Five‐year outcomes of a randomized controlled clinical trial comparing single‐tooth implant‐supported restoration with either zirconia or titanium abutments

Abstract

Aim To evaluate the influence of the abutment material (zirconia vs. titanium) on the long‐term aesthetic and clinical outcomes of implant‐supported restorations. Materials and Methods In 30 patients, a single implant‐supported restoration with either a zirconia or a titanium abutment was placed in the anterior maxilla (incisors, canines, and bicuspids). Aesthetic (Implant Crown Aesthetic Index or ICAI), clinical, radiographic, and patient‐centred outcomes were recorded at baseline (1 month after final restoration), 1 year, and 5 years of follow‐up. This study was registered in http://clinicaltrials.gov (NCT02315794). Results Twenty‐five subjects completed the follow‐up visits at 1 and 5 years. ICAI values showed statistically significant better aesthetic outcomes when zirconia abutments were used compared to titanium abutments. Between 1 and 5 years, the aesthetic sub‐analysis of the crown component worsened but the mucosal sub‐analysis improved. There were no significant changes in bone levels, but the plaque index, bleeding on probing, and probing depths worsened in both groups. Conclusions At 5 years, standard zirconia abutments achieved better aesthetic outcomes, although with similar clinical behaviour.

Material and abutment selection for CAD/CAM implant‐supported fixed dental prostheses in partially edentulous patients – A narrative review

“…With regards to the abutment material, both metal-ceramic (titanium, gold-alloys) and all-ceramic (zirconia) have been used with acceptable clinical outcomes (Ferrantino et al, 2023;Humm et al, 2023;Pjetursson et al, 2018). Although zirconia may appear esthetically superior (Bittencourt et al, 2023;Ferrantino et al, 2023), some mechanical concerns are raised due to the intrinsic brittleness of ceramics (Gehrke et al, 2016;Sailer et al, 2009).…”

“…The use of full zirconia abutments has been initially proposed to improve aesthetic outcomes in anterior regions (Bittencourt et al, 2023;Ferrantino et al, 2023). While in some studies survival rates are high and comparable to titanium (Ferrantino et al, 2023;Humm et al, 2023;Zembic et al, 2013), other studies reported fractures more frequently (Carrillo de Albornoz et al, 2014;Ferrari et al, 2016). These fractures may be associated with the specific geometry and dimensions of the utilized zirconia connections.…”