The Best Information Resource Online for Zirconia Dental Implants and Ceramic Implants: All You Need To Know About Metal-Free Implants is Here
The Page You Are About to Read is the top resource page for Zirconia Dental Implant Information Online. There is a lot to read, so much to learn, so kick off your shoes, grab a comfortable seat, and bookmark this page!
If you take the time to read the unrivaled informational resource (THIS PAGE!) about ceramic dental implants also known as zirconia dental implants, you will no doubt find it to be the most comprehensive informational website on zirconia dental implants anywhere. For full mouth and full arch cases with ceramic implants, we recommend after you finish reading this page, you read this one next and see some examples of All on X cases with zirconia dental implants. This page is to educate patients on the difference between ceramic dental implants and titanium implants and to help understand the process for metal-free biological single-tooth implant surgery and restorative techniques.
Why are Zirconia Ceramic Dental Implants better than titanium implants?
What is a zirconia dental implant?
A zirconia dental implant is a tooth replacement that is 100% metal-free and its chemical and material property “ZrO2” is ceramic not metal like its titanium “Ti” alloy mainstream counterpart. Zirconia implants are 90% made of zirconia oxide “ZrO2” and yttria oxide “YO2” which then combines into “YSZ” or yttrium stabilized zirconia known as yttria. Zirconia ceramic dental implants ARE NOT MADE OF “zirconium” which is “Zr” on the periodic table of elements and is an elemental metal. Ceramic implants are preferred by patients for their reduced plaque adhesion, beautiful esthetic white color, reduce the inflammatory response in the body, lowered host response (autoimmune reactions), no allergic responses, no metal rust or corrosion, no metal disturbances or “galvanization” and long term success rates with over 96% success after 12 years of placement. The opposite of this can be unfavorably said about titanium implants.
Why are ceramic implants better than titanium implants?
- a ceramic implant is 100% metal-free,
- ceramic dental implants are white in color like a tooth
- ceramic implants are biocompatible (does not stimulate a host response)
- ceramic implants are bioinert (non-reactive reducing chances of host response)
- zirconia implant material has no galvanizing (electrical conductivity) impact
- zirconia does not corrode (oxidation of metal)
- does not cause side effects like titanium implants
What are zirconia dental implants used best for in the mouth?
Ceramic implants are absolutely the best solution for front tooth implants. Dr. May has placed more front tooth ceramic implants than any holistic dentist or oral surgeon in the country as of 2021. At Natural Dentistry, the specialty is front tooth ceramic dental implants to replace infected root canals, bridges, and extracted or lost front teeth. On average, Dr. May sees 2-3 out of state patients every week just for front tooth replacements with zirconia dental implants alone. Why are front tooth anterior implants done with ceramic instead of titanium implants? Unlike titanium dental implants, zirconia implants look absolutely beautiful and natural in front teeth underneath the gums and help promote bone growth on the buccal bone unlike titanium implants which can cause more pronounced bone loss, grey-metal shadow show-through the thing gums around the front teeth and are more likely to cause gingival irritation and gum recession on the front teeth.
Secondly, a zirconia dental implant is preferable to a titanium implant for EVERY TOOTH in the mouth, including the molars. Why? Ceramic implants are incredibly strong, they do not corrode or oxidize, they are predicted to have a lower incidence of peri-implantitis than metal dental implants, zirconia implants are observed to experience less bone loss over time compared to metal implants, the gum tissue is healthier around ceramic implants relative to titanium plants, and ceramic implants to replace the back molars accumulate less plaque (and therefore bacteria and biofilm which causes gingivitis), unlike titanium implants. This last point is especially important as the back molars is where hygienist and dentist typically see more accumulation of plaque because its notoriously harder to brush and keep clean the back of teeth and the large molar regions than the front anterior teeth.
Thirdly, ceramic implants are a better choice for replacing ANY TOOTH or a full mouth of teeth as zirconia implants are biocompatible implants without corrosion, potential inflammatory responses, exacerbated bone loss, and long term implant failure compared to titanium implants.
Are Ceramic Implants safe? Are the zirconia implants FDA approved?
Zirconia implants have been CE approved in Europe for well over 20 years and in the USA for well over 15 years. Zirconia dental implants do NOT fracture and break like many conventional dentists like to incorrectly tell their patients. In fact, more and more ceramic implant companies are being approved by the FDA and entering the US market. In the last 3 years over 10 new zirconia ceramic dental implants have been approved in the USA (as they are more popular and used by more and more dentists.)
Why are Zirconia dental implants referred to as ceramic dental implants?
General properties of ceramics include high melting temperature, high hardness, high toughness, no electric conductivity, low elasticity, chemical resistance and low ductility but once we think about the medical realm, we also add that ceramic are generally bio-inert (non-reactive) and biocompatible (do not cause the inflammatory host response seen with metal int the body). There are several elemental properties that gain their basics from the periodic table of elements (remember high school chemistry?) The main misinformation that is spread about FDA and CE-approved zirconia implants by conventional dentists is that they are made of ZIRCONIUM which IS WRONG. Yes, it’s easy to confuse the word ZirconIA and ZirconIM but let’s clarify: zirconia dental implants or made from “ZrO2” and NOT Zr – those are two different materials – when Zr (zirconIUM) is processed and converted into “ZrO2” it transforms (remember transitions in chemistry?) and becomes a CERAMIC, which means it losses all of its original metal properties. Enough with the boring chemistry, (more on the deep chemistry later in the page if you want to get super nerdy with it!) let’s bring the focus back – why are zirconia dental implants called CERAMIC implants and not metal implants? Zirconia “ZrO2” has no electroconductivity like a metal material does – which means no galvanism – no electro current disturbances – no effects from EMF and “antenna” effects. The opposite is true for patients with titanium alloy implants who can experience and complain about PEMF / EMF disturbances such as headaches and nausea when in high radio magnetic fields or EMF zones. Like glass and like wood, a ceramic material DOES NOT conduct electricity. Another property of zirconia implants is they do not CORRODE – corrosion is another word for “oxidation” which means the breakdown of materials and we often see that as “rust” in metal.
In-Depth Knowledge Section: Time Study of Corrosion, Oxidation and Rust in Titanium vs Zirconia Ceramic Implants
Let’s go back in time the famously tragic Titanic ship built of mostly of steel (a metal alloy), decaying at the bottom of the ocean which has almost entirely oxidized and corroded, with little left but rust, dust, and seashells (the ship sunk in April 2012.) Now think of the Roman/Greek liquid containers “Amphorae” used initially by Etruscans to transport mostly wine by ship, are made of ceramic and date back to as early as 5th century BC. The ceramic containers were constructed mostly of clay, specifically terracotta, and fired at high temperatures at a kiln to seal them. Unlike the metal broken down Titanic which drowned in 1912 and was nearly fully corroded by the 1980’s, the ceramic amphora wine containers have been recovered from the bottom of the ocean floor after THOUSANDS of years fully intact and STILL found to contain liquid. The CERAMIC containers did not oxidize, corrode or rusk after thousands of years at the bottom of the same (not geographically) ocean. And similar to the ocean, our mouth, is a wet and harsh environment – so which material sounds more timeproof and durable for a dental implant? The metal implant made of Titanium alloy that corrodes and breaks down or the ceramic material, defined as a hard, heat-resistant, and corrosion-resistant material made from a non-metallic mineral, and processed at a high temperature?
Why Has My Dentist Told Me Ceramic Implants Have Metal In Them?
Your dentist isn’t a ceramic implant expert and has sadly given you incorrect information. Zirconia dental implants are 100% metal-free, in their chemical composition and in their material properties. There is no metal whatsoever in a ceramic implant, which is why its called “ceramic” and not “metal”. Truthfully speaking, whomever provided you the incorrect information is, plainly speaking, under-educated on the topic and is woefully incorrect. It’s frustrating when someone in the position of authority or trust clearly is giving out false information or is merely uneducated on something but is still acting like a source of knowledge. A professional in a position of authority, ESPECIALLY someone with a doctorate (or dental) degree who studies dental materials for their full-time career and doctorate SHOULD NOT make a mistake that INCORRECT when it comes to discussed dental materials with patients – so long story short – don’t believe what you hear from a conventional dentist on zirconia (not zirconium) dental implants since they clearly don’t have the knowledge to provide patients with proper, educated and correct information.
Does a pure Titanium dental implant exist? No, it does not.
Why are Titanium Dental Implants made of other metal materials, not just Titanium?
Titanium which is the main material for metal dental implants but NEVER the stand-alone material, is a METAL (Ti) element, just like Nickel (Ni), Aluminum (Al), Cadmium (Cd) and Vanadium (V). What do all those metals have in common? Those are ALL elemental metals and most of them are found in metal dental implants, 100% of which are METAL ALLOYS. What is a metal ALLOY? An alloy is a mix of at least 2 materials – which means metal implants are NEVER pure Titanium, pure titanium dental implants don’t exist because chemically and functionally Ti or Titanium does not have the strength, flexural, and corrosion profile to support a dental implant on its own. For this reason, it is 100% of the time mixed with other metals, often the precipitating factor in metal allergies to titanium implants as Cadmium, Vanadium, and Nickel are metals we never want to come into contact with our bodies, especially 24/7 and especially when exposed to liquid and heat like in the mouth.
Best dentist for full mouth reconstruction with zirconia implants? Are All on 4 or All on 6 Implants with Ceramic Implants Possible?
Dr. May is one of the top dentists in the country for full mouth ceramic implants and All on 4/6/8/10+ – many consider him the best zirconia dentist in the USA. Natural Dentistry completes extremely challenging full mouth ceramic implant cases regularly and it has become one of Dr. May’s subspecialties – we see patients from all over the globe and all across the states for these specific, intense and life-changing All on X procedures with specializing in the Biological Surgery “All In One Surgery” Concept.
Full Mouth Ceramic Implant All on 4/6/8/10+ Cases: (Click on the thumbnail images for full-size images & case details )
Why do most patients prefer ceramic implants to titanium implants after doing research?
A lesser-known fact is that up to 30%+ of titanium implant patients develop perio-implantitis (the #1 cause of long-term implant failure) from the titanium alloy material itself. This is exactly the type of inflammatory response that patients want to avoid short term and long term, in addition to titanium allergies and autoimmune responses which will be addressed later in the article.
While patients all over the world use Dr. Yuriy May’s ceramic implant website as the authoritative content zirconia dental implant information, its Dr. May’s innovative surgery techniques, new approaches to grafting with PRF and full mouth reconstruction completely 100% metal-free with zirconia implants that led to notoriety among the top echelons of biological dentists across the world. This has propelled Dr. May to become one of the most respected ceramic implant dentists in the world, with many choosing either Dr. May in the Northeast USA or Dr. Volz in Switzerland Europe for their full mouth ceramic reconstruction implant needs. Finding a top expert like Dr. Yuriy May will allow you to access treatment with an internationally published, top USA biological zirconia implant surgeon and restorative dentist! If you are a patient in the northeast USA, you’re lucky, as Dr. Yuriy May, a top ceramic dental implant expert in the USA, is responsible for over 90% of all metal-free dental implant placements and surgeries locally but also has patients from all over the USA and internationally from abroad! If you are a traveling patient, please see our travel info page…
Zirconia Dental Implants – 100% Metal-Free Implants Placed & Restored by Dr. Yuriy May
The superior alternative to traditional, metal dental implants, are the newer, FDA approved, durable, beautiful, biocompatible, biomimetic ceramic, metal free zirconia dental implants otherwise known as ceramic dental implants. Zirconia dental implants were introduced into dental implantology as an alternative to titanium implants. While metal dental implants made of titanium and titanium alloys have been widely used among traditional dentists, they posed a number of disadvantages such as potential immunologic (allergic) and esthetic (cosmetic) compromises. For this very reason, novel implant technologies became a highly focused effort in the biological dental community and among cosmetic dentists across the globe. At Natural Dentistry we focus of premium and progressive dentistry and after many dental implant patients found the zirconia implants as a superior alternative to titanium dental implants, ensuring that the proven ceramic dental implants maintain or exceed the characteristics that provide titanium implants with their long-term durability and safety. Zirconia is an optimal dental implant material because of its tooth-like color, mechanical properties, biocompatibility within the body, and low plaque affinity. After years spent placing titanium dental implants, Dr. May’s experience in biological and regenerative dentistry along with years of post-residency advanced surgical training in bone and tissue augmentation has earned him the reputation of being the country’s most foremost ceramic implant specialist providing dental implant candidates across the world with a superior alternative to titanium metal through the use of zirconia dental implants.
Why is the selection of Dental Implant Material so important for biocompatibility?
Teeth, restorations, or any dental prosthesis including dental implants in the oral cavity have to function in one of the most inhospitable environments in the human body. They are subject to larger temperature and pH variations than most other parts of the body. Corrosion, also known as the breakdown of a metal when exposed to oxygen (think rusty metal) is officially defined as “the graded degradation of materials by the electrochemical attack”Corrosion of titanium alloy dental implants is of concern particularly when dental implants are placed in the wet, hot, moist, mouth also known as a ” hostile electrolytic environment” provided by the human mouth. Allergic reactions may occur from the presence of ions produced from the corrosion of implants. The present article describes various manifestations of allergic reactions due to implant material in the oral cavity.50 Well-educated patients understand the critical importance of appropriate, biocompatible, and dental material selection and thus research dental implant professionals like the acclaimed Dr. May very carefully. Before selecting a dental implant material for dental applications, it is necessary to remember that the choice of the material depends on a number of factors such as
- Metal Particle Corrosion & Galvanization Prevention Metal titanium implants break down and rust (corrode) and zirconia implants do not
- Mechanical Properties & Durability Titanium and Zirconia Implants break less then 1% with correct implant placement. How long has it been FDA approved?
- Cost & Investment Decision Criteria Zirconia Implants are approximately 10-20% more expensive than titanium implants (not much given health benefits)
- Success Rates & Complications Both titanium metal and zirconia have 96% survivability rates at 12-year point history research studies
- Biocompatibility & Autoimmune Response Metal Titanium is considered more inflammatory and not biocompatible compared to ceramic implants
- Esthetic Appearance & Tooth Like Feel Metal implants are unsightly, grey, show through the gingiva and don’t look like teeth unlike perfectly white zirconia implants
Thus, for the application of existing and new dental materials, it is essential for the patient and especially the dentist to have a comprehensive knowledge of these attributes.
Zirconia Implants vs Titanium Implants
Titanium Dental Implants vs Zirconia Dental Implants: Which is better?
For years, there have been concerns among oral surgeons and implant dentists that titanium might evoke an unwelcome host reaction, known as “inflammation.” However, biological dentists like Dr. May have known for decades that not only do titanium dental implants actually cause inflammation, they can also lead to bone loss, severe infections and chronic systemic inflammatory issues for patients. For decades, the discussion on titanium metal side effects has been documented in medical, dental, and material research that a strong association between surface corrosion of titanium, alongside hypersensitivity reactions. It is well understood by those who study inflammatory responses in patients and host responses in patients (whether allergists, rheumatologists or holistic biological dentists like Dr. May) that when titanium dental implants make contact with mucosal tissues of the mouth, metal ions will be released from the dental implants, which then form complexes with native proteins and act as allergens, causing hypersensitivity reactions. In addition the host response generated by allergens in the metals of the titanium implants, literature has time and time again detected increased concentration of titanium peri-implant tissues (the gingival tissues touching the dental implant as opposed to intraosseous which is inside the bone), regional lymph nodes, and pulmonary tissues in animal models with failed implants. (See footnotes 51-60) Perio-implantitis is the number one cause of titanium implant failure – unlike zirconia dental implants which have a less than 2% instance of perio-implantitis long term.
In the dental implant market, the ceramic dental implant is considered the “Tesla” or “BMW M Series” or “Mercedes AMG” (you get the idea of premium car brands, right?) of dental implants compared to titanium implants which can be compared to your everyday budget car. The question every patient must ask themselves, “do I want to risk putting ‘budget’ materials into my body, blood supply, tissues and cranial structures or is my health worth the premium metal-free clinical solution on the dental implant market?”
Why Does My Conventional Dentist or Oral Surgeon Claim that Titanium Dental Implants better than Ceramic Implants?
Simply put, most conventional dentists in the USA aren’t trained in, or exposed to, premium or alternative dental materials. Usually, the reason that conventional dentist and oral surgeons aren’t familiar with ceramic implants is because titanium is the “mainstream” dental implant industry and is often tied into all dental schools, which then train dental students and oral surgeons based on the sponsorship of their “affiliates” such as Nobel, Straumann, etc. Additionally, once dentist graduate and can learn about many additional subjects and treatment options not covered in dental school, many tend not to pay attention to solutions if they are not mainstream dental treatments and the guy “next door” isn’t using it, it doesn’t grab the attention of the mainstream. Another reason is cost: all-ceramic implant dentist like Dr. Yuriy May spent years attaining zirconia implant placement certifications and training for surgery and restorative expertise which is all an out of pocket expense for the zirconia implant dentist. The investment for the highly specialized training is not something many dentists want to invest in given the very specialized metal-free dental market, the extraordinary amount of travel and weekend time required and the high cost of training. Additionally, the cost of FDA approved zirconia dental implants sometimes more than 10x that of FDA approved titanium dental implants. As an example, some of the cheapest titanium no-name brand dental implants can be purchased for as little as $50 while the lowest cost zirconia dental implants are at least 10x per implant – that means if the dentist is charging patients a fixed fee many (but not all) would want to purchase the lowest cost implants to reduce their costs. It’s understandable that economics drive certain medical professionals and it remains a fact that zirconia dental implants are significantly more expensive than titanium dental implants for a dentist to purchase and keep in stock in their office. Another remark we often hear is “they are new and unproven” and that remains untrue as zirconia implants have been FDA approved in the USA since 2001. They have been in use in Europe with a CE mark for over 20+ years and European clinical papers date back 30+ years showing zirconia dental implant placement and use. Most dental implant research is only considered relevant for the last 12-15 years and anything older is too different in the engineering of the models/designs/materials and as of 15 years ago, over numerous brands have been FDA approved not he USA market with more brands receiving approval every year (since zirconia dental implant market is quickly growing due to patient demand for metal-free dental implants.
Zirconia Dental Implant Brands Available in USA – FDA Approved – Expertly Used by Dr. May: Top Ceramic Implant Dentist in USA
SDS Zirconia Dental Implants
Z-Systems Zirconia Dental Implants (aka Zirkolith)
Ceraroot Zirconia Dental Implants
Zeramax Zirconia Dental Implants
Straumman Zirconia Dental Implants
Zibone Zirconia Dental Implants
- Nobel Pearl Zirconia Dental Implant (Same design as Zeramex)
Which FDA approved Zirconia Implants Does Dr. May Use? More than ANY OTHER USA DENTIST! Read below to know more than MOST DENTISTS about which ceramic implant brands are available in the US, where they are manufacture and their technical specifications.
Dr. May uses predominantly SDS Zirconia Implants imported from Switzerland as their specific material and variety of shapes and designs allows for the most targeted and stable clinical application. Prior to SDS becoming approved in the USA in 2019 (they have been available in Europe for over 20 years) Dr. May heavily relied on another Switzerland manufactured implant by the brand Z-Systems as for many years before the SDS Ceramic Implant FDA approval Z-Systems had been the most versatile implant available on the market and has now been available for over 18 years in the USA. Another longtime favorite of Dr. May is the Ceraroot implant, which is his top pick for large molar replacements and he prefers this ceramic implant due to its tooth-like and wide emergence profile when replacing large molars (back teeth). Ceraroot ceramic implants are only available in a 1 piece design and manufactured in Spain. While the Ceraroot material is manufactured differently than it’s Swiss-made metal-free dental implant counterparts, Ceraroot Zirconia Dental Implants have the most favorable emergence profile and anatomical shape, considered excellent options for posterior dentition restoration (large molars). In 2018, the addition to Zeramax to the FDA approved lineup, also manufactured in Switzerland and co-owned by Nobel (a large titanium implant manufacturer) was introduced and Dr. May placed Zeramex implants in clinical cases that called for its unique features, specifically being the only 2 piece screw-retained zirconia dental implant in the USA. Both Z-Systems Ceramic Implants and Zeramax Implants are available in 2 piece zirconia dental implants and are manufactured in Switzerland, and both are considered to be reputable zirconia materials and have been placed by Dr. May as soon as they have been FDA approved. In addition, Natural Dentistry Center also uses Straumann ceramic implant which only comes in a 1-piece design, available since 2015, along with Ceraroot 1 piece implants which have also been a long-standing leader in Canada and FDA approved in the USA for just about 20 years. Various risk factors are considered in the selection of the optimal zirconia metal-free dental implant for each patient, for each clinical indication, for each tooth location. New FDA approved zirconia implants are constantly being evaluated by Dr. May and he is occasionally approached to beta test experiential ceramic dental implants being evaluated for the USA market. He is currently a beta tester for certain SDS abutments and new to market implant shapes (like the oval and the balcony).
As the top dental implant dentist in the USA we Dr. May places ceramic dental implants from patients ALL OVER THE COUNTRY: Connecticut, New York, Massachusetts, California, Texas, Dr. May places more zirconia dental implants than any other dentist or oral surgeon on the East and West Coast Combined
Dr. May has placed hundreds of dental implants, and is one of the most experienced and sought after ceramic dental implant surgeons in Connecticut, New York, Massachusetts for ceramic and zirconia dental implants. Dr. May lectures around the country, helping other top implant dentists refine their dental implant placement techniques. As a leader across multiple dental implant societies, he is a member of the International Congress of Ceramic Implantology (IOCI), International Academy of Ceramic Implantology (IAOCI), American Academy of Implant Dentistry (AAID). Dr.May is a founding board member of the AACI (American Academy of Ceramic Implantology).
Why Dr. Yuriy May for Zirconia Dental Implants?
It remains an undisputed fact that Dr. May has become and continues to be one of the country’s top zirconia dental implant surgeons and influencers that exclusively specializes in the placement and restoration of ceramic dental implants. His lectures and training courses further the body of knowledge of other dental professionals and help more patients find qualified dentists who understand the benefits of and are trained in placement techniques of metal free dental implants. Since 2012 Dr. Yuriy May has been the most prominent dental implant specialist in Connecticut, New York, and Massachusetts, placing metal-free dental implants for over 98% of all patients in the state. To date, Connecticut’s leading zirconia dental surgeon has helped place hundreds of dental implants and is widely known as the top dental implant specialist for ceramic dental implants in the Northeast. Natural Dentistry Center has impressively accumulated over 500 hours in specific biocompatible dental implant placement techniques, focusing on tissue integration, tissue biocompatibility, papilla preservation, bone grafts using the most natural, animal-free materials, including the optimal healing and growth treatment: Platelet Rich Fibrin (PRF) made from patient’s own spun blood serum concentrating growth factors and deriving stem cells. It is no wonder that Dr. Yuriy May has grown his private biological dental practice to become the top dental implant center in the Northeast USA, offering international and local patients remarkable customization and options designed for optimal health, ultimate durability and celebrity-worthy beauty. At Natural & Esthetic Dentistry, anything is possible if it is in the hands of Dr. May!
Dr. Yuriy May is the top metal-free dental implant specialist in the country for Metal-Free, Zirconia Dental Implants which is the optimal implant material that over 90% of Osteopaths/Functional MDs/Chiropractors and Naturopaths recommend!
Dental Implant Process & Education
All patients are urged to learn about the entire process of having teeth replaced with superior dental implants and the tremendous health benefits offered with unique and very targeted optimizing procedures done at Natural Dentistry by Dr. Yuriy May. Reading below, patients will learn about elements of diagnosis, treatment planning, 3-D CAT scan analysis, surgical site preparation, bone grafting, ridge expansion/bone expansion, surgical placement of one or multiple dental implants, abutment placement and ultimately, final crown restoration process through the 3D Smile Design technologically advanced process, where patients help design their perfect smile appearance from beginning to end. Is critical to understand and discuss how the surgery and planning can prevent long-term complications such as peri-implantitis, also known as plaque accumulation, gum inflammation and ultimately bone loss adjacent to dental implants.
History of Zirconia & Metal-Free Dental Implants
Historically, Titanium and titanium alloys are widely used for the fabrication of dental implants. Because of potential immunologic and possible esthetic compromises with titanium implants, novel implant technologies have been developed over the course of the last 30 years and the mobilization to superior implant materials has started to take hold. Not only do these novel technologies maintain the characteristics that provide titanium implants with their high success rates but they also achieve benefits beyond the attributes of the go-to titanium implant. Zirconia implants were introduced into dental implantology as an alternative to titanium implants. Zirconia is far more suitable as a dental implant material because of zirconia’s near-perfect characteristics such as its tooth-like color, mechanical properties, biocompatibility, and low plaque affinity. The aim of this educational clinical review is to disclose the research conducted along with the benefits of zirconia dental implants, compare them with titanium dental implants, and provide information on zirconia dental implant osseointegration and mechanical strength. Zirconia dental implants have the potential to become the “GOLD STANDARD” alternative dental implants to titanium dental implants, even while they remain underused by the dental community.
The Search for a Better Dental Implant – Why Titanium Isn’t Ideal
Ceramic dental implants, specifically known as zirconium or zirconia dental implants, are one of the more modern (progressive) forms of dental implants in the oral reconstruction market, generated from the search for a better alternative to titanium dental implants.
What is Titanium? What lurks in the metal of a titanium dental implant?
Titanium is a chemical element with symbol Ti and atomic number 22. It is a lustrous transition metal with a silver metal color, low density, and high strength. While titanium is resistant to corrosion, it cannot be used as a single unbound molecule to make a 100% titanium metal dental implant, thus 100% of titanium dental implants are alloys which include nickel, (Ni), a corrosive and known metal allergen, along with copper, steel, vanadium and aluminum. Initially, zirconia dental implants became highly sought after by heath-conscientious patients and biological dentists alike for their metal-free and biocompatible properties, in addition to their exceptional tooth-like aesthetics.
Titanium Implants – Sub-optimal Cosmetic Results in the Aesthetic Smile Zone
In fact, it is well documented in dental literature that using conventional titanium dental implants to replace missing teeth may yield cosmetically flawed results. The use of titanium implants in the aesthetic zone (typically considered in dentistry to refer to the anterior teeth and gums that are easily visible during smiling) often becomes visible through the thin gum tissue covering the front teeth (peri-implant mucosa) thus impairing desired clinical outcomes. This, in turn, can cause unaesthetic smile defects in the tooth color and gum appearance due to the transparency of a dark gray color of a titanium metal screw showing through.5,6,7 In addition, the implant endpoint closest to the abutment may become undesirably visible due to soft tissue shrinkage, gum recession, and peri-implant lesions (also referred to as perio-implantitis).5,8
Titanium Implant Risks: Corrosion – Metal Particle Displacement – Allergic Reactions
Further, although titanium has had documented resistance to corrosion, continued investigations have shown increased titanium concentration in the bone near titanium implants9 with clinical findings10 that describe especially alarming findings. It is reported that an accumulation of titanium particles has been found in tissues close to dental implant surfaces42 local lymph nodes, 43 and elsewhere 44,45 in the body. While exploring the studies and their reported negative findings with regards to titanium implants, it is important to point out that there is general agreement among dental implant professionals on the absence of local or systemic toxic effects after the implantation of zirconia ceramics (zirconia dental implants) into muscles or bones of different animals. 46,47,48,49
Titanium Dental Implants Can Cause Galvanization and Galvanic Side Effects
And yet still, there is another cautionary flag documented in numerous studies demonstrating the galvanic side effects of titanium, after metal components of the dental implant come into contact with the cellular matrix of the body, including saliva, blood cells, tissue cells and bone particles.11
In-Depth Knowledge Section: Galvanism – What is it and Why Does it Happen in Our Mouth?
Galvanization occurs in the oral cavity in large because of the presence of several factors all combined in one inhospitable environment known as the mouth:
- Saliva – an electricity conductor
- Various Metals – Amalgam Fillings, Titanium Implants, Porcelain Fused to Metal Bridge, Gold Crown, Surgical Steel Post, Etc
- Intercellular and intracellular electric currents
The 3 factors together create a phenomenon akin to an unwanted battery that disturbs (rather than helps) the body’s biological processes. The different metals connected through saliva and charged from the internal cellular matrix create electro current disturbances, otherwise known as galvanization. This is why a metal-free mouth – is the most natural mouth with uninterrupted natural microcurrent flow to optimize health and regeneration processes within the body. Unlike Titanium dental implants, Zirconia implants do not corrode and will not have any impact on taste in the mouth, and importantly, avoid the health disturbing effects of galvanization (electro-current disturbance) which naturally disturbs the body’s energy meridians, inter-cellular electric currents, and causes or accelerates disease processes. Zirconia dental implants are the ultimate alternative for patients who are not comfortable with or are not able to tolerate metal (titanium) implants.
Zirconia ceramic dental implants studies go back 70 years
Zirconia was discovered in Germany by chemist M. H. Klaproth in 1789 but rediscovered only in the last 70 years again because of its unique properties and a renewed interest in biocompatibility of permanent implantation devices. Variations of zirconia implants have been around for almost 70 years in documented clinical dentistry, since their inception in the late 1960’s. Since that time, the original ceramic implants made of Al2O3 (polycrystals or single crystal) have been considered as an alternative treatment for improved aesthetics, osseointegration, no galvanizing side effects, reduce plaque adhesion and reduced incidence of peri-implantitis (otherwise known as gum inflammation around implant sites).12–14 In recent years, zirconia (Y-TZP; yttria tetragonal zirconia polycrystals), a high strength ceramic material with excellent long-term results in the field of medical implants, has become a go-to alternative for premium dental implants. Y-TZP has higher resilience and flexural strength than aluminum oxide and offers advantages over aluminum oxide for dental implants.27–33
What is Zirconia?
Understanding the Superior Metal-Free Biocompatible Dental Implant Material and its Affects on Your Health, Beauty, Function and Life Zirconia is a very hard material and has great strength.
Zirconia – Chemical Definition
- Zirconia (ZrO2) this is the high performance ceramic dental implant material made out of ceramic powder with no metal properties
- Zirconium (Zr) can be found on the periodic table of elements as #40 in the metal family. Zirconium is a metal in its elemental form with metal properties
Zirconia is chemically defined as Y-TZP, which is is a high strength ceramic material comprised of ZrO2 and Y2O3 particles. It forms a stable tetragonal structure at room temperature after sintering. The transformation toughening mechanism is one of the main reasons for the high strength and toughness of Y-TZP.28,31,34
Zirconia Material Properties
Y-TZP is a bioinert and non-resorbable metal oxide that has excellent resistance to corrosion and wear, high flexural strength, exceptional hardness, high fracture resistance, high radiopacity (definition: inability of electromagnetic radiation to pass through a material), low thermal conductivity, ivory coloring similar to that of the natural tooth, ability to be machined, transmission of light, and the most superior biocompatibility.1,2,7,12,27,28,35–41Because of its high biocompatibility, it is used in medicine (auditory, finger and hip prostheses) and dentistry (posts, crown and bridge restorations, implants, implant abutments). Zirconia has a similar color to teeth and is bio-compatible making it an alternative material in dentistry. Zirconia dental implants were approved by FDA in 2007 and have over 50 published clinical studies. They have been booming in popularity among the European elite and quickly gaining popularity in the US among the most cutting edge and leading progressive dentists concerned with using the highest quality materials for patient restorations and implantation.
Reported advantages of ceramic implants:
- Used over 40 years in medicine, mainly for prosthetic joints and dental implants, with great success
- Bio-compatible (completely tissue-friendly); there are no allergic reactions, no sensitivity to temperature and no impact on taste.
- Bioinert; do not cause tissue or bone reactions.
- Gum tissue-friendly material with low plaque adhesion and tissue inflammation.
- No galvanization side effects
- No corrosion – the zirconia dental implant material does not corrode or break down into particulate matter like titanium alloy particles, and thus is self-contained, preventing it from leaching into bodily tissues at a microscopic or molecular level like findings have indicated with titanium dental implants.
- Since zirconium is white and more similar to the color of natural teeth, it has distinct aesthetic advantages over titanium. In the rare event of gum tissue recession or shrinkage, ceramic dental implants will not reveal gray shadows/lines like in the case of titanium implants. However, it should be pointed out that while more difficult, similar remarkable aesthetic results can, in fact, be achieved with titanium dental implants if they are placed by and exceptional surgeons who use ceramic abutments and crowns.
Risks with Zirconia ceramic implants?
- Zirconium dental implants are available as both two-piece and one-piece FDA approved implants and comes with a variety of abutments to offer more flexibility in their angulation and aesthetic and functional restoration goals.
- While rare, there have been cases reported of non-integration (less than 2%) similar to rates the failure rate of titanium dental implants and implant/abutment fractures. However, with long-term studies supporting zirconia dental implants efficacy and longevity, there is strong evidence to suggest that zirconia dental implants have a superior clinical advantage over titanium implants.
- Zirconia implants may be subjected to hydrolysis (a physiological process) whereby they can absorb water and potentially become more prone to fracture. Although the initial studies are favorable indicating such occurrence is rare, more investigations are in progress.
The Heart of the Matter: Ceramic Implants vs Titanium Dental Implants?
The decision to use ceramic or titanium dental implants should be fully discussed between dental reconstruction patients and the countries prominent zirconia dental surgeon, Dr. Yuriy May. On one hand, many patients visiting Natural & Esthetic Dentistry Center request ceramic dental implants because of its superiority as dental implant material and its notable ‘metal-free’ properties. On the other hand, the Dr. May always follows evidence-based dentistry to make proper recommendations for long-term success and safety depending on the unique situation of each clinical case and patient. The following facts should be considered in the decision process:
- Zirconia dental implants are considered the “Platinum Standard” in surgical restorative dentistry whilst titanium is regarded as the ‘bronze standard’ for dental implant materials. Numerous studies have affirmed the high success and survival rates of zirconia implants providing 98% + success rate. Zirconia ceramic dental implants have over 20 years of research and distinguished clinical studies and reports in dental and medical literature. Although they titanium dental implants have shown favorable long-term results, their long-term success remains at 10-15 years while the prognosis for Zirconia implants is currently projected at 20+ years.
- Titanium implants demonstrate a comparable degree of integration with the bone and have excellent long term prognosis until signs of peri-implantitis (inflammation of tissues around the implant site) emerge and start to cause implant failures. The long-term integration properties of zirconia remain unparalleled compared to titanium implants with rare incidents of peri-implantitis due to reducing plaque adhesion (and reduced localized inflammation inflammatory cytokines IL-1).
- Zirconia implants have a definite aesthetic advantage over titanium implants not just in all areas of tooth replacement but specifically in the esthetic zone. When replacing teeth in the smile zone, Dr. May always uses zirconium abutments and crowns in conjunction with zirconia ceramic dental implant, providing incredible aesthetic outcomes. When gum tissues are thin, such as is typical with anterior (front of the smile) teeth, titanium’s gray shadow may become more visible greatly bothering the patients and creating displeasing aesthetics in the smile zone. This potential aesthetic complication can be avoided only by a top zirconia dental surgeon by proper material (zirconia) and implant size selection, implant site tissue development, proper placement of the implant, and always premium ceramic abutments and with ceramic or porcelain crowns.
- Zirconia implants may not be possible to use in every patient, whether it is because of position, bone quality, autoimmune and chronic degenerative disease processes, and functional challenges.
Dr. May’s Comparison of Titanium vs Zirconia Dental Implant Materials
Among Dental Implants: Zirconia Is King
Understanding the Superior Metal-Free Biocompatible Dental Implant Material
Summary of the Near-Perfect Qualities of Zirconia Dental Implants: Bioinert: Does not interfere with biological processes of the body. Neutral to the body. No negative effects unlike titanium Nonresorbable: Cannot be reabsorbed into the hard or soft tissue. Does not deteriorate. Non-corrosive: Does not oxidize like metal and breakdown from exposure to oxygen. Resistant to wear: Highly durable against abrasion and pressure forces High Flexural Strength: Ability to “give” when significant pressure forces are applied. Also known as bend strength, a material property defined as the stress in a material just before it yields in a breakage… High Hardness: Does not have the malleability of metals such as titanium alloys, allowing the material to withstand greater pressure and stronger forces without wear or loss of structural integrity. Low Thermal Conductivity: Material withstands heat and does not conduct heat to adjacent bone and tissue unlike titanium which conducts immediate heat transfer as a metal Light Transmission: material is partially translucent and has the ability to transmit light particles just as a real tooth does, allowing the biomimetic replication of original tooth aesthetics. Color: White to ivory color resembling the true color of natural teeth unlike steel and gray metal in titanium implants
Why Do Patients Need Dental Implants?
There are numerous clinical and lifestyle reasons to choose the optimal restorative choice which is a dental implant. Over the thousands of implants placed by Natural Dentistry, Dr. May has found the most likely dental implants result from the below scenarios:
- Failing root canals
- Heavily restored teeth – where the teeth have been crowned in re-crowned multiple times
- Decay below the crown or bridge
- Fracture of crowned or root canaled teeth
- Upgrade to dentures
- Physical trauma resulting in tooth loss
- Birth defects resulting in missing adult teeth
- Cancer or diseases affecting significant jaw or bone removal
- Bone infections
- Root abscesses and infections
Dental Implants are the Superior Solution Among All Restorative Options
Restorative Options for Missing Teeth & Endentulous Patients For patients with 1 or more missing teeth, but less than a full jaw of missing teeth (fully edentulous jaw or mandible) a dental implant is the optimal restoration.
- Dental Implants – Permanent
- Dental Bridge – Permanent
- Dental Partial Prosthesis – Removable
- Full Prosthesis or Denture – Removable
Preferred Method of Tooth Replacement
Dental implant treatment is the preferred method of tooth replacement in most situations, for all missing teeth due to their significant benefits over the other, less preferred restoration options. For single or several missing teeth, the optimal treatment restoration is a dental implant, and if the patient is a candidate, a zirconia dental implant (depending on location of missing teeth.) Some of the benefits of dental implant treatment include:
- A dental implant preserves the bone by replacing the missing tooth root.
- A dental implant enhanced the appearance of the face, helping develop bone and provides natural bone support for facial musculature and skin (especially around lips and the mouth), helping achieve a move youthful appearance for patients with missing teeth.
- A dental implant protects the adjacent natural teeth, as opposed to compromising them.
- A dental implant improves breathing and blood oxygenation, as opposed to removable that can block the natural movement of airflow into the body and even cause or exacerbate sleep apnea.
- A dental implant improves full mouth mastication (chewing) function by helping to evenly distribute pressure forces (during chewing) among the arches and equally among teeth, like natural teeth, unlike the options.
- A dental implant improves reduced wear of other teeth protecting all other teeth and increasing their longevity over the long term.
- A dental implant improves reduced wear of other teeth protecting all other teeth and maintaining the proper alignment and proportions of the smile, which is deteriorated and becomes less attractive when teeth are worn down.
- A dental implant improves symptoms of sleep apnea, which can be caused or exacerbated by removable non-implant restorations
- Superior long-term aesthetics are achieved by preventing a visible defect in the bone.
- An implant crown is more hygienic than a bridge because it is cleaned like a natural tooth and does not have food stuck underneath like a pontic bridge, partial or denture.
General Advantages of Dental Implants
- Dental implant treatment is the only solution that preserves bone and gum levels
- Maintains the facial musculature, achieving a more youthful, uplifted, fuller appearance of the face
- Superior long-term aesthetics by preventing a visible defect in the bone as a result of tooth loss.
- No compromise to the health of adjacent teeth (No drilling or cutting of healthy adjacent teeth)
- Dental implant restorations have a much better long-term prognosis (dental implants have a 96% success rate at 10-12 years longitudinal studies)
- Documented clinical studies indicate survivability rates for implants of 93-96% for 15-20 years
- Significantly reduced risk of periodontal disease formation at the surgical site of dental implant, due to bone and gum regrowth and continued support, versus bridge which typically results in poor hygiene, periodontal inflammation, disease progression, gum recession, and ultimately progressive bone loss.
- High survivability rates (better than 93% for 10 years)
- Decreased risk of caries of adjacent teeth
- Decreased risk of endodontic problems on adjacent teeth
- Improved hygiene
- Decreased cold or contact sensitivity of adjacent teeth
- Psychological advantage
- Decreased abutment tooth loss
Disadvantages of Dental Implants
- More planning time and treatment time required
- Treatment requires surgical procedure
- Higher cost (but results in lifetime stability and less future investment for revisions)
Illustration of Dental Implant vs Pontic Bridge Option
Dental Implant Costs Are Not Only Healthier, but cost LESS in the Long Run than Dental Bridges
Dental Implants are the ONLY restorative options that prevent BONE LOSS & Premature Aging
Dental Implants are the only restorative solution that prevents bone loss. Bone loss is an unfortunate side effect of tooth loss, which occurs because the jaw and mandible bone reabsorb back into the body, without a tooth root (or dental implant) stimulating bone growth. To explain further, “when you don’t use it, you lose it.” This concept indicates that when you have a normal tooth, you continuously experience chewing forces from grinding your teeth while eating food (masticating) which puts pressure on the bone and in return the bone provides strength and density. However, if an implant is not placed within 12 weeks after a tooth extraction and bone graft, the bone level will automatically start to diminish, weakening the jaw and adjacent teeth, alongside already injured bone at the extraction site. The ONLY way to prevent bone loss over the long term is to place a dental implant.
Bone Loss and Facial Disfigurement
Bone loss in the jaws severely changes the contours of the face and creates an aggressively aged facial musculature. The only way prevents premature aging, loss of facial elasticity, loss of adjacent teeth, loss of vertical bite (space between the chin and checks), skin drooping, deep wrinkle formation, TMJ dysfunction and other debilitating side effects it to reinforce the bone with dental implants after the loss of teeth.
Esthetic Consequences of Bone Loss
- Decreased facial height
- Loss of labiomental angle
- Deepening of vertical lines in lip and face
- Rotation of chin forward, giving a prognathic appearance
- Decreased horizontal labial angle of lip, making patient look unhappy
- Loss of tone in muscles of facial expression
- Thinning of vermillion border of the lips from loss of muscle tone
- Deepening of nasolabial groove
- Increase in columella-philtrum angle
- Increased length of maxillary lip so that fewer teeth show at rest and smiling, which ages the smile
- Ptosis of buccinator muscle attachment, which leads to jowls at side of face
- Ptosis of mentalis muscle attachment, which leads to witch’s chin
In the image below, a 30-year-old woman has lost her molars due to an infection, and 2 scenarios are displayed. One where the patient chose to restore her mouth with dental implants, and one where the patient chose to wear a partial denture and experienced bone erosion of adjacent teeth until all the remaining teeth were gone as well over a period of approximately 10 years. Notice in the dental implant option, the woman’s facial structure, and bone remained the same over the 10 year period due to the dental implant preserving bone, facial structure and providing the proper framework for the face and TMJ joint.
What are Dental Implants?
Dental implants provide a permanent and superior alternative to dentures, crowns, and bridges. They consist of three different parts:
The Implant: This is a screw that directly connects to your jaw and acts as a root for your replacement tooth. In some situations, the bone may need to be grafted before the implant can be installed.
The Abutment: Part of the implant that secures the prosthetic tooth.
Crown: This is the actual prosthetic tooth. It is made of porcelain, zirconium, or another dental material and is prefabricated in a dental lab so that it fits perfectly with your natural teeth. The Ultimate Solution: Ceramic dental implants provide better aesthetics, a more permanent tooth replacement solution, and better biocompatibility than titanium implants, metal implants, dental bridges, or dentures. The beautiful, long-lasting, biocompatible, metal-free and superior by every measure dental implants that Dr. Yuriy May places have numerous uses for different types of cases including: Dental implants are incredibly versatile and can replace one tooth, multiple teeth or the full jaw. They are often the best permanent solution for people who have failing teeth and other dental problems. Additionally, this type of treatment has a very high success rate for patients, over 95% of dental implants succeed and for those few with complications, 99% succeed during the second dental implant procedures. Approximately 98% of implants last for the rest of a patient’s life, where root canals, bridges, and other replacement options typically need to be addressed 3 to 7 years down the road.
- Single tooth dental implant replacements
- Implant supported bridges
- Full mouth reconstruction through multiple dental implant placements
- 4 dental implants and a removable overdenture
- 4 to 6 dental implants and a fixed, nonremovable overdenture
- Orthodontic anchorage devices
Single Tooth Replacements: Dental implants can permanently replace one or more missing teeth while also preserving bone, the shape of the mouth, supporting facial musculature and shape of the face. The dental implant will, over time, integrate with patients’ own natural jaw bone. This is called osseointegration, and ultimately the process stimulates the jaw bone, creating additional healthy bone growth which in turn combats bone loss and improves your overall facial structure, bone and tooth health. The crown, which attaches to the dental implant, will look and function just like or better than the patient’s own natural tooth, allowing patients to live, smile, laugh and rip through corn or steak with confidence.
Implant-Supported Bridges: Dental implant-supported bridges permanently replace multiple teeth while preserving the overall bone structure of not just the tooth but an entire jaw quadrant, which significantly helps maintain the structural integrity of the facial musculature and bone, allowing cheeks to avoid sallow looks and sagging of the skin. Traditional bridges are supported by the adjacent teeth, which puts pressure on your formerly healthy teeth, loosening of them over time (referred to in dentistry as the “cantilever effect”) and causing the additional and unnatural force to exacerbate erosion of the health teeth, otherwise know as “grinding down.” This causes several long-term problems for the patient including bone loss at the site of the missing and implant-less tooth, excessive and unbalanced force on the adjacent healthy teeth eroding the bone and tooth structure, bacteria and food particles being caught under the bridge (empty tooth location) causing gum inflammation and generating unhealthy bacteria growth in the mouth, and ultimately, loss of the integrity of the facial structures in terms of musculature and bone due to the erosion of both adjacent teeth and the jaw bone where the former tooth had once been. Unlike cantilever bridges, a dental implant-supported bridge is held firmly in place by the dental implant, and therefore bone growth is stimulated around the site of the missing tooth (now implant) and the natural pressure of the bite and chewing is equally and once again, naturally, distributed across the remaining natural teeth, preventing the healthy teeth from being damaged in the placement of the bridge. Additionally, the implants will stimulate the jaw bone growth, preventing bone loss and prolonging the preservation of facial musculature and bone structure resulting in a more youthful appearance.
Full Mouth Reconstruction (Full-Arch Replacements): Dental implant surgeons like Dr. Yuriy May use advanced dental implant technology every day to permanently restore an entire arch of teeth (mandible or maxilla of the mouth) in one efficient, permanent and health-enduring procedure. As few as four dental implants can be strategically placed to support a custom arch of beautiful teeth that will absolutely redefine the shape of the face for both men and woman, making them look younger and revitalizing their entire facial structure. During excessive tooth loss that patients experience either due to disease, medications, physical trauma. During the procedure, a beautiful and high-quality temporary prosthetic will be placed following the initial procedure, but once your implant sites heal you will receive your gorgeous, zirconia, custom designed, natural looking celebrity teeth that will allow you live the life your dreams – eat all the grass-fed, pastured, grass-finished steak or quinoa and organic corn your heart desires, while wearing the gorgeous, million dollars, never go out of style smile. Your incredible zirconia dental implants have a lifetime warranty from Dr. Yuriy May and you will realize, life would have been better with your fully restored arch if you only did it 30 years ago!
Orthodontic Anchorage Devices: Dental implant specialists like Dr. Yuriy May often work hand in hand with functional orthodontists to use dental implants as anchorage devices to move surrounding teeth for palate expansion and other uses, including the ALF (Advanced Lightwire Functional Appliance). After Natural Dentistry’s oral surgeon places the dental implant, a functional orthodontist various hidden devices to the dental implant and surrounding teeth. Having a stable anchor tooth allows the surrounding teeth to move into place faster to achieve the ideal mouth opening for aesthetic, breathing and functional objectives. Dental implant surgeons like Dr. Yuriy May continue to find new and inventive ways to utilize dental implant technology, and Natural Dentistry has only described a mere few of the most popular uses for dental implants. With all of the treatment options available, Dr. May is confident and committed to identifying the optimal, health supporting treatment that fits even the neediest patients’ needs, either with dental implants or other restorative solutions.
Choice of Dental Implant Procedure Types
Different procedures are conducted for different patients based on a wide array of variables including but not limited to dental surgery required, health of the patient, bone levels, implant site location, tissue health and risk level. Dr. Yuriy May educates all his patients on the various types of dental implant procedures, specific dental implant placement recommendation for the patient and a comprehensive overview or risk involved. The four various dental implant procedures that Natural Dentistry’s dental implant specialist performs are:
- Immediate Placement
- Immediate Placement & Immediate Load
- Delayed Placement & Immediate Load
- Delayed Placement & Delayed Load
Choice of Dental Implant Materials
- Zirconia Dental Implant with Zirconia Abutment – 100% Metal Free, Allergy Free Option
- Zirconia Covered Dental Implant with Zirconia covered Abutment – Limited Metal Contact with Tissue
- Titanium Oxide Dental Implant with Zirconia covered Abutment – Preferred Metal Implant, Less Reactive, 100% Titanium, Not an Alloy
- Titanium Oxide Dental Implant with Titanium Oxide Abutment
Zirconia Dental Implant with Zirconia Abutment – 100% Metal Free, Allergy Free Option Why Zirconia Dental Implants? Zirconia dental implants are bio-inert (neutral to the body and tissues) biocompatible (integrate naturally with the body and tissues) and entirely hard and soft tissue-friendly, there are no allergic reactions and no sensitivity to temperature. Given that they have a tooth color-like appearance, zirconia implants have an aesthetic advantage over titanium implants along with the other many unique properties that make zirconia dental implants the most superior dental implants available. Good esthetic results can also be obtained with titanium implants when ceramic posts and crowns are used. However, this significantly increases the cost of treatment. Ceramic implants cause little to no inflammation, display minimal plaque retention, and in case there is slight gum recession or shrinkage, they do not reveal unsightly gray lines like titanium implants. Zirconia implants do not corrode and will not have any impact on taste in the mouth, and importantly, avoid the disturbing health effects of galvanization (electro-current disturbance) which naturally disturbs the body’s energy meridians, inter-cellular electric currents and causes or accelerates disease processes. Zirconia dental implants are the ultimate alternative for patients who are not comfortable with or are not able to tolerate metal (titanium) implants.
Can any Surgeon Place Zirconia Dental Implants? Theoretically, yes. However ceramic implantology has now propelled dental implantology further into the realm of esthetic and cosmetic dentistry. Zirconia implants are one-piece (see picture), and their placement angle and position is extremely critical and must be precise. Unlike two-piece titanium implants errors in implant placement cannot be corrected with angled abutments (posts).Therefore any surgeon involved with these implants should have a high level of prosthetic awareness. Enhanced diagnostic tools and surgical preparation steps such as three-dimensional imaging, virtual planning, and computer generated surgical guides should always part of the implantation protocol.
Zirconia Dental Implant with Zirconia Abutment – Most Preferred Dental Implant, 100% Metal Free, 100% Biocompatible
Titanium Oxide Dental Implant with Zirconia covered Abutment – Preferred Dental Metal Implant, Less Reactive, 98% Titanium 2% Zirconium, DOES NOT CONTAIN NICKEL
Titanium Oxide Dental Implant with Titanium Oxide Abutment – Least Preferred Dental Implant Type, contains Nickel, Copper, Vanadium,
Optimal Choice of Bone Graft Materials
All bone grafting materials that Dr. Yuriy May employs in the practice have been hand selected through decades of research and are by design considered the most natural, effective and of course, premium materials available on the dental market. All the below grafting material choices have infection reducing properties, along with helping blood clotting in a bone graft, thus allowing the bone graft material to hold together and develop the necessary density. Very few traditional dentists or oral maxillofacial dental surgeons use the materials Dr. May utilizes as his choice of materials require more time, effort and cost on the part of the dentist, relative to the most widely used animal or synthetic bone graft material made of either animal material (bovine or porcine) or synesthetic compounds, including various forms of PTCP (beta-tricalcium phosphate). Dr. May’s grafting material is extremely effective, beneficial and safe because it is made from patients’ very own blood thus making it 100% natural, derived from patients’ own bodily tissue. The blood is spun down into a serum with white blood cells and healing properties and used as the perfect grafting matrix regenerating dense, healthy and incredibly robust bone growth, which is the goal of a bone graft. The materials described below have been very well studied and documented for many years. Dr. May’s patients experiencing the largest bone grafts in the case of sinus lifts and large cavitation grafts typically only need a mild pain reducer such as Advil or Tylenol after undergoing the procedure if they have had a dental bone graft with any of the below materials. Dr. Yuriy May has an extremely high success rate in rebuilding and transplanting bone for dental implants and for full mouth reconstruction cases, including post-dental cavitation procedures.
- PRP = platelet rich plasma
- PRF = platelet rich fibrin <= Dr. May’s preferred method of regenerating soft tissue, bone growth
- PDGF = platelet derived growth factor
- BMP = bone morphogenic protein
PRP = platelet rich plasma
PRP, or platelet-rich plasma therapy can accelerate bone and tissue growth and wound healing and help assure the long-term success of dental implant placements. PRP is the premium grafting material for sinus lift bone grafts, onlay block bone grafts, bone and ridge expansion, extractions, nerve repositioning and most surgical dental procedures. In addition to PRP’s amazing properties for accelerated healing of dental implant procedures and excellent bone growth regeneration, this amazing bone grafting medium is quickly gaining acceptance in orthopedics and sports medicine as well. Various orthopedic physicians have been using PRP with success for painful and hard to treat injuries like tennis elbow, tendonitis, and ligament damage. It is worth mentioning that PRP was used in 2009 pre-game Super Bowl treatment for two Pittsburgh Steelers players (Heinz Ward and Troy Polamalo), and both were instrumental in the team winning its 6th Super Bowl. James Rutkowski, DMD, PhD, and a prominent dental researcher and editor of the Journal of Oral Implantology reported at the recent annual scientific meeting of the American Academy of Implant Dentistry (AAID) that platelet-rich plasma therapy can accelerate bone and tissue growth and wound healing and help assure long-term success of dental implant placements. “What could be better than using the body’s own regenerative powers to grow bone and soft tissue safely and quickly? For dental implant procedures, PRP treatments can jump start bone growth and implant adherence in just two weeks, which cuts down the time between implant placement and affixing the dental crown,” said Dr. Rutkowski. Platelet-rich plasma is obtained from a small sample of the patient’s own blood. It is centrifuged to separate platelet growth factors from red blood cells. The concentration of platelets triggers intense, rapid growth of new bone and soft tissue. “There is very little risk because we are accelerating the natural process in which the body heals itself,” says Dr. Rutkowski. “PRP speeds up the healing process at the cellular level, and there is virtually no risk for allergic reaction or rejection because we use the patient’s own blood.” For dental surgery applications PRP is mixed as a gel that can be applied directly in tooth sockets and other sites within the oral cavity. It highly effective in cases when bone grafts are required to foster proper bone integration for dental implants, which is where Dr. May exclusively uses PRP. Growth factors in PRP preparations help the grafts bond faster with the patient’s own bone. Studies by Dr. Rutkowski have reported findings of increased radiographic bone density during the initial two weeks following PRP treatment when compared to dental implant sites that did not receive PRP treatment. “Accelerated healing is a goal we’re constantly seeking in implant dentistry and we now have treatment that activates the natural healing process. It is a most promising development for implant dentistry,” explained Dr. Rutkowski. Currently, only 10% of practicing implant dentists use PRP treatment due the higher level of effort and expertise required by the dental implant specialist, however, PRP is widely considered as setting the bar for best in class bone grafting material in the holistic and implant dentistry field. Dr. Yuriy May is one of the few dental implant specialists in Connecticut using platelet-rich plasma therapy for dental implant placement and bone grafting.
BMP = bone morphogenic protein
This is an additive known as recombinant human Bone Morphogenetic Protein-2 (rhBMP 2) made by Mectron.BMP is something that helps bone grow. BMP increases the price of dental implant bone grafts by $1500 to $7500, only for the BMP additive itself, not including the actual bone graft or dental implant and abutment, or the restorative crown! But, interestingly, BMP is not something Dr. May considers is necessary in all cases due to the fact that Natural Dentistry we are able to extract the natural Bone Morphogenetic Protein that each individual makes through the PRP (platelet-rich plasma therapy). The most cutting edge and effective of BMP is the natural, patient’s own modern PRP additive. Unlike PRP, the BMP available on the dental market is derived from other human beings, instead of the 100% bio-identical PRP made from each patient’s very own plasma and blood.
Traditional Bone Grafting Materials
There are currently procedures to save or preserve bone, and there are a number of conventional bone graft materials available to be used with these procedures in dentistry today, all of which are suboptimal in holistic dentistry as they use the foreign material to create a matrix to rebuild a dental patients’ oral and facial bone structure. They include:
Autograft: Recipient’s Own Bone Autograft is obtaining of bone from the patient’s own body and typically is the gold standard grafting procedure available now. Concerns: Autograft has its limitations, which include potential problems such as second surgical site and patient discomfort in terms of harvesting of a graft from another part of the patients body. It’s also a painful, complex and costly procedure for the patient.
Allograft: Bone from another Human Being Allograft is obtaining of bone graft materials from human cadavers. Concerns: The disadvantage of allograft is that the bone graft materials may be rejected by the recipient’s immune system. Also there is chance of disease cross transmission.
Xenograft: Bone from animal, usually porcine or bovine origins Xenograft is the obtaining of bone graft materials from tissue of animal origin, which includes bovine (cow’s bone) or porcine (pig’s bone) Concerns: Similar to allograft, such bone graft materials may be rejected by the recipient’s immune system or pose concerns of potential disease transmission.
Alloplast: Synthetic grafting materials Alloplast are synthetic grafting materials used for grafting. Concerns: They have limitations in terms of biocompatibility, resorption timing, local tissue reaction, and bone regeneration.
References & Citations
- 1. Depprich R, Zipprich H, Ommerborn M, et al. Osseointe- gration of zirconia implants compared with titanium: an in vivo study. Head Face Med. 2008;4,1–8.
- 2. Hoffmann O, Angelov N, Gallez F, Jung RE, Weber FE. The zirconia implant-bone interface: a preliminary histologic evaluation in rabbits. Int J Oral Maxillofac Implants. 2008;23:691–695.
- 5. Oliva J, Oliva X, Oliva JD. One-year follow-up of first consecutive 100 zirconia dental implants in humans: a comparison of 2 different rough surfaces. Int J Oral Maxillofac Implants. 2007;22: 430–435.
- 6. Silva NR, Coelho PG, Fernandes CA, Navarro JM, Dias RA, Thompson VP. Reliability of one-piece ceramic implant. J Biomed Mater Res B Appl Biomater.
- 7. Andreiotelli M, Kohal RJ. Fracture strength of zirconia implants after artificial aging. Clin Implant Dent Relat Res. 2009;11: 158–166.
- 8. Heydecke G, Kohal R, Glaser R. Optimal esthetics in single tooth replacement with the Re-Implant system: a case report. Int J Prosthodont. 1999;12:184–189.
- 9. Bianco PD, Ducheyne P, Cuckler JM. Local accumulation of titanium released from a titanium implant in the absence of wear. J Biomed Mater Res. 1996;31:227–234.
- 10. Weingart D, Steinemann S, Schilli W, et al. Titanium deposition in regional lymph nodes after insertion of titanium screw implants in maxillofacial region. Int J Oral Maxillofac Surg. 1994;23:450–452.
- 11. Tschernitschek H, Borchers L, Geurtsen W. Nonalloyed titanium as a bioinert metal – a review. Quintessence Int. 2005;36: 523–530.
- 12. Kohal RJ, Wolkewitz M, Hinze M, Han JS, Ba ̈chle M, Butz F. Biomechanical and histological behavior of zirconia implants: an experiment in the rat. Clin Oral Implants Res. 2009;20:333–339.
- 13. Andreiotelli M, Wenz HJ, Kohal RJ. Are ceramic implants a viable alternative to titanium implants? A systematic literature review. Clin Oral Implants Res. 2009;20(suppl 4):32–47.
- 14. Sandhaus S. The Cerasand endosseous implant. Actual Odontostomatol. 1987;41(160 Spec No):607–626.
- 27. Kohal RJ, Klaus G, Strub JR. Zirconia-implant-supported all- ceramic crowns withstand long-term load: a pilot investigation. Clin Oral Implants Res. 2006;17:565–571.
- 28. Hisbergues M, Vendeville S, Vendeville P. Zirconia: Estab- lished facts and perspectives for a biomaterial in dental implantol- ogy. J Biomed Mater Res B Appl Biomater. 2009;88:519–529.
- 29. Depprich R, Zipprich H, Ommerborn M, et al. Osseointe- gration of zirconia implants: an SEM observation of the bone- implant interface. Head Face Med. 2008;4:1–7.
- 30. Stadlinger B, Hennig M, Eckelt U, Kuhlisch E, Mai R. Comparison of zirconia and titanium implants after a short healing period. A pilot study in minipigs. Int J Oral Maxillofac Surg. 2010;39: 585–592.
- 31. Piconi C, Maccauro G. Zirconia as a ceramic biomaterial. Biomaterials. 1999;20:1–25.
- 32. Piconi C, Maccauro G, Muratori F, Brach Del Prever E. Alumina and zirconia ceramics in joint replacements. J Appl Biomater Biomech. 2003;1:19–32.
- 33. Helmer JD, Driskell TD. Research on bioceramics. Sympo- sium on Use of Ceramics as Surgical Implants, 1969. Clemson University, Clemson, SC.
- 35. Gahlert M, Burtscher D, Grunert I, Kniha H, Steinhauser E. Failure analysis of fractured dental zirconia implants. Clin Oral Implants Res. 2012;23:287–293.
- 36. Mellinghoff J. First clinical results of dental screw implants made of zirconium oxide [in German]. Z Zahnarztl Implantol. 2006; 22:288–293.
- 37. Kollar A, Huber S, Mericske E, Mericske-Stern R. Zirconia for teeth and implants: a case series. Int J Periodontics Restorative Dent. 2008;28:479–487.
- 38. Sollazzo V, Pezzetti F, Scarano A, et al. Zirconium oxide coating improves implant osseointegration in vivo. Dent Mater. 2008;24:357–361.
- 39. Rocchietta I, Fontana F, Addis A, Schupbach P, Simion M. Surface-modified zirconia implants: tissue response in rabbits. Clin Oral Implants Res. 2009;20:844–850.
- 40. O ̈ zkurt Z, Kazazog ̆ lu E. Zirconia dental implants: a literature review. J Oral Implantol. 2011;37:367–376.
- 41. Sennerby L, Dasmah A, Larsson B, Iverhed M. Bone tissue responses to surface-modified zirconia implants: a histomorpho- metric and removal torque study in the rabbit. Clin Implant Dent Relat Res. 2005;7(suppl 1):S13–S20.
- 42. Meyer U, Buhner M, Buchter A, Kruse-Losler B, Stamm T, Wiesann FI. Fast element mapping of titanium wear around implants of different surface structures. Clin Oral Implants Res 2006;17:206-11.
- 43. Weingart D, Steinemann S, Schilli W. Titanium deposition in regional lymph nodes after insertion of titanium screw implants in maxillofacial region. Int J Oral Maxillofac Surg 1994;23:450-2.
- 44. Frisken KW, Dandle GW, Lugowski S, Jordan G. A study of titanium release into body organs following the insertion of single threaded screw iplants ino the mandibles of sheep. Aust Dent J 2002;47:214-7.
- 45. Schliephake H, Reiss G, Urban R, Neukam FW, Guckel S. Metal release from titanium fixtures during placement in the mandible: An experimental study. Int J Oral Maxillofac Implants 1993;8:502-11.
- 46. Piconi C, Maccauro G, Muratori F, Prever BD. Alumina & zirconia ceramics in joint replacements. J Appl Biomater Biomech 2003;1:19-32.
- 47. Griss P, Von Adrian-Werburg HV. Biological activity & histocompatibility of dense Al 2 O 3 -MgO ceramic implants in rats. J Biomed Mater Res 1973;7:453-62.
- 48. Harms J, Mausle E. Tissue reaction to ceramic implant material. J Biomed Mater Res 1979;13:67-87.
- 49. Garvie RC, Urbani C, Kennedy DR, Mcheuer JC. Biocompatibility of magnesia-partially stabilized zirconia ceramics. J Mater Sci 1984;19:3224-8.
- 50. Chaturvedi, TP. “Allergy Related to Dental Implant and Its Clinical Significance.” Clinical, Cosmetic and Investigational Dentistry 5 (2013): 57–61.
- 51. Olmedo, D.G.; Paparella, M.L.; Brandizzi, D.; Cabrini, R.L. Reactive lesions of peri-implant mucosa associated with titanium dental implants: A report of 2 cases. Int. J. Oral Maxillofac. Surg. 2010, 39, 503–507.52. Egusa, H.; Ko, N.; Shimazu, T.; Yatani, H. Suspected association of an allergic reaction with titanium dental implants: A clinical report. J. Prosthet. Dent. 2008, 100, 344–347.53. Flatebø, R.S.; Johannessen, A.C.; Grønningsæter, A.G.; Bøe, O.E.; Gjerdet, N.R.; Grung, B.; Leknes, K.N. Host response to titanium dental implant placement evaluated in a human oral model. J. Periodontol. 2006, 77, 1201–1210.54. Sicilia, A.; Cuesta, S.; Coma, G.; Arregui, I.; Guisasola, C.; Ruiz, E.; Maestro, A. Titanium allergy in dental implant patients: A clinical study on 1500 consecutive patients. Clin. Oral Implants Res. 2008, 19, 823–835.55. Chaturvedi, T.P. An overview of the corrosion aspect of dental implants (titanium and its alloys). Indian J. Dent. Res. 2009, 20, 91–98.56. Siddiqi, A.; Payne, A.G.T.; de Silva, R.K.; Duncan, W.J. Titanium allergy: Could it affect dental implant integration? Clin. Oral Implants Res. 2011, 22, 673–680.57. Javed, F.; Al-Hezaimi, K.; Almas, K.; Romanos, G.E. Is titanium sensitivity associated with allergic reactions in patients with dental implants? A systematic review. Clin. Implant Dent. Relat. Res. 2013, 15, 47–52.58. Hallab, N.; Merritt, K.; Jacobs, J.J. Metal sensitivity in patients with orthopaedic implants. J. Bone Joint Surg. Am. 2001, 83, 428–436.59. Frisken, K.W.; Dandie, G.W.; Lugowski, S.; Jordan, G. A study of titanium release into body organs following the insertion of single threaded screw implants into the mandibles of sheep. Aust. Dent. J. 2002, 47, 214–217.60. Jacobs, J.J.; Skipor, A.K.; Black, J.; Urban, R.; Galante, J.O. Release and excretion of metal in patients who have a total hip replacement component made of titanium- base alloy. J. Bone Joint Surg. Am. 1991, 73, 1475–1486.