I was trained in dental implants in the mid-80s when they first came to the United States. Those were all titanium Branemark implants. Shortly after that, a number of other implants came to market with titanium alloy taking the place of pure titanium. We started using ceramic coated implants in the 1990s for certain applications and we had generally good luck with them. The advancements including sand blasted roughened titanium surface and improvements in the thread and surface configuration of the implants brought us back toward titanium alloy as being an ideal material.

The ceramic implants have always been out there and frankly, I have not seen any particular long term problems with any of the implant types that I have placed ceramic or titanium. There is an intuitive feeling that any implant surface that might be exposed even with some minor bone loss would be a harbor for microorganisms and cause progressive problems (and that would be the thought with a material like ceramic). Frankly, we just have not seen that. Overall, the long term success rate with all of implants has been excellent.

That brings us full circle around to the use of Ceramic Zirconia as an implant material instead of titanium. The beauty of it is that it is a white material and it does not show any dark area either through the bone or along the gingival margin, even if there is some bone loss.

I have not seen this technique yet, but I imagine that in the near future we will extract a tooth, take a cone beam scan of the socket, and then immediately mill a one piece dental implant and crown or dental implant with a prep using a CAD-CAM technique that would insert tight into a tooth socket that has been otherwise prepared to receive an implant, probably with some freshening of the surface or use of a healing interface such as PRGF. We could certainly even build in a roughened surface or retention grooves on the ceramic which would create a friction grip into the socket for secure placement.

We have tried contoured implants in the past which were designed to help maintain the papilla bone (bone and tissue spikes between the teeth). This was not successful, but I would imagine that a precision computer generated ideally contoured implant using ceramic material would have great promise. I am an innovator, but I am not a researcher or developer. I am an experienced surgeon who looks forward to this technology catching up with our dreams.