Comparison of Clinical and Histologic Outcomes of Zirconia Versus Titanium Implants Placed in Fresh Sockets: A 5-Month Study in Beagles

Abstract

This study evaluated the clinical and histomorphometric results of titanium (Ti) and custommade zirconia (Zr) implants placed into fresh extraction sockets in beagles that did not receive oral hygiene attention or a softened diet during postoperative healing. Materials and Methods: The roughness of the Ti and Zr implant surfaces was assessed by confocal microscopy. In eight beagle dogs, four implants each (two Ti and two Zr) were placed in the distal sockets of the third and fourth premolars with the implant shoulder at the bone crest and subjected to submerged healing. Standardized radiographs were taken after placement and 5 months after placement (at sacrifice). Histologic and histomorphometric measurements were performed on nondecalcified histologic sections. The main outcome measures included implant survival, bone-implant contact (BIC), and bone loss on the buccal and lingual plates. Results: Topographic analysis showed significant differences between the Zr and Ti surfaces. Roughness was higher for Ti than for Zr implants, kurtosis was close to 3 for Ti, and skewness was negative for Zr. After 5 months, the mean BIC was similar for the Zr (57.0% ± 15.2%) and Ti (56.5% ± 14.4%) implants, and the most severe bone loss site was observed on the buccal wall. The risk of failure was significantly higher for the Zr (43.8%) than for the Ti (12.5%) implants. Conclusion: The implant failure rate for the Zr implants was 3.5 times higher than that of the Ti implants. This may be partially explained by the less favorable topography of the Zr implants, which had, on average, significantly lower roughness (Ra = 0.85 ± 0.04 µm), negative skewness of the surface

Effect of Zirconia Dental Implant Surfaces on Bone Integration: A Systematic Review and Meta-Analysis

“…A total of 15 studies were included in this quantitative meta-analysis which were published from 2004 to 2015. Seven of the selected studies [ 14 , 18 – 23 ] evaluated the BIC values of machined zirconia and titanium surfaces. Three studies compared BIC values of titanium and etched zirconia implants [ 6 , 24 , 25 ] and 3 other studies [ 14 , 20 , 26 ] assessed those of titanium and blasted zirconia implants.…”

Zirconia dental implants: where are we now, and where are we heading?

“…These experiments confirmed the significance of surface texture on bone apposition. In a study performed on Beagle dogs , titanium and zirconia implants were placed in fresh extraction sockets. Implants were identical in dimension and shape, but different regarding the the surface topography.…”

Biological and osseointegration capabilities of hierarchically (meso-/micro-/nano-scale) roughened zirconia

“…54,[58][59][60][61][62] As a result, the strength of bone-implant integration and the percentage of bone formation around implants are lower for zirconia than titanium implants. [39][40][41]55,[59][60][61]63,64 Clinical studies also indicated that the success rate for zirconia implants is significantly lower than that for commonly used titanium implants. 39,59 Here we have created a Y-TZP zirconia surface with distinct hierarchical surface morphology consisting of meso-, micro-, and nano-scale roughness.…”

“…[39][40][41]55,[59][60][61]63,64 Clinical studies also indicated that the success rate for zirconia implants is significantly lower than that for commonly used titanium implants. 39,59 Here we have created a Y-TZP zirconia surface with distinct hierarchical surface morphology consisting of meso-, micro-, and nano-scale roughness. The objective of this study was to examine the biological and bone integration capabilities of this hierarchically roughened zirconia compared to relatively smooth machined zirconia.…”