Comparative Clinical, Radiographic, and Esthetic Outcomes of Zirconia and Titanium Implants in Single-Tooth Rehabilitations: A Systematic Review
Comparative Clinical, Radiographic, and Esthetic Outcomes of Zirconia and Titanium Implants in Single-Tooth Rehabilitations: A Systematic Review
DOI:
https://doi.org/10.51473/rcmos.v1i1.2026.2167Keywords:
Dental implants, Zirconia, TitaniumAbstract
Objectives: To comparatively evaluate the clinical, radiographic, and aesthetic performance of zirconia and titanium dental implants used in single-tooth restorations, through a systematic review and meta-analysis of randomized controlled trials (RCTs). Material and Methods: This systematic review was conducted according to the PRISMA 2020 guidelines and registered in PROSPERO (CRD42024541703). Only RCTs that directly compared zirconia and titanium implants in single-tooth restorations, with a minimum follow-up of 12 months after prosthetic placement, were included. Searches were conducted in ten electronic databases until January 2025. The risk of bias was assessed using the Cochrane RoB 2 tool. A random-effects meta-analysis was performed for marginal bone loss (MBL), peri-implant probing depth (PPD), and aesthetic outcomes assessed by the Pink Esthetic Score (PES). The certainty of the evidence was assessed using the GRADE approach. Results: Eight RCTs met the eligibility criteria. Qualitative analysis indicated a higher incidence of fractures and mechanical failures associated with zirconia implants in studies with longer follow-up. Quantitative synthesis revealed no statistically significant differences between zirconia and titanium implants in MBL (MD = -0.02 mm; 95% CI: -0.22 to 0.19; p = 0.88), PPD (MD = -0.01 mm; 95% CI: -0.28 to 0.26; p = 0.94) or aesthetic results (MD = 0.15; 95% CI: -0.18 to 0.48; p = 0.38). Implant survival was comparable in the short term, but zirconia showed greater variability over prolonged observation periods. Conclusions: Zirconia implants exhibit clinical and radiographic behavior similar to titanium implants in single-tooth restorations in the short and medium term. However, the higher risk of mechanical complications in zirconia implants should be considered in clinical planning. Further long-term studies are needed to confirm the biomechanical stability of this material.
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Copyright (c) 2026 Andrei Correa Guandalini, Nayara Diniz de Queiroz, Flávio Magno Gonçalves , Lélio Fernando Ferreira Soares, José Stechman Neto, André Misquilussi Moreira , Élcio Marcantonio Júnior (Autor)
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