Direct answer

A possible candidate is an adult with one or more missing or non-restorable teeth, adequate or reconstructable bone and healthy enough tissues, manageable medical and behavioral risks, and a restorative plan that can be predictably supported by the selected ceramic implant system. Only an in-person clinical evaluation can determine candidacy.

Key takeaways

  • Candidacy is determined by the whole treatment plan, not by a desire for a particular material.
  • Bone, gum tissue, implant position, bite, and restoration design must be evaluated together.
  • Smoking, diabetes control, medications, and healing history may affect risk.
  • Grinding or high bite forces may influence design and material decisions.
  • Some patients may need grafting, risk modification, another implant design, or a non-implant option.

Oral and anatomical factors

The evaluation considers which teeth are missing, bone volume and shape, gum health and thickness, available restorative space, proximity to nerves and sinuses, smile line, and the position an implant would need for a cleanable restoration.

Bone grafting or soft-tissue treatment may be recommended when the existing anatomy cannot support the planned result. Grafting needs are not determined by implant material alone.

Medical and healing factors

The clinician should review health conditions, medications, prior surgeries, allergies or sensitivities, diabetes control, immune and bleeding issues, radiation history, and other factors that can affect surgery or healing. Age alone is usually less informative than overall health and ability to heal and maintain treatment.

Medical risk does not automatically exclude treatment, but it may require coordination, modification, delay, or another plan. Patients should never stop medication without direction from the prescribing clinician.

Behavioral and maintenance factors

Smoking or nicotine exposure, plaque control, past periodontal disease, attendance for professional care, and willingness to clean around the restoration can influence long-term risk. Grinding and clenching may change implant dimensions, number, position, restoration material, or protective appliance recommendations.

Does a ceramic system fit the restoration?

One-piece ceramic implants may work well in selected situations but demand precise placement. A case needing major angle correction or a complex component may favor a flexible two-piece system. The evidence and component choices for a particular zirconia system should match the tooth position and restoration being planned.

A patient seeking fully metal-free treatment should ask whether the abutment connection or restoration contains a metal screw or substructure.

When treatment may need to change or wait

Active oral infection, uncontrolled gum disease, inadequate diagnostic information, unmanaged medical risk, insufficient restorative space, an unfavorable bite, inability to maintain the area, or anatomy that cannot support safe placement may require treatment before implantation or a different solution.

This is not a universal exclusion list. The significance of each factor is patient- and procedure-specific.

What to expect in a candidacy evaluation

  1. Discuss the missing tooth problem, goals, preferences, and alternatives.
  2. Review dental, medical, medication, and behavioral history.
  3. Examine teeth, gums, bite, smile, and available space.
  4. Use appropriate imaging to assess bone and nearby anatomy.
  5. Develop the restorative position before selecting implant size and design.
  6. Compare material and system options with their benefits and limitations.
  7. Plan timing, possible grafting, healing, costs, maintenance, and contingencies.

Selected references

  1. Roehling S, Gahlert M, Bacevic M, Woelfler H, Laleman I. Clinical and radiographic outcomes of zirconia dental implants—A systematic review and meta-analysis. Clinical Oral Implants Research. 2023;34(Suppl 26):112–124. doi:10.1111/clr.14133.
  2. Gul A, et al. Zirconia dental implants; the relationship between design and surface characteristics and clinical outcomes: a systematic review. Journal of Dentistry. 2024. PMID: 38437977.