Is zirconia a viable alternative to titanium for oral implant? A critical review

Sivaraman, Karthik; Chopra, Aditi; Narayan, Aparna I.; Balakrishnan, Dhanasekar

doi:10.1016/j.jpor.2017.07.003

Cited by 163 publications

(140 citation statements)

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“…Commercially pure titanium is the most widely used material in implant dentistry, but a search for alternatives has been ongoing for decades. Yttria-stabilized zirconia does appear to meet all important requirements as patients and dentists increasingly seem to prefer metal-free solutions (Sivaraman, Chopra, Narayan, & Balakrishnan, 2018). This trend is driven by growing concerns among patients about titanium sensitivity, allergies, or intolerance, even though there is scarcely any evidence that these factors might be clinically relevant (Fage, Muris, Jakobsen, & Thyssen, 2016;Hosoki, Nishigawa, Miyamoto, Ohe, & Matsuka, 2016;Thomas, Iglhaut, Wollenberg, Cadosch, & Summer, 2013).…”

Section: Introductionmentioning

confidence: 99%

Two‐piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial

Koller

Steyer

Theisen

et al. 2020

Clinical Oral Implants Res

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Objectives To prospectively evaluate, as part of an ongoing randomized pilot trial, the clinical outcomes of two‐piece zirconia implants in comparison with titanium implants 80 months after delivery of all‐ceramic (lithium disilicate) single‐tooth restorations. Material and methods The original sample included 31 (16 zirconia and 15 titanium) implants in 22 healthy patients. In addition to evaluating implant survival and success, a number of clinical or radiographic parameters were statistically analyzed: plaque index (PI), bleeding on probing (BOP), pink esthetic score (PES), and marginal bone loss (MBL). Both implant groups were compared using a Mann–Whitney U test. Results Three implants (2 zirconia and 1 titanium) had been lost, so that 28 implants (14 zirconia and 14 titanium) in 21 patients could be evaluated after a mean of 80.9 (SD: 5.5) months. All surviving implants had remained stable, in the absence of any fixture or abutment fractures and without any chipping, fracture, or debonding of crowns. The zirconia implants were associated with PI values of 11.07% (SD: 8.11) and the titanium implants with 15.20% (SD: 15.58), the respective figures for the other parameters being 16.43% (SD: 6.16) or 12.60% (SD: 7.66) for BOP; 11.11 (SD: 1.27) or 11.56 (SD: 1.01) for PES; and 1.38 mm (SD: 0.81) or 1.17 mm (SD: 0.73) for MBL. Conclusions No significant differences were found between the clinical outcomes of two‐piece zirconia and titanium implants based on the aforementioned parameters after 80 months of clinical service. Our results should be interpreted with the limited sample size in mind.

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Section: Introductionmentioning

confidence: 99%

Two‐piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial

Koller

Steyer

Theisen

et al. 2020

Clinical Oral Implants Res

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“…Together with its antibacterial effect, ZrO 2 7 may prevent peri-implant bone resorption and periimplant soft inflammation. 23 Moreover, it was previously shown that ZrO 2 coatings may promote adhesion and spreading of progenitor cells and bone-forming cells, i.e. osteoblasts.…”

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confidence: 99%

<p>Zirconium Oxide Thin Films Obtained by Atomic Layer Deposition Technology Abolish the Anti-Osteogenic Effect Resulting from miR-21 Inhibition in the Pre-Osteoblastic MC3T3 Cell Line</p>

Seweryn¹,

Pielok²,

Ławniczak-Jabłońska³

et al. 2020

IJN

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The development of the field of biomaterials engineering is rapid. Various bioactive coatings are created to improve the biocompatibility of substrates used for bone regeneration, which includes formulation of thin zirconia coatings with pro-osteogenic properties. The aim of this study was to assess the biological properties of ZrO 2 thin films grown by Atomic Layer Deposition (ALD) technology (ZrO 2 ALD). Methodology: The cytocompatibility of the obtained layers was analysed using the mice preosteoblastic cell line (MC3T3) characterized by decreased expression of microRNA 21-5p (miR-21-5p) in order to evaluate the potential pro-osteogenic properties of the coatings. The in vitro experiments were designed to determine the effect of ZrO 2 ALD coatings on cell morphology (confocal microscope), proliferative activity (cell cycle analysis) and metabolism, reflected by mitochondrial membrane potential (cytometric-based measurement). Additionally, the influence of layers on the expression of genes associated with cell survival and osteogenesis was studied using RT-qPCR. The following genes were investigated: B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), p53 and p21, as well as osteogenic markers, i.e. collagen type 1 (Coll-1), osteopontin (Opn), osteocalcin (Ocl) and runt-related transcription factor 2 (Runx-2). The levels of microRNA (miRNA/miR) involved in the regulation of osteogenic genes were determined, including miR-7, miR-21, miR-124 and miR-223. Results: The analysis revealed that the obtained coatings are cytocompatible and may increase the metabolism of pre-osteoblast, which was correlated with increased mitochondrial membrane potential and extensive development of the mitochondrial network. The obtained coatings affected the viability and proliferative status of cells, reducing the population of actively dividing cells. However, in cultures propagated on ZrO 2 ALD coatings, the up-regulation of genes essential for bone metabolism was noted. Discussion: The data obtained indicate that ZrO 2 coatings created using the ALD method may have pro-osteogenic properties and may improve the metabolism of bone precursor cells. Given the above, further development of ZrO 2 ALD layers is essential in terms of their potential clinical application in bone regenerative medicine.

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“…Zirconia with better optical, aesthetic, mechanical and biological qualifications, is a hopeful substitute to traditional Ti implant system for oral recovery [61][62][63][64], and is produced by the oxidation of zirconium [25,27,[65][66][67]. Zirconium, which is a transition metal [56,68] with greywhite color [69][70][71][72][73], can be used to make zirconia implant.…”

Section: Zirconia Implantsmentioning

confidence: 99%

Bioactive Glass Coated Zirconia for Dental Implants: a review

Zhang

2020

jcc

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Nowadays, zirconia has got extensive attention for dental implants, although it has disadvantages such as poor mechanical properties and brittleness that makes it unsuitable. On the other hand, bioactive glasses coating have been utilized on tougher substrates such as zirconia. Bioactive glass coatings can decrease the healing time and hence accelerate the formation of the bond between bone and implant. Hence in this study, we introduce the novel zirconia/bioactive glass composites with high mechanical strength and bioactivity to achieve the ideal implant dentistry. Furthermore, a review of bioactive glass coatings (i.e., 45S5 and 58S) on zirconia as well as surface modification methods (i.e., sol-gel, laser cladding, plasma spraying, etc.) is provided.

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Is zirconia a viable alternative to titanium for oral implant? A critical review

Cited by 163 publications

References 100 publications

Two‐piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial

Two‐piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial

<p>Zirconium Oxide Thin Films Obtained by Atomic Layer Deposition Technology Abolish the Anti-Osteogenic Effect Resulting from miR-21 Inhibition in the Pre-Osteoblastic MC3T3 Cell Line</p>

Bioactive Glass Coated Zirconia for Dental Implants: a review

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