Implant Prosthetic Materials: Comparing Fixtures, Abutments and PFM and Zirconia Crowns

An implant consists of three parts: the fixture (artificial tooth root) placed in the jawbone, the abutment (connecting post) fitted on it, and the crown (artificial tooth) that shows on the outside. The Korea Disease Control and Prevention Agency (KDCA, 질병관리청) explains that the fixture is made of titanium and bonds with the bone. In Korea, an insured implant for people aged 65 or older is covered only when a separable fixture and abutment are used with a PFM or zirconia crown.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

Fixture material	Titanium artificial tooth root (bonds with the bone by osseointegration) (source: KDCA National Health Information Portal)
Insured placement materials	Only the separable type, in which fixture and abutment are separate, is covered (source: Ministry of Health and Welfare Notice No. 2025-23)
Insured crown materials	PFM crown, zirconia crown (zirconia from February 1, 2025) (source: Ministry of Health and Welfare Notice No. 2025-23)
Custom abutment	Only the abutment is non-covered; the implant procedure stays covered (source: Ministry of Health and Welfare Notice No. 2025-23)
How the prosthesis is fixed	Fixed to the abutment with cement or a retaining screw (source: KDCA National Health Information Portal)

What parts is an implant made of?

The fixture is a screw-shaped artificial tooth root placed inside the jawbone. The KDCA explains that osseointegration, in which the titanium fixture bonds firmly with the bone, is the core principle of the implant. Products differ according to how the fixture surface is treated, and in the National Health Insurance treatment material list they are also classified by surface treatment method.

The abutment is the post that connects the fixture and the crown. The crown is the artificial tooth responsible for the chewing surface and the appearance, and its color, strength and cost differ with the material.

In addition, parts such as the cover screw that covers the fixture and the healing abutment that shapes the gum are used midway through treatment. For insured implants, the cost of such parts and of the crown material is included in the fee and is not charged separately.

What is the difference between separable and one-piece types, and between stock and custom abutments?

In the separable type, the fixture and the abutment are made separately and joined with a screw, while in the one-piece type the two parts are a single unit. Health insurance recognizes only the separable type, and if the procedure is done with a one-piece type, the entire implant becomes non-covered.

A stock abutment is a product made in a predetermined shape, while a custom abutment is made separately to fit the patient's gum height and angle. If a custom abutment is used in an insured implant, only that abutment is paid as non-covered and the rest of the procedure is handled as covered.

Even among separable materials, not every product is covered. The National Health Insurance Service says there are some fixture and abutment items set as non-covered in the treatment material list, so check with the clinic whether the product to be used is insured.

How do implant crown materials differ?

A PFM crown is a crown in which porcelain covers a metal framework to give a tooth color. A zirconia crown is made of zirconia ceramic without metal, so no metal color shows through at the gum line. A gold crown is made of a gold alloy and its color differs from the teeth.

Which material suits depends on whether it is a front tooth or a molar, the condition of the opposing teeth, teeth-grinding habits and the height of the remaining space. More important than the name of the material is being told why it is recommended for that site.

PFM: tooth-colored crown with porcelain over a metal framework; an insured material
Zirconia: metal-free ceramic crown; an insured material since February 2025
Gold, PFG and others: using them in an insured implant makes the entire procedure non-covered

How does health insurance in Korea differ by material?

Ministry of Health and Welfare Notice No. 2025-23 set the coverage target, from February 1, 2025, as implants done with separable placement materials and a PFM or zirconia crown. Before that, only PFM crowns were covered.

If a material outside these conditions is used, not a part but the entire implant procedure becomes non-covered. A prosthesis made in a form other than a crown, such as an overdenture in which a denture snaps onto ball-type abutments, is also not covered. If you are 65 or older, check whether insurance applies before deciding the material, which helps reduce the cost difference.

What is the difference between screw-retained and cemented crowns?

The KDCA explains that the artificial tooth is fixed to the abutment with cement or a retaining screw. The screw-retained type has a small hole in the crown, tightened with a screw and then filled, while the cemented type bonds the crown on top of the abutment.

The screw-retained type is easy to loosen and inspect if a problem arises, while the cemented type has no screw hole on the chewing surface. With either method, the bite and the gum line are checked on the day of placement, and for an insured implant you can have adjustments at the same clinic for 3 months after placement paying only the consultation fee. The handling when the screw later loosens or the crown comes off also differs by method, so make a note of it at placement.

Common myths and facts

Myth: An implant lasts longer if an expensive crown material is used.

The KDCA explains that implants are not permanent and that oral hygiene and regular check-ups matter for long use. Gum care and chewing habits matter more than the material.

Myth: Insured implants can only use metal crowns.

From February 1, 2025, both PFM crowns and zirconia crowns are covered materials.

Frequently asked questions

Can I not get an implant if I am allergic to titanium?

If you have a history of metal allergy, be sure to tell the dentist before surgery and discuss it with your physician. If you have allergy test results from a dermatology clinic or elsewhere, bring them to the consultation. Whether the choice of material and testing are needed is judged by the dentist from your personal history.

Is there an extra cost if I choose zirconia for an insured implant?

Since February 1, 2025, zirconia crowns are also covered materials, so they are handled within the coverage criteria. If non-covered materials are used together, such as a custom abutment, only that part is paid separately.

Are there big differences between fixture products?

There are various fixture products depending on the surface treatment and shape. More than the product name, what matters for long-term care is whether the clinic consistently treats with that product and can obtain parts afterwards.

What if I do not know the product of an implant placed in the past?

Product information may be needed when another clinic repairs it. If you request a copy of the medical record from the clinic that treated you and obtain the product name and specifications, it is easier to match parts later. If you are having a new implant placed, it is good to get and keep the product information when treatment ends.

Which material is good for a front tooth implant?

For front teeth, the gum line and color are clearly visible, so materials through which no metal shows are often considered. However, the thickness of the gum and the biting force must also be considered, so ask the dentist to explain using photos and models.

References

Korean version →