Long-Term Success of All-Ceramic Dental Implants Compared with Titanium Implants.

All-ceramic dental implants have been identified as a potential alternative to the traditional titanium-based implant systems used in dentistry to satisfy the demands for esthetic metal-free treatment of edentulous jaws. Among the all-ceramic implants introduced in dentistry, zirconia implants have emerged as the forerunner. The success of zirconia as an implant material has paralleled that of titanium in the short-term, however, few clinical studies assess success in the long-term. Failures of zirconia dental implants have been linked to improper operator techniques, manufacturing defects, and unfavorable loading, thereby necessitating optimal quality control measures by manufacturers and proper treatment planning by an experienced operator to reinforce the favorable properties of zirconia as an implant biomaterial. In this comprehensive review, the various implant-related, tissue-related, prosthesis-related, and patient-related factors affecting the success of zirconia implants have been discussed and compared with those of the titanium implant.