Purpose: To assess the clinical performance of a prefabricated all-ceramic zirconium dioxide implant abutment for single-tooth replacement in the posterior region. Materials and Methods: Forty implants (Xive S plus screw type, Dentsply Sirona Implants) were inserted into the posterior region in 24 patients and were provided with zirconium dioxide abutments (Cercon abutment, Dentsply Sirona Implants). The licensed range of indications for these abutments is limited to the maxillary and mandibular anterior teeth. The following parameters were used to document the state of the soft tissue: modified Plaque Index; modified Sulcus Bleeding Index; and pocket depth. Mesial and distal bone levels were determined on radiographs during the prosthetic treatment and at the 5-year recall. Results: A total of 34 functioning implants were followed up over a 5-year interval. Two patients wearing three abutments were lost to follow-up. In total, five abutments exhibited a rotational misfit during the observation period, causing significant gingival discoloration and damage to the implants. In the remaining restorations, the soft and hard tissue parameters were indicative of a low inflammatory status. Compared to the baseline situation, partly significant bone apposition could be observed. Conclusion: The observed specific type of failures after 5 years in function for full zirconia posterior implant abutments cannot be recommended, at least not in combination with the implant system used in this study.