Although titanium implants have the longest traceable record of predictable clinical performance and by far the widest diffusion in the market, some drawbacks have been recently pointed out. Titanium is not a completely bioinert material, since it may elicit allergenic reactions and is capable to diffuse not only within the adjacent tissues, which is proven by the elevated concentrations found in peri-implant bone and regional lymph nodes, but also systemically. Ceramic materials for oral application have been used for 40 years. Presently, the material of choice is yttria-stabilized tetragonal zirconia, which presents excellent mechanical and tribological properties together with biocompatibility. Concerns remain about the long-term durability of the material, owing to the report of in vivo failures that were caused by the low-temperature degradation of zirconia. To address this issue, research has developed improved oxide-based materials such as alumina–zirconia composites along with non-oxidic ceramics such as silicon nitride.
Part of the book: Dental Implantology and Biomaterial
Dental implantology has grown tremendously, since the introduction of titanium. To enhance osseointegration, roughening techniques such as grit blasting, chemical etch, electrochemical anodization have been used with good results. An oxide layer mainly composed of TiO2 covers the surface of dental implants ensuring excellent corrosion resistance and chemical stability. Despite its biological role in achieving bone interlock, surprisingly, little is known about the structure of TiO2, which may be either amorphous or crystalline. Furthermore, at least two crystalline polymorph phases can be found at the bone–implant interface: anatase (tetragonal) and rutile (tetragonal). Therefore, besides the recognized importance of surface topography, energy, and charge, a more refined knowledge of surface chemistry is advisable when studying the bone–implant interface. Recently, sophisticated analysis techniques have been applied to dental implants such as Raman spectroscopy and X-ray diffraction to obtain structural-crystallographic characterization.
Part of the book: Crystalline and Non-crystalline Solids