Randomized‐controlled clinical trial of customized zirconia and titanium implant abutments for single‐tooth implants in canine and posterior regions: 3‐year results

Abstract

Objectives: The aim was to test whether or not zirconia abutments exhibit the same survival and technical/biological outcome as titanium abutments. Material and methods: Twenty‐two patients receiving 40 single‐tooth implants in canine and posterior regions were included. The implant sites were randomly assigned to 20 zirconia and 20 titanium abutments. All‐ceramic and metal–ceramic crowns were fabricated. At baseline, 6, 12 and 36 months, the reconstructions were examined for technical and biological problems. Probing pocket depth (PPD), plaque control record (PCR) and bleeding on probing (BOP) were assessed at abutments (test) and analogous contralateral teeth (control). Standardized radiographs of the implants were made and the bone level (BL) was measured referring to the implant shoulder on mesial (mBL) and distal sides (dBL). The difference of color (ΔE) of the peri‐implant mucosa and the gingiva of control teeth was assessed with a spectrophotometer. The data were statistically analyzed with Mann–Whitney Rank and Student's unpaired t‐tests. Results: Eighteen patients with 18 zirconia and 10 titanium abutments were examined at a mean follow‐up of 36 months (range 31.5–53.3 months). No fracture of an abutment or loss of a reconstruction was found. Hence, both exhibited 100% survival. At two metal–ceramic crowns supported by titanium abutments chipping of the veneering ceramic occurred. No difference of the biological outcome of zirconia and titanium abutments was observed: PPD ( 3.2 ± 1 mm, mPPDTi 3.4 ± 0.5 mm), PCR ( 0.1 ± 0.2, mPCRTi 0.1 ± 0.2) and BOP ( 0.4 ± 0.4, mBOPTi 0.2 ± 0.3). Furthermore, the BL was similar at implants supporting zirconia and titanium abutments ( 1.7 ± 1, 1.6 ± 1; mBLTi 2 ± 1, dBLTi 2.1 ± 1). Both, zirconia and titanium abutments induced a similar amount of discoloration of the mucosa compared with the gingiva at natural teeth ( 9.3 ± 3.8, ΔETi 6.8 ± 3.8). Conclusions: At 3 years, zirconia and titanium abutments exhibited same survival and technical, biological and esthetical outcomes.

Comparative Analysis of Surface Topography of Custom CAD/CAM ZirconiaAbutments by means of Optical Profilometry

“…The line of the crown margin can be adjusted to the line of the soft tissue, and the requirement for an anatomic emergence profile and controllable cement gap in a single implant-supported restoration can be met individually. [4][5][6] Because of the biocompatibility and minor color change in the peri-implant mucosa, CAD/CAM abutments made of zirconia are used increasingly in the aesthetically important anterior region. 7,8 In addition to the different possibilities for connecting the implant and abutment, it is possible to use prefabricated stock-or individually milled CAD/CAM zirconia abutments, both of which today are available in one-and two-piece designs.…”

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.…”

Ki̇şi̇ye Özel Dental İmplant Abutmentlari

“…Ancak titanyum abutmentlar renginden dolayı özellikle ince 24 tarafından ise yitriyum stabilize zirkonyumdan kişisel abutment üretilmiştir. Zirkonyum abutmentların alü-mina abutmentlara göre daha üstün sonuçlar verdiğini gösteren klinik ve laboratuar çalışmaları [24][25][26][27][28] olmakla beraber benzer sonuçlara sahip olduğunu gösteren bir çalışmada bulunmaktadır 29 .…”