Titanium or Ceramic Dental Implants? A Comparison

by Dental-Pedia
Titanium or Ceramic Dental Implants? A Comparison

Dental implants are made of various materials. Titanium has become the preferred implant material because it does not trigger any rejection in the body and is well tolerated. Compared to other metals, it has a far better immunological compatibility, also known as biocompatibility. Titanium or Ceramic Implants? This article provides an exhaustive comparison of titanium implants and ceramic implants. 

Dental Implant Material Titanium: choose grade 4 to ensure best outcome

Dental Implant Material: Titanium

Titanium comes in different grades of purity. Since titanium is a relatively soft metal, it is adapted to the respective technical requirements by means of alloys. 

Titanium grade 1 is pure titanium (99.5%) 

Titanium grade 4 is primarily used in implantology 

Titanium grade 5 is mainly used for reduced-diameter mini-implants. The material is harder than titanium grade 4 because the alloy consists of 90% titanium, 6% aluminum, and 3% vanadium. However, this alloy also reduces biocompatibility. 

If you choose titanium implants, ensure you receive a titanium grade 4 implant. Various scientific papers discuss a link between Alzheimer's disease and the use of titanium grade 5 implants. 

What is Titaniuim Intolerance?  titanium oxide intolerance affects about 10 to 15 percent of the population

What is titanium intolerance?

Titanium oxide intolerance is generally detectable in 10-15% of the population. This is caused by the detachment of nano-titanium particles, which occurs with every implantation of titanium implants. Direct oxidation turns these particles into titanium oxide, which is almost always found in the surrounding bone or soft tissue of the implant. 

Tissue macrophages (clearance cells) absorb these titanium oxide particles and release pro-inflammatory cytokines. The body's immune response to this is highly individual and depends, among other things, on genetic variants. Titanium intolerance is therefore the result of an increased inflammatory response of tissue macrophages to titanium oxide particles. 

This is not an allergy! Whether a titanium oxide intolerance exists can be examined in a specialized laboratory prior to implantation. During the examination, the general practitioner draws blood and has it analyzed in an immunological diagnostic center (e.g. imd-berlin.de). A genetic predisposition analysis is performed as well as a special titanium stimulation test. 

Dental Implant Material Ceramic: Zirconia dental implants are hypoallergenic - no worries about allergies

Implant Material: Ceramic 

If you suffer from titanium oxide intolerance or don't want to have metal incorporated into your body as a matter of principle, you can still opt for another form of dental implant. 

Ceramic has been considered the ideal material for dental implants for many years, as there is no detachment of ceramic particles in the bone, and therefore no intolerance. Ceramic was already used as a material for the implant body in the early days of implants in the 1970s, e.g., the Tübingen implant. 
Since the materials used at that time, including aluminum oxide, were not up to the high mechanical requirements and frequent fractures occurred, ceramic implants disappeared from the market for many years. However, the material now used, zirconium dioxide, meets all the requirements for safe and durable ceramic implants. 
How metal-free is a ceramic implant?

How metal-free is a ceramic implant? 

Different zirconium dioxide compounds are used for ceramic implants. To prevent aging of the material, aluminum oxide (Al2O3) is added. Some ceramic implants contain 25% aluminum, others only 0.25%. 

But the term “metal-free” refers not only to the implant material, but also to the implant body, i.e., the abutment connection in the case of two-piece implants and the abutment itself. Various implant systems screw the abutment with a screw made of titanium, hard metal, carbon, gold, or even zirconium — the abutment itself is made of zirconium. 

 When the ceramic implant body is connected to the ceramic abutment, it leaves a microgap through which bacteria can migrate into the interior of the implant. These bacteria can also be MRSA bacteria (multi-resistant Staphylococcus aureus), which can lead to peri-implantitis and implant loss. 

You should ideally get ceramic implants with a low aluminum oxide content

What are completely metal-free ceramic implants?  

If you want, or need, a completely metal-free restoration, you can use one-piece or two-piece ceramic implants with abutments made of glass fiber. In such implants, the glass fiber abutment is bonded to the implant body without any gap, which actively prevents bacteria from migrating into the implant nerve. 

Modern ceramic implants are made of zirconium dioxide, which is stabilized by the addition of aluminum oxide (Al2O3). You should ideally get ceramic implants with a low aluminum oxide content of only 0.25% or less. Although aluminum oxide is chemically not a metal, molecules can detach from this compound and form a new bond.
Before you have a metal-free restoration, please ask your implantologist about the aluminum oxide content of the implant system. 


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