Is Zirconia a Viable Alternative to Titanium for Dental Implantology?

Aim: To review the literature using a systematic approach to answer the question: 'Are zirconia dental implants an alternative to titanium dental implants?' This was evaluated by assessing the evidence for survival rate, success rate and marginal bone loss of the two implant materials.
Methods: Relevant studies were identified after searching PUBMED, EMBASE and the Cochrane library. Two reviewers assessed the papers using the specified inclusion criteria, title and abstracts. Studies that were not related to the outcomes of: survival rate, success rate or marginal bone loss of zirconia dental implants were excluded.
Results: From a total of 1617 titles and abstracts, 33 potentially relevant full text papers were identified. Of these, 18 met the criteria for inclusion in the review. The review revealed heterogeneity between the studies in terms of surgical characteristics, implant characteristics, defining success and measuring marginal bone loss therefore making comparisons between studies difficult. However, in the three randomised control studies included in this review, which compared zirconia implants to titanium implants, the survival rate was lower for zirconia implants, but the success rate and marginal bone loss were found to be similar.
Conclusion: Overall, initial studies indicate that zirconia dental implants could be a viable alternative to titanium implants but need further well-designed studies need to be carried out to assess their long-term survival rate, success rate and marginal bone loss. At present, zirconia implants should be used with caution but can be an alternative option if a patient has an absolute contraindication to titanium.
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