Dental Implants: Titanium or Zirconia
In the world of dental implants, there are a plethora of choices. For the novice, the availability of implant types and materials can be overwhelming. So we aren’t surprised when a patient asks us about what type of implant is best. It’s important to do your research before having a foreign object placed into your body. However, where we often see the road bump for patients is that research is done online, where advertising dollars have pushed some dental implant materials to the forefront, even though they may not be the best material to choose. This is often where we begin to have the discussion about titanium vs. zirconia.
Zirconia material is widely touted on the internet as the best ceramic material for dental implants. Unfortunately, this is a blanket statement that does not reveal all the information needed to make an educated decision. Although zirconia is seeing an increased use in dental implants, it still is not necessarily the best choice. Zirconia originally became available for use in dental implants in the 1970s. Unfortunately, it had a very poor success rate at that time due to its biomechanical instability. Although this has improved with time, it’s still a major concern.
A surprise to most people, zirconia is fabricated from a shiny, gray-white metal named zirconium. Processing zirconia from zirconium causes zirconia to be very unstable. Therefore, limestone, magnesia, ytria and alumina are added to zirconia to increase its stability. However, is it enough? That is the question.
Most studies show that zirconia has a higher incidence of zirconia implant fracture when compared to titanium implants. Zirconia dental implants are relatively new in the United States, so there are few clinical studies on long-term success of zirconia implants. Various studies have shown up to 30% incidence of fracture with zirconia implants. And then what happens? Well, imagine a screw embedded tightly into a hard piece of wood, and the top of the screw breaks off. How do you remove the screw? The wood around the screw has to be removed in order to loosen the screw. This is the same thing that has to occur in the jawbone around a broken implant. Therefore, the morbidity associated with a broken implant is very high.
Titanium dental implants do not have high fracture rates. And titanium dental implants have an excellent track record of long-term success. So why all the questions about using zirconia rather than titanium? Metal allergies and sensitivities.
Titanium allergy is noted to be about 0.6%. This is extremely low. And noted in the dental literature, allergic reactions to pure titanium are rare. The problem seems to exist with allergies to titanium alloys. Titanium alloy dental implants contain many impurities that may cause hypersensitivity and allergic reactions. These alloys often have added beryllium, cobalt, chromium, copper, iron, nickel and palladium. So the key then is to utilize a pure titanium implant system. This allows for excellent strength characteristics as well as excellent biocompatibility–a win, win!
At Origin Dental Wellness, we utilize a titanium implant system that does not contain alloy impurities. If we have a patient with concerns about hypersensitivity or allergy, we work with a functional medicine physician before the dental implant is placed in order to address the concerns. We want dental implants to have long-term success with no concerns about fracture or biocompatibility. As materials change and improve, we will adapt to make those positive changes as well. Currently, the best material is a pure titanium with no impure alloys.