Losing a tooth can be dreadful. Missing teeth may lead to detrimental changes to mind, body, appearance, speech, overall health, and longevity.  But sometimes for the sake of overall health, we must make the hard choice and remove a tooth. This is especially true in biological dentistry where removal of root canal treated teeth is a primary goal. Luckily, recognizing the importance of a complete and stable bite, dentistry provides a handful of technologies to replace missing teeth: bridges, dentures, and implants.

Dental implants are the most ambitious, with the promise of long-lasting function and esthetic results. Today's dental implants can be metal or metal-free.  Some applications even combine metal and non-metal parts.

Titanium Implants are versatile and have a long track record.  They've been in use for about 40 years.  Ceramic implants are newer, in use since about 2005 in Europe and since 2011 in the USA.

Both types are still actively researched technologies that continue to evolve.  Both are available from multiple manufacturers, but since titanium has been around longer, it comes in a wider variety of brands and styles, and most dentists or oral surgeons have more experience placing titanium.

Titanium implants are not pure titanium. They're an alloy (a mix) which always contains nickel, a common allergen. Recent studies have revealed that nickel exposure can lead to cancer. Titanium itself is a metal that easily reacts and oxidizes.  In fact, titanium is chemically weak to acid, to oxygen, and even to fluoride.  What this means is that when your implant is exposed to any of these reactants, titanium readily leaches off in the form of titanium ions, salts, or oxides.  This can cause health consequences.  Titanium dioxide is also a known carcinogen, a potential allergen, a hapten, an immune disruptor, a lymph disruptor, and more. Listed are some relevant scientific references:

◦ Titanium Allergy: A Literature Review -- NCBI
◦ General Review of Titanium Toxicity -- NCBI
◦ Biological Responses to Metal Implants -- FDA

And here are some facts about titanium:

◦ Titanium particles trigger inflammation
◦ Titanium is banned in some countries
◦ Tissues surrounding titanium implants express levels of dangerous cytokines (RANTES / CCL5) that are 30 times higher than normal

Because of titanium's toxicity, a state of perpetual inflammation is created around the implant and in the lymph nodes. The body attempts to protect itself from this inflammatory foreign object by surrounding it with a sclerotic, bony layer.  The jawbone "encases" the implant. And, ironically, the implant is retained (held in) quite well.  This is why titanium implants work -- due to the body's inflammatory reaction to them.

The end result is a new tooth that feels great, looks great, and restores the jaw to proper function. However, issues like chronic inflammation, the perpetual lymphatic burden of metal byproducts with subsequent immune disruption, galvanism, and interference with meridians (more on this later) can detract from health.

Zirconia is a ceramic made mostly of zirconium oxide.  Unlike titanium, zirconia is non-reactive.  It is invulnerable to acid, oxygen, fluoride and other potential reactants.  Therefore, unlike titanium, zirconia is biologically inert. It does not inflame soft tissue or bone. It does not "force" the body to provide any sort of inflammatory or biological response.

To integrate, bone must grow around and "into" the zirconia implant.  Since there's no inflammatory stimulus, bone growth and integration will occur naturally, almost passively, or even peacefully.

Zirconia is one of the very few known materials that fibroblasts will attach to. This means your gums grow and adhere to zirconia implants, sealing any connection from the mouth to tissues deeper down, just like a natural tooth. Titanium could never do this!

Given zirconia's biological process, understanding "mineral management" is helpful for optimal results.  The biological protocol is a bit too involved for a short article like this one, but your biological consultation will spend plenty of time on this important topic to best prepare you for successful ceramic implants.

The end result is a biocompatible replacement tooth that not only restores proper jaw function, but does so by keeping bone and gums healthy and meridian flow open.

And last but not least, well-integrated ceramic implants are beautiful and provide dependable, healthy function.

When using proper biological protocols, zirconia is extremely successful, and even more successful than titanium -- especially long-term, and especially in regards to health. In fact, a 2023 study showed that zirconia implants enjoy a 15-year success rate of 98.69%. In contrast, titanium dental implants have a 93% success rate after only 10 years.

Both titanium and zirconia have high success rates when placed correctly.  Placing titanium is easier with no "holistic" requirements, and no consideration for long-term health.  Placing zirconia is harmonious to good overall health and aims to preserve long-term health.

Titanium implants generally harbor bacteria and suffer from chronic inflammation. Zirconia is biocompatible and demonstrates amazing and healthy tissue response.

Zirconia is the healthier choice.  Titanium is the default choice.

It is important to understand that they should not be considered interchangeable choices.  They are different treatment options that belong on completely different paths. Only zirconia should be a part of your biological journey.