The best in biocompatibility – Luc Trevisan
Featured Products Promotional FeaturesPosted by: Dental Design 7th June 2018
Dental implants have grown in popularity among patients and are widely recognised as an effective solution to tooth loss. The type of materials used for implants play a crucial role in the long term success of treatment. In fact, the biocompatibility of implants determines how well they perform within the oral cavity. Practitioners should be able to identify different biomaterials used in modern dental implants, in order to formulate the most effective treatment plan for each patient.
In an attempt to replace a missing tooth, many biomaterials have been used in the design of dental implants, which date as far back as the Mayan civilisation. In 1931, archaeologists found the bones of a Mayan female in her twenties and discovered that she had three tooth-shaped pieces of shell placed into the sockets of three missing lower incisor teeth. It was believed by the archaeologists that these shells were placed after death, in a manner that had been similarly observed in ancient Egyptians. When Professor Amadeo Bobbio took radiographs of these specimens in 1970, he noted that compact bone had formed around two of the implants and came to the conclusion that they must have been placed when the Mayan woman had been alive. The concept of integrating foreign material with living tissue began to take shape.[i]
Stone and ivory had been used as dental implants in both Egyptian and Chinese culture. Gold was reported to have been applied in the sixteenth and seventeenth centuries, while lead, iridium, stainless steel and cobalt alloy are substances that were used in the early twentieth century. During this time, synthetic polymers, ceramics and metal alloys started replacing naturally derived materials in implant design because they delivered more predictable results.[ii]By the early 1980s, a Swedish orthopaedic surgeon had made a breakthrough and pioneered the discovery that titanium implants integrated with the surrounding bone without any significant reaction to hard and soft tissue.ii
Extensive clinical research and advancements in biotechnology have allowed implant systems to evolve from the early metallic systems to the modern day variety of biomaterial combinations. These biomaterials not only fulfil the functional requirements of a natural tooth but also improve the overall aesthetic result. For example, pure titanium (cpTi) is frequently used commercially as a reliable implant biomaterial. The success of titanium dental implants can be credited to its mechanical features and excellent biocompatibility, due to the formation of a stable oxide layer on its surface.[iii][iv]
However, there is an aesthetic issue surrounding titanium because of its grey colour. In almost all implant cases, there is some soft tissue recession, which results in components becoming visible under the gingiva. Some ceramic implant systems are considered to be aesthetically superior to their titanium counterparts and also known for accumulating less plaque, which offers an improvement in soft tissue management. However, properties including weak ductility and brittleness have limited the use of these ceramics in dental implantology.ii[v]
Consequently, research has focused on discovering tooth-coloured materials that are highly biocompatible, which improve the aesthetic appearance of dental implants and are able to withstand the harsh environment of the oral cavity – zirconia was found to have potential. Best known for its likeness to diamonds, zirconia is the crystal form of the transitional metal, zirconium. When treated, stabilised and converted into its crystal phase, zirconium becomes a zirconium oxide ceramic (zirconia). This ceramic material resembles a natural tooth’s colour and, unlike other ceramics, has a very high resistance to cracking and thermal expansion, making it ideal for application in implant dentistry.[vi]
However, technical failure as a result of the zirconia fracturing is still a major concern within the dental community. Therefore, the most effective implant system takes advantage of the properties exhibited by both zirconia and titanium. The TBR Z1 implant system available from Dental Express combines zirconia and titanium in one seamless component. Not only does it function like a natural tooth, the unique zirconia collar of the Z1 helps improve the overall aesthetic result, by encouraging the surrounding tissue to heal around the implant in a way that mimics natural gingival growth – so patients do not need to worry about receding gums and grey spots following implant placement. Dental implants have come a long way from their historic beginnings, but further research is essential in order to identify all the factors that determine the optimum success of implants. Practitioners require this knowledge so as to become better prepared at formulating effective treatment plans, which they deliver on the demands of implant patients.
For more information visit Dental Express at www.dental-express.co.uk, call 0800 707 6212 or learn more about the Z1 implant at http://z1implants.co.uk/and the full range of implants at http://dental.tbr-implants.com/en/
[i]Wikipedia. (2018) Dental implant. Link: https://en.wikipedia.org/wiki/Dental_implant. [Last accessed: 24.01.18].
[ii]Saini, M., Singh, Y., Arora, P., Arora, V. and Jain, K. (2015) Implant biomaterials: A comprehensive review. World Journal of Clinical Cases. 3(1):52-57. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295219/. [Last accessed: 24.01.18].
[iii]Cranin, A.N., Silverbrand, H., Sher, J. and Satler, N. (1982) The requirements and clinical performance of dental implants. Biocompatibility of dental materials. 4:92-102.
[iv]Tschernitschek, H., Borchers, L. and Geurtsen, W. (2005) Nonalloyed titanium as a bioinert metal—a review. Quintessence Int. 36:523-530.
[v]Gupta, S. (2017) Zirconia Promises Superior Strength and Aesthetics in Dental Implants. Link: http://www.dentistrytoday.com/news/todays-dental-news/item/2251-zirconia-promises-superior-strength-and-aesthetics-in-dental-implants?highlight=WyJ6aXJjb25pYSIsInppcmNvbmlhJ3MiLCInemlyY29uaWEiXQ. [Last accessed: 24.01.18].
[vi]Daou, E. E. (2014) The Zirconia Ceramic: Strengths and Weaknesses. The Open Dentistry Journal. 8:33-42. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026739/. [Last accessed: 24.01.18].
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