Volume 20, Issue s4 p. 32-47

Are ceramic implants a viable alternative to titanium implants? A systematic literature review

Marina Andreiotelli,

Marina Andreiotelli

Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Freiburg, Germany

Hans J. Wenz,

Hans J. Wenz

Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany

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Ralf-Joachim Kohal,

Ralf-Joachim Kohal

Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Freiburg, Germany

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Marina Andreiotelli,

Marina Andreiotelli

Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Freiburg, Germany

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Hans J. Wenz,

Hans J. Wenz

Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany

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Ralf-Joachim Kohal,

Ralf-Joachim Kohal

Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Freiburg, Germany

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First published: 24 July 2009

https://doi.org/10.1111/j.1600-0501.2009.01785.x

Citations: 256

Correspondence to:
Ralf-Joachim Kohal
Hugstetter Straße 55
79106 Freiburg
Germany
Tel.: +49(761) 270 4977
Fax: +49(761) 270 4824
e-mail: [email protected]

Conflicts of interest:
The authors declare no conflicts of interest.

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Abstract

Aim: The aim of this systematic review was to screen the literature in order to locate animal and clinical data on bone–implant contact (BIC) and clinical survival/success that would help to answer the question ‘Are ceramic implants a viable alternative to titanium implants?’

Material and methods: A literature search was performed in the following databases: (1) the Cochrane Oral Health Group's Trials Register, (2) the Cochrane Central Register of Controlled Trials (CENTRAL), (3) MEDLINE (Ovid), and (4) PubMed. To evaluate biocompatibility, animal investigations were scrutinized regarding the amount of BIC and to assess implant longevity clinical data were evaluated.

Results: The PubMed search yielded 349 titles and the Cochrane/MEDLINE search yielded 881 titles. Based upon abstract screening and discarding duplicates from both searches, 100 full-text articles were obtained and subjected to additional evaluation. A further publication was included based on the manual search. The selection process resulted in the final sample of 25 studies. No (randomized) controlled clinical trials regarding the outcome of zirconia and alumina ceramic implants could be found.

The systematic review identified histological animal studies showing similar BIC between alumina, zirconia and titanium. Clinical investigations using different alumina oral implants up to 10 years showed survival/success rates in the range of 23 to 98% for different indications. The included zirconia implant studies presented a survival rate from 84% after 21 months to 98% after 1 year.

Conclusions: No difference was found in the rate of osseointegration between the different implant materials in animal experiments. Only cohort investigations were located with questionable scientific value. Alumina implants did not perform satisfactorily and therefore, based on this review, are not a viable alternative to titanium implants. Currently, the scientific clinical data for ceramic implants in general and for zirconia implants in particular are not sufficient to recommend ceramic implants for routine clinical use. Zirconia, however, may have the potential to be a successful implant material, although this is as yet unsupported by clinical investigations.

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List of excluded full-text articles and the reason for exclusion

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Citing Literature

Volume20, Issues4

Special Issue:European Association for Osseointegration; 19‐22 February 2009, Pfaffikon, Switzerland; 2nd Consensus Conference

September 2009

Pages 32-47

Are ceramic implants a viable alternative to titanium implants? A systematic literature review

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Are ceramic implants a viable alternative to titanium implants? A systematic literature review

Abstract

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