Ceramic implants - towards a stronger evidence base - Opinion Paper​

Abstract

Commonly lost among personal preferences and scattered clinical results, ceramic implants have been commonly regarded as a therapeutic solution “of last recourse”, “holistic only” or “if the patient is allergic” procedures. While the clinical possibility of mechanical breakdown and the phantom of breakage and catastrophic failure has always been present, the aesthetic qualities of ceramic have been widely lauded. With alumina and other materials were randomly failing in clinical trials, the use of titanium reached new heights during the 90´s and early 2000´s. The 1981 Toronto conference set the tone for the development of new titanium surfaces, connections, and microgeometries, transforming dental practice and clinical protocols. In a quest to dominate the titanium dental implant market, it was an era of ambitious organizations such as NobelBioCare ™, Straumann ®, Astratech ®, Dentsply Sirona, Biomet 3i ® among others. Survival curves shot up to 98% and osseointegration time was cut in half (88/89 % for the machined Branemark implant). The “Titanium train” had left the station, more of a TGV than a steam locomotive with brand and market share (and demand from clinics) ruling out any possibility of the use of an alternative biomaterial.