Abstract
ObjectivesThe aim of this review was to evaluate the clinical success and survival rates of zirconia ceramic implants after at least 1 year of function and to assess if there is sufficient evidence to justify using them as alternatives to titanium implants.Materials and methodsAn electronic search in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) databases was performed in April 2015 by two independent examiners to retrieve clinical studies focusing on the survival rate of zirconia implants after at least 1 year of function. Implant survival was estimated using the overall proportion reported in the studies with a Clopper-Pearson 95 % confidence interval (random effect model with a Der-Simonian Laird estimate).ResultsFourteen articles were selected out of the 1519 titles initially screened. The overall survival rate of zirconia one- and two-piece implants was calculated at 92 % (95 % CI 87–95) after 1 year of function. The survival of implants at 1 year for the selected studies revealed considerable heterogeneity.ConclusionsIn spite of the unavailability of sufficient long-term evidence to justify using zirconia oral implants, zirconia ceramics could potentially be the alternative to titanium for a non-metallic implant solution. However, further clinical studies are required to establish long-term results, and to determine the risk of technical and biological complications. Additional randomized controlled clinical trials examining two-piece zirconia implant systems are also required to assess their survival and success rates in comparison with titanium as well as one-piece zirconia implants.Clinical relevanceZirconia implants provide a potential alternative to titanium ones. However, clinicians must be aware of the lack of knowledge regarding long-term outcomes and specific reasons for failure.
Highlights
In a world with increasingly heightened esthetic demand, ceramics have become progressively more popular in the dental industry
Sintered alumina (Al2O3) and yttria-stabilized tetragonal zirconia polycrestal ceramics (Y-TZP) are currently the materials of choice for ceramic abutments [1]. When it comes to oral implants, zirconia has repeatedly been proven superior to other ceramics in terms of bending strength and fracture toughness [2]
The aim of this review was to evaluate the clinical success and survival rates of zirconia ceramic implants after at least 1 year of function, and to assess if there is sufficient evidence to justify using them as alternatives to titanium implants
Summary
In a world with increasingly heightened esthetic demand, ceramics have become progressively more popular in the dental industry. Its low modulus of elasticity and thermal conductivity, low affinity to plaque, and high biocompatibility, in addition to its white color, have made zirconia ceramics a very attractive alternative to titanium in implant dentistry [3,4,5,6]. Still, when it comes to disadvantages, lowtemperature degradation, known as ageing, is considered one of zirconia’s major drawbacks. It is a process which results in degradation of the mechanical properties due to the
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