Dental implant with reinforced zirconia abutment.

Dental Implant Dilemmas: Can Titanium Inserts Save Zirconia Abutments?

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"Explore how titanium inserts are revolutionizing internal-connection zirconia abutments, enhancing fracture strength and offering a promising solution for dental implants."

In the ever-evolving field of dentistry, the demand for aesthetically pleasing solutions has driven significant advancements in dental materials. As patients increasingly seek natural-looking restorations, ceramics have emerged as a popular alternative to traditional metals. This shift is evident not only in crowns and bridges but also in implant components, where the goal is to mimic the appearance of natural teeth seamlessly.

Ceramic implant abutments, in particular, have gained traction for their ability to prevent the appearance of unnatural metallic colors through the gums. This is especially crucial in the anterior region, where aesthetics are paramount. However, the inherent brittleness of ceramics has historically limited their application. Zirconia, a high-strength ceramic, has emerged as a promising material due to its exceptional resistance to fracture and fatigue, coupled with its aesthetic advantages.

Despite the benefits of zirconia, challenges remain, particularly in the design and connection of implant abutments. Internal friction connections, which rely on screw tightening and friction between the implant and abutment, offer improved force distribution compared to external connections. However, when zirconia is used in internal friction connections, the implant-abutment interface becomes a vulnerable point for fracture. This has spurred research into innovative solutions to reinforce zirconia abutments and enhance their long-term stability.

The Titanium Insert Solution: A Reinforcement Strategy

Dental implant with reinforced zirconia abutment.

To address the vulnerability of zirconia abutments in internal friction connections, researchers have explored the use of titanium inserts as a reinforcement strategy. The concept is to replace the direct contact point between the zirconia abutment and the implant with a titanium component. This essentially transforms the connection into a hybrid system that leverages the benefits of both materials.

A recent study investigated the effectiveness of titanium inserts in enhancing the fracture strength of zirconia abutments. The study compared three types of abutment assemblies:

Titanium abutment with titanium screw (Ti-Ti)
Zirconia abutment with titanium screw (Zr-Ti)
Zirconia abutment with titanium insert and titanium screw (Zr+Ti-Ti)

The study subjected these assemblies to compressive loading until deformation or fracture occurred. The results revealed significant differences in fracture strength between the groups. The Ti-Ti group exhibited the highest fracture load, followed by the Zr+Ti-Ti group, while the Zr-Ti group showed the lowest fracture strength. Notably, the inclusion of a titanium insert significantly improved the fracture resistance of the zirconia abutment.

Implications for Clinical Practice

The findings of this study have significant implications for clinical practice. The use of titanium inserts in zirconia abutments offers a promising approach to enhance the fracture resistance of these restorations. By strategically reinforcing the weakest point in the internal friction connection, clinicians can improve the long-term stability and success of implant-supported prostheses. This is particularly relevant in cases where high occlusal forces or parafunctional habits may compromise the integrity of the abutment.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.11607/jomi.3768, Alternate LINK

Title: Fracture Strength Study Of Internally Connected Zirconia Abutments Reinforced With Titanium Inserts

Subject: General Medicine

Journal: The International Journal of Oral & Maxillofacial Implants

Publisher: Quintessence Publishing

Authors: Hyo-Jung Chun, In-Sung Yeo, Joo-Hee Lee, Seong-Kyun Kim, Seong-Joo Heo, Jai-Young Koak, Jung-Suk Han, Shin-Jae Lee

Published: 2015-03-01

Everything You Need To Know

Why are ceramic implant abutments preferred over traditional metals?

Ceramic implant abutments are chosen over traditional metals, like those used in crowns and bridges, because of their ability to prevent the appearance of unnatural metallic colors through the gums, especially in the anterior region. Zirconia, a high-strength ceramic, is often used because of its resistance to fracture and fatigue, and its aesthetic advantages. This helps the restoration mimic the appearance of natural teeth seamlessly, which is a key goal for patients and clinicians alike.

What is the role of titanium inserts in dental implants?

Titanium inserts are used to reinforce the zirconia abutments. They are placed within the internal friction connection to replace the direct contact point between the zirconia abutment and the implant. This turns the connection into a hybrid system that uses the advantages of both materials. This is an important reinforcement strategy to improve the fracture resistance of these restorations, especially when dealing with high occlusal forces or parafunctional habits.

What are internal friction connections, and why are they important?

Internal friction connections are used in dental implants. These connections rely on screw tightening and friction between the implant and abutment, offering better force distribution compared to external connections. However, when zirconia is used in these connections, the interface becomes a vulnerable point for fracture. This is why solutions like titanium inserts are important for reinforcement. The study compared the titanium abutment with titanium screw (Ti-Ti), a zirconia abutment with a titanium screw (Zr-Ti) and the zirconia abutment with titanium insert and titanium screw (Zr+Ti-Ti). The results showed that the Zr+Ti-Ti group had significantly improved fracture resistance when compared to the Zr-Ti group.

What are the benefits of using titanium inserts in zirconia abutments?

The use of titanium inserts in zirconia abutments improves the long-term stability and success of implant-supported prostheses. When a zirconia abutment is used with internal friction connections, the implant-abutment interface becomes a vulnerable point. By reinforcing this weakest point with titanium inserts, the fracture resistance is improved. This reinforcement is particularly relevant in cases where high occlusal forces or parafunctional habits may compromise the integrity of the abutment.

What were the key findings of the study on abutment assemblies?

A recent study investigated the fracture strength of different abutment assemblies. They tested a titanium abutment with a titanium screw (Ti-Ti), a zirconia abutment with a titanium screw (Zr-Ti), and a zirconia abutment with a titanium insert and a titanium screw (Zr+Ti-Ti). The results showed that the Ti-Ti group had the highest fracture load, the Zr+Ti-Ti group was next, and the Zr-Ti group had the lowest fracture strength. The inclusion of the titanium insert significantly improved the fracture resistance of the zirconia abutment, which is a promising approach to enhance the long-term success of implant-supported prostheses.