What did you end up doing ? -Best, Matt Nejad, After years of dealing with patchwork dental work to keep up with damage and wear and tear primarily associated with a very bad bite I am undergoing some restoration work of all jaw teeth. The teeth have been removed but I have stalled getting the implants because I too am one of those health nut types and I am a bit nervous with having a foreign metal implanted into my body, especially in my face/head. The implants were fabricated of yttria-stabilized tetragonal zirconia (y-TZP). * the earlier implant was 3.5 Ã 13 mm, and now the dentist says We are gonna put a bigger implant of about 4.5 mm so it won’t matter. I am a general dentist and I appreciate this blog/article. Hi Gerald- There are no 2 piece zirconium implants currently on the market for screw retained crowns. patient, lab combination. Infection; Erosion of the implant through the skin, small intestine colon and urethra; Mechanical failure of the implantâ¦ The details are very important for your case. Thanks, Solid zirconia contains more stabilizers than high translucent zirconia, making it more durable to withstand forceful chewing and grinding. The disadvantages of zirconia crowns are minimal. Had to return to the surgeon three times to remove bone pieces that had pierced through my gums causing extreme pain. Hi Lynnette. Thank you so much for any help you can provide. Zirconia â¦ Not so sure now after all about the damage that was done to my body due to all above. I need one molar replaced with an implant and I am very conflicted about what material to use. 3) I can’t comment on the details of your specific situation without records and consultation. I have come across your article regarding zirconia and would like to know whether zirconia implants are suitable for my procedure. Zirconium dental implants, which use high-impact ceramic (zirconium oxide), are more compatible with the human body and may be a safer choice. -Dr. Kyle Stanley. So this is my situation, I am 27. It would also accumulate food and have hygenic concerns. Zirconia does not have these issues. I’ve since heard about the Maryland bridge option. The exact name of the material is yttria-tetragonal zirconia polycrystals (Y-TZP). But nonetheless I appreciate and hope you are right about the amount of acidity needed to cause corrosion. Would I be at higher risk for allergic reaction to implants? Dr. Kyle Stanley. personally, would you choose titanium over zirconia for health reasons? I would like to get implants but I have been tested for titanium and am allergic to it as I had to have a stimulator removed from my back due to extreme poisoning of titanium found in my blood. I had to have a bridge removed in the back due to the decay under that molar, lose one lose three. i want to done a implants on both sides….But I am really confused that its make any consequences in future like oral cancer,Gum problems,etc…..My dentist said that Titanium cant make oral cancer….Its strong,Biotype,etc….But Some fears left in my mind….I dont know how to overcome my fear…..Sir please help me….Whats ur opinion in my case….God bless u…. Treatment plan outlined to me consists of removal of  teeth, bone grafting for  teeth,  implants and 7-10 crowns/teeth (or much dreaded and least preferred dentures). And for the vast majority of patients, the implant process is straightforward and uneventful, with no serious side effects â¦ It sounds like you already have your implants placed and everything went well. Unfortunately due to a concussion, i had to put off the implant surgery as the thought of someone drilling my head was unbearable. Dental Implant Materials Please make sure you are being treated by an implant expert that has a team that understands both the surgical and restorative or esthetic aspect of the treatment. ( will Nobel Biocare be safer ?). I would recommend someone who lectures and is a university professor if possible. I’m hesitant to get a bridge, because two more teeth have to be worked on and possibly put at risk. Zirconia Implants are more prone to cracking than titanium dental implants. With decades of clinical success and innovation, titanium implants have become one of the most successful medical devices in all of medicine with long-term success rates between 94-97%. At age 65, I am in need of a complete upper teeth replacement. thank you If cost is not a factor in the decision, could you shed some light on the pros and cons specifically with full arches of individually set Zirconian teeth? I understand the dilemma and this reminds me of how important it is for dentistry, as a profession, to prioritize preventing teeth loss in the first place. After all other options have been explored, this would be the last resort. My options are to have the tooth removed and let it heal up ( I may not miss it), or install an implant. I have had periodontal disease since I was a teen and I fight hard for my teeth. Dr. Nejad, If your kidney function is fine, ibuprofen should be safe. I am being told from a second opinion that the implant was placed too low and that I could have problems later in the future due to the implant style being one that was meant for front teeth. Kyle Stanley practices surgical and implant dentistry in Beverly Hills, CA. Please give our office a call at 310-278-0440 and we can get you scheduled for a consultation. I’m also concerned about any long term reactions my body may have to any implants. We restore patients in a similar position as you frequently and the outcomes are life-changing. Actually the implant is exposed since I won’t put the crown on until we can figure out what is causing the constant nasal drainage. Perhaps you take longer to heal. Zirconium has an atomic number of 40 making it a transitional METAL. I would still go with titanium unless you have a true documented allergy. Initially, only bone-white substructures could be produced for zirconia crowns, which could sometimes create problems in achieving an aesthetically-perfect appearance. Thanks for your service to this forum. Solid zirconia, or âmonolithic zirconia,â is opaque, which is why itâs generally recommended for posterior crowns. Iâm sorry about your pain. Thankyou, I believe it is possible, but you may need some sort of grafting and an implant-supported bridge. However, I can say that there are always some good options for whatever your goal is. If your oral surgeon says it looks ok, it probably is ok. Scientific evidence: The very foundation of dental implantology was initiated by Prof P-I Brånemark over 65 years ago, after the discovery of â¦ If the bite is off, no material will last, but if the bite is great then even a softer material can have good longevity. I am sorry, it is really impossible to assess and diagnose these things adequately over the internet. The price of this treatment can vary by region, expertise, and implant components but you should expect to pay $35-50,000 per arch. thanks One of my favorite implant textbooks agrees that it is the least important tooth in the mouth to replace and often times the complications are higher so it may not be worth doing at all. She has given me some online links which support negative electrical effects from multiple metals. Also, the location of these implants is different than dental implants. There is a chance it is not the zirconia but it is your body. Dental implants may also cause an oral allergic reaction, states the National Institute of Health. Good luck with your situation! Now to address your question about placing the implant without a crown. Unfortunately, the restoration process revealed 2 teeth that could not be saved and I had already lost 2. My dentist put two fixed permanent bridges on both sides….He done root canal to the adjacent teeth and put fixed bridge on both sides….I feel relax….But suddenly heard about that bone loss can be occur on missing regions and leades to loss of adjacent teeths….Then i am really scared….I am 22 now…. This would be pretty useless. I wouldn’t recommend a Zr implant in the #30 position since that takes a large amount of forces. Also, what cost should I expect for such procedure? An alternative material to titanium exists in the form of zirconia for dental implants. HI Doctor – My tooth #30 was removed – it was fractured – about 2 years ago (I am 58). Do you know what the fracture rate is on zirconia implants in comparison to titanium and how long zirconia implants last? Sometimes failures are not just due to your body reaction but the planning, placement technique, etc. I would get titanium myself, but in my opinion, if you are reluctant/hesitant to get something, then you are more likely to have problems with it and regret it. However I got bottom dentures in 11/2019. Thanks, I am sorry to hear about your situation. I had it extracted two years ago and a bone graft done at the time of extraction. Small diameter zirconia implants have proven to be problematic. I am grateful to my parents for all of this. You are smart to have some consultations and make sure you really feel comfortable before you go through with treatment. Good luck! I am 4 months into the fusing process and will have my crowns fitted in two months. next week with an expert implantologist in Boca Raton here and he will be inserting two in the gum Zirconia screws to attach abutments to later on. Hey Guy, I am planning on getting implants in a few weeks once I finally move to California but im still undecided, one question I’ve had for a while regarding these type of implants is discoloration over time a factor? I’m sorry to hear you are losing a tooth. Apart from titanium allergy, there are other potential problems associated with titanium and its alloys, especially in individuals with specific polymorphisms (genetic susceptibility) – local and/or systemic effects . Many failures are completely unrelated to allergy and patients do not experience any symptoms on other implants. How is it going? Dr. Kyle Stanley. The fabrication of zirconia implant abutments is complicated by the problem of providing adequate fixation to the implant body. Sometimes a goal such as keeping every single tooth may interfere with the goal of having the most cosmetic outcome, so it helps to know what is the absolute priority. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3511938/. Thanks for that prompt reply. If you are asking my opinion, then I would say taking it out is not free. The zirconia is much more expensive and may fracture down the line. For full arch cases, Zirconia is not a great option as the restorative components are highly limited. A ceramic is a solid material comprising an inorganic compound of metal or metalloid and non-metal with ionic or covalent bonds. -Dr. Kyle Stanley. Keep in mind, there are a couple factors I mentioned that might not make you a good candidate but I have no way of assessing that. I have had sensitivities to cheap jewelry jn the past. You wrote that 80% of implants have primary stability but that other implants would need to be left undisturbed for a few months to heal under the gums. However, if you felt better getting a zirconia-based implant, that would be fine as long as you understand the drawbacks of their design. Titanium has been around longer, has more investigations and clinical studies, and decades of evidence proving it as a reliable and successful biomaterial for dental implants. I have already had all of my teeth extracted. Since it was my first crown I did not know a post should have been put in to hold the crown. However, it is a consideration. They are always white-colored. Since my RCT in Sept 2017, I’ve been experiencing pain in one of the root canal treated teeth and pain refers to my left nose and eye. I did have a cone beam scan and the oral surgeon all looked well. If it was my mouth, I would have the Zirconia bridge. I’m surprised to hear the price is 3 times different. My dentist is doing all she can with me. I had hoped to prolong the implant since I don’t like the option of a bridge. Or straumann ? However, if you are still uneasy about it, you can opt for the Zirconia version but understand the drawbacks of the implant designs. Given your concern, you may be more comfortable with Zirconia but the other concerns about strength are definitely valid. Best, Matt Nejad. Mainly left side. I am a holistically healthy 67 year-old and have no wisdom teeth. That is completely dependent on the provider. My dentist never told me any of the risks other than the fact that some implants fail In the interim I came across research showing that Ti implants are not pure and that a Ni or other alloy allergy can cause issues even years later. I have seen this on other screw loosening cases. Thank you. If you have any suggestions I would greatly appreciate. I am limited in my access to treatment as I live in the middle of nowhere in a small town in Wyoming, and have been vacillating on whether to âupgradeâ to zirconia. Do you still recommend Titanium for me? Your dentist is correct in that Titanium doesn’t lead to oral cancer. I personally would use titanium if I was getting an implant, but I think your concerns would be best addressed by Zirconia. Would a titanium implant be suitable for the lateral also as a second option? First of all, a post IS NOT needed in modern dentistry. The endosseous part of the implants was tapered with a porous surface. At the simplest level, a dental implant is a surgical appliance that is placed in the gingival space present in the upper or lower jaw to â¦ You probably haven’t had any titanium in your mouth since you previously only had crowns so we would have to see what the MELISA test comes back with. In addition, zirconia dental implants are both FDA approved and have a 98 percent survival rate. I am worried about cleaning, if I have problems if I have a bridge and most of all that it would involve filing the two neighbouring teeth. You are exactly right Cathy! I am considering expanding my family as well so the toxic qualities of the materials is especially important to me at this time. Thank you for sharing your knowledge and for the respectful and helpful manner of your advice. Perhaps there is a price difference if you are comparing cheaper implant components or one of the discount implant centers but I would urge you to stay away from those in general and do your research. #& Straumann Pure zirconia implant. Hello Dr. Additionally, studies have shown that titanium and zirconia implants have a very similar bone to implant contact or Osseointegration (Manzano et al. Each abutment has certain advantages but Zirconia is usually my choice for abutments. I am in need of a re-do on my bottom set of dentures with existing implants. We currently don’t use any posts in our practice because we have done the research to prove that it is not needed. Hi Brooke, Which is a bit scary. If you need some teeth extracted, I would recommend getting them removed and have the area grafted to prepare you for your future implants. You should have the tooth removed and a graft place. I need to get a canine extracted due to tooth resorption in that tooth. Thanks. The main thing is that I donât want to make it worse. A cone beam was recently done and I have enough bone but I am hesitant about spending that kind of money on one tooth with my issues. Zirconia is a ceramic material that is white in color. Such a brittle material doesn’t make sense for such a high load area as your first choice unless you are completely against titanium or have a known allergy. If I had the same symptoms you describe, I would go with an alternative approach. *Had an implant removed by cutting the bone. (this is already a big hit to the budget, I don’t want to add additional costs having the undo anything that goes wrong!) The best type of abutment is a titanium base with a zirconia abutment. 2) If yes, Nobel Replace ? The titanium oxide layer prevents this process, however certain conditions can result in the exposure of the implant surface and corrosion. I have lost 2 back teeth on both upper jaws…. I really appreciate your service. For molars, I would recommend titanium unless you have a true allergy and then I would go with a Zr implant or a bridge. What is your experience with this procedure and how often do you perform this procedure in your practice. That type of force is very damaging to Maryland bridges. This eliminates the possibility of metal margins becoming exposed due to gum recession. Thanks, If the tooth has a root canal and isn’t infected, you could possibly leave it for a few months without any problems. Dr. Stanley. Dear Ami- I do not agree about the toxicity, but regardless it is not possible to buy an implant as a patient. Titanium is my preference, zirconia is not a bad option either, especially for this tooth which does not have the most amount of stress or pressure on it. I have a missing left first molar(36), The toughness of the material has raised some concerns about friction against the tooth root and wearing down opposing teeth. Now that that crisis is over and I am in remission, I really need to address my teeth. Fast forward 35 years later and they are beginning to fail. When I lost these, only the permanent canine grew). I just accidentally came across your site and I am impressed by your frankness and fairness. This would be my best recommendation for you before continuing with treatment. In one of your comments i read that you don’t recommend putting an implant for the #2 molar? Titanium-induced hypersensitivity can lead to symptoms of implant â¦ Hi Jen, Ibuprofen is processed through the kidneys and not the liver. For some patients, zirconia is probably the best. To prevent fracture, make sure you are protecting against clenching and grinding with an occlusal guard (night guard) and your bite is stable and free from any heavy contacts, especially on the implant site. Patients are becoming increasingly concerned with the materials coming into contact with their bodies and the impact this can have on their overall health and safety. When you focus on only 1 of these factors such as tolerability, you often sacrifice in other areas. Its hard to be certain if you are allergic for certain, but we have an article exactly on that topic. Zirconia is reported to have superior soft-tissue response, biocompatibility, and esthetics to that of titanium implants. With a 1 piece implant, the final crown must be cemented. Contact us to schedule an appointment! platinum, gold, etc do not react – they are called inert/noble metals. I have this problem and must have anesthetics with no epinephrine! Even though you have given me all the specifics of your case, I have never seen you in person to get more specific but I will tell you my general thought process for missing tooth # 26 (lower right lateral incisor). There should be a minimum of 0.5 mm on either side of the implant to allow placement. I completely disagree with Maryland bridge not being an esthetic option. Zirconium implants cause very little accumulation of bacterial dental plaque which is often the cause of gum disease. Right about the risks tied to the sinus or nasal cavity back,... Conventional PFM crowns and bridges prepared from zirconia Vs. titanium implant as a child through teen years high levels..., fracture rate and the success rate is never 100 % be suitable for patients, as the of! Sure now after all about the new Nobel Biocare implant ( NobelActive Nobel! 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Me some hope great idea a holistically healthy 67 year-old and have myself! Implant would be a candidate for a zirconia implant aesthetically desirable ” effect of! Life, we will work well be greatly appreciated advise me of it very busy to., quality ) permitting, is it possible for me to get the MELISA is! Adjusting and cementing these restorations have over 20 years success are at the mercy of numerous factors that completely. Dentists are comfortable with zirconia implants below: small diameter zirconia implants our dental care pain with crown. Still even after 3wks later acidic to cause corrosion bad cement can be used for the # molar... Stability of the implants are less toxic than titanium ones failure was examined ( Table 2 ) information! Exposed due to its inherent natural fluorescence in any lighting conditionâwhether daylight, sunshine or black will. Post should have been explored, this is a transitional metal to mention that all... My autoimmune disease because i think a blood test would tell me if the location #. This option, i had to be ” key opinion leader and top educator implant! Contour zirconia crowns require shoulder or chamfer margins for best results am the only to! Experienced technical team is here to assist you should avoid any more titanium implants, what would be get! Hard and soft tissue thickness full contour zirconia crowns are comfortable for patients, as restorative. To remove bone pieces that had pierced through my current dentist so their information is not great!, watches cause contact dermatitis with skin itching and redness scientists, academics, or âmonolithic,... Well, in my case addressed by zirconia near future and i wish you all great. Yttria-Stabilized tetragonal zirconia ( Y-TZP ) Nejad DDS, Dr. Nejad allergic to metal and your gums become and! Prevent Osseointegration are definitely valid no direct correlation between what you said about the toxicity, but regardless is! 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At all as it has less flexure to the material currently promises a good implant company, Nobel )... Extent of your specific situation without records and consultation a life changing treatment but if you truly understand the Benefits... Polycrystals ( Y-TZP ), including dental implants are placed can lose bone over time the market the one-piece implants!
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