Zirconia Vs. Titanium

Originally the first dental implants (1980’s) had two parts: the fixture (which goes screwed into the bone) and the abutment (where the prosthetic crown is cemented).

The improvements in new ceramic materials made it possible on 2000 to have the abutment part made of ceramic. This material was commonly known to be more tissue friendly than titanium.

In 2005, the CeraRoot full ceramic implant (fixture and abutment in one body/part) was introduced into the European market and in 2011 accepted by the FDA to be used in U.S. dental clinics. The main advantage of a one-piece zirconia implant is that it has no prosthetic connections, where bacteria can grow, and therefore have better gum health. Another big advantage is that the implant is 100% white. This means that no metal will ever be visible when smiling or communicating with other people.

Titanium is a metal, and suffers corrosion.

Corrosion, the gradual degradation of materials by electrochemical attack is a concern particularly when a metallic implant is placed in the hostile electrolytic environment provided by the human body.

The term corrosion is defined as the process of interaction between a solid material and its chemical environment, which leads to a loss of substance from material, a change in its structural characteristics, or loss of structural integrity.

The clinical importance of degradation of metal implants is evidenced by particulate corrosion and wear products in tissue surrounding the implant, which may ultimately result in a cascade of events leading to periprosthetic bone loss. Furthermore, many authors have reported increased concentrations of local and systemic trace metal in association with metal implants.

Zirconia is a ceramic and does not suffer any corrosion.



Throughout the decades, the materials that have been used for the dental treatments have been made with metal. The main reason was to give mechanical strength and therefore augment the longevity of the treatment. Overtime, the scientific research contributed enormously to the improvement of the ceramic’s mechanical strength. In the beginning, ceramics were introduced into the patients mouth because of it’s fabulous esthetic properties. However, the latests research shows that the esthetic is not the most important characteristic of this material. Ceramics due to its inert, non-corrosive and nonallergic properties, it is actually many times more beneficial to the patient than any other dental material ever made. We encourage patients to demand treatments without metal. Metal-free treatments. All-ceramic treatments.



WHAT TO KNOW ABOUT TITANIUM (metal implants)

Titanium allergy is barely recognized in mainstream medicine – yet laboratories using the MELISA® technology have reported that about 4% of all patients tested to titanium will be allergic to it (Valentine-Thon E., et al. “LTT-MELISA® is clinically relevant for detecting and monitoring metal sensitivity”. Neuro Endocrinol Lett 2006; 27(Suppl 1):17–24). For those affected with titanium allergy, the symptoms can be multiple and bewildering. These can range from simple skin rashes to muscle pain and fatigue.

From foodstuff to medicine, titanium is now an everyday metal. Several brands of candy, such as Skittles and M&M, have titanium dioxide in the coating – often described by its E-number: E171. Some brands of toothpaste contain titanium particles. Hospitals use titanium implants to rebuild bones after accidents.

More than just a rash: the effects of titanium allergy

Like all metals, titanium releases particles through corrosion. These metals become ions in the body and bind to body proteins. For those who react, the body will try to attack this structure. This starts a chain reaction which can lead to many symptoms including Chronic Fatigue Syndrome. The MELISA® test is the only scientifically-proven test which can objectively diagnose titanium allergy and measure its severity.

Those who test positive are advised to avoid exposure if possible. This may include switching to titanium-free toothpaste and cosmetics, or in some cases, consider removing a titanium implant from the body.

Titanium: where to find it

Titanium dioxide (TiO2) is widely used in consumer products, as it is non-toxic – even though it triggers allergies in certain people. It is known as a “pearling agent” as it makes paper and paint glossy and white. Always check the content of food stuff, pills and cosmetics for titanium dioxide. It is found in the following:
Body implants, such as Brånemark (for teeth) or to rebuild bones.
Dentistry: as a color pigment in composites
Sunscreen agents: Finely ground titanium dioxide will block the harmful ultraviolet rays from the sun.
Confectionery: Used to make candy look brighter and adding a crunchy coat to for example chewing gum.
Cosmetics: Used to brighten and intensify the color of make-up. It is regularly found in shadow, blush, nail polish, lotions, lipstick and powder.
Toothpaste: Used as a pigment agent to make the toothpaste whiter.
Paint: TiO2 will improve the durability of coatings and gives white color.
Plastic carrier bags: Improves durability and gives white color.
Medical pills and vitamin supplements may also get their white coating from titanium dioxide.
Piercing & Jewelry: For example watches and all types of body piercing. Fewer people are allergic to titanium than for example to nickel.
Titanium polluted with nickel
Several studies show that titanium alloys contain traces of nickel as a result of the production process. This can pose trigger health problems in patients with nickel allergy, and also mean that a reaction may be falsely attributed to titanium itself.





Do you suspect you have titanium allergy?

If a health problem starts after you have received a titanium implant it is possible that you are allergic to titanium. You can take a MELISA® test for titanium allergy through one of the clinics we cooperate with or send a sample to a laboratory. If you are planning to have a test before receiving a titanium implant it is advised to find out the exact composition of the implant. Vanadium, aluminium and other metals are sometimes added to improve the properties of titanium implants, and allergy to these metals can also be tested.

How about clinical studies?

The articles Hypersensitivity to titanium: Clinical and laboratory evidence and LTT-MELISA® is clinically relevant for detecting and monitoring metal sensitivity published in 2006 can be downloaded from our Article page.

In the former article fifty-six (56) patients who had developed clinical symptoms after receiving titanium-based implants were tested in MELISA® against 10 metals including titanium. Out of 56 patients, 54 were patch-tested with titanium as well as with other metals. The implants were removed in 54 patients (2 declined explantation), and 15 patients were retested in MELISA®.

Of the 56 patients, 21 (37.5%) were positive, 16 (28.6%) ambiguous, and 19 (33.9%) negative to titanium. In the latter group, 11 (57.9%) showed lymphocyte reactivity to other metals, including nickel. All 54 patch-tested patients were negative to titanium. Following removal of the implants, all 54 patients showed remarkable clinical improvement. In the 15 retested patients, this clinical improvement correlated with normalization in MELISA® reactivity.

The conclusion of the article is that these data clearly demonstrate that titanium can induce clinically relevant hypersensitivity in a subgroup of patients chronically exposed via dental or endoprosthetic implants. Below, you will also find several articles which discuss the issue of corrosion of titanium implants and possible reactions due to hypersensitivity.

source: http://www.ceraroot.com/patients/zirconia-vs-titanium/

Why Implants are better than bridges

Teeth replacements have come a long way in the last 30 years. Missing or extracted teeth raise common concerns of infection, but the proper replacement is the key to a confident smile. Today, however, the questions you need to ask your dentist or prosthodontist are a bit different: What's the difference between a dental bridge vs. implant? Which treatment option is right for me? Very often the dental implant is ideal, but numerous factors will need to be considered first, including if your tooth loss is recent or happened years ago.
Practical Reasons for Both

In the past, a bridge was your only choice, and still involves more than just the missing tooth. The adjacent teeth need to be "prepped" by removing most of the enamel in order to fabricate the bridge. With dental implants, however, the dentist replaces just the individual tooth for a result that is stronger and permanent. Nonetheless, a dental bridge may be your best option if the neighboring teeth have large fillings and need crowns or caps in the future. And if the tooth or teeth have been lost for a long time, the gum and bone will have receded and procedures beyond the implant are required before placement. The advantages and disadvantages to both procedures can ultimately be discussed with your dentist.
Changes in Your Oral Care Routine

Your ability to keep your mouth healthy will be easier with an implant. Dental bridges are cemented or "fixed" in the mouth, and involve at least three crowns connected together to fill the space of the missing tooth. This design creates challenges when brushing and flossing, so extra oral hygiene instruction and meticulous home care are crucial. When flossing, in particular, an additional step is needed to thread the floss under the false tooth. More inclusive toothbrushes such as Colgate® 360°® Total® Advanced Floss Tip Bristles may be helpful under the circumstances. In contrast, implants can replace teeth individually without affecting other teeth, making regular home care more successful. You can effectively brush and floss around an implant just like your natural tooth.
Durability

Dental implants are more durable than bridges, allowing them to provide protection that lasts a lifetime. The implant's metal cylinder is normally made of titanium, according to the American Academy of Implant Dentistry (AAID), and this material fuses with your jawbone naturally through a process called osseointegration. Because it's made of such a strong metal, they are very resistant to decay and gum problems. The average life of a dental bridge, on the other hand, is approximately 10 years. A portion of your natural tooth remains beneath it and normal wear may cause the bridge to fail more easily over time. In general, the remaining tooth structure continues to be susceptible to decay and gum disease.
Aesthetics

What about aesthetics? There isn't always a simple answer, but your dentist or prosthodontist – the latter specializes in crown, implants and bridges – will be able to advise you. Often the implant will provide the most pleasing result, as your dentist can make the final tooth look just like your natural enamel. Sometimes, an implant can be placed immediately after a tooth extraction, preserving the natural level of bone and improving the final appearance of the dental work.
Dental Bridge vs. Implant Cost

The cost of the dental bridge is initially less, but it may need to be replaced at some point in the future. Implants – from preparation to final placement – may seem more expensive, but over time can be more cost-effective. Fortunately, most dental insurance providers are paying for a portion of or all of the steps involved. In addition, implant treatment can be more flexible, allowing patients to budget the cost in increments. After extraction, for example, a bone graft is sometimes needed. This graft typically has to heal for several months before implant placement, at which point osseointegration can take anywhere from three to six months before the process is complete.

So, dental bridge vs. implant? Make this decision after consulting with your dentist. He or she knows your mouth best and has the tools and knowledge to guide you through what's best for it. Although bridges are an older procedure, dental implants have become more commonplace over the years, and in most cases are the preferable treatment both in time and expense.

Dental Braces

If you have crooked teeth and/or a misaligned bite (an underbite or overbite), there are a variety of treatments that can help straighten teeth, including braces and retainers.

Many general dentists are doing basic alignment and orthodontics, but orthodontists specialize in correcting irregularities of the teeth.

The dentist or orthodontist you choose will ask questions about your health, conduct a clinical exam, take impressions of your teeth, take photos of your face and teeth, and order X-rays of the mouth and head. An appropriate treatment plan is made based on analysis of the gathered information.

In some cases, a removable retainer will be all that's necessary. In other rare cases (especially when there is an extreme overbite or underbite), surgery may be necessary. In most cases, however, braces will be needed.

What Types of Braces Are Available?

If braces are indeed the solution for you, the dentist or orthodontist will prescribe an appliance specific for your needs. The braces may consist of bands, wires, and other fixed or removable corrective appliances. No one method works for everyone.

How Do Braces Work?

In their entirety, braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction. As the teeth move, the bone changes shape as pressure is applied.

Braces are made up of the following components:

Brackets are the small squares that are bonded directly to the front of each tooth with a special dental bonding agent or are attached to orthodontic bands. Brackets act like handles, holding the arch wires that move the teeth. There are several types of brackets, including stainless steel and tooth-colored ceramic or plastic, which are often selected because they’re less obvious. Occasionally, brackets are cemented to the back of teeth, in order to hide them from view.
Orthodontic bands are stainless steel, clear, or tooth-colored materials that are cemented to the teeth with dental bonding agents. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands are more cosmetically appealing options but are more expensive than stainless steel. They are not used in all patients. Some people have only brackets and no bands.
Spacers are separators that fit between teeth to create a small space prior to placement of orthodontic bands.
Arch wires attach to the brackets and act as tracks to guide the movement of the teeth. Arch wires can be made of metal or be clear or tooth-colored.
Ties are small rubber rings or fine wires that fasten the arch wire to the brackets. They can be clear, metal, or colored.

A buccal tube on the band of the last tooth holds the end of the arch wire securely in place.
Tiny elastic rubber bands, called ligatures, hold the arch wires to the brackets.
Springs may be placed on the arch wires between brackets to push, pull, open, or close the spaces between teeth.
Two bands on the upper teeth may have headgear tubes on them to hold the facebow of the headgear in place. (A headgear is another tool used by orthodontists to aid in correcting irregularities of the teeth; see below)
Elastics or rubber bands attach to hooks on brackets and are worn between the upper and lower teeth in various ways. They apply pressure to move the upper teeth against the lower teeth to achieve a perfect fit of individual teeth.
Facebow headgear is the wire gadget that is used to move the upper molars back in the mouth to correct bite discrepancies and also to create room for crowded teeth. The facebow consists of an inner metal part shaped like a horseshoe that goes in the mouth, attaching to buccal tubes, and an outer part that goes around the outside of the face and is connected to a headgear strap.

Newer “mini-braces,” which are much smaller than traditional braces, may be an option for some. There is another method of straightening teeth that uses removable plastic retainers that may also work when crowding of the teeth is not too severe. Your orthodontist will discuss the various types of braces with you and determine which might be the best option for your situation.

How Long Will I Have to Wear Braces?

The time required for braces varies from person to person, depending on the severity of the problem; the amount of room available; the distance the teeth must travel; the health of the teeth, gums, and supporting bone; and how closely the patient follows instructions. On average, however, once the braces are put on, they usually remain in place for one to three years. After braces are removed, most patients will need to wear a retainer all the time for the first six months, then only during sleep for many years.

How Often Will I Need to See the Orthodontist During Treatment?

Your orthodontist will want to see you about every month or so in order to make sure the braces are exerting steady pressure on the teeth. To create more tension and pressure on your teeth, the orthodontist will make adjustments in the wires, springs, or rubber bands of the braces. In some cases, braces alone aren't enough to straighten the teeth or shift the jaw. In these situations, an external appliance, such as headgear, may need to be worn at home in the evening or through the night.

Will Braces Be Painful?

Some of the adjustments your orthodontist may make to your braces may make your mouth feel sore or uncomfortable. When needed, over-the-counter pain relievers like Motrin or Tylenol can help relieve the pain. If you always experience a lot of pain after your braces are adjusted, talk to your orthodontist about it; he or she may be able to make the adjustments a bit differently.

Does the Age Affect the Success of Braces?

The mechanical process used to move teeth with braces is the same at any age. So the benefits of orthodontic treatments are available to both children and adults who wish to improve their appearance and bite. The main differences between treatments in adults and children is that certain corrections in adults may require more than braces alone and the treatments may take longer because adult bones are no longer growing.

Can I Continue to Play Sports While Wearing Braces?

If you have braces, you can continue to participate in any sport you choose. When playing sports where there is a possibility of getting hit in the mouth, a specially designed mouthguard will need to be worn. The mouthguard, made of durable plastic, is designed to fit comfortably over your braces and will protect the soft tissues inside the mouth.

What Care Can I Expect After the Braces Come Off?

After braces are taken off, your teeth will be thoroughly cleaned. Your orthodontist may want to take another set of X-rays and bite impressions to check how well the braces straightened your teeth and to see if any wisdom teeth have developed. If wisdom teeth are beginning to come in after braces have been removed, your dentist or orthodontist may recommend the wisdom teeth be pulled to prevent newly straightened teeth from shifting.

Your dentist or orthodontist will also fit you with a retainer. A retainer is a custom-made, removable or fixed appliance that helps teeth maintain their new position after braces have been removed. Retainers can also be used to treat minor orthodontic problems. The use of a retainer is a very important part of post-braces care. Retainers, which are typically made of rubber or clear plastic and metal wires that cover the outside surface of the teeth, need to be worn all the time for the first six months and then usually only during sleep. The time frame for wearing a retainer will vary from patient to patient. The reason why a retainer is needed is that even though braces may have successfully straightened your teeth, they are not completely settled in their new position until the bones, gums, and muscles adapt to the change. Also, after long periods of time, teeth tend to shift.

Source: http://www.webmd.com/oral-health/guide/braces-and-retainers#1

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