Abstract
ABSTRACT
Objective
To compare the 3‐year clinical, radiographic, esthetic, and patient‐reported outcomes of zirconia (Zr) and titanium (Ti) implants placed in posterior sites in a randomized, controlled within‐subject design.
Materials and Methods
Forty‐two patients each received one Zr and one Ti implant. Clinical and radiographic outcomes were evaluated at baseline, 1, and 3 years after crown delivery. Marginal bone levels (MBL), peri‐implant soft‐tissue parameters, technical complications, esthetic outcomes (Δ
E
values, VAS scores), and patient‐reported measures were assessed. Thirty‐nine patients (37 Zr; 39 Ti implants) were available at 3 years.
Results
The 3‐year survival rate was 100% for Ti and 94.9% for Zr implants. MBL remained stable after the initial remodeling phase, with no clinically relevant differences between materials. Peri‐implant soft‐tissue conditions (BOP, plaque presence, PD, KT) were similar for Zr and Ti. Two zirconia implants were lost during the observation period. Peri‐implantitis was diagnosed in 7.9% of the implants, affecting three titanium and three zirconia implants. Technical complications differed between groups: chipping occurred significantly more often at Zr implant‐supported crowns. Ti implants showed two screw‐loosening events, while Zr implants showed two cases of decementation. Esthetic and patient‐reported outcomes were comparable, with low perceived mucosal color differences and a slight preference for Zr sites, if detectable.
Conclusion
Zr and Ti implants showed similar peri‐implant health, marginal bone stability, esthetic outcomes, and patient satisfaction after 3 years. Zr implants, however, demonstrated a slightly lower survival rate and more chipping.
Trial Registration
The trial is registered in the German Clinical Trials Register (DRKS) under the ID DRKS00008591