Clinical Assessment of the Relationship of Dental Implant Materials (Titanium and Zirconia) and Peri-Implantitis: A Systematic Review

Objective
This study analyzed clinical parameters to assess whether dental implant material is a risk factor for peri-implantitis.
Methods
A literature search was performed on PubMed Central, Cochrane, PubMed/MEDLINE, Embase, and Scopus. The PICO strategy involved healthy patient, partially or fully edentulous, receiving at least one dental implant; zirconia or titanium dental implants; comparison involving assessment of whether there were differences in the risk of peri-implantitis among different materials used for dental implants; clinical parameters. Quality assessment was performed using the modified Jadad scale.
Results
Nineteen articles met the inclusion criteria. BoP did not have statistically significant differences comparing zirconia and titanium implants or natural teeth. MBL had diversified results; sometimes, it was higher in zirconia implants than titanium; otherwise, there was no significant difference. Comparing implants with natural teeth, MBL was lower in titanium implants over prolonged observation periods, and greater severity was found in the zirconia group. Notably, natural teeth had minimal bone loss. Zirconia implants demonstrated reduced plaque accumulation and minimal microbial contamination compared to titanium implants and control teeth. The quality assessment was considered poor to low in 9 studies and good to excellent in 10. The development of peri-implantitis was influenced by several patient-specific and clinical factors, underscoring the need to adopt a comprehensive and personalized approach to implant dentistry and peri-implantitis prevention.
Conclusion
It was not possible to draft any solid conclusion for the relationship between implant material and peri-implantitis.