Titanium Implants vs. Ceramic Implants

by Dental-Pedia
Titanium vs. Ceramic Implants: Which one to choose?

Titanium is currently the most common material used for dental implants. Titanium implants have been used since the 1950s, so they have an incredibly long track record with a nearly perfect success rate. They’re incredibly strong and resistant to fractures. However, in recent years, there’s been growing concern about the small (but significant) risk of titanium sensitivity, inflammation, and allergies.

The dental implant material Zirconia (ceramic) is a relatively new invention, but it’s quickly being adopted as the new benchmark for successful implants. Initially, there was some hesitance about zirconia implants because they exhibited a higher risk of fractures. But thanks to recent innovations, zirconia implants have a similar success rate as titanium implants. They’re also made of metal-free materials, making them more suitable for people with titanium allergies.

Below, we provide a detailed comparison of titanium and zirconia implants.

Appearance of Titanium vs. Ceramic Implants

When looking for dental implants, their appearance shouldn’t be the primary deciding factor because the implants remain unseen. They’re surgically screwed into the jawbone under the gum tissues, so they remain out of sight. Only the prosthetic attached to the abutment is visible. However, the implants can occasionally rise to the surface over time due to a receding gum line. As your gums recede with age, the lining of the implant might become visible.

Titanium implants are metallic — they don’t look like a natural part of your dental anatomy. That’s not usually an issue because the implants remain under the surface of the gum tissues. However, in gum recession, the metallic implant might be visible through the gum tissues, standing out prominently against the gum tissues.

Appearance of Titanium vs. Ceramic Implants, which looks better?

Zirconia (zirconium dioxide) is a ceramic material made of zirconium metal and oxygen in a 1:2 ratio. The oxidation of zirconium leads to a chemical reaction that turns it into a ceramic component called zirconia. Zirconia implants have the same color and texture as natural teeth. They perfectly blend with the surrounding teeth even when they rise to the surface due to gum recession and are the preferred dental implant material for many when it comes to aesthetics.

Success Rate of Titanium Implants vs. Ceramic Implants

Titanium has been the primary material for dental implants for decades. As such, titanium implants have decades of clinical evidence and studies. Research has shown that titanium implants have a success rate of 97% and a 10-year survival rate of 98.8%. That means over 97% of all titanium implants are completely successful, with a negligible risk of implant failure, fractures, and complications.

Zirconia implants don’t have the same volume of clinical studies and evidentiary backing because they’ve only been in use for a decade. It’s also hard to find long-term studies for zirconia implants for the same reasons. However, recent studies have shown that zirconia implants have similar success rates as titanium implants — approximately 97%. This shows that zirconia implants are viable metal-free alternatives to titanium implants.

Risks of Titanium vs. Zirconia Implants

One of the most significant risks of titanium implants is peri-implantitis, a condition wherein bacteria enter the space between the implant and the gums, leading to inflammation and infection. Patients with titanium implants often experience gum and bone inflammation, for which they need antibiotic treatments. Peri-implantitis can lead to bone loss around the implant, bleeding, redness, pus formation, and pain.
What are the risks of Titanium vs. Zirconia Implants?
    The risk of inflammation is higher with titanium implants for two reasons
    • Bacteria can easily adhere to the titanium implant surface.
    • Natural gum and bone tissues don’t adhere to titanium implants as well as natural bone.
    Titanium implants also carry a risk of hypersensitivity or titanium toxicity. The corrosion and wear of titanium implants often lead to the release of titanium and titanium alloy particles and ions, leading to bone loss, inflammation, and implant failure. Some patients are also allergic to titanium, but the symptoms of titanium allergies can often manifest years after receiving the implant, making it hard to diagnose.

    Zirconia implants don’t carry the same risks as titanium implants. When zirconia implants first came into the picture, they were seen as unreliable implants with a high risk of fractures or implant failure. However, recent studies show that zirconia implants are just as strong, reliable, and durable as titanium implants. They might have a higher chance of fractures under force, but the studies show that the difference in durability is negligible. Zirconia implants are also free from the risks of titanium implants.
    Zirconia implants are non-metallic, so they don’t carry the same risks of titanium or metallic allergies. They have an incredibly low affinity to plaque and bacteria, minimizing the risk of bacterial infections and peri-implantitis, and they have a negligible risk of corrosion. As such, all things considered, zirconia implants promise better and safer long-term results than titanium implants. However, it’s too early to make that assessment with complete certainty because of the lack of sufficient long-term studies.

    Healing Time of Titanium vs. Ceramic Implants

    The “healing time” refers to the time it takes for the jawbone tissues to heal around the implant structure via a process called osseointegration. Both titanium and ceramic implants have a comparable healing rate. After the implant surgery, you might experience some pain and discomfort for a week, manageable with pain medications. After the first week, the osseointegration will continue in the background without your active awareness — the overall healing time ranges from 3 to 6 months for titanium and ceramic implants.

    Comparison of titanium and zirconia implants at a glance

    Titanium Implants
    Zirconia Implants
    Used since the 1950s
    Used since the 2000s 
    Risk of metallic visibility through the gums
    No risk of visibility due to tooth-colored appearance
    Success Rate
    Approx. 97%
    Approx. 97%
    Risk of Peri-Implantitis
    Limited, but present
    Risk of Corrosion
    Limited, but present
    Risk of Allergies
    Limited, but present
    Risk of Fractures
    NegligibleLimited, but present
    Healing Time 
    3 to 6 months
    3 to 6 months 

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