The last three decades have seen an increase in the use of dental implants to replace missing teeth. The use of Titanium root form implants in the rehabilitation of the partially or completely edentulous is based on the fact that titanium implants “osseointegrate” with native bone.
It is widely accepted that the clinical outcome of titanium implants in terms of rigid fixation and long term functional success is good, however, negative aesthetic late complications and soft tissue recession are widespread especially in the esthetic zone. These late complications have led to the advent of white zirconia transgingival abutments in an attempt to minimize soft tissue recession in an effort to reduce aesthetic failures.
A possible alternative to the use of titanium is the use of ceramic as the material for the dental implants. One such material is Zirconia (Y-TZP), possessing the capacity to osseointegrate and very favourable physical properties, such as flexural strength (900-1200MPa), hardness (1200 Vickers) as well as a favorable threshold stress intensity factor needed for long term stability and success. Moreover, the one piece design and white colour simplify esthetic rehabilitation of the partially edentulous. A literature search through Medline by Assal. 2013 enables one to see zirconia's potential but also to point out and identify its weaknesses. Assal's search shows that zirconia is a biocompatible, osteoconductive material that has the ability to osseointegrate. However, the studies do not allow for the recommendation of the use of zirconia implants in dailypractice. The lack of studies examining the chemical and structural composition of zirconia implants does not allow for a "gold standard" to be established in the implant manufacturing process. Randomized clinical trials (RCT) are urgently needed on surface treatments of zirconia implants intended to achieve thebestpossible osseointegration.
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