Dental surgical implant treatment modalities continue to be relatively successful within musculoskeletal restorative systems. Because available systems include a wide range of metallic and ceramic biomaterials plus multiple designs for the implant body, transgingival abutment, and intraoral crown constructs, failure analyses of explanted devices must include comprehensive information. The current opinions are based on approximately 4000 musculoskeletal implant device studies conducted from 1970 to 1997. As a subset, the dental systems with and without calcium phosphate ceramic on the endosteal portion of the implants will be considered at 0 to 1, 1 to 5, 5 to 10, and beyond 10 years in vivo. Observations will be reported and opinions provided about the advantages and disadvantages of ceramic coated implant systems.