In 2011, the FDA approved zirconia dental implants. Since the approval, they have quickly gained popularity with patients and clinicians alike. Zirconia implants have been in use for more than a decade, providing excellent biocompatibility and stability as a tooth-replacement solution. As with most dental treatments, not all patients are good candidates for this option. There are also specific clinical situations where zirconia dental implants are an excellent solution.
In recent years, patients have become more aware and interested in materials which are coming into contact with their bodies. In addition, patients are better educated on how various materials can potentially impact their health, safety, and general wellbeing. When working with dental implants, it is important to use materials which are the least reactive and least toxic. Other important considerations include the strength, clinical success, manufacturer quality, and design factors related to the implant material.
There has been a recent trend to avoid the use of metals in our body. In the past, titanium implants were the preferred solution. Titanium is extremely durable and well received by the body, however, it is a metal. One alternative material to titanium is zirconia which can be used in dental implants. Patients who are especially health-conscious often want to know if zirconia dental implants are better than the titanium version. There is unfortunately not a simple answer to this question. It is important for patients to fully understand the potential benefits, limitations, risks, and data associated with zirconia implants.
Zirconia or Zirconium dioxide is a ceramic which contains Zirconium and Oxygen. Zirconium also has an atomic number of 40, which means it is a transitional metal. While Zirconia implants contain metallic atoms of Zirconium, they are not considered a metal. This is due to its metal oxide structure. Because of the addition of the oxide, it changes its composition structure, behavior, and name.
Zirconia dental implants are often advertised as a non-metal alternative to titanium implants. Zirconia is a ceramic material and is white in color. Patients are often surprised to learn that ceramics contain metals and non-metals.
It is common for patients to be curious if zirconia implants are a superior solution to titanium implants. This is actually challenging to answer as it varies based on the priorities of the patient. Titanium has been used significantly longer, has more clinical studies, data, and decades of evidence to support that it is an excellent biomaterial to be used in dental implants. Zirconia, in comparison, is proving to be a promising alternative for use in implant systems. Zirconia reportedly has superior soft-tissue response, biocompatibility, and esthetic results when compared to titanium implants.
Studies have also demonstrated that titanium and zirconia implants have very similar osseointegration results, which is critical for the success of the implant. The ability for the jawbone to fuse to the implant is critical in its overall success. It also determines the stability of the implant and is vital for the implant’s function. Below is a summary of the advantages and challenges associated with Zirconia implants.
Zirconia Implant Advantages
1. Zirconia is the only implant option for patients interested in dental implants who desire metal-free dentistry. The material is inert and a good solution for patients who have known metal sensitivities or allergies.
2. Zirconia implants eliminate the risk of dark lines around the gingival margin and can be more aesthetic.
3. Implants are available as a one or two-piece implant. The two-piece solution allows for the customization of abutments.
4. Zirconia retains less plaque and calculus compared to titanium, making the implant healthier for the soft tissue. This is especially true when selecting a one-piece implant.
5. The material has good flexural strength, making it superior to other ceramics in its ability to resist fractures.
6. It is naturally white in color, making it easy to match to the natural teeth.
7. According to clinical studies, zirconia is equal to or even better than titanium with its osseointegration properties. There is a high level of contact between the implant and the jawbone which allows the bone to firmly fuse together with the implant and creates a strong base.
Zirconia Implant Challenges
- Over time, zirconia dental implants have a low-temperature degradation. This can result in the material becoming damaged, having reduced strength, density, and overall durability. There are limited clinical studies regarding the long-term success of the products.
- Aseptic loosening caused most failures reported for two-piece dental implants. Based on limited research on two-piece zirconia dental implants, some clinicians prefer using one-piece implant systems. There are limitations which should be considered. For example, there are reduced options for the angle of the abutment which compromise the surgical position of the implant.
- When a zirconia implant is placed in a non-ideal location, it can negatively impact the physical properties of the material.
- Single-piece implants require a healing period of the implant being load-free. This can be extremely challenging in some situations.
- The use of zirconia dental implants is relatively new, which means there are limited clinical studies into the long-term success and viability of the treatment. In comparison, titanium implants have been studied in great detail for decades, producing reliable data on their long-term success.
The studies which have been completed on Zirconia implants have produced good results. The survival rates are equal to those of titanium implants. A common complication with titanium dental implants is excess cement which can provoke an inflammatory reaction. Peri-implantitis has not yet been reported in zirconia dental implants. It is possible that the success is due to zirconia's high biocompatibility qualities but could also simply be from the lack of research and data. It is critical for patients who are considering zirconia dental implants to be aware of the benefits and potential challenges associated with the material.
While Zirconia has some incredible advantages and has demonstrated promising results, there are also challenges and limitations which should be considered. Zirconia has proven to be a safe implant alternative to titanium. However, titanium implants may still be the best solution for some patients. Prior to beginning treatment, patients should work with their dentist to fully understand the potential benefits, limitations, and risks associated with zirconia implants. They are a promising implant solution that may work well for many patients.