Evaluation of immediate placement and restoration of zirconia implants with regard to esthetic outcome in the maxillary anterior region: A systematic review

Abstract

Statement of the Problem: Traditional titanium implants, while functionally reliable, may pose esthetic challenges, particularly in the anterior region, due to their metallic color and potential for soft tissue discoloration. This has prompted interest in zirconia implants as a more esthetic alternative. Purpose: This systematic review aimed to assess the esthetic outcomes of zirconia implants placed and restored immediately in the anterior maxilla. Materials and Methods: An extensive search of PubMed, Cochrane Library, Google Scholar, and other indexed databases was conducted, restricted to English-language studies. The selection of studies adhered to PRISMA guidelines and PICOS inclusion criteria. Two reviewers independently screened articles, evaluated methodological quality, and extracted the relevant information. Results: The studies included in this review reported consistently favorable esthetic results for zirconia implants, assessed using indices such as the Pink Esthetic Score (PES) and White Esthetic Score (WES). Evidence supports their effectiveness when immediately placed and restored in the maxillary esthetic zone. Conclusions: Zirconia implants present a tooth-colored, metal-free alternative with excellent esthetic potential, particularly suited for the anterior maxillary region. Their use may be considered a reliable option to conventional titanium implants in esthetically demanding cases.