First off, I will advise you before you start reading that this is an opinion piece and I am just giving you my experience, although in our practice we have extensive experience in the use of both titanium and ceramic implants. The “reintroduction” of ceramic implants in our practice is what brought on this blog post.

Ceramic implants were developed to meet increasing patient desire to achieve natural-looking esthetics. The “new” ceramic implants are milled from zirconia (atz). We use the NobelPearl Implant. It is a 100% metal free white ceramic implant that gives a natural soft tissue appearance upon placement because of its color. There is a study from 2014 that shows that the soft tissue around zirconia implants presents a better color match to the soft tissue of natural teeth when compared with titanium which may give a darker color to the tissue, especially if there is bone loss or tissue recession over time. Zirconia implants are especially beneficial to patients with a thin gingival biotype or thinness to the gums around the teeth. In fact, the tissues around the zirconia implants have been shown to be comparable to those around natural teeth in esthetics. These implants are designed for a low inflammatory response. Zirconia has also demonstrated a low plaque affinity as well.

We have been placing dental implants for over 30 years. In our practice we have used ceramic coated implants in the past, but with the use of zirconia, because of its strength, we are now able to use an implant completely made out of ceramic rather than the previously used ceramic fused to metal. For the sake of discussion, the previous technology worked well and we have hundreds of these implants placed that are still functioning well. We feel the new technology is even better, again with a metal-free alternative when making your implant choices.

The advantages of the all-ceramic implant are that it has a homogenous color, the studies have shown that the gum response around these implants is favorable, the tendency is to have a better height of the gum point between the teeth (interdental papilla), and a reduced inflammation in the gingival sulcus or the gums around the implant crown. Each of these points are based on studies and in our practice we have not had these implants in use for a long enough period of time to make this as a long term judgement. The plain truth is that patients are now seeking treatment with metal-free restoration options. It is my personal opinion that there is no problem with titanium and the use of titanium metal implants and in our practice we have never seen a problem with a patient having an adverse reaction to the material. However, with the superior esthetics that are offered with this new implant, and if it meets the patients’ desires for a nonmetal restoration, we are happy to provide this as an alternative.

One of the unique features of the NobelPearl Implant is that it has an innovative retention screw for the restoration which is made out of a carbon fiber reinforced polymer which gives a strong ceramic to ceramic connection. The ceramic material absorbs compressive forces and the screw withstands tensile forces due to the way they have designed the carbon fiber reinforced polymer.

These implants can be used for a broad range of applications including single tooth restorations and multiple unit restorations. It can also be used in guided surgery applications. We are excited to be offering these as an implant alternative in our practice and we continue to look forward to progress and advancements for the benefit of our implant patients.

nobel pearl ⋆ Dental House


The above posting is based off of the article Metal-Free Implant Solutions for Optimal Integration and Esthetics: NobelPearl Implants, Author: Nader K. Salib, DDS© Nobel Biocare USA, LLC.