Zeramex

A tooth-coloured implant with no metal in its implant components, for people considering an alternative to titanium in their jaw. Zeramex is one of the ceramic implant systems we work with as part of our metal-free dental implants service at Nuffield Dental.

If you've been told you need an implant and would prefer to avoid metal-containing implant components, Zeramex is one ceramic option that may be considered depending on clinical suitability.

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What Is Zeramex?

Zeramex is a ceramic implant system made in Switzerland and available in Singapore since 2021. The implant is zirconia, a hard white ceramic, so there's no metal in the part that sits in your jawbone.

It comes in two pieces: an anchor that goes into the bone, and a post above it that carries your crown. In most two-piece implants a small titanium screw joins the two. Zeramex uses one made from carbon fibre instead, which is what lets the system stay metal-free all the way through.

That's the part most people want to know. If you're curious about the engineering, the ceramic handles squeezing forces well while the carbon-fibre screw takes the pulling and bending, and the zirconia itself is blended with alumina to stop small cracks spreading.

Replacing a Missing Tooth: The Options

An implant is one way to replace a missing tooth. A dental bridge uses the teeth either side of the gap for support, and dentures rest on the gum and come out for cleaning. Which suits you depends on how much bone you have, the condition of the neighbouring teeth, your general health and what you want day to day.

Implant treatment is minor oral surgery and carries the usual risks: infection, swelling and slower healing in some people. An implant can also fail to fuse with the bone, which happens in a small number of cases and is more likely if you smoke or have untreated gum disease. Ceramic implants have a shorter published record than titanium, and two-piece designs have been studied less than one-piece ones. Your dentist will go through all of this with you before you agree to anything.

What Treatment Involves

Zeramex is placed in two stages with a healing period in between. Your implant goes in first and is left to fuse with the bone before your final crown is fitted, with healing typically taking around three months in the lower jaw and six months in the upper, depending on the individual case.

That staged approach is normal for ceramic implants. If timing matters to you, say so when your options are being discussed, because some titanium systems can carry a temporary tooth sooner, and the expected timeline can be discussed for your own case before anything is decided.

Is It Right for Your Gap?

Three sizes are available here, in a range of lengths designed for different single-tooth situations.

The narrowest implants have a defined role. They're used for the front teeth in the lower jaw and the side teeth next to your front teeth in the upper jaw, or to anchor a denture. So if your gap is narrow and sits further back, we'd look at a wider implant or a different system. It's one of the first things we check from your scan.

Your crown, bridge or denture can be screwed onto the implant rather than cemented, which makes it easier to take off and service later if it ever needs attention.

How Well Ceramic Implants Hold Up

Ceramic implants have a shorter research record than titanium, and the available evidence continues to develop.

What was measured	Result
Two-piece ceramic survival (six studies, 298 implants)	96.31%
Zeramex specifically (independent 2026 study, 31 implants)	93.55% at around 29 months
Survival compared with titanium at one year	No significant difference
Extra bone loss compared with titanium at one year	0.16mm, gone by five years

One-piece ceramic implants currently have the longer research record, and reviews that separate the two tend to report slightly higher survival rates for one-piece designs than for two-piece designs like this one. What two-piece designs give you in return is the ability to correct the angle and to screw the crown on, which a one-piece implant can't offer. Both have their place.

Your result depends a great deal on your bone, your gum health, whether you smoke and how carefully the case is planned. Those factors are considered during treatment planning.

What to Weigh Up

Metal content: there's no metal in the implant, the post or the screw. A few items used during treatment aren't ceramic, such as the surgical drills, but none of them stay in your mouth. The more precise description is that the system may be considered by patients seeking to avoid metal-containing implant components, subject to clinical suitability.
Appearance: zirconia is white, so it may reduce the appearance of a grey shadow at the gum line if your gum thins over the years. This matters most for front teeth.
MRI scans: zirconia isn't magnetic, so it produces less interference on an MRI than titanium does. Worth raising if you expect head or neck scans.
Where the evidence sits: strongest for single teeth and short spans. For a larger rebuild, or where an implant has to sit at a steep angle, titanium usually remains the better fit.
Timing: the staged healing period above is part of the deal, so if speed is your priority this may not be the right route.

Zeramex at Nuffield Dental

Ceramic implants sit within our holistic dentistry service, alongside amalgam replacement and attention to material considerations when planning care. Dr Samintharaj Kumar's clinical focus includes ceramic implantology alongside full-arch and zygomatic work, and he has worked across several implant systems since 2004.

We work with more than one system, and which we suggest for you follows from your imaging and assessment rather than a preference set in advance.

If you have a missing tooth, or one your dentist has said cannot be saved, an assessment can help determine which options may be suitable. Imaging may be used to assess the area and support treatment planning. Our dental implants page sets out both materials side by side.

Orchard Dental

Nuffield Dental Jewel
Wheelock Place501 Orchard Road #05-01 Singapore 238880

+65 6950 2866

+65 9657 4331

jewel@nuffielddental.com.sg

Closed on Public Holidays

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FAQs

How long does treatment take with a Zeramex implant?

Your implant is placed first and left to fuse with the bone before your final crown is fitted, which takes three months in the lower jaw and six months in the upper. If a shorter timeline matters to you, mention it at the planning stage, as some titanium systems can carry a temporary tooth sooner.

Is it really completely metal-free?

The implant, the post and the screw that joins them contain no metal, and those are the parts that stay in your mouth. Some instruments and laboratory components used during treatment do contain metal, and none of them remain once your crown is fitted.

Do ceramic implants lead to less gum disease than titanium?

A 2026 review found no significant difference between the materials. Laboratory work on plaque has been somewhat more favourable to zirconia. Either way, daily cleaning and regular reviews help maintain the health of the gums around an implant.

Can Zeramex parts be replaced years from now?

Replacement parts need to come from the same system and are subject to component availability. It's a closed system and isn't compatible with the manufacturer's earlier generations, so ask for the system name, size, length and lot number to go into your notes, and keep a copy for yourself.

Medical References

Apaza Alccayhuaman, K. A., Zandinejad, A., Beltrao, R., Schick, F., & Rohr, N. (2026). ZrO Summit 2025, Group 4: Biological complications and peri-implant tissue response of zirconia compared with titanium dental implants: A systematic review and meta-analysis of clinical evidence. International Journal of Oral & Maxillofacial Implants. Advance online publication. https://doi.org/10.11607/jomi.11786

Atalay, B., Emes, Y., Işsever, H., Şahabettinoğlu, A., Aybar, B., Eyüboğlu, T. F., & Özcan, M. (2026). Assessment of mid-term success in various types of zirconia implants: A retrospective clinical analysis. Clinical Oral Investigations, 30(1), 59. https://doi.org/10.1007/s00784-026-06751-9

Al-Nawas, B., Lambert, F., Andersen, S. W. M., Bornstein, M. M., Gahlert, M., Jokstad, A., Jung, J., Kwon, Y. D., Laleman, I., Oteri, G., Roehling, S., Schiegnitz, E., Takeda, Y., & Terheyden, H. (2023). Group 3 ITI Consensus Report: Materials and antiresorptive drug-associated outcomes in implant dentistry. Clinical Oral Implants Research, 34(S26), 169-176. https://doi.org/10.1111/clr.14135

Bazal-Bonelli, S., Castro-Janeiro, M., Ríos-Barbero, J., Cano Sánchez de Tembleque, M., López-Quiles, J., Meniz-García, C., & Cortés-Bretón Brinkmann, J. (2025). Clinical behavior of two-piece zirconia implants. A systematic review. Medicina Oral, Patología Oral y Cirugía Bucal, 30(3), e313-e321. https://doi.org/10.4317/medoral.26752

Morton, D., Gallucci, G., Lin, W. S., Pjetursson, B., Polido, W., Roehling, S., Sailer, I., Aghaloo, T., Albera, H., Bohner, L., Braut, V., Buser, D., Chen, S., Dawson, A., Eckert, S., Gahlert, M., Hamilton, A., Jaffin, R., Jarry, C., ... Zhou, W. (2018). Group 2 ITI Consensus Report: Prosthodontics and implant dentistry. Clinical Oral Implants Research, 29(S16), 215-223. https://doi.org/10.1111/clr.13298

Pachiou, A., Delgado-Ruiz, R., Schnurr, E., Kim, D. M., Romanos, G. E., & Balmer, M. (2026). ZrO Summit 2025, Group 1: Survival and clinical performance of zirconia compared to titanium implants: A systematic review and meta-analysis. International Journal of Oral & Maxillofacial Implants. Advance online publication. https://doi.org/10.11607/jomi.11788

Why Choose Nuffield Dental?

Nuffield Dental is a dental clinic in Singapore providing services across several dental disciplines. Treatment is planned after a consultation and clinical assessment.

Nuffield Dental provides dental services across several disciplines at its clinics in Singapore. After a consultation and clinical assessment, your dentist sets out the treatment options that apply to your case, what each option involves and what it costs, before treatment begins.

More about Implants

Our dentists are registered with the Singapore Dental Council. The team includes dentists who provide root canal treatment, oral surgery and dental implant treatment. Each dentist's qualifications and registration details are listed on their profile page.

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