Cao Y, et al. - In this review involving 16 studies from 18 publications, researchers assessed the long-term implant survival rate of titanium implants with zirconia abutments and the impacts of zirconia abutment implants on marginal bone loss and pocket probing depth compared to all-titanium implants. At the low risk of bias, none of the comparative studies was evaluated. According to this systematic review and meta-analysis, the overall implant survival rate of zirconia abutments implants was estimated to be 96%. Implants with zirconia abutments may have acceptable peri-implant health performance compared to all-titanium implants. However, the implant survival rate of zirconia abutments implants in long-term follow-up is slightly lower than all-titanium implants. There is a need for further research to clarify this dichotomy.