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

Abstract

Despite decades of titanium as the gold standard in oral implantology, the search for alternatives has been growing. High esthetic standards and increasing incidence of titanium allergies, along with a rising demand for metal‐free reconstructions, have led to the proposal of ceramics as potential surrogates. Following numerous experimental studies, zirconium dioxide (zirconia) has earned its place as a potential substitute for titanium in implantology. Yet, despite zirconia's excellent biocompatibility and tissue integration, low affinity to plaque and favorable biomechanical properties, early failures were significantly higher for zirconia implants than for titanium implants. Technical failure as a result of fracture of the material is also a major concern. So far, zirconia implants have been mainly manufactured as one‐piece implant systems because of the material's limitations. Nevertheless, various two‐piece systems have been progressively emerging with promising results. Screw‐retained abutments are desirable but present a major technical challenge. Innovation and technical advances will undoubtedly lead to further improvement in the reliability and strength of zirconia implants, allowing for novel designs, connections and reconstructions. Additional clinical studies are required to identify all relevant technical and biological factors affecting implant success and patients’ satisfaction. However, the evidence for a final verdict is, at present, still incomplete.

Zirconia dental implants: A clinical and radiographic evaluation

“…Cionca et al reported a cumulative soft tissue complication rate of 0% in 76 zirconia implants placed in 52 patients . Literature evaluating the soft tissue interface around implants seems to favor zirconia implants over titanium, although further investigations are needed …”

“…Currently, zirconium dioxide (zirconia) ceramics in dental implants are emerging as an alternative to titanium mainly due to superior soft tissue healing . The advantages of zirconia implants are the white color and the apparent less affinity to bacterial biofilm formation …”

Evaluation of oral microbial corrosion on the surface degradation of dental implant materials

“…Recently, zirconia (ZrO 2 ) has been introduced as an alternative to Ti‐based dental implant bodies or screws . Like Ti, ZrO 2 presents an oxide surface that is conducive to osseointegration to a similar degree as Ti .…”

The Role of Epigenetics on Dental Implant Therapy: A Systematic Review

“…For example, the passage of time could influence the cells' phenotype much more than implant surfaces [49]. However, a recent review on zirconia implant outcomes concluded that early failure rate of zirconia implants was higher when compared with titanium ones [68].…”