Biomechanical and Biological Performance of Next-Generation Materials in Implant-Supported Prosthetic Restorations

The evolution of implant-supported prosthetic restorations has been driven strongly by the pursuit of improved biomechanical stability, biological compatibility, and aesthetic integration. While titanium and cobalt-chromium alloys remain the conventional choice due to their proven strength and corrosion resistance, limitations related to soft tissue interaction and esthetics have accelerated the transition toward advanced ceramic alternatives, particularly zirconia. Zirconia implants and abutments demonstrate favorable biological responses and excellent esthetics; however, their inherent brittleness and reduced fracture resistance under functional loading remain critical concerns. To overcome these challenges, zirconia–titanium hybrid abutments have emerged as a promising solution, uniting the strength of titanium with the soft-tissue and esthetic advantages of zirconia. Parallel to these developments, additive manufacturing (AM) techniques, such as selective laser melting (SLM) and direct metal laser sintering (DMLS), have enabled the fabrication of highly precise and patient-specific prosthetic frameworks. Evidence indicates that AM-produced titanium infrastructures exhibit mechanical properties equal to or superior to those of conventional casting, while additively manufactured zirconia, despite having lower flexural strength compared to subtractively manufactured zirconia, demonstrates promising clinical applicability. Clinical outcomes highlight restoration-type-specific complication patterns, with screw loosening, veneer chipping, and peri-implant inflammation being the most frequently observed. Furthermore, advances in surface optimization, digital workflows, and artificial intelligence–assisted planning are contributing to enhanced long-term clinical performance. Despite these innovations, limitations persist regarding the standardization of AM protocols, the availability of long-term clinical data, and comprehensive patient-specific risk assessment. Future directions should prioritize multicenter longitudinal studies, advanced biomechanical simulations, and the integration of next-generation materials with digital technologies to optimize both biomechanical and biological outcomes of implant-supported prosthetic restorations.