People have a surprisingly long history of permanently replacing missing teeth with artificial prosthetics. While this is generally thought of as a modern practice, there is evidence of people at least attempting this medical endeavor which dates back thousands of years. Astoundingly, the earliest evidence we have of the osseointegration of dental implants dates back to 600 AD.
Those ancient implants were made of sea shell. From a medical standpoint, that material was as effective as any other implant material human beings could come up with, until the first titanium dental implants were placed in patients during the 1960s. At that point titanium had already been used in various other surgical implant procedures due to its propensity to integrate with bone structure.
While titanium implants had unprecedentedly high success rates, it does have some less than ideal attributes as a dental implant material. One is the manner in which titanium decays, as it results in titanium oxide particles being dispersed into the soft tissue, the bone, and the blood stream. People have varying levels of sensitivity to titanium in their body. Titanium oxide contamination in the body can cause myriad health complications, but some people’s sensitivity to the metal is so acute that it causes their body to reject the implant itself. Additionally, people with especially visible implants often find that the grey titanium post can be seen through their tooth colored crown.
Today there are currently about 600 different dental implant systems produced by over 140 different manufacturers around the world. Virtually all of those implant systems are made with either titanium or zirconia. Zirconia-based ceramic material was first created in 1975 by a British physicist named Ron Garvie. It was found to be a highly biocompatible material, and a few years later it was being used to make hip joint replacements. It wasn’t long before people were looking to zirconia as a potentially superior dental implant material to titanium. Zirconium dioxide, or zirconia, was first used as a dental implant material by professor Sami Sandhaus in Geneva, Switzerland.
The tooth colored ceramic immediately proved a better cosmetic option for front teeth replacement. Soon the material was being used to create durable, tooth colored crowns that were attached to existing tooth structure. It was quickly discovered that, unlike titanium, zirconia facilitated the growth of soft tissue as well as bone. Zirconia implants are also less susceptible to corrosion, and the material is commonly used in spaceship construction due to its resistance to fracture and heat damage.
While zirconia quickly proved in various clinical trials to have multiple short term advantages over titanium as an implant material, some American skeptics have pointed to a lack of long term data regarding the success rate of ceramic dental implants. While zirconia implants have only had FDA approval since 2007, the ceramic material has been used to make dental implants in Europe since 1987. Just as technology and methods have evolved with metal implants and indeed the field of dentistry at large, many adaptations have been implemented to the concept of ceramic implants that have significantly improved the standard of care. Even without adjusting for these improvements, however, there is more than enough long term data from Europe to attest to the long-term viability of zirconia dental implants, even by conservative standards.
Three million people in the U.S. currently have dental implants, and that number is growing by an estimated half a million people each year. Since an increasingly large number of these patients opting for metal free implants over recent years, the amount of long term data from the U.S. will soon increase dramatically, and there is no reason to believe that the results will be notably different from the positive outcomes observed in Europe. Fortunately for prospective implant patients, the number of doctors who are gravitating toward and being trained in ceramic implant technology is also increasing rapidly.