Show Notes
Is titanium still the gold standard for implants? Are zirconia implants just hype from biological dentistry… or something more? Do ceramic implants really integrate as well as titanium? And should we already be offering patients a choice? Zirconia implants are no longer a fringe concept—they’re entering mainstream conversations. In this episode, Dr. Pav Khaira returns to break down the science, clinical decision-making, and real-world application of zirconia vs titanium implants. From corrosion and osteoimmunology to occlusion and case selection, this is a practical, evidence-led discussion for clinicians navigating modern implant options. https://youtu.be/-RCvf2KOdSc Watch PDP264 on YouTube Protrusive Dental Pearl: Thriving in Challenging Times 💡 Prioritize quality sleep—it sharpens decision-making, improves mood, and reduces irritability (6–7 solid hours beats longer, disrupted sleep). ➡️ Remember, stress comes from how we respond, not the situation itself—focus on what you can control and let go of the rest. 📢 Lean on your support system and make time for reflection and gratitude—they help reframe pressure and build resilience. Key Takeaways Zirconia implants integrate just as well as titanium, with comparable clinical outcomes Early healing may be slightly faster around zirconia, but long-term results are similar Titanium can corrode over time, releasing particles linked to peri-implantitis Zirconia does not corrode, removing this biological risk factor Modern implant thinking focuses on osteoimmunology, not just osseointegration Zirconia implants are often one-piece → no microgap and improved crestal bone stability Surgical placement must be highly precise—zirconia is less forgiving than titanium Guided osteotomy is strongly recommended for ceramic implants Fracture risk in modern zirconia implants is low when manufactured correctly Hot isostatic pressing significantly increases zirconia strength and reduces defects Case selection is critical—limited bone or complex angulation may favour titanium Zirconia implants are typically cement-retained only Excess cement remains a risk factor for peri-implant disease → manage carefully Zinc phosphate cement is useful due to radiopacity and bacteriostatic properties Angled screw correction (titanium) is predictable only up to ~15 degrees Patient preference for metal-free dentistry is a growing driver of zirconia demand Episode Highlights 00:00 Teaser 00:49 Introduction 02:32 Protrusive Dental Pearl: Advice for Dentists during challenging times 05:14 Basics: What Are Implants Made Of? 07:13 Osseointegration: Zirconia vs Titanium 08:28 Why Zirconia? Biological Rationale 11:13 Clinical Advantages of Zirconia Implant 14:09 Zirconia Implants Limitations in Clinical Use 17:45 Case Selection: When to Use Zirconia Implant 19:16 Fracture Risk: Myth vs Reality 21:30 Midroll 24:51 Fracture Risk: Myth vs Reality 25:29 Importance of Manufacturing Zirconia Implants 27:49 Weaknesses & Clinical Considerations of Zirconia Implants 30:49 Occlusal Programming for Implants 32:24 Screw vs Cement Retention in Implants 34:07 Angle Screw Correction (titanium Context) 36:20 Cement Choices for Zirconia Implants 38:27 Market Share & Future Trends of Zirconia Implants 40:25 Learning Resources for Zirconia Implants 41:51 Medico-Legal Considerations of Zirconia Implants 47:37 Training & Education Pathways for Zirconia Implants 48:25 Outro Want to go deeper into implants? Explore Dr. Pav Khaira’s Academy of Implant Excellence— training designed to help you truly understand the why behind implant dentistry, not just follow protocols. Hands-on options, mentorship, and advanced training available. ✨Follow Academy of Implant Excellence on Instagram: https://www.instagram.com/academyofimplantexcellence Mentioned resources from this Episode Book: Zirconia: Material Properties and Surgical Principles for Dental Implants and Restorations Want more? 📢 Check out more episodes on implant complications and treatment plan
More from Protrusive Dental Podcast
Is your diary running you — booked weeks ahead, no white space, drowning by Thursday? Do you really have to specialise to get referrals? How does an associate negotiate a month off every August — and get a yes? And what changes when you start treating yourself as your most important instrument? This is Part 1 of a two-part conversation with Dr Ronit Patel — a Richmond GDP of 20-odd years, an associate at the White House Dental Clinic in Kew, and one of the nicest and geekiest members of the Protrusive community. He works three and a half days a week, takes Wednesdays off, and typically takes the whole of August off. This episode is how he got there: staying a generalist when specialising beckoned, buying a microscope he wasn’t allowed to see, building a referral book without social media, and — the big one — taking control of the diary. It’s a warm, reflective conversation rather than a technique masterclass, and Ronit is refreshingly honest that it hasn’t always been smooth. Part 2 goes into fuel versus friction: what fills you, and what drains you.
Ever felt like being a good clinician is just the entry fee? Have you got an idea you’ve been sitting on — and no one telling you to go for it? Practice ownership, a side business, or staying a happy associate: how do you know which is right for you? And when you tell a patient the fee… do you stay silent, or start talking? This is an Interference Cast — a non-clinical episode designed purely to inspire. My guest, Dr Jawad Abbas, is a young associate who’s already building two ventures alongside his clinical work: an AI tool for radiographic analysis and treatment-plan communication, and a luxury oral-care brand. We start with the communication skills that turn patient trust into comprehensive care — then dig into what it really takes to build something of your own, and whether you even should. We’re living through a moment where, if you can think it, you can increasingly build it. If there’s a big enough problem out there and you have a good solution for it, this episode might be the spark you needed.
Beyond Scaling: How to Get More From Your Ultrasonic
Would you dare promise patients a refund if they felt any pain? Why do so many of us still skip topical — and what does that say to the patient in the chair? How do you take the sting out of an inferior alveolar nerve block, a palatal, or a screaming hot pulp? And when the lip is numb but the patient still feels it — what went wrong before you even picked up the handpiece? My guest is Dr Nigel Kennedy, known to his Brighton patients as “No Pain Nigel” — a dentist who backed his injections with a money-back guarantee, and who has recently retired. Fair warning: there is no revolutionary technique or new anaesthetic agent in this episode. It is the foundations of painless anaesthesia, done properly and done every time — a great reminder of the why for experienced colleagues, and an aspirational one for younger dentists. We finish on something bigger: how to stay calm, stay well, and enjoy a long career in dentistry.
When a filling doesn’t go to plan, how many times do you replay it on the drive home? Have you fallen out of love with dentistry — or just with the way you’re experiencing it right now? Why do the habits that could help your headspace get forgotten by Wednesday? And when did you last ask yourself: have my thoughts been serving me today?