Consensus Statement 1: Bone-level implants with zirconia and titanium transmucosal abutments demonstrate comparable peri-implant parameters (MBL and PD) after 1 and 5 years. Bleeding on probing could not be compared because of the heterogeneity of the used indices. This statement is based on meta-analyses of six RCTs. (mean diff and 95% CI after 1-year: MBL: −0.24 mm [−0.65,0.16], PD: −0.06 [−0.41,0.30] and after 5 years: MBL: [], PD: −0.06 []).

Consensus Statement 2: Both zirconia and titanium transmucosal abutments are clinically comparable regarding biological complications, esthetic outcomes and patient satisfaction. This statement is based on descriptive data from nine RCTs

Consensus Statement 3: Limited data regarding peri-implant tissue parameters were found for gold and alumina transmucosal abutments. Thus, a direct comparison with titanium is not possible. This statement is based on descriptive data of respectively two and three RCTs.

1) Do zirconia abutments provide additional biological esthetic or patient satisfaction benefits over titanium implants?

Based on biological peri-implant parameters and patient satisfaction, titanium and zirconia can be recommended as transmucosal abutment materials. However, even though the scientific evidence remains unclear, zirconia abutments might be preferred in the esthetic region.

2) What material allows for adequate peri-implant soft tissue integration?

Titanium (alloy) and zirconia are well-documented biocompatible restorative materials for final restorations allowing cell adhesion. If ceramic glaze or other restorative materials are considered, placing these materials submucosally as coronal as possible is recommended.

1) Are zirconia abutments more esthetic than titanium ones?

Yes. We can achieve good esthetic results with titanium abutments, but where esthetics are critical, zirconia abutments are usually preferred. This avoids the risk of the metal showing through the gums in the places that become visible when you smile. This patient's perspective is based on expert opinions.