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Ceramic vs Titanium Implants | Zirconia or Titanium Implants | Dental Implant Materials

Comparing Titanium vs Zirconia Dental ImplantsTitan ium vs Ceramic Implants - Comparing metal and ceramic dental implants

What is the difference between metal and ceramic dental implants?

In this article we will be comparing zirconia dental implants which are made from ceramic metal-free materials to titanium metal alloy dental implants based on the 6 criteria below:

  • FDA Approval in USA /CE Approval in Europe
    • Metal Implants have been FDA approved for over 30+ years in USA and Europe. Zirconia implants have been FDA-approved 15+ years in USA and 20+ years in Europe.
  • Metal Particle Corrosion & Galvanization Metal titanium implants break down and rust (corrode) and zirconia implants do not (see Titanic comparison below)
    • Metal Implants corrode, oxidize, breakdown and rust, whereas zirconia implants do not corrode or rust as they are not metal. Titanium implants can cause galvanization (electro-current disturbance) whereas ceramic implants do not conduct or disturb any biological electrical signals in the body.
    • Metal implants are also known to cause EMF disturbances for highly EMF/radiation sensitive patients. Cases have been reported of “antennae” effects with metal implants and never with ceramic implants
  • Mechanical Properties & Durability Titanium and Zirconia Implants break less than 1% with correct implant placement.
    • Metal Implants Break AND corrode both at the implant and at the abutment junction, whereas zirconia implants can are only known to break at the abutment collar junction for two piece zirconia implants only
    • Zirconia implants have only been known to break in incorrect placement by the doctor which allowed the implant to absorb unnatural pressure forces or the crown was placed incorrectly
    • Incidence of titanium implants breaking and one-piece zirconia implants breaking are both extremely rare, and occurrences are less than 1% statistically.
    • Zirconia Implants – One Piece do NOT break any more than titanium metal implants break
  • Cost & Investment Decision Criteria 
    • Zirconia Implants are approximately 10-20% more expensive than titanium implants (given potential health benefits, the investment is worth it)
  • Success Rates & Complications 
    • Both titanium metal and zirconia have 96% survivability rates at 10-12-year point history research studies (GENERALIZED BETWEEN MULTIPLE RESEARCH STUDIES)
    • Zirconia Implants showed a 100% survivability after 10 years in a study published in 2021 Zirconia Implants 10 Year Follow Up (Borgonovo, A. E., Ferrario, S., Maiorana, C., Vavassori, V., Censi, R., & Re, D. (2021). A Clinical and Radiographic Evaluation of Zirconia Dental Implants: 10-Year Follow-Up. International journal of dentistry2021, 7534607.
    • One Piece Implants have 94.7% success after 8 years post immediate placement and 89.5% success with delayed Implant Placement, according to a study published in 2023. The survivability of 1 piece implants after 8 years was 100% in the same study. (Kiechle, S., Liebermann, A., Mast, G., Heitzer, M., Möhlhenrich, S. C., Hölzle, F., Kniha, H., & Kniha, K. (2023). Evaluation of one-piece zirconia dental implants: An 8-year follow-up study. Clinical oral investigations, 10.1007/s00784-023-04935-1. Advance online publication.
    • Immediately Loaded 1 Piece Implants have cumulative survival rates of 96.9% after 1 year and 96.8% at five years (evaluated in cohorts between 4.3 and 6 years after placement).  Grassi, F. R., Capogreco, M., Consonni, D., Bilardi, G., Buti, J., & Kalemaj, Z. (2015). Immediate occlusal loading of one-piece zirconia implants: five-year radiographic and clinical evaluation. The International journal of oral & maxillofacial implants30(3), 671–680.
    • A 2018 meta-analysis study spanning over 1700 zirconia implants across 1000 patients and over 7 years concluded an average 95% survivability rate.
      • 1349 studies were selected. In total, 1704 implants from 1002 patients were evaluated with the placement of both 1 and 2-piece zirconia implants with follow-up between 1 and 7 years. The mean survival rate was 95% (95% CI 91-97%). Haro Adánez, M., Nishihara, H., & Att, W. (2018). A systematic review and meta-analysis on the clinical outcome of zirconia implant-restoration complex. Journal of prosthodontic research62(4), 397–406.
  • Biocompatibility & Autoimmune Response 
    • Metal Titanium is considered more inflammatory and not biocompatible compared to ceramic implants
    • Metal Titanium Implants break down and corrode and displace small metal particles in surrounding tissue causing heightened inflammatory responses such as TNF4 responses (citation added shortly)
    • Titanium implants are known to stimulate a “host response” which is an inflammatory process in patients (citations coming soon) where ceramic implants are bio-inert and do not react with tissues
  • 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 which look very similar to real teeth color
  • Plaque and Biofilm Accumulation 
    • Titanium implants attract and collect more dental plaque than zirconia ceramic dental implants\
    • Research studies show that plaque adhesion is higher in titanium implants than zirconia implants
    • Plaque adhesion long term is a major contributing factor to peri-implantitis, inflammation around the titanium implant site and bacterial growth in the mouth alongside a more acidic environment
  • Gum Inflammation & Recession 
    • Titanium implants develop peri-implantitis (inflammation and bone loss around the implant) in up to 30% of all titanium implants over the life of the metal dental implant placed.
    • Ceramic dental implants have virtually no peri-implantitis research or studies completes as it is not an observable issue and ceramic implant dentist observations are peri-implantitis is observed in less than 1% of patients long term

Metal Rust & Corrosion Comparison Analogy: Zirconia Implant vs Titanium Metal Implant Comparison:

Zirconia Dental Implants better than Metal Dental Implants Ceramic vs Titanium implants



Technical Titanium vs Zirconia Implant Comparison:

Zirconia vs Titanium Implants Ceramic vs Metal Dental Implants Natural Dentistry Zirconia Dental Implant Comparison

What are Biocompatible Dental Implants?

Unlike traditional, titanium implants, biocompatible implants are non-metal implants and are known to be the most non-reactive and tissue-friendly due to their inflammation-reducing properties. Dr. May is the first and only dental implant specialist in Connecticut / Greater New York to offer biocompatible dental implants, made entirely of ceramic metal free material. This newest form of biocompatible dental implants, called ceramic dental implants or zirconia dental implants, offer a more stable, aesthetic and tissue-friendly alternative to traditional titanium implants.

Ceramic Metal Free Dental Implants NO METAL Metal Free Implants Z Systems

The Material: Ceramic Dental Implants – Zirconia Dental Implants

Ceramic implants are made from a wide range of materials that, when compared to traditionally used metal implants, are harder and have higher temperature resistance, strength, lower density and excellent resistance to corrosion. These properties make ceramic implants the optimal choice for use in the oral environment where high temperature, corrosion and constant abrasion is present. Once of the most used and strongest ceramic materials is zirconia which is a glass-like material, making it completely non-reactive with bodily tissues. Zirconium dental implants are made from special, industrial, high impact resistant ceramic (zirconium oxide, ZrO2) that is customarily used in aerospace engineering because of its high resistance to fracture and heat. This is highly advantageous over metal dental implants due to reduced inflammation around the implant, reduced bacterial colonization at the screw-crown junction and reduced long-term bone loss. Ceramic implants retain less plaque and calculus than titanium resulting in healthier gums and overall health. The rough surface of zirconium integrates itself exceedingly well to the jawbone.(1) Zirconium dental implant is the highest quality material and the best choice for dental implantation, preferred by cosmetic focused traditional dentist and exclusively used by holistic dentists.

Unlike zirconium, pure titanium or titanium alloy implants contain metals that some individuals may have reactions to, expressed as either metal allergies or irritation and inflammation. Ceramic implants are biocompatible, eliminating concerns of allergies and biocompatibility issues thereby lessening concerns for damage to the immune system. Currently, it is estimated that 3%-5% of patients may be sensitive to titanium. (2) For those with titanium sensitivities, damaging results can be immediate or take years to accumulate, resulting in a wide array of symptoms and autoimmune disorders ranging from local inflammatory pathologies to chronic inflammation including cancers, and various neurologic symptoms, all frequently misdiagnosed as unrelated to dental materials.

Biocompatibility is always a key consideration for Dental Solutions when it comes to restoring the patients’ teeth and mouth to optimum health and function. Dental Solutions offers multiple chemical sensitivity testing (MCS) for dental materials and MELISA® metal testing to ensure that the perfect implant material is chosen. Overall, patients are requesting metal-free biologic implants and restorative solutions with increasing frequency. For more information on biocompatible dentistry and biocompatible implants, call our office for a consultation or see our holistic dentistry section.


Are Ceramic Dental Implants Metal-Free? The science behind titanium and zirconia dental implants.

Ceramic vs Metal Implants Zirconia vs Titanium Dental Implants The Science The Materials Metal Free Natural Dentistry Dr Yuriy May Holistic Dentist Zirconia Dental Implants


Is Zirconium (Zr) a Metal? What about Zirconia vs Zirconium?

Contrary to popular belief both among many clinicians and the public, zirconia is not a metal. Zirconia is the crystal form of the metal zirconium just like alumina is for aluminum. While looking at the periodic table of elements below, zirconium, aluminum and even titanium are in a group called transition metals (second row and second column in the yellow area), however the titanium used to make implants is used in its metal phase. That means that after extraction from the earth, upon certain specific, highly sophisticated and complex treatment such as Yttria stabilization and transformation protocols such as HIP (Hot Isostatic Press), zirconium is converted into its crystal phase which is non-metal and ceramic. Therefore the ceramic phase of the transitional metal zirconium is zirconia which is also called zirconium dioxide and used to manufacture bio-inert, biocompatible and structurally stable zirconia dental implants.(3)