Implantes de titânio e zircônia na reabilitação oral: um panorama geral das evidências científicas – revisão de literatura

Miqueias Santos Bispo
Mestrando em Implantodontia SLM
ORCID: 0009-0004-2609-7231

Matheus Menezes da Silva
Mestrando em Implantodontia SLM
ORCID: 0000-0002-2389-3601

Rafael Fidêncio de Lima
Mestrando em Implantodontia SLM
ORCID: 0009-0006-7757-731X

Natallia Cristina Roberto Tiago
Mestranda em Implantodontia SLM
ORCID: 0009-0002-0359-7001

Erika Larissa Andrade Martinez Venâncio
Mestranda em Implantodontia SLM
ORCID: 0009-0005-8037-0187

José Carlos Felix
Mestrando em Implantodontia SLM
ORCID: 0009-0001-7790-1400

Lucia Beatriz Belluomini
Mestranda em Implantodontia SLM
DOI: 0009-0008-3013-9325

Lilian Hasimoto
Mestranda em Implantodontia SLM
ORCID: 0009-0004-3399-9268

Julia Lima Sidaoui
Mestranda em Implantodontia SLM
ORCID: 0009-0000-6743-7141

Paulo Victor Guedes de Carvalho Peleteiro
Mestrando em Implantodontia SLM
ORCID 0000-0002-2634-5221

Julia de Almeida Smanio
Mestre e Doutora em Implantodontia – USP
ORCID: 0009-0009-3352-4066

Rafael Ortega Lopes
Mestre e Doutor em Implantodontia – UNICAMP
ORCID: 0000-0003-0028-611X

 

DOI: https://doi.org/10.71440/2675-5610.10.4.25.490-495.art

 

RESUMO

Objetivos: Verificar quais sao as principais evidencias cientificas disponiveis sobre as características e desfechos dos implantes dentarios de titanio e zirconia. Material e Métodos: Uma busca eletronica, utilizando bases de dados como PubMed, SciELO e LILACS, realizada entre 2015 e 2025, com trabalhos em língua portuguesa e inglesa, priorizando ensaios clínicos, revisões e metanálises, foi realizada. Os descritores utilizados na busca booleana incluíram termos como: “implantes dentários”, “titanio”, “zirconia”, “osseointegracao”. Escalas de qualidade foram aplicadas para cada desenho de estudo na determinação dos possíveis vieses. Resultados: Dos 112 estudos selecionados, apenas 28 (4 revisoes sistemáticas com metanálise, 5 revisoes sistematicas sem metanálise, 11 revisoes narrativas, 1 estudo clinico controlado, 4 estudos laboratoriais, 1 estudo laboratorial ex vivo e 2 estudos de coorte) foram incluídos. A qualidade geral foi considerada boa. Implantes de titanio com formato cônico e macrogeometria de rosca robusta favorecem a estabilidade primaria, além dos tratamentos de superficie aditivos/ subtrativos que melhoram a osseointegracao. Entretanto, a hipersensibilidade imunológica ao titanio ainda e controversa pela evidencia escassa e pelos testes disponiveis com potencial diagnostico não totalmente conclusivo. Os implantes de zircônia adquirem grande potencial de osseointegração quando recebem algum tipo de tratamento superficial, como o ataque ácido ou o laser, favorecendo a proliferação de células osteogênicas. Embora o fenômeno de degradação hidrotérmica seja preocupante, ele não afeta a rugosidade superficial da zirconia, o que traria um bom desempenho mecânico ao longo do tempo. Conclusão: A escolha entre implantes de titânio e zircônia deve considerar fatores como estética, resistência e a resposta do tecido ósseo. As modificações na superfície dos implantes de titanio e zirconia demonstram ser um fator determinante para o sucesso clinico. A pesquisa sugere que ambos os tipos de implantes têm seu lugar na pratica clínica.

 

Palavras-chave: Implantes dentarios; titanio; zirconia; osseointegracao.

 

Titanium and zirconia dental implants: an overview of the scientific evidence – literature review

 

ABSTRACT

Objectives: To verify the main scientific evidence on the characteristics and outcomes of titanium and zirconia dental implants. Material and Methods: An electronic search of PubMed, SciELO, and LILACS identified studies published from 2015 to 2025 in Portuguese and English, prioritizing clinical trials, reviews, and meta-analyses. The Boolean search used the descriptors “dental implants,” “titanium,” “zirconia,” and “osseointegration.” Risk-of-bias and methodological quality assessment tools were applied. Results: Of 112 records screened, 28 studies were included (4 systematic reviews with meta-analysis, 5 systematic reviews without meta-analysis, 11 narrative reviews, 1 controlled clinical trial, 4 laboratory studies, 1 ex vivo laboratory study, and 2 cohort studies). Overall methodological quality was considered good. Tapered titanium implants with robust thread microgeometry favored primary stability, and additive/subtractive surface treatments improved osseointegration. However, immunologic hypersensitivity to titanium remains controversial due to limited evidence and the non-definitive diagnostic performance of available tests. Zirconia implants exhibit strong osseointegration potential when subjected to surface treatments (e.g., acid etching or laser), which promote osteogenic cell proliferation. Although hydrothermal degradation is a concern, it does not appear to affect zirconia surface roughness, suggesting favorable mechanical performance over time. Conclusions: The choice between titanium and zirconia implants should consider esthetics, mechanical strength, and host bone response. For both materials, surface modification is a key determinant of clinical success. Current evidence indicates that both implant types have defined indications in clinical practice.

Keywords: dental implants; titanium; zirconia; osseointegration

 

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