Because biocompatibility isn’t optional for the biological dentist, we prioritize metal-free materials. No mercury amalgam “silver” fillings. No stainless steel crowns. No dentures with cobalt or other metal reinforcement. Over the years, we’ve seen excellent results with materials such as composite resins, ceramics, and flexible thermoplastics.
Even the dental implants we replace missing teeth with are zirconia, a type of ceramic, rather than titanium.
Not only has our clinical experience with these implants been positive, It aligns with a growing body of research that suggests zirconia implants can perform just as reliably as the more common metal implants. Now, a new study adds to that evidence.
Its authors set out to compare zirconia and titanium implants in patients receiving single-tooth replacements. Each patient was randomly assigned to get one material or the other and was then followed for a year after placement to see the results. The research team looked at several important measures, including implant survival, bone loss, and the health of tissues surrounding the implant.
After a year, the zirconia implants showed a 100% survival rate, compared to titanium’s rate of 96.5%. Bone levels around the implants – an important sign of long-term stability – were very similar between the two groups.
Because the differences between the groups were small, the researchers concluded that neither material could be considered better than the other. But this also showed that zirconia implants can perform just as reliably as metal.
And that raises an interesting question: Why use titanium at all? The answer, in part, is historical.
Back in the 1950s, Swedish orthopedic researcher Per-Ingvar BrĂĄnemark was studying bone healing using small titanium chambers placed in rabbit bone. When the experiment ended, he tried to remove the chambers and found that the bone had fused tightly to their titanium surfaces.
That phenomenon – later named osseointegration – turned out to be incredibly useful in both medicine and dentistry. Titanium implants placed in bone could integrate with surrounding tissue and remain stable for many years. The discovery quickly led to the development of modern dental implants, with titanium being the standard material used.
As dentistry evolved, however – particularly within biological and holistic approaches – some clinicians began to look more closely at how materials placed in the body interact with tissues over time.
Zirconia implants were eventually developed as a metal-free alternative. Broad biocompatibility is one of zirconia’s stellar features, after all, along with its incredible strength. Over the past two decades, they’ve been increasingly studied as clinicians and researchers explore options that could offer advantages in both biocompatibility and aesthetics.
Titanium may be standard, but in biological dentistry, we ask a question beyond simply whether a material functions well mechanically. We also want to know how it interacts with the body’s tissues and specific chemistry over time.
From this perspective, a restoration or prosthetic that functions well but may introduce chronic stress, toxicity, or immune disruption in an individual would be hard to consider a true success. And a number of concerns have been raised about titanium implants over the years, including corrosion, ion release, and the presence of trace metals in particular titanium alloys – some of which are known to be toxic to humans.
For patients who prefer to avoid metals – or who are concerned about potential sensitivities or long-term biological interactions – ceramic implants offer an appealing alternative. After all, being ceramic, they don’t corrode or release metal ions. They eliminate the possibility of triggering galvanic reactions with other metals in the mouth. Their white color brings an aesthetic advantage, as well, particularly in areas where gum tissue is thin. Being tooth-colored, zirconia implants can’t create dark shadows along the gumline.
At Pride Dental, our goal is not simply to replace a missing tooth, but to do so in a way that works in harmony with the body’s natural structures and healing processes.
