{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:16:38Z","timestamp":1788513398158,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["204395\/2025"],"award-info":[{"award-number":["204395\/2025"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["314479\/2023\u20106"],"award-info":[{"award-number":["314479\/2023\u20106"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["408905\/2025\u20105"],"award-info":[{"award-number":["408905\/2025\u20105"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Implant Dent Rel Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Zirconia implants (ZIs) have emerged as a metal\u2010free alternative to titanium implants (TIs) because of their favorable esthetic and biological properties. However, the prevalence of peri\u2010implantitis associated with ZIs and the potential influence of implant material on peri\u2010implant disease remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the implant\u2010level prevalence of peri\u2010implantitis associated with ZIs and to assess whether implant material influences peri\u2010implantitis prevalence by comparing ZIs and TIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic searches were conducted in four databases and gray literature sources up to February 2026. Randomized clinical trials (RCTs) and cohort studies evaluating peri\u2010implantitis associated with ZIs were included. The risk of bias was assessed using the RoB 2 and ROBINS\u2010I tools. Random\u2010effects meta\u2010analyses were performed to estimate the pooled peri\u2010implantitis prevalence at the implant level. Subgroup analyses according to follow\u2010up duration and sensitivity analyses were additionally conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen studies comprising 687 patients and 995 implants were included. The mean follow\u2010up reported across studies was approximately 49\u2009months. In studies with follow\u2010up \u2264\u20093\u2009years, the pooled prevalence of peri\u2010implantitis associated with ZIs was 2% (95% CI: 0%\u20136%;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200979.3%). Studies with follow\u2010up &gt;\u20093 to 5\u2009years demonstrated a pooled prevalence of 2% (95% CI: 0%\u20138%;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200938.9%), whereas studies with follow\u2010up &gt;\u20095\u2009years showed a pooled prevalence of 8% (95% CI: 0%\u201323%;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200982.1%). Comparative analysis of five RCTs demonstrated no statistically significant difference in peri\u2010implantitis prevalence between ZIs and TIs (RR\u2009=\u20091.66; 95% CI: 0.48\u20135.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.42). Sensitivity analyses did not identify studies with a critical risk of bias as the primary source of heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current evidence suggests a low short\u2010 to mid\u2010term implant\u2010level prevalence of peri\u2010implantitis around ZIs, with higher estimates observed in studies with longer follow\u2010up. However, the certainty of evidence remains limited because of methodological heterogeneity, variability in diagnostic definitions, inconsistent patient\u2010level reporting, and the lack of long\u2010term comparative studies. Limited comparative evidence did not demonstrate a statistically significant difference in peri\u2010implantitis prevalence between ZIs and TIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cid.70176","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:10:44Z","timestamp":1785222644000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Peri\u2010Implantitis Around Zirconia Implants: A Systematic Review and Meta\u2010Analysis of Current Evidence"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5739-394X","authenticated-orcid":false,"given":"Vittorio","family":"Moraschini","sequence":"first","affiliation":[{"name":"Department of Oral Surgery, School of Dentistry Fluminense Federal University  Niter\u00f3i Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Baptista","family":"de Moraes","sequence":"additional","affiliation":[{"name":"Department of Dental Research, School of Dentistry Veiga de Almeida University  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Maria","family":"de Oliveira Silva","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, School of Dentistry Fluminense Federal University  Niter\u00f3i Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7559-2555","authenticated-orcid":false,"given":"Alexandre Marques Paes","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, School of Dentistry Rio de Janeiro State University  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0889-2448","authenticated-orcid":false,"given":"Rafael Seabra","family":"Louro","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, School of Dentistry Fluminense Federal University  Niter\u00f3i Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Jos\u00e9 Veras","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Department of Dental Research, School of Dentistry Veiga de Almeida University  Rio de Janeiro Brazil"},{"name":"Department of Prosthodontics, School of Dentistry Rio de Janeiro State University  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9129-7849","authenticated-orcid":false,"given":"Victoria L.","family":"Souza Costa","sequence":"additional","affiliation":[{"name":"Dental Research Division Universus Veritas Guarulhos University  Guarulhos S\u00e3o Paulo 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