Peri-implant diseases are not uncommon following implant therapy. Long-term maintenance care for high-risk groups is essential to reduce the risk of peri-implantitis. Informed consent for patients receiving implant treatment must include the need for such maintenance therapy.

This review of the literature indicates that titanium can induce hypersensitivity in susceptible patients and could play a critical role in implant failure. Furthermore, this review supports the need for long-term clinical and radiographic follow-up of all implant patients who are sensitive to metals. At present, we know little about titanium hypersensitivity, but it cannot be excluded as a reason for implant failure.

Background: Conventional implant protocols advocate a two-stage technique with a load-free, submerged healing period. Recent studies suggest that immediate restoration of single implants may be a viable treatment option.

The rehabilitation of single missing mandibular molars by immediately placed and restored wide-diameter implants was associated with a relatively high failure rate.

The outcome of this study indicates caution before recommendation can be made for the use of single-piece zirconia implants for overdenture support. Their use should be limited to cases with proven allergy to titanium. This is mainly due to the increased bone loss and higher fracture rate observed for zirconia implants. Future biomaterial research should focus on producing surface characteristics on zirconia implants with outcomes similar to those established for the optimum osseointegration of titanium implants.