Zirconia vs. titanium dental implants in maxillofacial trauma: a preliminary comparative biomechanical analysis in the maxilla using the finite element method.

INTRODUCTION: With increasing life expectancy and physical activity, patients with dental implants face a growing lifetime risk of traumatic injury. In this context, the present study aimed to evaluate and compare the traumatic biomechanical effects between titanium and zirconia single dental implant in maxillary central incisor localization exposed to frontal maxillofacial trauma. MATERIALS AND METHODS: In a 3D-FEA study design, maxillary models with titanium (model-A-IT) and zirconia (model-A-IZ) implants in region 21 and a bone model without dental implant (model-B) were subjected to a frontal traumatic load of 2000 N. The von Mises stress for all 3 models was measured at a predefined cortical peri-implant region of interest (ROI) and the stress values evaluated were compared between the models. Additionally, the maximum stress values within the implants were recorded and compared for the titanium and zirconia implants. RESULTS: The peri-implant cortical stress value/cortical fracture risk increased significantly for both implant models (model-A-IT, model-A-IZ) as compared to the implant-free bone model (model-A-IT/model-A-IZ vs. model-B; p < 0, 001); however, no difference between the two implant models evaluated (model-A-IT vs. model-A-IZ; P = 0.806) was seen. The stress values within the dental implants measured showed a higher maximum stress peak for the zirconia implant (IZ: 1137 MPa) than for titanium implant model (IT: 686.7 MPa). CONCLUSION: When exposed to frontal trauma application both implant materials showed similar effects on cortical peri-implant bone; however, zirconia dental implants provide for a significantly higher maximum stress value within the implant than titanium implants representing a higher risk of fracture.