Ceramics WILL replace titanium, BUT...

When in the 60's and 70' of last century, the first ceramic implants were inserted, this was not a real success. The former Tübingen implant had high failure rates due to incomplete healing and fractures and therefor was unacceptable for general use. These complications caused the initial (and actual) skepticism around ceramic implants. The general consensus was that ceramic materials would never be strong enough for use as dental implant material.

More than 50 years later the public opinion completely changed. Recent publications by Albrektsson and De Bruyn (2016) stated that titanium can give more foreign body reactions then we think, leading to the actual and future tsunami of peri-implantitis. But more important, the actual zirconium di-oxide ceramics have all necessary properties as safe and successful dental implants.

We know that not only the safety is of importance, but also the excellent tissue compatibility (less bacterial adhesion / better soft tissue acceptance), the outranging esthetics and only the exceptional appearance of peri-implantitis, play a decisive role.

But, just as with titanium implants, there are different suppliers who offer different kind of products. These differences are not only limited to implant-shape or geometry, implant surface characteristics or the specific ceramic material used; but there is moreover a difference between systems only offering 1-phase implants or 2-phase implants and systems who spent money on prior peer-reviewed scientific research or companies who don't.

Some companies just select a "media genius" surgeon to promote their products that often have no scientific background. In other cases "media horny" surgeons start their own pseudo-scientific organization to promote their self and/or the products of the company. These both situations lead to complete confusion at patient level. A gullible patient will not know that behind the facade of a good surgeon, there is an inferior product; whereas other patients don't know that good products are also used by narcissistic surgeons with inferior capacities...

Therefor it will be important to create soon a worldwide list of well trained and well experienced surgeons in the field of ceramic implantology AND a list of well established and well documented products, so that the patient/consumer is well informed to take the step to metal-free implantology.