Findings of a Four-Year Randomized Controlled Clinical Trial Comparing Two-Piece and One-Piece Zirconia Abutments Supporting Single Prosthetic Restorations in Maxillary Anterior Region

Abstract

The purpose of this randomized controlled study is to investigate the clinical results obtained over four years and incidence of complications associated with one- versus two-piece custom made zirconia anchorages, in single tooth implant-supported restorations of the maxillary anterior region. Sixty-five patients, with a total of 74 missing maxillary teeth, were selected in the period from February 2007 to July 2010. Two different ways of custom made zirconia abutment and final prosthetic restoration were evaluated: a standard zirconia abutment associated with a pressed layer of lithium disilicate with an all-ceramic cemented restoration versus one-piece restoration with the facing porcelain fired and pressed straight to the custom made zirconia abutment. In 29 cases, the restoration consisted of an all-ceramic restoration for cementation (two pieces); in 45 cases the restoration was a screw-retained restoration (one piece). Three all-ceramic restorations broke during the observation time. Two one-piece restorations fractured after 26 months. At follow-up examination there were no significant differences between one-piece and two-piece groups regarding the PI, BI, and MBL. Awaiting studies with longer follow-up times, a careful conclusion is that zirconia anchorages for single-implant restorations seem to demonstrate good short-term technical and biological results.

All‐ceramic single crowns supported by zirconia implants: 5‐year results of a prospective multicenter study

“…As a result, the chipping frequency in the present study was significantly higher than the estimate calculated by Rabel and collaborates (Rabel et al, ). One reason for this might be considered the fact that reconstructions of the present evaluation were located in posterior regions, whereas multiple investigations in the meta‐analyses included a mixture of both anterior and posterior reconstructions (Chappuis et al, ; Nejatidanesh, Moradpoor, & Savabi, ; Paolantoni, Marenzi, Blasi, Mignogna, & Sammartino, ; Tartaglia, Sidoti, & Sforza, ; Wittneben et al, ; Worni, Kolgeci, Rentsch‐Kollar, Katsoulis, & Mericske‐Stern, ). It was shown that single crown location has a significant impact on the occurrence of veneer fractures in favor of reconstructions located in the anterior region (Rabel et al, ).…”

The clinical performance of all‐ceramic implant‐supported single crowns: A systematic review and meta‐analysis

“…The "Cochrane Collaboration's tool for assessing risk of bias in randomized trials" was used to evaluate the RCTs in this systematic review (Bömicke et al, 2017;Hosseini, Worsaae, Schiodt, & Gotfredsen, 2011;Paolantoni et al, 2016;Payer et al, 2015;Thoma, Brandenberg, Fehmer, Buchi, et al, 2016;Wittneben et al, 2017) (Supporting information Table S2). All RCTs provided enough information for the evaluation of any incomplete outcome data and selective reporting.…”

“…Most of the investigations were published between 2013 and 2017. The cohorts of the investigations from Paolantoni, Marenzi, Blasi, Mignogna, and Sammartino (2016) and Wittneben et al (2017) were divided into two groups each and evaluated separately. In the former investigation, two different custom-made zirconia abutments/prosthetic restorations were evaluated: (A) a lithium disilicate crown cemented on a zirconia abutment and (B) a directly veneered zirconia abutment.…”

“…(Cooper, Stanford, Feine, & McGuire, 2016;Joda, Ferrari, & Brägger, 2017;Paolantoni et al, 2016 A;Payer et al, 2013Payer et al, , 2015Peron & Romanos, 2016;Spies, Pieralli, et al, 2017;Thoma, Brandenberg, Fehmer, Buchi, et al, 2016;Vanlioglu, Kahramanoglu, Yildiz, Özkan, & Kulak- Özkan, 2014). Monolithic single crowns were followed up in six of the studies using LiS2(Cooper et al, 2016;Joda et al, 2017;Paolantoni et al, 2016 A;Payer et al, 2015;Peron & Romanos, 2016;Spies, Pieralli, et al, 2017). One study was included that evaluated monolithic resin-nanoceramics (RNC)(Schepke, Meijer, Vermeulen, Raghoebar, & Cune, 2016).…”

Titanium-Reinforced Zirconia Abutments Versus Pure Zirconia Abutments for Implant-Supported Single Tooth Restorations: A Systematic Review.

“…However, this lack of RCTs could be attributed to the narrow scope of the review, since RCTs were found comparing other types of implant abutments. Baldini et al (23) ; Cosgarea et al (24) ; Carrillo de Albornoz et al (25) ; Ferrari et al (26), (27) ; Sailer et al (28) ; Zembic et al (29), (30) , compared different types of titanium abutments versus zirconia; while others compared between the different types of zirconia abutments: Büchi et al (31) and Thoma et al (32) compared the veneered zirconia versus white zirconia; Paolantoni et al (33) compared one-piece versus two-piece custom made zirconia anchorages and final prosthetic restoration; and Schepke et al (34) reported the comparison between stock versus customized zirconia.…”