Objectives: The objective of this systematic review was to assess the published data concerning the short-term and
midterm survival and success rates of ceramic dental implants (alumina, yttria-stabilized tetragonal zirconia
polycrystals) and to describe the incidence of biological complications (implant loss, peri-implant disease).
Methods: An electronic search was conducted to identify prospective cohort and retrospective clinical studies, case
series, as well as previous reviews on ceramic implants with a mean follow-up time of at least one year. The search
was performed in the following databases: Medline, Cochrane Library, Biosis, Embase and Web of Science.
Furthermore, the reference lists of related review articles selected for inclusion in this review were screened. The last
search was conducted in January 2016. All studies were first reviewed by abstract and subsequently by full-text by
two examiners independently.
Results: The electronic search yielded 1022 publications and 223 abstracts. Full-text analysis was performed for 50
articles resulting in a total of 36 clinical studies that fulfilled the inclusion criteria. Clinical studies using alumina dental
implants showed survival/success rates in the range of 23% to 98%. The survival rates for zirconia implants range
from 74-100% after 12-60 months, with success rates between 79.6-91.6% 6-12 months after functional loading.
Conclusions: Alumina implants do not perform satisfactorily and therefore it can be concluded that they should not be
considered an alternative to titanium. Concerning the zirconia implants, the evidence available to date indicates that
they are inferior to titanium implants with regard to survival and success rates. Zirconia implants with roughened
surfaces though, might be a viable solution. More longitudinal clinical studies are necessary to substantiate the longterm clinical efficacy of zirconia in implant dentistry
