When you picture a dental implant, you probably think about the new tooth. But what happens around the implant matters just as much.
Healthy gums protect the bone supporting your implant, create a stable seal around it and frame the new tooth so it looks natural. This is one area where ceramic implants made from zirconia have attracted particular interest: zirconia is biocompatible, tooth-coloured and has shown favourable interactions with the tissues around dental implants.
Here is what the research tells us about ceramic implants, plaque, gum health and aesthetics — and what you can do to keep the tissues around your implant healthy for the long term.
At a glance
Your gums: the quiet hero of every implant
A natural tooth and a dental implant connect to the gum differently, but both depend on healthy surrounding tissues.
Around an implant, the gum forms a close soft-tissue barrier. This helps protect the deeper tissues and supporting bone from the constant bacterial challenge present in the mouth.
That is why successful implant treatment is not only about placing an implant securely in bone. The way the surrounding gum heals, how easy the area is to keep clean and how stable those tissues remain over time all matter.
For Dr. Suli, this fits naturally into a biological approach to implant dentistry: choosing materials and planning treatment with the surrounding tissues in mind from the beginning.
Why gums respond well to ceramic
Zirconia is a ceramic material known for its biocompatibility. Research examining zirconia in contact with peri-implant soft tissues has shown favourable tissue attachment and inflammatory responses.
For patients, that means zirconia provides a surface around which healthy gum tissue can establish itself.
Some ceramic implant systems are made as one piece, while others use a two-piece design. The way the implant is designed determines which part of the ceramic sits in contact with the gum.
Whatever the design, the aim is the same: to create a stable, healthy environment around the implant that can be maintained easily over time.
What research shows about plaque around zirconia
Plaque is one of the main reasons gums become inflamed, so the way an implant surface interacts with bacteria is important.
Research into zirconia has produced encouraging findings.
A long-term clinical study followed patients with one-piece zirconia implants for an average of 7.8 years. The researchers found significantly less plaque and less gum recession around the zirconia implants than around the patients' neighbouring natural teeth.
A larger systematic review published in 2025 also reported reduced plaque accumulation and minimal microbial contamination around zirconia in several of the studies it examined. The authors noted variation in study quality, so these findings should not be interpreted as meaning that zirconia simply cannot collect plaque.
The practical message is much simpler: Zirconia has shown favourable plaque and soft-tissue findings, but ceramic implants, like your natural teeth, still need to be cleaned every day.
No implant material replaces good oral hygiene.
A natural-looking gum line
Ceramic implants also have an aesthetic advantage that is easy to understand: zirconia is naturally light in colour.
Gum tissue can be surprisingly translucent, particularly when it is thin. What sits underneath the gum can therefore influence its appearance.
Zirconia's light colour can be especially helpful when the gum tissue is thin, because it is less likely to create a darker shadow underneath the gum.
This can be particularly important for implants in the smile zone, where the appearance of the gum around the new tooth plays a big part in the final result.
But the material itself is only part of creating a natural result.
The thickness of the gum, the amount of supporting bone, where the implant is positioned and the contours of the final tooth all help determine how naturally the restoration emerges from the gum.
This is why aesthetic implant treatment begins with careful planning of the whole area, rather than simply choosing the colour of the implant.
Ceramic implants and peri-implantitis
Keeping the gums around an implant clean and healthy is an important part of long-term care.
Research on zirconia implants is reassuring. A 2026 review of 19 studies involving 687 patients and 995 zirconia implants found a low rate of peri-implantitis in studies following patients for up to five years.
The researchers concluded that zirconia implants showed a low short- to mid-term prevalence of peri-implantitis.
For patients, the takeaway is simple: healthy gums, good daily cleaning and regular professional care all help support the implant over time.
Dr. Suli has lectured fellow dentists on the prevention and treatment of peri-implantitis. Protecting the gum and bone around an implant is therefore not an afterthought — it is part of how the treatment is planned from the beginning.
Keeping your gums healthy around a ceramic implant
Once your ceramic implant is in place, a few simple habits help keep the surrounding gums healthy.
The goal is not complicated: keep the area clean, keep the surrounding tissue healthy and identify changes early.
Part of Dr. Suli's biological approach
For Dr. Suli, ceramic implant dentistry is about more than replacing a missing tooth. His approach is minimally invasive and biologically oriented, with careful attention to the materials used, the condition of the surrounding bone and gums, and the long-term health of the tissues supporting the implant.
Every ceramic implant case therefore begins with an assessment of the bone, gum tissue, bite and proposed position of the new tooth before treatment is planned.
Frequently Asked Questions
Zirconia is highly biocompatible and research has shown favourable soft-tissue responses around ceramic implant components and implants. Clinical studies have also reported low plaque levels and stable gum tissues around zirconia implants.
Plaque can develop around any implant. However, several studies have reported favourable plaque findings around zirconia. Daily cleaning remains important because even a biocompatible implant needs a healthy, plaque-controlled environment.
Zirconia's naturally light colour can be an advantage beneath thin or highly visible gum tissue. The final appearance also depends on your gum thickness, bone, implant position and the shape of the restoration.
Yes. No implant is immune to gum inflammation or peri-implantitis. However, recent research has found a low short- to mid-term prevalence of peri-implantitis around zirconia implants. Regular maintenance helps protect the surrounding gum and bone.
Researchers are also studying how your immune system responds to the implant itself, a growing field called osteoimmunology. Zirconia is a highly biocompatible ceramic, and early animal and laboratory studies suggest it may encourage a calmer, healing-focused immune response in the tissue around the implant. It's a promising area, and more human studies are still needed to confirm what it means for patients.
Your maintenance schedule should be personalised to your gum health, implant design and individual risk factors. Dr. Suli will recommend the appropriate interval after treatment.
A successful ceramic implant begins with more than choosing a material. Your bone, gum tissue, bite, implant position and long-term maintenance all need to work together.
Dr. Suli assesses each of these factors when planning ceramic implant treatment, with the goal of creating a restoration that looks natural, integrates with the surrounding tissues and can be maintained for years to come.
References
- Abouel Maaty FAN, et al. Peri-implant soft tissue in contact with zirconium/titanium abutments from histological and biological perspectives. Cells. 2025;14(2):129. doi.org
- Lorenz J, et al. Prospective controlled clinical study investigating long-term clinical parameters, patient satisfaction, and microbial contamination of zirconia implants. Clinical Implant Dentistry and Related Research. 2019;21(2):263–271. doi.org
- Shrivastava D, et al. Clinical assessment of the relationship of dental implant materials and peri-implantitis: a systematic review. Journal of Maxillofacial and Oral Surgery. 2025;24(4):1010–1028. doi.org
- Moraschini V, et al. Prevalence of peri-implantitis around zirconia implants: a systematic review and meta-analysis of current evidence. Clinical Implant Dentistry and Related Research. 2026;28(4):e70176. doi.org
- Herrera D, et al. Prevention and treatment of peri-implant diseases: the EFP S3 level clinical practice guideline. Journal of Clinical Periodontology. 2023;50(Suppl 26):4–76. doi.org
- Jung RE, Sailer I, Hämmerle CHF, Attin T, Schmidlin P. In vitro color changes of soft tissues caused by restorative materials. International Journal of Periodontics & Restorative Dentistry. 2007;27(3):251–257.pubmed.ncbi.nlm.nih.gov