This is why I DON'T USE zirconia implants

Many of you have asked whether I use zirconia implants. I use zirconia for restorations, so this question makes sense. However, the answer is a hard no. And the reason? Because of this coffee cup. You see, this coffee cup is my FAVORITE coffee cup. That is, it WAS my favorite cup until it broke. Why did it break? That's the question.
Just like my coffee cup, zirconia implants are made from a very strong (stronger than steel!) substance. So how come I'm worried about breakage?? Well, that's not my only concern with zirconia implants. Check out the video to see exactly why I don't use zirconia implants.
Check out stanleyinstitute.com/ for more information.

[@michelstronguin6974]

The doctor is historically correct. But the new generation of zirconia implants are just as fracture resistant as titanium.

[@Stanleyinstitute]

There are material handbooks that one can look up toughness values for material. Grade 23 titanium alloy is 20 times more fracture resistant than 3Y zirconia. Despite what the companies are marketing these material properties don’t lie. The hardware store sells metal hammers not zirconia hammers. It’s not a strength issue. It is a toughness issue. I sincerely hope this is making sense. When an implant fractures it has to be surgically removed. It is at least a big deal for the patient if not for the doctor too. Please consider the facts and not the sales pitch.

[@antoniovasquez5587]

I agree

[@AnnieT369]

​@@Stanleyinstitutethey don't make ceramic hammers because they would be very expensive!

[@anthonyloveanthonylove2159]

This video is only been made 8 months ago

[@fyohox742]

plz stop talking crap. no ceramic, silicate, porcelain or zircon come even close to metals in pull, shear, twist and cutting forces. yes they can compete and even surpass in pushing forces and positive pressure, but they lack also elasticity and plasticity to absorb shock. no.

[@philindeblanc]

Aluminum is a neurotoxin, and so are other metals. Not putting that in my mouth from people who have falsely told me to use fluoride for it being good for my teeth, which is also a neurotoxin.

[@Stanleyinstitute]

With good genetics and proper oral hygiene you shouldn’t ever need to replace your teeth.

[@dandyfi4076]

I am in a situation were I have been considering an implant. I have my doubts that having a metal or ceramic screw put in my jaw would feel right for my body. I like the idea of better biocompatibility of the ceramic type. The question I have after this video is how often do ceramic break and under what circumstance? Also, I never knew that the Titanium type are alloyed with aluminum which has been proven to be toxic to the human body. For that reason alone I’d be more inclined toward ceramic. Seems logical that ceramic, similarly to glass, is more inert than metal.

[@Stanleyinstitute]

If you go with a zirconia implant the most important thing is the implant must be placed In The proper position! Otherwise, it will likely only last a few years. Properly placed it might last a lifetime. The way to get the implant in the ideal location is the virtually place the ideal prosthetic solution(crown) and then place the implant underneath the crown such that the loads seen by the implant are directed along the length of the implant and they do not create a bending moment(force). After the plan is complete the doctor can uses a type four surgical guide to ensure proper execution of the virtual plan. With proper planning and placement you should be set for a very long time. Good luck and thanks for watching.

[@melissamasters6102]

I have a posterior zirconia implant. I have had it for 5 years so far without issues, I eat walnuts, almonds and cashews daily. Every dds will have a different opinion on this topic, you tube dentists are sketchy.

[@naimaiherb-ss8op]

@@melissamasters6102 so should i have zircinia

[@UNLOCKsilo]

@@melissamasters6102 I’m wondering about the cost if you don’t mind sharing

[@Androshi]

THERE ARE MILLION OF CASES THAT WE DONT HEAR ABOUT ,THAT HAVE PROBLEMS WITH METAL DENTAL IMPLANTS. TALK ABOUT THAT TOO PLEASE ! LIKE REJECTION OF THE DENTAL IMPLANT .

[@Stanleyinstitute]

I have addressed this, and will continue to addresss this. You are abosolutly correct in your statement regarding too many implant failures. The number one reason, for almost all dental implant failures, is the implants location, not the material. ANY improperly placed implant will have complications and failures! This is one of my four cornerstones to implant success. One MUST get the implant in the proper location in order to have success. Check out this video. kzbin.info/www/bejne/rKPGdYKEoNt6o8U

[@MarinaMartin-yl6zl]

@@Stanleyinstitute Nope! Metal allergies are way more common than most medical professional want to admit. This is so frustrating for us, who are brushed off like it's so rare. Sure placement might be a problem for some, but most rejections I've ever heard about was the metal itself! Every time I hear someone having problems with metal implants, I ask them if their doctors test them for metal sensitivities and allergies and it's always NO. Why? Every one of them did it on their own and came very reactive to the metal doctors had used. So much suffering and for what? Testing before implanting should be a regular practice, but practically no one does it.

[@GoatzombieBubba]

@@MarinaMartin-yl6zl because it is rare.

[@me4011]

​@@MarinaMartin-yl6zlyes, I have titanium grade 4 now and experiencing galvanic shocks and feel electric zaps when eating I will have to remove and replace with metal free option 😔

[@drsaurabhgupta6144]

Please refer scientific research before answering the question. Technology is advancing and the fracture rates of zirconia implant is as similar to titanium implants according to Las test scientific research paper published by Stephen Rohling and group in 2019.

[@Stanleyinstitute]

I’m sorry. Pub med and google is not locating the paper you are referencing. Would you be so kind to provide more details or the citation link itself? Thank you. I look forward to reading it.

[@drsaurabhgupta6144]

“ Performance and outcome of zirconia dental implants in clinical studies: A meta-analysis Page - 149 Column 2, 1st paragraph It says - The presently evaluated fracture rate of 0.2% for zirconia implants is comparable to data reported in systematic review on titanium implants)

[@devin_3875]

@@drsaurabhgupta6144I’m interested in a reply by the doctor. I see there was none

[@ranjankumarmahanta8518]

​@@drsaurabhgupta6144 You are right. The study is available on Google.👍

[@h.debeau7995]

Well technically that isn’t a “zirconia” coffee mug, zirconia and ceramic have different qualities

[@Stanleyinstitute]

Zirconia is in the family of ceramics. Ceramics in general are strong but not tough resulting in brittle behavior. The coffee mug breaking represents an analogy to help people understand this important distinction. I hope this helps and thanks for watching.

[@anthonyloveanthonylove2159]

@@Stanleyinstitutethe kind of ceramic’s you currently demonstrating with it’s never known as strong in history

[@ank6043]

Dr Stanley, thanks for the video. But it seems there is a strong link between titanium dental implants (allergy or metal toxicity) and autoimmune disease start. Titanium alloys toxins are closely associated with the neuroendocrine system, or itching or urticaria problems. There are so many high-ranking academic articles on this topic (please search "Allergic contact dermatitis caused by titanium screws and dental implants"; "Metal allergy patient treated by titanium implant denture: A case report with at least 4-year follow-up", "Zirconium Implant as an Alternative to Titanium Implant in a Case of Type IV Titanium Allergy: Case Report").

[@Stanleyinstitute]

Words are powerful. To use a phase like “strong link” but then support the premise with a few case reports suggests a supposition rather than evidence. Case reports are considered the weakest of all evidence used in medicine. With such weak evidence it is hard to make any real decisions. The facts are clear. With the abundant use of titanium in orthopedics and dentistry the quantitative evidence does not support the idea that there is any significant level of allergic reaction or rejection. On the other hand, fracture failures are readily seen in everyday practice around the world. When a dental implant fractures it has to be surgically removed which is no small surgery and can lead to significant long lasting defects. Therefore, a prudent approach would be to reduce the significant number of current catastrophic failures rather than increase those failures by selecting a material that lacks toughness which would directly contribute to an increase in failures. Zirconia is a wonderful material and I use it all the time for the prosthetic solutions (the crowns). If a crown breaks we simple unscrew the broken one and screw in a new one like changing a tire on a car. It’s not that zirconia is bad it just has limitations for use as the foundation for tooth replacement options. Now, if someone has a medically documented allergy to titanium then a zirconia implant would be a viable option and a detailed discussion of the mechanical risks associated with its use would be covered prior to initiating treatment.

[@naturalhealing9970]

All Titanium Implants have other metals in them. I am allergic to Nickel. I tried a Titanium implant many years ago and my jaw simply would not heal. My only option is Zirconia. I can't image that Zirconia implants would resemble any material in a coffee cup.

[@MarinaMartin-yl6zl]

@@naturalhealing9970 Looks like this dentist is promoting Titanium implants. I was not convinced by his argument in the slightest. Zirconia implants are not ceramic cups. This is so ridiculous I was laughing. I don't know how intelligent people listen to him and don't realize that he is talking to them like they are 6 year olds. Zirconia is very very durable, especially in dentistry, unless you drop your head on the ground... He talks from his perspective because he has no experience with Zirconia. There are more and more dental professionals who work with Zirconia for many years by now and they will never ever use anything else for obvious reasons: it's the best material available at this time. It's not easy to use, there is certain precision has to be done, but totally worth it. I have a bridge with two missing teeth for 5+ years and it looks exactly the same as it was the first day. It's the best thing I've ever had done to me. I am so sensitive to metals, I am allergic to damn gold! I've changed so many crowns from one type to the other until I lost all of those teeth because of constant gum infections which led to gum recession which led to root fractures. Metal allergy is very common and medical professionals like this dentist have to stop brushing it off like it so rare. It's more common than they want to admit. Changes are hard. New technologies replace old professionals so they start bashing anything new. They don't want to be left behind since it's too much to learn the new technics all over again.

[@blendzol]

@@MarinaMartin-yl6zl and only the handle broke which is an add-on to the actual cup after molded. Of course, it's going to break first.

[@Returntognoing333]

Imagine the amount of electromagnetic frequencies pinging off that metal...

[@beasaroseco5840]

I just saw a story of a woman who thought that she got Titanium, instead she got nickel and she had an allergic reaction. Im also concerned about the cold from food and weather hurting my nerves.

[@Stanleyinstitute]

That is awful.

[@martinchrom4444]

Is there any way to upload twice a week? Great content, once week is just not enough

[@Stanleyinstitute]

That is the nicest comment of the year! Thank you. If you are ready to learn it all we cover everything in a logical order in our classes? Go to stanleyinstitute.com for course listings and more information.

[@edc1969]

Im getting Titanium implants with zirconia teeth. I never heard of the implants themselves being made of zirconia. I would question that setup!

[@kwaobenti]

I have recently heard of a type of implant called "Roxolid" composed of 15% zirconia and 85% titanium. Supposedly it's very strong. Would this be a good compromise?

[@altruismfirst6489]

Metal causes disruptions in the Meridian system that leads to other side-effects over time, with heart issues and other complications for many.

[@Stanleyinstitute]

The human body cannot exist without metals. Can you name a few?

[@Stanleyinstitute]

Roxolid has better strength than grade 4 titanium but is a little weaker than grade 5 and grade 23. This difference might not be clinically significant.

[@naturalhealing9970]

I am allergic to nickel, which is part of the titanium metal that is used.

[@Stanleyinstitute]

In a controlled environment, grade 23 titanium alloy is completely free from any traces of nickel. You can rest assured, as your safety is guaranteed!

[@naturalhealing9970]

@@Stanleyinstitute Which brand of implant is Grade 23 Titanium? Thanks!

[@MarinaMartin-yl6zl]

@@Stanleyinstitute Hopefully 100% free, but is it? "Implant materials that comply with standardized specifications may still contain trace amounts of elements that are unintended and possibly harmful. For example, in addition to the elements shown above, it is possible to have impurities such as nickel present in a standard-compliant material. When present, these impurities are in extremely small quantities, typically measured in parts per million. Surgeons and patients alike should be aware that there is a risk associated with any implantable material due to possible impurities." "Many people have demonstrated sensitivity to nickel and materials containing nickel. While titanium is considered to be “nickel free,” and titanium alloy is commonly used as an alternative to stainless steel alloys for patients who may have nickel sensitivity, it is possible that trace amounts of impurities including nickel could be contained within these materials. Nickel impurities in titanium implants, even in very small amounts, could lead to a patient reaction." - www.acumed.net/wp-content/uploads/2017/12/Acumed-Metal-Sensitivity-Statement-EN-GEN60-02-C.pdf You would not know until patient get it in his mouth and get reaction. Metals are everywhere these days and metal allergy becomes a real problem, a BIG problem. The reactions are not just irritations and rashes, but autoimmune disorders and many conditions so many people in modern times suffer. Europe is a head of USA on this subject and they studied it quite extensively, but it takes time to find other publication sources. Going by only what is researched in US is to ignore the whole problem on purpose. In general, I find that research and studies are very bias and business oriented in US. It's unfortunate, but even serious publications have to be questioned all the time as time proved that industry dictates any research outcomes to benefit itself. I don't imply that all doctors are paid off to harm their patients to make profits for industries, but that industry influenced medical research is making it difficult for doctors to make really informed decisions based on the real evidence and science. It was reveled that time after time how manufacturers hid away most results that did not fit their desirable outcome for certain products to present only desirable outcomes to pass their product through FDA. To decide what implants to use is more important than just the look and strength, by the way. It's also how much plastic do you want to eat through out your life since those fixtures with titanium are covered with plastics. They wear off so fast! Look in to effects of plastic too.

[@iolite2]

Well Robert, I am not a car, I have a porous mouth which can readily absorb what I put into it which over time create an effect which is harmful for my health. A CAR is not going to have complications from having steel added on to it! Poor comparison. Just because something has been used forever (RE: titanium joints), doesn't mean it's the best. At one point someone could have said "we never use seatbelts in cars", but obviously a new and essential way emerged which set a new standard for an industry. Hey, maybe you could try being a used car salesmen if this dentistry thing goes south. They certainly value a good coffee cup during a work day too.

[@Stanleyinstitute]

Thank you for your reply.

[@pianoman7652]

AMEN! I NEVER DID LIKE HEAVY METAL! CAN ANYONE SAY MERCURY?

[@naturalhealing9970]

Then why are most all crowns today made of ceramic?

[@Stanleyinstitute]

Zirconia possesses a remarkable toughness, being 3-4 times tougher than lithium-disilicate. However, it falls short when compared to the toughness of titanium, being approximately twenty times less tough. Consequently, zirconia emerges as an exceptional option for dental crowns. Nonetheless, when considering its application as an implant, caution must be exercised due to the potential for brittle fracture mechanics. In the unfortunate event of a crown fracture, replacement is a simple and straightforward procedure. Conversely, if an implant were to fracture, it would necessitate complete removal from the jaw. Hence, the risk-to-reward ratio concerning the use of zirconia as an implant is not deemed justifiable.

[@blendzol]

This is such nonsense. The handle on the mug broke not the mug itself. The handle is added after the mug is molded. Our mouths are not cars. This procedure may cost as much as a car. A person falling from 2 feet face first will break their natural teeth. Zirconia is 10 to 12 times stronger than porcelain. Any of these procedures is better than what George Wahington had for dentures. Wooden teeth!

[@Stanleyinstitute]

Nope! Zirconia is only four time stronger than emax ceramic. But here is the point. It is 20 times less tough than titanium. Ceramics are strong and brittle. Metals are tough and ductile. It’s really simple. Also, George’s teeth were not made of wood! It’s always nice to have engagement from someone who has a passion for learning. Thanks.

[@blendzol]

Thanks for the history lesson. I learned something new. That's why public school education is inferior to others. Still doesn't excuse your mug demonstration.

[@altruismfirst6489]

The coffee cup was not made of 3Y Zirconia and the auto shock springs are 500x larger than the product so nonsense is correct.

[@user-sv7ij4st8e]

Thank you!

[@Stanleyinstitute]

You're welcome!

[@CDaeda]

The coffee cup is made out of what exactly?

[@Stanleyinstitute]

The coffee mug is made out of a family of materials called ceramics. Ceramics share similar mechanical properties. They tend to be strong but not tough. The two terms string and tough mean two distinct things in engineering. Toughness is the measure of how much energy can be captured by a material. Ceramics are not tough. That is why you see metal hammers and not ceramic hammers at the local hardware store. A ceramic hammer would be strong but would likely break after just a few nail strikes. Hope this helps.

[@CDaeda]

Some ceramics are more brittle than others. @@Stanleyinstitute

[@spirgtudsrubec7776]

I have no idea if what he is saying is true or not, but the first story about the cup falling was totally lame. If you begin with a lame story don't expect to be believed.

[@Stanleyinstitute]

Your funny. If I was going to make up a story it would for sure be better than a bouncing coffee mug. Sometimes real life is simple. Thanks for watching

[@Swanselm]

Omg dental work gives me so much anxiety I have autoimmune my mouth is rotting What do I do I keep getting crap work

[@Stanleyinstitute]

Don’t give up. Keep looking for the right dentist. There is a patient for every dentist and a dentist for every patient.

[@goodpublicunitedindia268]

Find a good holistic/biological dentist

[@devin_3875]

I suggest trying to get the autoimmunity and inflammation to calm down first. :) I’m in the same boat. One thing that’s *really* helped me is doing the Wim Hoff method every day. Both the breathing technique, and the cold shower. Search for his KZbin channel - you can do the breathing along with his guided video. Another option which I’ve heard works well for autoimmune conditions is a keto diet - or even a full carnivore diet. Good luck!

[@prohind]

The cup example given by the doctor looks ridicules to me. He is comparing apple with oranges. Also his arguments looks biased as if he has some vested interest in promoting one view over another by citing incompatible situations.

[@manuelbtst]

What kind of doctor is that?

[@Stanleyinstitute]

The smileengineer of course. Dual doctorates in mechanical and aerospace engineering and Doctor of Dental Surgery.

[@Aki-wq6xh]

Do I really don’t need to worry about toxins and stuff? 😢 I only have titanium as an option here

[@RoaringRory80]

It's a bad argument

[@Stanleyinstitute]

It’s science

[@devin_3875]

@@StanleyinstituteSounds like The Science™

[@12masterr]

​@Stanleyinstitute your science is all wrong!

[@12masterr]

What a load of bull

[@Stanleyinstitute]

Just basic material science. Thanks for watching

[@Cyberoll]

Doctor be slow to judge, your coffee cup is not exactly the same molecular structure as Zirconia, I challenge you to create the same size cup made of Zirconia and recreate the accident scenario. Then share it here.

[@Stanleyinstitute]

The coffee mug is an analogy to help explain the concept of brittle vs tough. The material specifications are readily available and the simple truth is titanium is 20 times tougher than Zirconia. It’s basic material science. Both zirconia and titanium are strong. These words are not synonyms. They mean very different things to an engineer. Based on the material properties you are 20 times more likely to have an implant made of zirconia fracture vs a titanium implant. This is a risk I’m not willing to subject my patients to. Hope this helps clarify things.

[@SusanRichardsDay]

Mercury fillings are not ok .

[@Stanleyinstitute]

Please share the literature.

[@user-bi2xg5hc9w]

Wow, it makes sense! If big implants like knees and hips are made of titanium, then there is no problem with the small dental implants, I guess with the exemption of the patient being alergic to those metals. BTW Why all female dentists are freaking beautiful?.... anyways, after they see the worse of you (your mouth) there is not even room to ask them for a date hahah

[@roycampbell3433]

Why not make a hybrid zirconia implant with a titanium pin or rod incased within, or a titanium zirconia coated implant.

[@Stanleyinstitute]

A general design goal is to make things as simple as possible. To add complexity to a system there has to be a reason. Currently there is no reason not to use medical grade titanium since it is one of the most biocompatible materials know to man.

[@esinfa]

Titanium alloyed with nickel and aliminium in my body... No thanks!

[@Stanleyinstitute]

There is no nickel in medical grade titanium. Aluminum is the most common metal on the surface of the planet.

[@me4011]

​@@StanleyinstituteIt is important to remember that titanium implants still have nickel in them, but it is a minimal amount, and is a more readily available material from implant manufacturers compared to carbon fiber for fracture fixation.Feb 24, 2020. These articles demonstrate that various “commercially pure” and alloyed titanium samples contain a low but consistent percentage of contaminants that are associated with allergies. For example, traces of nickel, related to the manufacturing process were found in titanium materials used for surgical implants. “Nickel allergic patients may develop hypersensitivity reactions due to this low nickel content.

[@raheemb3217]

💯👏🏽

[@mmwosu]

It’s definitely not just esthetics. Some people just object to the idea of metal in their body. Often these are people who eat excessive amounts of granola, avoid sodium fluoride, and aren’t swayed by evidence. Oh, and they’re proud of all three of those things

[@Stanleyinstitute]

Sounds like the topic for an additional video;-)

[@bodnardentalacademy]

You have so nice energy, doc! Great video as usual!

[@ank6043]

It seems there is a strong link between titanium dental implants (allergy or metal toxicity) and autoimmune disease start. Metal toxins are closely associated with the neuroendocrine system. There are so many high-ranking academic articles on this topic.

[@mmwosu]

@@ank6043 There really aren’t though. As someone who has been helping patients by providing this treatment for over a decade now, I’m going to stand squarely in the way of your ability to spread this misinformation. True ectopic reactions to medical grade titanium are vanishingly rare. You are wrong. Full stop.

[@ank6043]

@@mmwosu There are several highly respected academic journals on the link between titanium allergy/toxicity to the body's nerves and the neuroendocrine system. Please search "Allergic contact dermatitis caused by titanium screws and dental implants", "Metal allergy patient treated by titanium implant denture: A case report with at least 4-year follow-up", "Zirconium Implant as an Alternative to Titanium Implant in a Case of Type IV Titanium Allergy: Case Report", "IMMUNOTOXICOLOGICAL ASPECTS OF BIOCOMPATIBILITY OF TITANIUM", "Titanium implants and silent inflammation in jawbone-a critical interplay of dissolved titanium particles and cytokines TNF-α and RANTES/CCL5 on overall health?", "Titanium levels in the organs and blood of rats with a titanium implant, in the absence of wear, as determined by double-focusing ICP-MS", "Hypersensitivity Reactions to Titanium: Diagnosis and Management", "Hypersensitivity to titanium: Clinical and laboratory evidence", "Metals, autoimmunity, and neuroendocrinology: Is there a connection?", "Autoimmunity in connection with a metal implant: a case of autoimmune/autoinflammatory syndrome induced by adjuvants". "Titanium: A New Allergen". "Titanium Sensitivity" "Titanium deposition in regional lymph nodes after insertion of titanium screw implants in maxillofacial region" " Cytokine response of human macrophage-like cells after contact with polyethylene and pure titanium particles". All of them say titanium sensitivity is not a typical allergy, due to the titanium and its alloys lymphatic, neuroendocrine or immune systems may be negatively effected.

[@wanshanz6754]

Dr Stanley is not addressing the conductivity btw these posts in the mouth are high act like an antenna … 😮

[@Stanleyinstitute]

Did you happen to know my PhD was on antennas? Homework problem for you. What frequency do you think would resonate a 12mm implant as an antenna?

[@wanshanz6754]

@@Stanleyinstitute Meant no offense, Dr. Stanley. I’m an engineer and a teacher fascinated with the human body. Just happened to have read the work of Dr. Nunnally where they evident the presence of measurable electric fields as a result of the implant. I’m happy to continue to learn.

[@apacur]

With zirconia implants as well?

[@apacur]

@@Stanleyinstitute Zirconia wouldn't act like an antenna would it? or would it? If so, what frequency?

[@MarinaMartin-yl6zl]

@@apacur No, it's not conductive material.

[@laurenSmith-bf4fc]

Such bs zirconia is better than titanium and nickel combined

[@Stanleyinstitute]

This is basic high school level physics. There are brittle materials like zirconia and tough materials like titanium. Here is an example. Skyscrapers are built out of metal beams and covered with glass windows. Glass is brittle and metal is tough. Both are good at their respective jobs but hopefully everyone would agree that a skyscraper built with only brittle glass would not last.

[@teeduck]

Horrible analogy

[@Stanleyinstitute]

Ceramics are brittle. Metals are ductile. These are basic material properties. If you have a good analogy please share so together we can help more people understand the risks and benefits of these two materials.