May 11, 2023 Tri Le Credit: Authority Dental. Dental implants are a marvel of modern medicine, offering patients a potentially lifelong solution to the problem of missing teeth that functions as well as it looks. Nevertheless, if you’re going to imbed something in your jaw, it’s perfectly reasonable to ask what its makeup is. Below we’re taking a somewhat deep dive into the materials used in the three components of dental implants so that you can be informed about and confident in your restoration. What are the Three Implants Parts Made From? A dental implant consists of: a post, or screw, placed in the jaw that fuses to the bone for a solid basean abutment, which acts as the connector between the post and the restorationa crown, also called a prosthetic or restoration, that looks and acts like the visible part of a natural tooth. For an implant, the “crown” could be an actual crown or a bridge or dentures. 3 components of a dental implant (top to bottom): restoration crown, abutment, and titanium post. Photo credit: Neville Desantis. With that in mind, here are the materials used for each part… What is the Implant Post Made From? Two main materials are used for implant posts: titanium and zirconium. Titanium has been used for dental implants since 1981 because of its high strength, light weight, durability, corrosion resistance, and biocompatibility, meaning it integrates well with surrounding gum tissue. It should be noted that the “titanium” so often used in posts is technically titanium alloy, commonly Titanium 6Al-4V ELI Grade 23. In other words, it is roughly 90% titanium, with other metals mixed in. This is used because alloys can be made even stronger than pure titanium and able to hold up to the demands that teeth must face. But this is also one reason why zirconium, or ceramic, is gaining ground as a chosen alternative in post material. Though rare, some patients may have metal allergies triggered by the presence of titanium in the mouth. Moreover, the other metals that may make their way into titanium alloy often include aluminum and vanadium. The presence of too much of these metals in the body can be a serious medical issue, and bacteria around the implant has been found to cause the metal to corrode. Research continues to support using titanium in implant posts, but for those concerned about allergic reactions, zirconium is more natural-looking than titanium due to its white color and is even more corrosion- and plaque-resistant. Drawbacks of zirconium include a higher cost, lower fracture strength, and less adaptability for different dental scenarios than titanium posts offer. What is the Implant Abutment Made From? As with implant posts, abutments are most commonly crafted from titanium and zirconium. Because the abutment is more likely to be visible in the mouth than the post, zirconium may be preferred over the more noticeable titanium. This can be either full zirconium or a combination of zirconium exterior (superstructure) and titanium, cast gold or cobalt chrome (also referred to as UCLA), or surgical grade stainless steel core, in what’s known as a hybrid abutment. In general, titanium is a good choice when a patient is replacing a single tooth at the back (posterior) of the mouth, which is the most common dental implant scenario, or if they have a low lip line and thick gums that can help mask the visibility of titanium. When the tooth replacement is in the front (anterior) of the mouth, shaded, custom zirconia abutments are ideal. One other abutment material is worth mentioning. A thermoplastic polymer called polyether ether ketone (PEEK) is a recent innovation that has shown promise for use in a wide variety of industries, including dentistry. Although PEEK trails titanium and zirconium in popularity, more dentists are starting to use it because of its excellent toughness and durability, its natural color, and its biocompatibility with both hard and soft tissue. What is the Implant Restoration Made From? When it comes to the “finishing touch” of the implant, ceramic is the most popular material, with porcelain being the most commonly used type of ceramic. It looks and feels the most like a natural tooth, although it is more prone to creating tooth sensitivity, and it’s a more expensive option than most. An offshoot of all-ceramic restorations is porcelain-fused-to-metal (PFM). This type combines the aesthetics of porcelain with the durability of metal by utilizing combinations of either precious (40% gold with palladium, platinum, silver, etc.), semi-precious (25% precious with tin, cobalt, zinc, etc.), or non-precious (cobalt, chromium, tungsten, etc.) metals as the core of the prosthetic. A potential drawback of PFM crowns is the gray line of metal that can appear at the gums if the gums recede. But they can be a sound option for long bridges where the metal is necessary for strength. And while PFM crowns are cheaper than all-porcelain, they carry the same risk of metal allergy as implant posts. A similar method to PFM is to use zirconia placed over titanium for a look that is similarly pleasing to the eye as porcelain, although color-matching teeth can be trickier. They are also a pricier option than some of the others. Another ceramic option is a lithium disilicate glass-ceramic called IPS e.max. Able to be used in crowns, bridges, and hybrid abutments, e.max is a high-strength alternative to zirconia with accurate tooth shade-matching and long-lasting performance. Of course, all-metal crowns such as full-cast gold remain a time-tested option that’s long-lasting and resistant to breaks and chips. High precious metals prices and the fact that they don’t look like real teeth make them best for one-off implants in out-of-sight tooth locations, i.e. molars. Finally, all-resin dental crowns are a cost-effective option, but because they are more prone to fractures than PFMs, they tend to be restricted to use in temporary crowns. When it comes to dentures, however, acrylic resin is a lighter, less expensive alternative to porcelain false teeth. Are Dental Implant Materials Safe? Since we’ve touched on risks such as allergies, you may wonder what safety standards are in place for implant materials. The U.S. Food and Drug Administration (FDA) is responsible for overseeing dental implant systems’ safety. The FDA in turn relies on international consensus standards such as International Organization for Standardization (ISO), ASTM International, and American National Standards Institute (ANSI) in evaluating new dental implant systems for market. These standards are numerous and cover issues such as fatigue testing, shear testing, tension testing, and shear & bending fatigue testing. In these tests, implants are evaluated at maximum abutment angulation (or worst case scenario), to maximum load and beyond, and in environments meant to mimic the mouth. So as it relates to the mechanics of implants, products are “put through the ringer.” Biocompatibility testing is also done to show that a material’s use doesn’t cause complications such as irritation or allergic reaction in most–but not all–people. What Implant Materials Are Best? All things considered, most patients will likely end up with titanium or zirconium implants as these are the industry standards. But your dentist can discuss all the options with you to consider your budget, your age, the health of your teeth and whether you grind them, and more. These factors may make you a good candidate for a lesser-used material. Getting Implants at Bunker Hill Dentistry Dental implants require a level of skill that combines technical prowess with artistry. You’ll find that Dr. Le and our team deliver the expertise necessary to help replace missing or damaged teeth and renew your smile. Learn more about our implant services. Tri LeA practicing dentist since 1987, Dr. Le has been running successful dental practices in Texas with his wife Ann since 1990. A member of the ADA, AACD and AADSM, Dr. Le has also contributed to several leading dental journals.