Bioceramics have shown to produce minimal triggers that would evoke an inappropriate biological response, proving the excellent biocompatibility of ceramic materials. In orthopedics, the ceramic composites, like zirconia-toughened alumina (ZTA), have long-been used for bearing applications and have become a benchmark in hip arthroplasty. In dentistry, the usage of yttria-stabilized tetragonal zirconia (Y-TZP) was introduced in the 2000’s for metal-free and aesthetic dental restorations and has successfully been applied as dental implant and abutment since.
Ceramic biomaterials of different composition and shape will be discussed, which are currently in use, or are under development and showing a high potential for use in dental applications. As such, favorable properties of zirconia dental implants and abutments are discussed, like their aesthetics, biocompatibility, and low bacterial adhesion to the surface. Further, ZTA ceramic composites, as the BIOLOX^®delta, which celebrates 20 years of successful clinical use as bearing in total hip arthroplasty, will be introduced. Both ZTA and TZP are discussed in light of a novel advanced technology for direct foaming of ceramic materials, which enables manufacturing of three-dimensionally structured ceramic components with a porosity of 60 – 80 %, and with pore sizes mimicking trabecular bone structure. The porous surface enables direct ceramic-to-bone contact and may improve dental implant integration or serve as scaffold for cranio-maxillofacial reconstruction. An in vivo pilot study revealed very good to excellent osseointegration of ZTA and TZP foam implants both in cortical and trabecular bone in sheep, while local host response was absent or minimal, indicating a very low irritant potential.
Additionally, an improved medical grade ceramic injection moulding technology to manufacture a two-piece dental implant will be presented, allowing for a standard production of custom-made components, and for high precision manufacturing, especially required for the fine features of the dental implant.