Abstract
Zirconia abutments can enhance esthetics by providing a natural appearance due to their semitranslucency. Evidence for final outcomes of using zirconia abutments compared to other available materials are diverse. This study aims to review all available evidence from previous reviews to compare zirconia and titanium abutments regarding biological, mechanical, and esthetics indices and survival. An electronic search was conducted on six databases (PubMed, Scopus, Embase, Web of Science, ProQuest, and Cochrane) for systematic reviews/meta-analyses published until 2023. The relevant data were extracted and reviewed from the selected studies. Fourteen articles were included following a systematic application of the inclusion and exclusion criteria. These studies evaluated various factors, including soft tissue recession, width of keratinized mucosa, papilla index, plaque accumulation, Copenhagen Index Score, Implant Crown Aesthetic Index, gingival discoloration, pocket probing depth, marginal bone loss, bleeding on probing, Pink Esthetic Score, White Esthetic Score, survival rate, and patient's satisfaction. Zirconia abutments showed better or similar effects than titanium in biological, esthetic, and mechanical factors and survival.