Dental implants are an excellent option for replacing missing teeth and restoring your smile. The two most common materials used for implants are titanium and zirconia. Both have their own sets of pros and cons. In this comprehensive guide, we’ll look at how zirconia and titanium implants compare on factors like strength, aesthetics, cost, and more to help you decide which material is better for your needs.
Titanium Implants
Titanium has been the go-to implant material for decades. Here are some of its key features:
- Highly biocompatible and integrates well with bone
- Very strong and durable – can last decades with proper care
- Time-tested with excellent long-term clinical success rates
- Greyish metal color that may show through thin gums
Titanium’s excellent biocompatibility comes from the protective oxide layer that forms on its surface. This allows surrounding bone to integrate directly with the metal. The result is a strong, durable connection called osseointegration.
Most dental implants today have a modified titanium surface to encourage faster, stronger osseointegration. Common surface treatments include plasma spraying, acid etching, and sandblasting.
Titanium Implant Properties
Here are some key properties of titanium implants:
| Property | Titanium |
|---|---|
| Strength | Very high |
| Biocompatibility | Excellent |
| Osseointegration | Very good |
| Durability | High. Can last 20-30 years or more. |
| Aesthetics | Grayish metal color visible through thin gums. |
The high strength of titanium allows implants to withstand the forces of chewing and last for decades. Its biocompatibility and osseointegration ability result in success rates of over 95% in ideal conditions.
Zirconia Implants
Zirconia (zirconium dioxide) was introduced as an implant material in the 1990s. Here are its key features:
- White, tooth-colored appearance
- Very biocompatible like titanium
- Excellent strength suitable for implants
- More esthetically pleasing, especially for anterior teeth
- Newer material, so long-term data is limited
The main advantage of zirconia is its white color, which eliminates the visible gray line that can appear with titanium implants. This makes zirconia a great choice for replacing front teeth for cosmetic reasons.
Zirconia must be very dense to achieve adequate strength. Surface treatments such as sandblasting and acid-etching are used to improve its osseointegration abilities.
Zirconia Implant Properties
| Property | Zirconia |
|---|---|
| Strength | Very high |
| Biocompatibility | Excellent |
| Osseointegration | Very good |
| Durability | High, but less long-term data than titanium |
| Aesthetics | White, tooth-colored. No gray shadowing. |
Zirconia has strength levels similar to titanium. Short-term clinical studies show success rates comparable to titanium, but more long-term data is needed.
Comparing Titanium and Zirconia Implants
Let’s compare titanium and zirconia implants on some key factors:
Strength and Durability
Both titanium and zirconia are very strong implant materials. However, titanium has a longer track record of surviving decades in the mouth.
In terms of implant strength, a 2013 review found:
- Titanium implant failure rates were 2.4% after 3 years and 3.4% after 5 years.
- Zirconia implants showed a 5.5% failure rate after 2 years.
The researchers concluded that zirconia implants showed an acceptable success rate, but results weren’t as good as titanium yet. However, zirconia technology and manufacturing continue to improve.
Osseointegration
Osseointegration refers to the joining of bone and implant on a microscopic level. Both titanium and zirconia can integrate with bone, but zirconia requires surface treatments to achieve comparable bonding.
A 2016 review found bone-to-implant contact after 3-6 months was:
- Around 60% for titanium implants
- Around 50% for zirconia implants
While somewhat lower, zirconia can still achieve excellent osseointegration. New surface technologies are also improving zirconia’s results.
Aesthetics
For aesthetics, zirconia is the clear winner. Its white color won’t show through the gums like titanium’s grayish hue.
Zirconia is especially advantageous for front teeth or patients with thin gingival tissue. However, titanium implants can still look very natural with good placement and restorative work.
Cost
Zirconia implants are 20-30% more expensive on average. According to NewMouth, costs per implant can range:
- Titanium: $800 – $1500 per implant
- Zirconia: $1000 – $2000 per implant
The extra cost for zirconia may be worth it for highly esthetic restorations. But other factors like the experience of the surgeon are also important.
Biocompatibility
Both metals have demonstrated excellent biocompatibility in studies. Around 10-15% of patients have metal sensitivities, which could prevent integrating titanium implants. But in general, both materials integrate well with bone and soft tissues.
Which Material Should You Choose?
When choosing between titanium and zirconia, there are several factors to consider:
- Location: Zirconia is ideal for front teeth where aesthetics are critical. Titanium works well for less visible areas.
- Cost: Zirconia is more expensive. Weigh the added cost vs. benefit for your particular case.
- Metal sensitivity: If you have a confirmed titanium allergy, go with zirconia.
- Surgeon experience: Choose a surgeon highly experienced with your preferred material.
Work closely with your dentist to select the right material based on your specific needs, budget, and expectations.
Frequently Asked Questions
Does zirconia show through the gums?
One of the biggest advantages of zirconia is that it does not show through the gums. The white color has an appearance similar to a natural tooth. Titanium’s grayish hue may be visible in patients with very thin gingival tissue.
Do zirconia implants fail more than titanium?
Early zirconia implants had higher failure rates. But as the material and manufacturing have improved, zirconia implants now show similar success rates to titanium. In a 2016 review, titanium implants had a 95.6% success rate after 5 years compared to 93.3% for zirconia.
Which is better, screw-retained or cement-retained crowns on implants?
Both options can work well. Screw-retained crowns make retrievability and access easier if the implant requires maintenance. Cement-retained crowns may offer better esthetic results. Discuss the pros and cons of each option with your dentist.
Can you be allergic to zirconia implants?
Allergies to zirconia are very rare. About 10-15% of patients have titanium allergies and cannot get titanium implants. For these patients, zirconia is an excellent biocompatible and aesthetically pleasing alternative.
Do zirconia implants need a metal sleeve?
Zirconia implants are one-piece and do not require a titanium sleeve. The zirconia abutment and implant are all one structure. This improves aesthetics compared to two-piece titanium options.
Conclusion
Both titanium and zirconia can make excellent implant materials with high success rates. Titanium has a longer track record, while zirconia offers superior esthetics.
Factors like location in the mouth, cost, metal sensitivity, and surgeon experience should guide your decision between the two. Work closely with your dentist to select the best choice for your unique needs.
With continuing advances in research and technology, both titanium and zirconia will continue improving and providing patients excellent function, comfort and beauty.
