Performance and Outcome of Zirconia Dental Implants
Amsterdam 2018
Prosthodontics and Implant Dentistry
Consensus Statement
Treatment Outcomes and Continuing Care
Preamble

In recent history (since 2000s), numerous zirconia implant types exhibiting different physical properties and designs have been introduced to the dental market. This systematic review was undertaken to evaluate the performance of these implants. Primary outcomes investigated included implant survival and peri-implant marginal bone loss. Secondary outcomes included implant fractures, technical complications, biologic complications and aesthetic outcomes. Upon review of the literature, it became apparent that the data should be classified into two separate groups, those currently commercially available (CA), and those no longer commercially available (NCA).

Consensus Statements
  • The published data for CA zirconia implants only allow valid statements for one-piece designs. This statement is based on nine clinical studies (8 Prospective and 1 Retrospective) including 510 implants followed for 1-year, and five clinical studies (5 Prospective) including 192 implants followed for 2 years.
     
  • Comparing survival rates of CA one-piece zirconia implants with published data on titanium implants, 1-year (98%) and 2-year (97%) results showed similar outcomes. This statement is based on nine clinical studies (8 Prospective and 1 Retrospective) including 510 implants followed for 1 year, and five clinical studies (5 Prospective) including 192 implants followed for 2 years.
     
  • The survival rates of CA one-piece zirconia implants are statistically significantly higher than NCA implants. This statement is based on 18 clinical studies (14 Prospective and 4 Retrospective) including 1,128 implants.
     
  • CA zirconia implants show a mean peri-implant marginal bone loss on 0.67 mm (range: 0.20–1.02 mm) after 1 year. This statement is based on seven clinical studies (6 Prospective and 1 Retrospective) including 376 implants.
     
  • Comparing NCA and CA zirconia implants, marginal bone loss is not statistically significantly different. This statement is based on 14 clinical studies (11 Prospective and 3 Retrospective) including 839 implants.
     
  • Comparing NCA and CA zirconia implants, the fracture rate of onepiece designs has reduced from 3.4% to 0.2%. This statement is based on 18 clinical studies (14 Prospective and 4 Retrospective) including 1,128 implants.
Clinical Recommendations
  • Based on available data (up to 2 years), the use of one-piece CA zirconia implants can be recommended in cases where a one-piece soft tissue level implant with a cemented prosthesis in indicated and if requested by the patient.
     
  • Placement of one-piece zirconia implants should be prosthetically driven according to established guidelines for the implant design.
     
  • When using one-piece CA zirconia implants, the difficulties relating to a submucosal prosthodontic margin, removal of cement excess and difficulty with explantation have to be considered.
     
  • Two-piece CA zirconia implants can only be recommended with caution due to insufficient supporting data.
Review Paper
Classification Tags
Complications
Components & Materials
Consensus Statement
Implants
Outcomes
Success and Survival
Zirconia Implants
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Publication date: November 16, 2018 | Review date: November 09, 2018 | Next review date: November 09, 2021