Dental implantology has seen rapid development and several paradigm shifts since its introduction in the early 1980s. Initial research in this field mostly focused on improving the osseointegration of the implant itself, and the investigation of different implant materials, geometric designs and surface topographies. Fixed implant-supported restorations were traditionally made from a metallic substructure which provided mechanical stability and a ceramic coating to improve the esthetic appearance. While these porcelain-fused-to-metal (PFM) reconstructions have been very well documented over the years (Pjetursson et al. 2018; Sailer et al. 2018; Lemos et al. 2019), they have several noteworthy inherent drawbacks. Due to the bi-layered nature of PFM restorations, technical complications such as fracture of the porcelain layer have been observed and remain a problem (Pjetursson et al. 2018; Sailer et al. 2018). Furthermore, the gray color and intense opacity of the metallic core make the fabrication of an esthetically pleasing reconstruction challenging.

With the invention of high-strength ceramics, a new material class has become available for fixed dental/implant prostheses (FDPs). Depending on the chemical composition and crystallization density, ceramics can present versatile mechanical and optical properties. Zirconium-dioxide, better known as zirconia, is one of the most widely used ceramic materials in dentistry due to its high flexural strength, wide clinical indication spectrum, color stability and excellent biocompatibility. Furthermore, zirconia offers the possibility of fabrication using computer-aided design and computer-aided manufacturing (CAD/CAM) procedures, making it both time- and cost-effective for the dentist, dental technician and patient alike (Joda and Brägger 2015; Mühlemann et al. 2018, 2019).

On the other hand, however, zirconia as an implant restoration material has several limitations which should be taken into consideration. In contrast to metal, for example, zirconia is more prone to propagating microcracks which may lead to catastrophic failure when handled incorrectly. Furthermore, adhesive bonding to zirconia is more technically challenging compared to silica-based ceramics. Detailed knowledge about zirconia ceramics is therefore required by both dental technician and dentist to achieve an optimal clinical result.

Therefore, this article aims to highlight the advantages as well as the current limitations of zirconia as an implant restoration material.