The main aim of this case series was to report the clinical and radiographic outcomes of 22 one-piece zirconia dental implants positioned in 19 patients to restore single edentulisms and followed up for at least 2 years. The mean observation period was 58.18 months. At the last follow-up visit, no issues, such as foreign body sensation, discomfort or pain, were reported by the patients. No implant showed signs of infection with suppuration or implant mobility. Marginal bone levels (MBL) were assessed through standardized dental radiographs and a dedicated software. The mean distance between the implant head and the first detectable bone to implant contact was calculated at the mesial and distal aspect of each implant. The mean MBL at baseline was 1.82 ± 0.63 mm while the mean MBL at the last follow-up visit was 2.57 ± 0.72 mm. The results obtained in the present case series over a mean follow-up period of 58.18 months (range 27–96) showed that one-piece zirconia dental implants could be an alternative option to support single crowns in patients requiring metal-free restorations. Nevertheless, further better-controlled research featuring an adequate study design and longer follow-up is needed in order to clarify advantages and limitations which are related to this treatment modality.

CAD/CAM technology can enhance the dentistry application of ceramic materials that meet the more relevant biocompatibility and aesthetics demands. In implant-borne prosthesis rehabilitation, yttria-stabilized zirconia appeared to be a valid alternative to metal-alloys and titanium, with comparable mechanical properties and even better interaction with bone and soft tissues. The improvement of monolithic CAD/CAM manufacturing allows for a reliable, predictable, and rapid workflow that can correspond to a holistic treatment philosophy associated with zirconia fixtures. This reported clinical case highlights the advantages of this approach in resolving particularly functionally and aesthetically complex situations. A 40-year-old patient with permanent canine impaction and the persistence of a deciduous tooth compromised by caries was successfully rehabilitated with the surgical removal of the enclosed tooth, the seating of a mono-phase zirconia implant after the deciduous extraction and its loading with a zirconia single crown, without any clinical or radiographical alteration up to seven years follow-up.

Objectives: The aim of this retrospective study was to evaluate the long-term clinical and radiographic performance of zirconia dental implants with one-piece and two-piece configurations supporting single-tooth restorations. The primary outcome was implant survival, while the secondary outcome was the assessment of interproximal marginal bone loss (MBL) over time. Materials and methods: A total of 67 implants placed in 55 patients were included, with a mean follow-up of 60.6 months. Forty-five implants were one-piece systems and twenty-two were two-piece systems. All surgical and prosthetic procedures were performed by the same operator, following the manufacturer’s recommendations. Final restorations were delivered three months after implant placement. Marginal bone levels were assessed radiographically at the time of definitive prosthesis delivery (T0) and at the last follow-up examination (T1). Statistical significance level was set at 5% (α = 0.05). Results: The overall implant survival rate was 100% in both groups. One-piece implants showed higher initial MBL values than two-piece implants; however, bone level changes over time were limited in both configurations, with no significant intra-group differences between T0 and T1. Conclusions: Both implant configurations showed excellent clinical and radiographic outcomes, with a 100% survival rate and limited marginal bone loss during long-term follow-up. Marginal bone levels appeared to be influenced more by implant neck design than by implant configuration, suggesting that zirconia implants with a smooth transmucosal design may represent a reliable metal-free option for single-tooth rehabilitation in properly selected patients.