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Dental implants have now been an important part of dentistry for decades. Over time, various materials have been used with varying degrees of success.

Titanium Implants: The Gold Standard

The most frequently used dental implant by far is made from alloys of titanium.

Why titanium is widely used

Titanium has some important characteristics such as biocompatibility and osseointegration, i.e., it attaches well to bone and is accepted by the body without a foreign object response. Another key benefit of titanium is how well it can be machined and polished, ensuring microscopic fits and the ability to exclude bacteria.

Zirconia Implants: Metal-Free & Aesthetic

There have been some moves in recent years towards more holistic implants such as zirconia. This material is exceptionally biocompatible, and tissue health can be extraordinarily good around it. Often gum sticks well to polished zirconia, allowing an excellent tissue seal around the implant. This reduces the risk of infection, bone loss and implant failure.

Benefits: colour, tissue compatibility, low plaque retention

Dr Vaidas' Zero Bone Loss Dental Implants - 7 years in

Titanium vs Zirconia: Strength & Longevity

The jury is still out on this one. We don’t have the same amount of long-term data on zirconia that we have on titanium. Zirconia is a strong material but it degrades in strength over years and it is more brittle than titanium. Does that matter in your case? Maybe. If you have high aesthetic needs, e.g., a 19-year-old lady with a high smile line, it may be best to get zirconia. High grinder—choose metal.

Osseointegration: Material's Role in Bone Bonding

Both materials integrate well with the human body and are highly biocompatible.

Aesthetics & Tissue Response

Titanium may have a greyish tinge underneath thin gum tissue versus zirconia’s tooth-like colour. Titanium is typically not well received by gum tissues compared with polished zirconia. Polished zirconia responds exceptionally well to gum tissue in the plaque zone, helping to form a tight seal around the gum.

Allergies & Sensitivity: Who Should Avoid Metals?

There are, unfortunately, a small number of people with titanium allergies. If they get a dental implant it may fail or become chronically inflamed over time. In a study involving over 1,500 dental implant patients, the prevalence of titanium allergy was reported at 0.6%. Testing ahead of an implant is not always useful aside from the cost, as the skin may not be adequately sensitive to titanium versus the gum and bone in chronic contact. Additionally, there are always alloys of titanium used in implants which further complicates the matter of testing.

For anyone with a sensitivity to metal generally, it is advisable to consider benefiting from zirconia’s hypoallergenic profile instead.

Implant System Types: One‑Piece vs Two‑Piece

Typically with titanium dental implants we can manufacture them in two pieces. This means the implant can be placed without loading it from day one. With most zirconia implants, the material does not lend itself to this process and so there is a post protruding through the gum on day one. This can lead to higher forces on the implant during the important healing phase. For patients with high forces this is typically best avoided.

Cost Comparison & Long-Term Investment

Zirconia implants cost significantly more on average than titanium. They are more complicated to place and restore for dentists, and there are not many dentists who currently place them. Titanium has a track record proven over decades while zirconia is still gathering long-term survival data. Early studies are very positive but we cannot be sure until the data is there in greater numbers.

New Frontiers: 3D‑Printed & Hybrid Materials

New materials and techniques are always being invented. It is likely future implants will be customised for your individual needs rather than mass-produced as the technology improves.

CAD CAM Dental Implant Placement

There are currently very clear benefits of using CAD/CAM techniques for placing implants. As can be seen here, this case was fully planned in 3D from a CT scan of the patient. That way Dr Vaidas was able to optimally place the implants for best available bone, lowest possible forces and best aesthetic outcome. The risks of damage to nerves and sinuses are also vastly reduced or eliminated with this technique.

Thinking about dental implants?

Visit our Dental Implants page to learn more, or book a consultation online with our experienced team today.