Why Don't We Recommend Zirconia For Full Mouth Dental Restoration?

The following insights reflect the professional experiences and observations of Dr. Vijah, who has navigated the evolving landscape of dental materials over his distinguished career. In this article, Dr. Vijah shares his journey from initial enthusiasm for Zirconia to a decisive pivot back to trusted materials like Titanium and PMMA, underscoring his unwavering commitment to patient health and successful dental outcomes.

Zirconia has been heralded as a groundbreaking material in dental prosthetics, particularly for full-mouth restorations. Its introduction into the UK market over 15 years ago marked a significant shift in dental material technology. As one of the early adopters of zirconia in the UK, I have observed its evolution first hand from 2005 to 2015, gaining unique insights into both its potential and limitations.

The Unpredictable Nature of Zirconia

My journey with zirconia began with enthusiasm but was tempered by the challenges inherent in its processing. The material itself is processed from a powdered form into a disc, which is then intricately cut to shape before undergoing a critical baking process. This involves heating it incrementally to temperatures as high as 1700 degrees Celsius and then cooling it back to room temperature. This cycle can last between eleven to eighteen hours, a painstaking process that revealed a fundamental issue: the inconsistency in the material’s density after baking, which I observed by examining cross-sections under an electron microscope.

Clinical Observations and Concerns

Despite manufacturers' claims of zirconia's durability and reliability, clinical studies and papers readily available online discuss its propensity for fracture and failure. My experiences align with these findings highlighting zirconia's excessive hardness, which becomes a critical flaw when used in dental implants. In natural teeth, the periodontal ligament acts as a shock absorber, dampening the forces of chewing before they can impact the bone. However, dental implants lack this natural shock absorption system. When a material as hard as zirconia is used in implants, it transmits significant stress to the jawbone, potentially leading to accelerated bone loss and implant failure.

Transition to Alternative Materials

We conducted extensive testing with Zirconia, driven by its potential benefits and growing popularity in dental applications. However, as we delved deeper into its practical usage and observed its performance first hand, the shortcomings of Zirconia became increasingly apparent. Despite its aesthetic appeal, we encountered significant issues with its hardness and inconsistency after processing, which compromised its effectiveness as a shock absorber and heightened the risk of bone loss. These critical insights led us to the decisive action of discontinuing Zirconia as a future material choice in our practice. Our commitment to patient health and successful long-term outcomes necessitated a return to solely using proven materials like Titanium and PMMA, ensuring our treatments align with the highest standards of dentalcare.

The decision to cease using zirconia was not made lightly but was necessitated by a commitment to patient health over aesthetic claims. The dental field must continually evaluate the materials and technologies we use, ensuring they meet the highest standards of clinical performance. As advancements are made, particularly in materials like zirconia, they must not only meet aesthetic expectations but also address the biomechanical dynamics of natural teeth.

Reflection

This exploration into the practical application of zirconia in dental prosthetics underscores the importance of rigorous clinical evaluation and innovation in dental materials. While zirconia offers promising aspects, its application in dental implants requires careful consideration of its physical properties and long-term impact on patient health. As we move forward, the integration of new materials into dental practice must prioritise functionality and patient outcomes, ensuring that new technologies truly enhance the quality of care we provide.

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