Abstract
Purpose of ReviewThe goal of the present review is to update the reader on the scientific background of zirconia ceramic implants. Clinical investigations using zirconia ceramic implants over the last couple of years have brought up some new developments and questions. Can we be confident in placing zirconia ceramic implants given the recently published data? Is there a difference in the application of one- and two-piece implants?Recent FindingsSystematic reviews on preclinical investigations of zirconia implants revealed that one-piece zirconia implants (> 4 mm) are sufficiently stable for clinical use. The same is true for some clinically available two-piece implant systems. Osseointegration and soft tissue integration are, according to the reviews, similar between titanium and zirconia implants with similar surface topographies. Regarding the clinical outcome, a meta-review exists evaluating systematic reviews. The findings of the systematic reviews and the meta-review are that there are good short-term clinical results for one-piece zirconia implants. However, the data for two-piece implants is not robust.SummaryIn certain applications (single tooth restorations and small bridges), the results of zirconia implants are comparable with titanium implants in short-term studies. Some mid-term investigations support the short-term results. However, according to the current scientific data available, zirconia implants cannot yet be considered an alternative to titanium implants because there are many areas where there is a lack of clinical studies on zirconia implants. Currently, they are an addendum to the titanium implant armamentarium for situations where they are useful (patient request, known hypersensitivity to titanium, or questions of esthetics when titanium might appear inappropriate for a certain situation/condition), but long-term studies are needed. Without a doubt, there is a need for two-piece zirconia implants, but limited research exists to support their clinical use at the moment.
Highlights
The global dental implant market in 2016 was approximately US$3.8 billion
The removal torque for titanium implants was identical in both reviews, whereas a difference of 23 Ncm existed for the RTQ for zirconia implants between the two reviews
When summarizing the presented newer investigations, the systematic reviews, and the meta-review, the authors of this narrative literature review would conclude that one-piece zirconia implants are a valid treatment option over a period of up to 5 years with results comparable with those of titanium implants
Summary
The global dental implant market in 2016 was approximately US$3.8 billion. Between 2018 and 2024, it is anticipated to. Curr Oral Health Rep (2020) 7:344–351 our patients because they can positively support an esthetic outcome of a reconstruction due to their tooth-like color [1, 2] Another argument in favor for ceramic implants is the wish of the patient to be restored without metals. A final and obviously very important point is that zirconia lacks titanium particles which might cause adverse effects like hypersensitivity This topic is discussed widely in the dental implant community [3–8]. It should be pointed out that quite a few companies sell zirconia ceramic implants, only a few commercial implant systems provide data on preclinical and clinical performances. Since the surface treatment of alumina implants was difficult—in the sense of “surface roughening”— only macroscopic surface enlargements were produced These modifications, did not improve the clinical outcome, and today, there is no alumina ceramic oral implant commercially available any more [24]. The implants that have been used in clinical investigations so far were fabricated generally from 3Y-TZP or ATZ [30, 36]
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