Since receiving FDA approval in 2011, zirconia dental implants are becoming used by more and more clinicians. These implants have been used in Europe for over a decade and can provide excellent biocompatibility and stability. Although not suitable for everyone, sometimes zirconia dental implants may be a better choice for particular clinical situations.
Pros of Choosing Zirconia Dental Implants
For patients wishing to have dental implants but are concerned about metal-free dentistry, zirconia is the only viable option. This material is completely inert and can be a good choice for people with known metal allergies or sensitivities. Zirconia implants may be more aesthetically pleasing, eliminating the risk of any dark lines around the gum. Originally, they were only available as a one-piece implant, but the introduction of two-piece zirconia implants now allows for abutments to be fully customised, creating the best outcomes. A metal-free zirconia implant could be healthier for gum tissue because this material retains less plaque and calculus than titanium, especially when a one-piece zirconia implant is selected. Zirconia has a good flexural strength and is known to be superior to other ceramics in terms of fracture toughness. Its white colour, low modulus of elasticity, and low thermal conductivity has made this material a very attractive choice for implant dentistry. Clinical studies have shown zirconia to be as good or even better than titanium in terms of osseointegration. This is due to the high level of contact between the implant and the jaw bone, allowing the bone to fuse firmly with the implant, resulting in good osseointegration.
Cons of Choosing Zirconia Dental Implants
One of the biggest drawbacks of choosing zirconia dental implants is low-temperature degradation as the product ages. This could potentially result in the mechanical properties of the material becoming degraded, reducing the strength, density, and toughness of the material. As yet, there haven’t been many clinical studies into the long-term success of these products. Most of the failures recorded for two-piece dental implants were due to aseptic loosening. Due to the lack of research into two-piece zirconia dental implants, some clinicians may prefer to use one-piece dental implants, but the limitations of these systems needs to be considered. The options for abutment angulation are reduced, and this could compromise the surgical positioning of the implant. Additionally, positioning a zirconia implant in a less-than-optimal location could have an adverse effect on the physical properties of the material. Single-piece zirconia dental implants also require a load-free healing period, which can sometimes be tricky to achieve in normal clinical situations.
Clinical studies into the long-term success and viability of zirconia dental implants are quite limited since the use of zirconia dental implants is still relatively new. Whereas titanium dental implants have been extensively studied for decades, producing reliable data on their long-term use, studies into zirconia dental implants only assess two or three-year survival rates. Where they do exist, these studies produce good results, with cumulative survival rates equalling those of titanium dental implants. One interesting point is that excess cement is a frequent complication with titanium dental implants. It can provoke an inflammatory reaction, yet peri-implantitis has not been reported in relation with zirconia dental implants, at least not yet. It isn’t quite clear if this is due to the high biocompatibility of zirconia or because of the lack of research into this subject. Patients choosing to have zirconia dental implants should be aware of the possible contraindications of using this material as well as the potential benefits.
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