Zirconia Implants and Marginal Bone Loss: A Systematic Review and Meta-Analysis of Clinical Studies.

Abstract

The purpose of this study was to provide sufficient information on the clinical outcome of zirconia implants, mainly observing the survival rate and marginal bone loss (MBL), with a minimum follow-up of 12 months, to verify the adoption of ceramics as a rational possibility for dental implants. A systematic electronic search through the PubMed (MEDLINE) and EMBASE databases was performed by two independent reviewers to identify clinical studies published between January 2005 and April 2019 containing a minimum of 10 patients per study and 12 months of follow-up after functional loading. References from the selected articles were manually reviewed for further studies. From the initial 1,225 articles retrieved, 19 met all the inclusion criteria. The marginal bone remodeling accounted for mean losses of 0.8 mm (95% CI: 0.60 to 1.00 mm) and 1.01 mm (95% CI: 0.72 to 1.29 mm) at 1 year and 2 years postloading, respectively. The failure rate of 6.8% was calculated for a mean follow-up period of 2.75 years, where the prevalence of early failure, late failure, and implant fracture was 3.4%, 1.7%, and 1.7%, respectively. The meta-analysis associated with the survival rate of one- and two-piece zirconia dental implants was hindered due to the lack of confidence interval or standard deviation information in most of the included articles. Zirconia implants presented MBL values consistent with the standard in the global consensus, high survival rates, and considerable clinical results at short-term observation periods following prosthetic delivery.