The aim of the present review was to evaluate the clinical and radiographic performance of one-piece zirconia implants (O-PZI). This review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines that addressed the following focused question: What is the overall clinical and radiographic performance of O-PZI? The MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register databases were searched. Six clinical studies were included. For studies evaluating O-PZI compared with one-piece titanium implants, zirconia implants showed higher crestal bone loss (CBL) in both the studies. However, one study demonstrated a high failure rate compared to titanium dental implants, while one study demonstrated comparable survival rates between zirconia and titanium dental implants. For studies evaluating O-PZI for the restoration of single crown and fixed dental prostheses, O-PZI showed comparable bone loss and survival rates for single crowns and fixed dental prostheses. Two studies were included that compared O-PZI with two-piece zirconia (T-PZI). One study showed a higher CBL and low survival rate for O-PZI compared to T-PZI, whereas the other study demonstrated comparable CBL and survival rates between O-PZI and T-PZI. It is still debatable whether O-PZI demonstrate better clinical performance when compared with titanium implants or two-piece design.
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