Abstract
Titanium, zirconia, and polyetheretherketone (PEEK) are among the most extensively studied materials in dental implantology, each offering unique properties that influence their clinical performance. This review systematically compared their physicochemical characteristics and their in vitro and in vivo behaviors. It also evaluated various surface modification techniques designed to enhance osseointegration and antibacterial properties. Titanium, recognized as the gold standard, is renowned for its exceptional mechanical strength and superior osseointegration, although it is associated with a higher risk of peri-implantitis. Zirconia, valued for its excellent aesthetics and compatibility with soft tissues, presents a promising metal-free alternative; however, its brittleness can limit its mechanical reliability. PEEK, a high-performance polymer, offers stress distribution and biocompatibility benefits, but it requires substantial surface modifications to improve its osseointegration capacities. Additionally, this review delved into the prevalence of peri-implantitis, clinical survival rates, and the impact of systemic conditions such as aging, osteoporosis, and diabetes on implant success. The findings underscored the critical importance of material-specific surface treatments and tailored modifications to ensure the long-term success of dental implants.