Comparison of Soft and Hard Tissue Outcomes Between Root-Analog Zirconia and Conventional Zirconia Implants: A Prospective Clinical Study.

Objective: To compare oral hygiene parameters, crestal bone stability, and early postoperative outcomes between zirconia root-analog implants (RAIs) and conventional zirconia implants (CZIs) over 3 months. Materials and Methods: This prospective, controlled clinical study included 30 participants assigned to either an RAI or CZI group based on anatomical suitability for fabricating a custom RAI. RAIs were designed from digital scans of the extracted roots and milled from zirconia, while the CZI group received standardized Straumann PURE Ceramic Implants. Clinical indices and cone-beam computed tomography (CBCT)-based radiographic measurements were recorded at 1 and 3 months. Data were analyzed using independent Results: No significant differences were observed in plaque index (PI) or bleeding on probing (BOP) between groups at 1 and 3 months. Crestal bone height remained stable for both implant types, with only a slight reduction in CZIs. RAIs demonstrated reduced postoperative swelling, pain, and inflammation at 1 month. Soft tissue indices and bone levels were comparable across both groups at 3 months. Conclusion: RAIs offered improved early patient comfort and bone preservation, suggesting a potential trade-off between mechanical reliability and biological performance. Further long-term studies are needed to optimize RAI design and clinical protocols.