Are dental implants made from ceramics ready to consider as a viable alternative to metal?
Since their introduction over 40 years ago, dental implants have become an established treatment modality that had revolutionized the concept of replacing missing teeth. Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners has been considered a pioneer in computer-assisted implant dentistry. His first implant case was in 1988. According to Dr. Johnson, “The recent material of choice for manufacturing dental implants is commercially pure titanium, because of its excellent biocompatibilty and mechanical properties However, the gray colour of the titanium may be disadvantageous and give rise to esthetic problems, especially if the soft tissue situation is not optimal and the dark colour shines through the thin peri-implant mucosa. The profession has been looking for options to address this concern. Some implant companies are wrapping a pink material along the collar of the implant while others are developing ceramic implants.”
Zirconia ceramics (yttrium-stabilized tetragonal poly-crystals) seem to be a suitable material for dental implants because of their tooth-like colour, their excellent mechanical properties and their good biocompatibility. They have extensively been used as ball heads in total hip replacements with remarkable clinical outcomes. Recent animal studies have also shown successful bone healing of dental zirconia implants under both unloaded and loaded conditions. Dr. Johnson has been using zirconia to fabricate his dental crowns for many years without outstanding success. As the conventional fabrication of zirconia rods usually results in realtively smooth surfaces, only few studies have investigated rough surface modifications of zirconia implants. This is a critical aspect, since it has been already demonstrated that surface roughness and topography also influence osseointegration of zirconia implants.
A recent study by Rita Depprich, et al, in Head and Face Medicine, looks at the comparison of titanium and zirconia implants on pigs and concludes that, “zirconia implants with modified surfaces display features of osseointegration similar to those of titanium implants. These results are promising for using zirconia implants for dental applications in the future”.
“It’s still early in the game” according to Dr. Johnson, “but it may be available in the next few years after clinical trials are complete. Until then, titanium implants are sill the gold standard. ”
Original article: https://head-face-med.biomedcentral.com