The urge to replace missing teeth dates back to the origin of medicine. Along history, organic materials, metals, alloys, polymers, glasses, and carbon were used to substitute teeth, but only in the past thirty years was a truly scientific approach implemented introducing the concept of osseointegration. This review aims at recapitulating the materials of choice, the surface modifications, and the most updated research advancements in the field of oral osseointegrated implants. As the accepted clinical standard, commercially pure Titanium, Ti–6Al–4V and, to a lesser extent, zirconium dioxide will be described from the perspective of physical, mechanical, and biological features, together with in vitro, in vivo, and clinical assessment of biocompatibility. Outlines of the researches that are presently conducted in an endeavor to limit the drawbacks of the current technology are also provided. Novel Titanium alloys such as Ti–Zr and Ti–20Nb–10Zr–5Ta, Zr61Ti2Cu25Al12, innovative production methods for non metallic materials as well as ceramic composites will be considered as possible promising candidates for future dental implants