanium
* Limited Component and Design Varieties: Because their use in dental implants is relatively recent, zirconia implants are early in their development process. Some important design improvements, like two-piece screw-retained abutments, only just became available in the United States in 2019. As such, options for zirconia dental implant designs are limited compared to their titanium counterparts. This can make it very difficult to achieve optimal results for challenging cases and can be especially problematic if several teeth require replacement. This is generally not a concern for routine procedures to replace a single tooth.
* Questionable Long-Term Success: Unlike titanium that has been used in dental implants for several decades, the newness of zirconia also makes it difficult to determine the material’s long-term effectiveness in dental implant restorations. Titanium is backed by decades of clinical research and innovation that has produced long-term success rates of up to 98%. Because less is understood about zirconia, there is concern that zirconia implants may not have the same longevity and could create potential complications down the road.
* Strength and Resistance to Fracture: When compared to titanium, zirconia is more brittle, has less flexural strength, and lower fracture strength. While strong under compression, zirconia has a greater risk of fracturing from bending or flexing forces (flexural strength) than titanium. This increases the chances of fracture or long term complications.
* Small Diameter Zirconia Implants Are Prone to Fracture: Using small diameter zirconia implants has shown to be an issue. When placing implants, dentists often have to utilize implants with diameters of 3.0-3.75mm because of small space between the teeth or thin bone. Studies have shown that zirconia implants with diameters less than 4mm almost always result in catastrophic fracture.
* Nut Suitable for Complex Restorations of Implant Supported Dentures: Patients missing all of their teeth or need them replaced with implant dentures are likely not candidates for zirconia implants. Cases of this type require a greater degree of planning and variety of components which typically makes titanium the more suitable material choice.