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Introduction. In addition to the success of titanium implants since Branemark, several researchers report effects observed on the adjacent implant tissues. The interactions between these tissues and the implant depend on the type of biomaterials, the characteristics of the individual and the environment. The objective of our study was to compare bone resorption around titanium and zirconia implants in two groups of melano-African and European leukoderma patients. Methods. A randomized, single-blind clinical trial was conducted in 28 patients with bilateral mandibular intercalary edentulism, 26 implants in Cameroon and 30 in Belgium. The procedure consisted of the placement of one titanium and one zirconia dental implant on each hemi-arch. Bone resorption was evaluated by the variations of mesial and distal crete heights measured with the Cone Beam at 06, 12 and 18 months.   Results.  At 18 months, mesial (p=0.004) and distal (p=0.046) bone resorption around titanium implants was greater in melano-African patients. These results are similar in European leukoderma patients, p=0.010 mesially and p=0.010 distally. The comparison of patients according to their origin showed less distal bone resorption in the Cameroon group (p=0.001). Conclusion. Bone resorption at 18 months around titanium and zirconia implants is less important in melano-African patients. These results may allow a better choice for implant durability in Africa in the long term.


Zirconia Titanium Bone resorption Osseointegration Zircone Titane Résorption osseuse Ostéointégration

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Jules Julien Ndjoh, Georgette Marina Allou Amoin, Mengong Moneboulou Hortense, Sandra lydie Akena Ndeng, N’goran Justin Koffi, & Charles Bengondo Messanga. (2023). Comparison of Marginal Bone Loss Around Titanium and Zirconia Implants: Clinical Trial in Cameroon and Belgium. HEALTH SCIENCES AND DISEASE, 24(2 Suppl 1). Suppl 1.4272


  1. Jacobs R, Schotte A, van Steenberghe D, Quirynen M, Naert I. Posterior jaw bone resorption in osseointegrated implant-supported overdentures. Clin Oral Implants Res. 1992 Jun;3(2):63–70.
  2. Kitamura E, Stegaroiu R, Nomura S, Miyakawa O. Biomechanical aspects of marginal bone resorption around osseointegrated implants: considerations based on a three-dimensional finite element analysis. Clin Oral Implants Res. 2004 Aug;15(4):401–12.
  3. Hansson S, Halldin A. Alveolar ridge resorption after tooth extraction: A consequence of a fundamental principle of bone physiology. J Dent Biomech [Internet]. 2012 Aug 16 [cited 2020 Apr 6];3. Available from:
  4. Bert M. Les lois de Wolff. Conséquences cliniques 2e partie. Actual Odonto-Stomatol. 2018 Feb 1;(288):3.
  5. Evrard L, Waroquier D, Parent D. [Allergies to dental metals. Titanium: a new allergen]. Rev Med Brux. 2010 Feb;31(1):44–9.
  6. Pigatto PD, Brambilla L, Ferrucci S, Zerboni R, Somalvico F, Guzzi G. Systemic allergic contact dermatitis associated with allergy to intraoral metals. Dermatol Online J. 2014 Oct 15;20(10).
  7. Manicone PF, Rossi Iommetti P, Raffaelli L, Paolantonio M, Rossi G, Berardi D, et al. Biological considerations on the use of zirconia for dental devices. Int J Immunopathol Pharmacol. 2007 Mar;20(1 Suppl 1):9–12.
  8. Sivaraman K, Chopra A, Narayan AI, Balakrishnan D. Is zirconia a viable alternative to titanium for oral implant? A critical review. J Prosthodont Res. 2018 Apr 1;62(2):121–33.
  9. Triplett RG, Frohberg U, Sykaras N, Woody RD. Implant materials, design, and surface topographies: their influence on osseointegration of dental implants. J Long Term Eff Med Implants. 2003;13(6):485–501.
  10. Herforth A, Arimond M, Álvarez-Sánchez C, Coates J, Christianson K, Muehlhoff E. A Global Review of Food-Based Dietary Guidelines. Adv Nutr. 2019 Jul;10(4):590–605.
  11. Putman MS, Yu EW, Lee H, Neer RM, Schindler E, Taylor AP, et al. Differences in Skeletal Microarchitecture and Strength in African-American and Caucasian Women. J Bone Miner Res Off J Am Soc Bone Miner Res. 2013 Oct;28(10):2177–85.
  12. Freedman BI, Divers J, Palmer ND. Population ancestry and genetic risk for diabetes and kidney, cardiovascular, and bone disease: modifiable environmental factors may produce the cures. Am J Kidney Dis Off J Natl Kidney Found. 2013 Dec;62(6):1165–75.
  13. Möller B, Terheyden H, Açil Y, Purcz NM, Hertrampf K, Tabakov A, et al. A comparison of biocompatibility and osseointegration of ceramic and titanium implants: an in vivo and in vitro study. Int J Oral Maxillofac Surg. 2012 May;41(5):638–45.
  14. Degidi M, Artese L, Scarano A, Perrotti V, Gehrke P, Piattelli A. Inflammatory Infiltrate, Microvessel Density, Nitric Oxide Synthase Expression, Vascular Endothelial Growth Factor Expression, and Proliferative Activity in Peri-Implant Soft Tissues Around Titanium and Zirconium Oxide Healing Caps. J Periodontol. 2006 Jan;77(1):73–80.
  15. Roehling S, Schlegel KA, Woelfler H, Gahlert M. Performance and outcome of zirconia dental implants in clinical studies: A meta-analysis. Clin Oral Implants Res. 2018 Oct;29 Suppl 16:135–53.
  16. Sterner T, Schütze N, Saxler G, Jakob F, Rader CP. [Effects of clinically relevant alumina ceramic, zirconia ceramic and titanium particles of different sizes and concentrations on TNF-alpha release in a human macrophage cell line]. Biomed Tech (Berl). 2004 Dec;49(12):340–4.
  17. Rimondini L, Cerroni L, Carrassi A, Torricelli P. Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study. Int J Oral Maxillofac Implants. 2002 Dec;17(6):793–8.
  18. de Freitas AR, Silva TS de O, Ribeiro RF, de Albuquerque Junior RF, Pedrazzi V, do Nascimento C. Oral bacterial colonization on dental implants restored with titanium or zirconia abutments: 6-month follow-up. Clin Oral Investig. 2018 Jul;22(6):2335–43.
  19. Kassem A, Lindholm C, Lerner UH. Toll-Like Receptor 2 Stimulation of Osteoblasts Mediates Staphylococcus Aureus Induced Bone Resorption and Osteoclastogenesis through Enhanced RANKL. PloS One. 2016;11(6):e0156708.
  20. Pasold J, Markhoff J, Tillmann J, Krogull M, Pisowocki P, Bader R. Direct influence of titanium and zirconia particles on the morphology and functionality of mature human osteoclasts. J Biomed Mater Res A. 2017 Sep;105(9):2608–15.
  21. Conradie M, Conradie MM, Kidd M, Hough S. Bone density in black and white South African women: contribution of ethnicity, body weight and lifestyle. Arch Osteoporos. 2014;9:193.
  22. Finkelstein JS, Lee M-LT, Sowers M, Ettinger B, Neer RM, Kelsey JL, et al. Ethnic variation in bone density in premenopausal and early perimenopausal women: effects of anthropometric and lifestyle factors. J Clin Endocrinol Metab. 2002 Jul;87(7):3057–67.
  23. Monje A, Aranda L, Diaz KT, Alarcón MA, Bagramian RA, Wang HL, et al. Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis. J Dent Res. 2016 Apr;95(4):372–9.
  24. Vashishth D, Verborgt O, Divine G, Schaffler MB, Fyhrie DP. Decline in osteocyte lacunar density in human cortical bone is associated with accumulation of microcracks with age. Bone. 2000 Apr;26(4):375–80.

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