Direct answer

Zirconia’s white color may reduce concern about gray show-through when gum tissue is thin or recession exposes an underlying component. Titanium can also produce excellent esthetic results. Comparative clinical studies have not established a consistent overall esthetic advantage for zirconia implants; tissue volume, implant position, abutment, crown, smile line, and healing all affect appearance.

Key takeaways

  • Color can matter most in thin tissue and highly visible sites.
  • Implant-body material and abutment material are separate esthetic variables.
  • Three-dimensional implant position strongly affects gum contour and crown form.
  • White material cannot compensate for missing bone, recession, or a poorly shaped restoration.
  • Current comparative evidence does not show a consistent Pink Esthetic Score advantage.

When implant color may matter

Gray titanium may influence tissue color where facial gum tissue is thin, translucent, recessed, or lacking underlying bone. White zirconia can be less visually conspicuous in those conditions. The effect varies with tissue thickness, depth, position, abutment, and lighting.

What usually shapes the final appearance

  • Existing bone and gum volume
  • Smile line and visibility of the site
  • Implant depth and facial-lingual position
  • Tissue thickness and recession risk
  • Abutment color and emergence profile
  • Crown form, surface, shade, and contact points
  • Healing response and long-term tissue stability

What comparative evidence shows

A 2026 review found no pooled difference in Pink Esthetic Score between zirconia and titanium implants in the included comparative evidence. Earlier abutment research suggested a tendency toward improved mucosal color with zirconia abutments, but heterogeneous studies did not establish a universal advantage across outcomes.

Plan the esthetic result before choosing material

The team should evaluate the intended crown position, tissue phenotype, bone support, smile, possible grafting, provisional restoration, and component choices before selecting an implant. Ask which part of the proposed esthetic benefit comes from the implant body and which comes from the abutment, tissue treatment, or crown.

Selected references

  1. Apaza Alccayhuaman KAA, et al. Biological complications and peri-implant tissue response of zirconia compared with titanium dental implants. International Journal of Oral & Maxillofacial Implants. 2026. doi:10.11607/jomi.11786.
  2. Linkevicius T, Vaitelis J. The effect of zirconia or titanium as abutment material on soft peri-implant tissues: a systematic review and meta-analysis. Clinical Oral Implants Research. 2015;26(Suppl 11):139–147. doi:10.1111/clr.12631.