One-piece zirconia oral implants supporting three-unit fixed dental prostheses: Ten-year results from a prospective case series.

OBJECTIVES: This prospective case series aimed to evaluate the long-term clinical and radiographic outcomes of one-piece zirconia implants used to support three-unit fixed dental prostheses after a decade of functional loading. The primary endpoint was implant survival.

MATERIALS AND METHODS: A total of 54 implants were placed in 27 patients using a one-stage surgical approach with immediate provisionalization. Peri-implant bone loss was assessed using standardized radiographs; soft-tissue parameters were also evaluated. Statistical analysis was conducted using linear mixed regression models and Wilcoxon Signed Rank tests to compare differences over time and between variable groups (p < 0.05).

RESULTS: One patient was lost to follow-up after one year, and another declined participation in the 10-year evaluation. Over the 10-year period, 21 implants failed, leading to a cumulative survival rate of 59.26 %. The mean marginal bone loss of the remaining implants was measured at 1.61 mm. Probing depth, clinical attachment loss, bleeding on probing and plaque index showed an increase from the initial prosthesis placement to the 10-year follow-up.

CONCLUSIONS: The studied one-piece zirconia implants demonstrated lower survival rates compared to previously reported survival rates of zirconia and titanium implants. Implant failures were mainly due to peri‑implantitis, necessitating their removal. This specific implant is not commercially available.

CLINICAL SIGNIFICANCE: Despite favorable initial outcomes, the one-piece zirconia implants studied showed a low 10-year survival rate, primarily due to peri‑implantitis. These findings highlight the importance of long-term monitoring and material selection when using zirconia implants to support multi-unit restorations. Clinicians should exercise caution with similar implant designs.