Implant indications

The speaker said that a common treatment option is to use titanium implants and ceramic abutments/reconstructions. The speaker explained that since he prefers a two-piece bone-level design, he uses titanium implants because there is still insufficient documentation on two-piece bone-level zirconia implants.

“A common treatment option is to use titanium implants and ceramic abutments/reconstructions”

Regarding plaque accumulation and soft tissue response: current research shows conflicting results with respect to titanium. Although the aesthetic appearance seems to be one of the main benefits and ‘strong points’ of zirconia, the use of ceramic reconstructions on titanium implants seems to work quite well in terms of aesthetics.

Titanium implants have been demonstrated to be highly predictable in the long term. The survival of implants supporting single crowns was recently evaluated in two meta-analyses (Jung et al. 2012; Rabel et al. 2018). The results at ten years showed survival rates of 95–97%.

“But titanium implants also face several disadvantages”

But titanium implants also face several disadvantages. An increasing number of cases involving peri-implant recessions leading to mucosal discolorations have been reported (Buser et al. 2017). Another potential problem is the presence of titanium particles as a result of tribocorrosion, which may elicit a pro-inflammatory response or hypersensitivity (Mombelli et al. 2018). Until now, no pathology has been associated with the presence of titanium particles in peri-implant tissues. Out of millions of implant patients, only a few case histories have presented relatively strong evidence of titanium allergies (Albrektsson et al. 2018). It should be noted that zirconia particles have also been found in tissues surrounding zirconia implants, and the potential biological effects of this are not yet known.

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