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The widely available options of different manufacturers in dental implant systems have complicated the selection criteria process for periodontists, necessitating careful consideration of various factors when selecting suitable solutions for individual patient needs. Optimal implant selection requires careful consideration of the patient-specific factors, implant design, and surgical technique. Understanding the biomechanical behavior of implant–tissue interactions is crucial for achieving successful and long-lasting implant therapy. To adequately address this issue and improve the rigorous selection criteria from a biomechanically numerical approach, this research aims to analyze the stress distribution fields, strain patterns, and load transfer displacements within the implant system and the implant–biological interface (gingival and bony tissues) of titanium three-piece to two–one-piece ceramic implant systems. Thus, three different commercially available dental implants designed to be placed in the jaw molar region were considered for evaluation through the finite element method under both oblique and occlusal loading conditions. The results have exhibited an increasing trend to highlight the outstanding behavior of two-piece ceramic implants to dissipate the stress distribution better (6 and 2 times lower than the three- and one-piece systems under occlusal loads and almost 5 and 1.3 times more efficient for oblique loading, respectively), minimize peak stress values (below 100 MPa), and reduce strain peak patterns compared with the other two evaluated designs. On the other hand, the effects generated in biological tissues are strongly associated with implant geometry features. This biomechanical approach could provide a promising strategy for predicting micro-strains and micromotion in implant system pieces and geometries. Hence, these findings contribute to a deeper understanding of the biomechanics spectrum in the behavior of dental implant systems and emphasize the importance of carefully selecting appropriate material systems for accurate patient-specific biomechanical performance. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the present prospective case series was to investigate the clinical and radiological outcome of one-piece zirconia implants fabricated from 3Y-TZP with a moderately roughened endosseous surface (Sa = 1.24 μm) to support three-unit fixed dental prostheses (FDP) after five years in function., Materials and Methods: Twenty-seven patients received a total of 54 implants in a one-stage surgery with immediate provisionalization. Peri-implant bone loss was assessed using standardized radiographs. Additionally, soft-tissue parameters were analyzed. Statistical analyses were conducted using linear mixed regression models and Wilcoxon Signed Rank tests (p < 0.05). All patients participated in an annual maintenance program., Results: Eighteen implants were lost up to the 5-year follow-up, resulting in a cumulative survival rate of 66.67%. The mean marginal bone loss of the remaining implants amounted to 1.89 mm. Probing depth, clinical attachment loss, and bleeding on probing increased from prosthesis insertion to the 5-year follow-up, while the plaque index showed no significant changes during the same period., Conclusions: The investigated one-piece zirconia implant showed low survival rates as compared to previously reported survival rates of one-piece zirconia or two-piece titanium implants. Implant failure was attributed to peri-implantitis, leading to the necessity of implant removal. The implant is not commercially available., (© 2025 The Author(s). Clinical Oral Implants Research published by John Wiley & Sons Ltd.)