When it comes to giving you a life long smile, the material used for your prosthetic teeth can make a significant difference in the long-term success of your treatment. Two of the most popular options available today are Zirconia and PMMA.
While both materials have their merits, there are some key differences to consider when making your decision. To help you understand these differences, we've delved into the latest research to provide a comprehensive comparison of Zirconia and PMMA.
When evaluating prosthetic materials, it's important to rely on evidence-based information from credible sources. For this comparison, we've summarized data from respected institutions such as the National Library of Medicine and the National Institute of Health, among a handful of other credible sources. We've aimed to present this information in a way that is easy to understand, while still providing links to the original studies for those who want to explore the topic in greater depth. You can also find a list of additional Zirconia-related clinical studies at the bottom of this page.
At New Life Teeth, our team of experienced surgeons and laboratory staff have worked with both Zirconia and PMMA extensively over the years. Based on our first-hand knowledge and the available scientific evidence, we believe that Zirconia is the superior choice for permanent fixed teeth. Here's a closer look at why we have chosen to provide every patient with our Prettau Unbreakable Zirconia teeth:
One of the most important considerations for any dental material is how well it integrates with the natural tissues in your mouth. This is known as biocompatibility. Zirconia exhibits excellent biocompatibility in the oral environment, interacting well with fibroblasts, osteoblasts, dental pulp cells, and macrophages, demonstrating good biocompatibility in the mouth [1]. The smooth surface of Zirconia is less likely to attract bacteria, ensuring long-term cleanliness and reduced maintenance.
Zirconia prosthetics offer superior aesthetics, resistance to staining, and are less prone to breakage compared to PMMA acrylic prosthetics [2]. The smooth, polished surface of Zirconia prosthetics means is does not attract bacteria or plaque, thus lowering the chances of developing gum disease, tooth decay, or bad breath [3].
In contrast, PMMA acrylic prosthetics, while cost-effective for companies, have some drawbacks. They are more prone to potential breakage, wear and tear over time, and issues like staining and bacterial build-up [2]. PMMA can also become discoloured over time and is more susceptible to attracting bacteria and plaque compared to Zirconia.
Citations:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839238/
[2] https://northtexasdentalsurgery.com/choosing-the-right-all-on-four-prosthesis-zirconia-vs-pmma-options-explained/
[3] https://ariadentalcare.com/blog/acrylic-vs-zirconia-dental-implants/
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360736/
[5] https://www.sciencedirect.com/science/article/abs/pii/S0928493118325839
The appearance of your new teeth is a top priority, as you want a smile that looks vibrant, healthy, and natural. Zirconia offers superior aesthetics compared to PMMA. Zirconia prosthetics can provide a more natural and lifelike appearance, closely mimicking the look of natural teeth. One of the key advantages of Zirconia is that it can be manufactured with varying degrees of translucency, allowing it to more accurately mimic the light-transmitting properties of natural teeth. While PMMA can also look beautiful, it may not have the same level of translucency as Zirconia.
Both materials can be customized for individual patients. However, Zirconia offers more options for shade matching and characterization to achieve a highly natural look. This versatility allows skilled technicians to create a smile that blends seamlessly with your unique facial features and skin tone.
Another important factor to consider is the long-term appearance of your prosthetic teeth. Zirconia maintains its aesthetic qualities for longer periods due to its durability and resistance to wear. In contrast, PMMA may require more frequent replacements or repairs, which can affect its aesthetic appeal over time.
While both materials can provide attractive results, Zirconia is generally considered the premium choice for aesthetics in full mouth dental implant prosthetic teeth due to its superior properties in terms of appearance, durability, and stain resistance.
Citations:
[1] https://northtexasdentalsurgery.com/choosing-the-right-all-on-four-prosthesis-zirconia-vs-pmma-options-explained/
[2] https://www.youtube.com/watch?v=aoEFc45G22M
[3] https://drsehmi.co.uk/all-on-4-materials-what-is-better-zirconia-pmma-or-acrylic/
[4] https://www.bunkerhilldentistry.com/2019/01/18/all-on-4-tooth-materials/
[5] https://www.oralhealthgroup.com/features/an-alternative-prosthetic-design-for-lower-full-arch-implant-restorations/
Maintaining your new smile is an important aspect of long-term success. There are several key differences in the maintenance requirements for Zirconia versus PMMA prosthetics.
Firstly, Zirconia prosthetics maintain their surface properties better over time compared to PMMA. This means that Zirconia prosthetic teeth are easier for patients to maintain with self-care and require less professional intervention. The smoother, more polished surface of Zirconia is less prone to plaque adhesion and calculus formation compared to PMMA, resulting in reduced maintenance needs.
Another important consideration is stain resistance. Zirconia is highly resistant to staining, while PMMA is more prone to discoloration over time. As a result, PMMA prosthetics may require more frequent professional cleaning or replacement to maintain their aesthetic appearance.
Durability is also a factor in maintenance requirements. Zirconia prosthetics are more durable and resistant to wear compared to PMMA. While PMMA prosthetics may require repairs or replacements every 3-5 years, Zirconia prosthetic teeth can last much longer with proper care, it's why we are confidently able to provide our industry leading 15 year warranty.
It's important to note that with some providers, Zirconia prosthetic teeth have a higher initial cost, as the material is significantly more expensive to manufacture compared to PMMA. However, at New Life Teeth, we offer Zirconia prosthetic teeth at a more affordable cost than other clinics offer PMMA and we provide a 15-year warranty on our teeth.
In comparison, if you choose PMMA teeth, other providers typically offer a 3-5 year warranty. This means that in the long run, you may need to pay for breakages and repairs to your PMMA teeth, which can cost on average £1500 per arch to replace. Zirconia is therefore a more cost-effective material in the long term compared to PMMA, which may require more frequent replacements and maintenance.
Citations:
[1] https://decisionsindentistry.com/article/maintaining-implant-supported-hybrid-prostheses/
[2] https://northtexasdentalsurgery.com/choosing-the-right-all-on-four-prosthesis-zirconia-vs-pmma-options-explained/
[3] https://www.nature.com/articles/s41405-024-00214-7
[4] https://www.youtube.com/watch?v=aoEFc45G22M
[5] https://www.sciencedirect.com/science/article/pii/S0022391321002651
One of the key advantages of Zirconia is its significantly higher flexural strength (900-1200 MPa) and fracture toughness compared to PMMA. This makes Zirconia more resistant to breakage and wear over time, ensuring that your prosthetic teeth can withstand the rigors of daily use.
In addition to its strength, Zirconia also has a much higher hardness ratio (1200 HV) compared to PMMA. This contributes to better wear resistance and longevity of Zirconia prosthetic teeth, helping to maintain their appearance and functionality for years to come. We've seen some clinics claim that "Zirconia is too hard", this is false and we will cover this in one of the following sections, we will provide you with clinical studies, unlike other claims.
When subjected to 3D finite element analysis, Zirconia shows less deformation (0.168 mm) under load compared to PMMA (1.035 mm). This indicates better dimensional stability for Zirconia prosthetics, ensuring a precise and comfortable fit that lasts.
It's worth noting that Zirconia prosthetics are significantly heavier than PMMA (6.34 g vs 1.33 g for a 4-unit fixed dental prosthesis). However, this higher weight does not negatively impact its mechanical performance or the success of the implant treatment. You will also not be able to notice this weight difference when it's fitted to your implants.
While PMMA has some advantages, such as lower weight and costs to the provider, Zirconia's superior strength, hardness, wear resistance, and long-term stability make it generally preferable for permanent full mouth dental implant prosthetics. However, the optimal choice may depend on the specific clinical situation and individual patient needs.
Citations:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515448/
[2] https://northtexasdentalsurgery.com/choosing-the-right-all-on-four-prosthesis-zirconia-vs-pmma-options-explained/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670660/
[4] https://iopscience.iop.org/article/10.1088/1757-899X/987/1/012031
[5] https://www.sciencedirect.com/science/article/abs/pii/S0928493118325839
Zirconia restorations are far superior in stain resistance compared to PMMA (acrylic) teeth [1]. Zirconia can better endure staining from substances like coffee, wine, curry, and nicotine, maintaining its appearance over time.
In addition to its stain resistance, fewer bacteria attach to the zirconia surface compared to PMMA. This property helps prevent gum discoloration and reduces the risk of bacterial build-up, which is a common issue with PMMA prosthetics. The smooth, polished surface of Zirconia contributes to its resistance to both staining and bacterial adhesion. This makes it easier to maintain the cleanliness and freshness of the prosthetic over time.
The superior stain and bacterial resistance of zirconia contributes to its long-term durability and aesthetic appeal. In contrast, PMMA is more prone to discoloration and bacterial accumulation over time. While both materials require regular cleaning, zirconia's resistance to stains and bacteria makes it easier to maintain its appearance and hygiene with standard oral care practices.
Furthermore, the reduced bacterial adhesion on zirconia surfaces can contribute to better overall oral health for the wearer, potentially reducing the risk of gum inflammation and other oral health issues associated with bacterial build-up.
Citations:
[1] https://www.dentaprme.co.uk/dental-blog/what-you-need-to-know-about-dental-crowns-made-from-zirconia/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503455/
[3] https://www.researchgate.net/publication/344212884_Effect_of_Cleansers_on_the_Colour_Stability_of_Zirconia_Impregnated_PMMA_Bio-Nanocomposite
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558324/
[5] https://stomadentlab.com/denture-services/zirconia-pmma/
Over the last few months we’ve had an influx of people ask us this question, while we can understand the question, we want to clarify that it’s not the case. Unlike natural teeth, which are supported by the periodontal ligament, implants rely on a process called osseointegration, where the titanium posts fuse directly with the jawbone to provide a stable foundation. The implants are positioned at precise angles to maximize contact with the existing bone. Once integrated, the implants support a full-arch prosthetic that mimics natural teeth in appearance and function.
At New Life Teeth, we always aim to provide clinical research to back up our points, if you hear information online that is not backed up with genuine clinical studies, try do your own research before believing it.
To answer this question we have put together a summarized version of the clinical study “Influence of Framework Material and Posterior Implant Angulation in Full‐Arch All‐on‐4 Implant‐Supported Prosthesis Stress Concentration”. The focus of this study was to see how different prosthetic materials influence the amount of stress on the implants:A previous study used the finite element method to analyse the effects of different framework materials (including Metal, Zirconia, and Polyether ether ketone (PEEK) ) on the "All-on-4" implant system. The highlights of the study show that:
The stress distribution pattern at the implant-bone interface was significantly influenced by the material.
Zirconia framework showed the minimal stress magnitude.
The length of the implant increased stress concentrations, regardless of the framework materials.
Zirconia showed lower strain patterns compared to PEEK.
The authors justify these results by asserting that an increased elastic modulus of the framework reduced the stresses transmitted to the implants and bone. The choice of material does in fact impact the stress distribution and strain patterns in the implant-bone interface. Materials with higher elastic moduli, such as Zirconia, appear to be more effective in minimizing stress and strain compared to PEEK, which has a lower elastic modulus.
Based on this study, as well as over a decade of experience doing 1000's of full mouth rehabilitation and more than 5 decades of clinical research with Professor Brånemark. We can confidently re-assure you that Zirconia is not too hard, and will not increase bone loss beyond what is normal for dental implants. If you have further questions about this please do reach out to us and we will answer any of yours questions, we have nothing to hide as our process is backed by decades of clinical research and development.
Citations:
https://www.researchgate.net/publication/357841764_Influence_of_Framework_Material_and_Posterior_Implant_Angulation_in_Full-Arch_All-on-4_Implant-Supported_Prosthesis_Stress_Concentration
In the comparison between Zirconia and PMMA for dental implants, Zirconia emerges as the superior choice for long-term, high-quality dental restorations. Its excellent biocompatibility, superior aesthetics, durability, and resistance to stains and bacteria make it an ideal material for patients seeking optimal results.
While PMMA remains a viable option for temporary restorations or budget-conscious patients, Zirconia's long-term benefits often outweigh its higher initial cost. The material's ability to provide natural-looking, long-lasting restorations with reduced maintenance needs and lower complication rates makes it a preferred choice for many dental professionals.
Ultimately, the decision between Zirconia and PMMA should be based on individual patient needs, considering factors such as long-term oral health, aesthetic expectations, and overall value. As dental technology continues to advance, Zirconia's role in dental implants and prosthetics is likely to grow, offering patients increasingly refined solutions for their restorative dental needs.
If you want to read even more clinical studies we have listed even more below…
Fill out this form to get in touch with our patient coordinators. They will answer any questions you have either over text or phone call and help you to book your free assessment!
Zirconia: Established facts and perspectives for a biomaterial in dental implantology:
https://onlinelibrary.wiley.com/doi/10.1002/jbm.b.31147
Performance and outcome of zirconia dental implants in clinical studies: A meta-analysis:
https://onlinelibrary.wiley.com/doi/10.1111/clr.13352
Zirconia Implants and Marginal Bone Loss: A Systematic Review and Meta-Analysis of Clinical Studies:
https://pubmed.ncbi.nlm.nih.gov/32724922/
Long-term survival and success of zirconia screw-retained implant-supported prostheses for up to 12 years: A retrospective multicenter study:
https://www.thejpd.org/article/S0022-3913(21)00265-1/fulltext
Prosthetic Materials Used for Implant-Supported Restorations and Their Biochemical Oral Interactions: A Narrative Review:
https://www.mdpi.com/1996-1944/15/3/1016
Zirconia: Established facts and perspectives for a biomaterial in dental implantology:
https://onlinelibrary.wiley.com/doi/10.1002/jbm.b.31147
Zirconia in dental implantology: A review:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515795/
Clinical Success of Zirconia in Dental Applications:
https://onlinelibrary.wiley.com/doi/10.1111/j.1532-849X.2009.00513.x
Implant Supported Fixed Dental Prostheses Using a New Monotype Zirconia Implant—A Case Report:
https://www.mdpi.com/2304-6767/3/3/79
Zirconia in dental implantology: A review:
https://pubmed.ncbi.nlm.nih.gov/26236672/
Zirconia as a Dental Biomaterial:
https://www.mdpi.com/1996-1944/8/8/4978
