Implants: Titanium vs. Zirconia

What’s Better Titanium or Zirconia?

There are pros and cons with each type of material and we would recommend a certain type of implant after listening to our patient’s concerns and goals. Below are a few categories most often analyzed when deciding between the two.

• Cost – The cost to manufacture zirconia (think cubic zirconia jewelry) is higher than titanium so zirconia implants will cost patients more money. Insurance companies often do not cover dental implants however, more and more we are seeing dental insurance covering a portion of the costs.
• Osseointegration and Soft Tissue Healing – Both Zirconia and Titanium implant materials are biocompatible and integrate well with the bone and gums. Titanium implants often last for 20 years or moer while Zirconia is still under research as it has not been used long enough to tell long-term success. Older Zirconia versions have been known to fracture requiring surgical removal and surgical placement of new implants. Some Zirconia manufacturers will scare patients into thinking that Titanium will cause a shock or a piezo-electric/galvanic current if there is any other type of metal in the mouth. However, this concern is unfounded as we have not found any documentation on this ever being a problem for patients.
• Ease of Placement – Titanium implants have been the standard in care for tooth replacement for quite some time as more people are turning to them instead of dentures for multiple tooth replacement. Titanium implants have become a very common dental procedure and are considered technically more straightforward for an implant surgeon, like Dr. Etess, to place without complications if bone density and bone health are good. Successful surgical placement of Zirconia implants has proven to be more challenging. Most Zirconia implants are single pieces (both implant and abutment in one solid piece) which cannot be placed completely under the gums and are difficult to place at an angle. Being able to place the implant at a slight angle is important to the dentist because occasionally, due to bone density and teeth profile, the optimal position of an implant is slightly off center. There are newer two piece models that should be more easily placed however they have not yet been widely tested, and have seen higher abutment fracture rates versus one piece zirconia and titanium.
• Aesthetics – For most patients, Titanium produces great results. However, some patients are concerned about developing a visible grey line under the gums or along the tooth ridge. If patients have thin bone or gum tissue, the abutment of the dental implant can be made of ceramic so that no grey metal will show through. On the other hand, Zirconia is known for its aesthetics. The beautiful white color of the ceramic material looks very natural and does not show through gum tissue.
• Strength – Titanium implants are incredibly strong, have high flexural properties and resist fracture. Zirconia has a lower elasticity that can lead to more micro fractures, but is also very hard and strong.

With so much information regarding both Titanium and Zirconia dental implants, it is no wonder many patients have a difficult time deciding which material they prefer. Most of the time, I recommend Titanium dental implants to my patients and I would opt for Titanium in my own mouth. Titanium dental implants have served the medical and dental industry for many years. They are reliable and well proven. Although Zirconia implants show promise, their long-term success is not proven. If, aesthetics or allergy sensitivity is what is driving you towards Zirconia, a Zirconia abutment with a Titanium implant may be the best solution.