We get a lot of questions about ceramic implants. There are many implant systems and companies who make implants. At this time there are many companies in Europe making ceramic implants. In the United States there are currently three companies. Z-Systems, Strauman and Ceraroot. We currently use Z Systems. In the near future Swiss Dental Systems will have approval by FDA for use in the United States.

I had Swiss Dental System implants placed in my mouth one year ago while attending the Europeon ceramic implant meeting. I know the creator of these implants and have been trained in their use. They are similar to the Z Systems implants that we are currently placing in our practice.
There are reasons that both dentists and patients do not want the titanium implants that are more common. These range from improved esthetics with Zirconia implants, concerns about allergy to metals. Some titanium implants contain up to 6 % aluminum. According to Vera who developed the Melissa test for allergies titanium implants contain up to 20 trace elements that some people react to in very minute amounts. Another concern that some people have is electro galvanism. When dissimilar metals are in contact with each other or solutions like water or saliva a current is generated. I have practiced metal free dentistry for many years because of my own sensitivity to metals in my mouth.

There are two procedures for placing dental implants, “Delayed” is the most common. This is when the tooth is removed and A bone graft is placed in the clean socket. It then heals from two to six months or more. Then an implant is placed. Once the implant is placed it needs to be integrated to the bone. This process can take 3-6 months. Then a crown is placed onto the implant. Again we use all ceramic implants so no metal is present in the implant or crown. Immediate implants are also another option. This type of implant is placed when the tooth is removed or extracted. In either type there has to be enough good quality and quantity of bone for a successful placement.
There are one piece ceramic dental implants and two piece ceramic implants. The included photographs I am showing are of a one piece ceramic implant. There are advantages and disadvantages with each type. Whether it is a one piece or two piece implant, a dental implant crown is needed once the implant is integrated with the bone. In some immediate implants a temporary crown can be placed at the time the implant is placed in the mouth. This is the type I had placed in my mouth.

The following case shows a Delayed ceramic implant. The patient came to me with a missing tooth. The implant was placed and the photograph is from right after the implant was placed. Note there is virtually no bleeding. Most of the time minimal or no pain medication is needed. In my personal case I took no pain medication as it did not hurt beyond a little soreness. This is common for most our patients.
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Missing Tooth

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Surgically Placed Implant

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X-ray of Implant Placed

The x-ray shows how the implant looks in the bone. There are threads similar to a wood screw. At the time of placement this is mechanical placement. Over time the implant is integrated to the bone.

The next photograph shows the final porcelain crown cemented to the zirconia implant and below it is the x-ray showing the implant and crown together. The patient was very happy with the look of the new crown.

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Cemented Implant Crown

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X-ray of Implant and Crown

The last two photographs shows one of the advantages of the zirconia implant. In the first photo notice how natural the crown and gum tissue appears in the mouth. Can you find the implant? Now notice the next photo is a titanium implant placed by another dentist. The crown looks nice but the final result is limited by the metal in the titanium implant. See how the metal shows through the gum. This happens when the gum tissue is thin over the implant. With zirconia implants the results can be far more aesthetically pleasing.

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Implant dentistry is complex. It is highly successful and many factors need to be considered on an individual basis. Planning is essential to success in dentistry. An evaluation involves a thorough review of your health history, an examination including gums, teeth and bite, and comprehensive x-rays that also includes having a 3 D x-ray called a CBCT.

Hope you enjoyed this educational tour of implants.

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