Titanium implant grades and alloys

Titanium as the standard material

Most dental implant systems are made of titanium or zirconium oxide.¹ The research that defined osseointegration used threaded screws of unalloyed (commercially pure) titanium.² The FDA requires implant materials to be considered safe for medical and dental use by ISO or ASTM International.¹

The same 1981 report found no wear products in bone or soft tissue around titanium implants loaded for up to 90 months.² Soft tissue also adhered closely to the titanium where it passed through the gum.²

Commercially pure titanium grades

ASTM F67 is the standard for unalloyed titanium used in surgical implants.³ It covers four grades, numbered 1 to 4, each with its own chemical and mechanical requirements.³

Titanium alloy

ASTM F136 is the standard for titanium-6aluminum-4vanadium ELI (extra low interstitial) alloy used in surgical implants.⁴ This alloy is titanium with small amounts of aluminum and vanadium.⁴ A separate alloy, titanium-zirconium, is covered in its own topic.

Surface treatment

Implant surfaces differ in texture (roughness), and surface texture influences how bone responds.⁵ A systematic review of experimental studies found that moderately rough titanium surfaces produced stronger bone responses than smooth or minimally rough surfaces.⁵

How titanium implants perform

A 2019 systematic review of 18 prospective studies of contemporary solid-screw, roughened-surface implants estimated 10-year implant survival at 96.4 percent.⁶ A sensitivity analysis in the same review that accounted for patients lost to follow-up estimated 93.2 percent.⁶

Questions to ask

The FDA suggests asking the dentist about the specific brand and type of implant planned and keeping notes of the discussion.¹

General information about dental implants. Treatment decisions are made with a licensed dentist.

Sources

1. U.S. FDA: Dental Implants, What You Should Know. fda.gov
2. Albrektsson T et al. Osseointegrated titanium implants. Acta Orthop Scand 1981. pubmed.ncbi.nlm.nih.gov
3. ASTM F67: Unalloyed Titanium for Surgical Implant Applications. store.astm.org
4. ASTM F136: Wrought Ti-6Al-4V ELI Alloy for Surgical Implant Applications. store.astm.org
5. Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: systematic review. Clin Oral Implants Res 2009. pubmed.ncbi.nlm.nih.gov
6. Howe MS, Keys W, Richards D. Long-term (10-year) dental implant survival. J Dent 2019. pubmed.ncbi.nlm.nih.gov