Zirconia Minimizes Myeloid Innate Immunity as Dental Implants: An In Silico and In Vivo Study.

AIM While titanium has traditionally been the industry standard, zirconia presents superior physical and chemical properties that merit further investigation into its clinical efficacy. This study aims to examine the immunological responses associated with zirconia and titanium dental implants, emphasizing the potential advantages of zirconia as a viable alternative. MATERIALS AND METHODS This study compares the immune responses to titanium and zirconia implants using a murine model, in which two implants were placed in the maxillary edentulous region for 7 days. Following this period, peri-implant tissue was harvested from 9 and 45 mice to assess myeloid immunity at both the transcriptomic and cellular levels, respectively. RESULTS Our findings indicate that zirconia implants exhibit superior biocompatibility compared to titanium implants, evidenced by transcriptomic data showing a minimal myeloid cell-mediated inflammatory response. Specifically, zirconia implants significantly reduce the infiltration and attachment of myeloid cells, particularly polymorphonuclear neutrophils. Additionally, zirconia implants prevent the polarization of macrophages to the inflammatory M1 phenotype, which is markedly heightened in titanium peri-implant tissues, promoting instead a shift toward the regenerative M2 phenotype. CONCLUSIONS These results suggest that zirconia implants can minimize inflammation and promote better healing. This experimental in vivo study provides evidence that zirconia implants offer a more biocompatible solution in the field of dental restoration compared to titanium.