In the past, dental implants made of zirconium dioxide were seen as niche products, but today they are increasingly going their way into modern dental implantology.
The first available preclinical, as well as short- and mid-term clinical data of the biomaterial "zirconia" show promising results and thus offer clinically concrete practical advantages over titanium implants. These include healthier soft tissue, reduced peri-implant inflammation (peri-implantitis), no corrosion and improved esthetics. Numerous clinical and preclinical studies have demonstrated these success factors of the new generation of ceramic dental implants.
In the past, ceramic dental implants were still associated with functional complications such as fractures and unacceptable failure rates. However, in recent years there has been a massive technological development in terms of material properties and implant surface design. In these aspects, too, modern implants made of zirconia are already almost on a par with titanium implants.
Developments today are primarily concerned with the practical and stable connection of the implant as an invisible part in the bone with the dental crown as a visible part. Various concepts are currently on the market: one-piece and two-piece implants, cemented, bonded or screw-retained restorations. The challenges lie in the material properties: titanium as a metal is elastic, flexible and therefore easy to bond. On the other hand, zirconia as a ceramic is not elastic, hard, susceptible to bending forces and therefore difficult to join. New approaches are being pursued with carbon fiber reinforced connecting bolts.
 Further development of the biomechanical properties of the biomaterial "ceramic" and the development of long-term reliable connection concepts is desirable.
The prerequisite for this is a fundamental knowledge of the clinical indications, the requirements for dental implant systems and the nature of their application. Based on survey results of the European Society for Ceramic Implantology ESCI, these most important backgrounds of ceramic implantology will be highlighted and the importance of cooperation between biomaterial research and clinical application will be elaborated