Zirconia Dental Implants
With people paying more attention to their health, patients are increasingly cautious about what materials come into contact with their bodies and how it impacts their overall health. When choosing the type of dental implant to use, selecting the least toxic and least reactive material possible is ideal. Other considerations include the implant’s strength, manufacturer quality, clinical success, and design.
Despite titanium being used successfully in dental implants for several decades, the recent trend has been away from using metal in the body. A metal-free alternative to titanium, zirconia is a newer material being used in dental implants. Patients that are health-conscious may wonder if zirconia dental implants are superior to titanium. To better address the question, this article will examine the benefits and limitations of zirconia dental implant treatments.
Zirconia Dental Implant: An Overview
Used to replace missing or lost teeth, titanium dental implants have been the medical standard since the 1960s. After decades of research, development, use, and innovation, titanium dental implants have a success rate of almost 98%.
Released in 1987, zirconia implants are a modern alternative to titanium that is growing in popularity. While a ceramic and often advertised as a non-metal alternative, zirconia contains both non-metals and metals. Also known as zirconium dioxide, zirconia is comprised of the elements oxygen and zirconium. With an atomic number of 40, zirconium is considered a transitional metal.
Are Zirconia Dental Implants Superior to Titanium?
The answer will vary depending on what the patient prioritizes. One advantage of titanium is that it has been used significantly longer than zirconia. As such, more clinical studies and investigations about its success and reliability exist than zirconia.
However, evidence is emerging that zirconia is a suitable alternative to titanium dental implant systems. Data suggests that zirconia has superior biocompatibility, stimulates a better soft-tissue response, and is cosmetically more attractive than titanium. Studies also have demonstrated that zirconia implants have similar osseointegration capabilities to titanium which is vital to the long-term success of the implant.
Advantages of Zirconia vs. Titanium Dental Implants
- Appearance: Patients prone to receding gums or who have thin, translucent gums, could wind up with titanium showing around the crown margin. Because they match the color of natural teeth, zirconia implants will not show through the gum tissue. This can be quite beneficial in the esthetic zone as titanium implants run the risk of grayness or tissue discoloration showing through.
- Metal Sensitivity or Allergy: Although 90-99% of the implant material is titanium, other metals like iron, tin, manganese, nickel, and chromium are used in the alloy. Despite being very rare, some patients could have sensitivity or allergic reactions to the metals used in titanium dental implants. In many cases, sensitivity issues develop years after implant surgery and present as inflammation and itchiness around the implant. This creates a perfect setup for bone loss and implant failure. Zirconia offers a non-metal alternative for patients concerned about metal sensitivity.
- Less Plaque Accumulation: With its smooth surface, data indicates that less plaque forms around zirconia implants and fewer infections occur. Because of their single-piece design, zirconia implants leave fewer spaces for bacteria to accumulate and since they are highly biocompatible, periodontal health is improved. This helps guard against implant failure by reducing bacteria and related inflammation.
- Resistant to Corrosion: Because it is a biocompatible material, zirconia provides a higher level of resistance to corrosion and scratching than titanium. Titanium has been proven to corrode in wet environments like the mouth especially if other metals, like amalgam fillings or metal bridges, are also in the vicinity. Fluoride in water supplies, mouthwashes, and toothpastes also exacerbate metal corrosion of titanium dental implants. When titanium corrodes and oxidizes, patients could have a resulting metallic taste in their mouths that zirconia avoids.
- Not Thermally or Electrically Conductive: Zirconia implants do not run the risk of heat or electrical conductivity. This is important because the non-conductivity of zirconia implants make it more difficult for bacteria to grow on the surface. This creates a healthier oral environment and promotes periodontal health. In addition to conducting heat, titanium can retain heat which could damage adjacent tissues.
Disadvantages of Zirconia vs. Titanium Dental Implants
- Limited Variety of Designs and Components: As previously mentioned, zirconia dental implants have not been in use as long as their titanium counterparts. The development cycle of zirconia implants is still fairly early and as such, there are limited implant design options and parts are more scarce than titanium. This can be problematic for challenging cases or when several teeth require replacement.
- Long-Term Success Not Fully Known: Since they lack the several decade track record that titanium implant have, less is known about the long-term success of zirconia implants. Decades of research, development, and innovation have contributed to the high success rates associated with titanium. Until more information is available, there are concerns that zirconia may not have the long-term efficacy titanium does.
- Strength and Resistance to Fracture: More brittle than titanium, zirconia has lower flexural and fracture strengths. While strong under compression, zirconia is more prone to fracture from flexing or bending forces. As such, the chance of fracture and long-term complications is higher with zirconia. The risk of fracture also makes using small diameter zirconia implants, often needed when bone is thin or spaces exist between the teeth, problematic.
- Limited Scope of Use: For patients that are missing all their teeth or need to replace them with implant dentures, zirconia implants are not ideal. Treatments of this type require a higher degree of planning and require a larger selection of component options. Generally, a better variety of components are available with titanium dental implant systems that vary in purpose, size, and angulation compared to zirconia implant systems.
- Cost of Zirconia Implants: Because of the complex manufacturing process involved with zirconia, zirconia implants are typically more expensive than titanium versions. A dentist typically pays $300-$500 per titanium implant whereas zirconia implants cost around $500-$600 each. It should be noted this only covers the parts. Actual cost to the patient typically costs between $3000 to $6000 per implant.