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Titanium or zirconium computer-aided design/computer-aided manufacturing abutments are now widely used for aesthetic implant treatments; however, information regarding microscopic structural differences that may influence the biological and mechanical outcomes of different implant systems is limited. Therefore, the characteristics of different connection systems were investigated. Optical microscopic observation and scanning electron microscopy showed different characteristics of two internal systems, namely the Astra Tech and the Replace Select system, and for different materials. The scanning electron microscopic observation showed for the Astra Tech that the implant-abutment interface seemed to be completely sealed for both titanium and zirconium abutments, both horizontally and sagittally; however, the first implant-abutment contact was below the fixture top, creating a microgap, and fixtures connected with titanium abutments showed significantly larger values (23·56μm±5·44 in width, and 168·78μm±30·39 in depth, P<0·001). For Replace Select, scanning electron microscopy in the sagittal direction showed that the sealing of titanium and zirconium abutments differed. The seal between the implant-titanium and implant-zirconium abutments seemed to be complete at the butt-joint interface; however, the displacement of the abutment in relation to the fixture in the lateral direction was evident for both abutments with no statistical differences (P>0·70), creating an inverted microgap. Thus, microscopy evaluation of two commonly used internal systems connected to titanium or zirconium abutments showed that the implant-abutment interface was perfectly sealed under no-loading conditions. However, an inverted microgap was seen in both systems, which may result in bacterial accumulation as well as alteration of stress distribution at the implant-abutment interface.

This study evaluated the clinical outcomes of immediately loaded maxillary anterior single implants placed in fresh extraction sockets. A patient cohort that was treated 1.5 years earlier was recalled, and 18 patients (6 men, 12 women) with 21 implants were included. Clinical photographs and periapical radiographs were taken at follow-up and baseline to determine the bone loss and change in esthetics. No marginal bone loss was detected at followup (mean bone level ± standard deviation = 0.32 ± 0.82 mm). Immediate implant placement and loading resulted in predictable clinical and esthetic outcomes, with soft and hard tissue levels remaining stable over time. (Int J Periodontics Restorative Dent 2015;35:715-723.

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