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Introduction: Titanium implants are the gold standard, but due to problems with
aesthetic and structural components, there has been an increase in research for
zirconia implants. They have ivory color, good biomechanical characteristics, and
a satisfactory survival rate. Thus, this study's goal was to systematically verify the
literature to compare the osseointegration levels between titanium and zirconia
dental implants, shown through histological analysis.
Material and Methods: This review was conducted following the PRISMA
guidelines and was registered in PROSPERO. Electronic and manual searches
were carried out through PubMed/Medline, PMC, and Embase databases, with a
platform-specific search strategy combining controlled terms (MeSH and Emtree)
and text words. The selection of articles was carried out by two independent
investigators and Cohen's kappa coefficient was used to assess the agreement,
which was then evaluated using the defined inclusion and exclusion criteria.
Results: From the initial 271 abstracts screened, 17 articles were included for
full-text reading. All of them were preclinical in vivo studies that compared the
osseointegration level between zirconia and titanium implants. A total of 370
titanium implants (Ti) and 537 zirconia implants (Zr) were evaluated. The
percentual average of osseointegration for Zr was 55.51% (min. 17.6% and max.
89.09%), whereas Ti was 58.50% (min. 23,2% and max. 87.85%). There was no
statistical difference between studies at 2 months of histomorphometry (p =
0.672). While for the studies analyzed at 1 month and 3 months, statistically
significant data of p < 0.001 were found for both.
Conclusion: Zirconia implants have presented a similar level of osseointegration
compared to titanium implants. Therefore, based on results on osseointegration
it was conceivable to conclude that Zr implants are a viable choice for oral
rehabilitation. Nonetheless, because these findings are based on preclinical
research, all data must be thoroughly examined, and clinical trials evaluating
osseointegration of Ti and Zr implants are required.
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Dental implants Osseointegration Systematic review