Survival rate and aesthetic outcomes of two-piece zirconia dental implants: A one-year single clinical trial of partially edentulous patients

Titanium dental implants, traditionally used for tooth replacement, face certain biological and esthetic limitations. Recently, zirconia has become a notable alternative, valued for its esthetics and biocompatibility. This study evaluated the efficacy of 2-piece zirconia dental implants, particularly their impact on inflammatory cytokines and their survival rate over 1 year. This study was a single-center, prospective trial and included adults aged 18 and above. From 2021 to 2022, 9 2-piece, tissue-level zirconia implants were placed in 8 patients. Following a 3-month osseointegration phase, crowns were cemented. Over a year, we assessed plaque and gingival indices, pocket depth, and tissue color and texture. Peri-apical radiographs measured bone levels, and IL-1β in peri-implant crevicular fluid was quantified using the enzyme-linked immunosorbent assay. Eight subjects (ages 31–63) participated. One implant failed after 6 months, resulting in a 1-year survival rate of 88.8%. Plaque and gingival indices rose, but peri-implant soft tissue remained stable in color and texture. At 12 months, average bone loss was minimal and insignificant compared with the baseline, and IL-1β levels were similar to those at contralateral teeth with no correlation between IL-1β, pocket depth, and bleeding on probing. Two-piece zirconia implants emerged as a viable tooth replacement option with an 88.8% 1-year survival rate. They maintained stable soft tissue and bone levels, indicating their potential as effective dental restoratives.