Objectives: To quantify the number and type of complications that occur with a monolithic zirconia implant supported fixed prosthesis (MZISFP) and to examine change in oral health quality of life over the course of six months. Methods: Fifteen edentulous patients were enrolled. Each patient was provided conventional dentures, four mandibular implants, and a mandibular MZISFP. Complication data were recorded over 6 months. The 49-item Oral Health Impact Profile was administered on three occasions: at enrollment, at implant surgery, and at 6-month recall. Results: Seven complications occurred during the MZISFP observation period. Implant survival was 93% and 98% from the patient and implant perspectives respectively. Prosthesis survival was 93%. OHIP-49 severity and extent scores decreased significantly over the course of the study (p<0.001). Conclusions: Complications were infrequent and patient centered outcomes were significantly improved with a MZISFP.