Clinical Longevity of Zirconia Implants with the Focus on Biomechanical and Biological Outcome

• Published in: Current oral health reports Vol. 7; no. 4; pp. 344 - 351
• Main Authors: Kohal, Ralf-Joachim, Dennison, David K.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2020; Springer Nature B.V
• Subjects: Alumina; Biomechanics; Dental implants; Dental Restorative Materials (M Özcan & P Cesar; Dentistry; Medicine; Medicine & Public Health; Oral and Maxillofacial Surgery; Prostheses; Section Editor; Systematic review; Titanium alloys; Topical Collection on Dental Restorative Materials; United States > US; Zirconia; Osseointegration; Biocompatibility; Systematic review; Artificial mouth; Review; Dental implants; Meta review; Clinical study
• ISSN: 2196-3002; 2196-3002
• DOI: 10.1007/s40496-020-00289-9

Purpose of Review The 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 Findings Systematic 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. Summary In 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.