Immunohistochemical assessment of the peri‐implant soft tissue around different abutment materials: A human study

Abstract

Background Soft tissue reaction to dental implant abutments influences the sustainability of restoration. Several abutment materials, such as titanium and gold alloy, have been introduced for strength and esthetic solutions. Zirconia and titanium‐base abutments have also become popular in recent years due to high esthetic demands. Purpose To investigate the immune cell infiltration into the soft tissue in response to different abutment materials. Materials and Methods Twenty dental implants were placed in the posterior regions of 17 patients. Titanium, zirconia, gold alloy, and titanium‐base were randomly selected for each patient on the day of surgery. After 8 weeks of healing, the abutments were removed along with 1 mm of peri‐implant soft tissue. Immunohistochemical assessment was performed using labeled streptavidin‐biotin to identify T cells, B cells, macrophages, plasma cells, and microvascular infiltration. Results Gold alloy demonstrated an overall higher inflammatory cell infiltration and highest number of CD3+, CD20+, and CD 68+ cells (P value <.05). The number of plasma cell and new microvascular infiltrations among abutment materials was not significantly different. Conclusion Titanium, titanium‐base, and zirconia abutments showed comparable infiltration profiles; gold alloy abutments showed the highest B‐cell, T cell, and macrophage infiltration. None of the abutment materials caused clinical inflammation; hence, they can be effectively used.

Titanium Base Abutments in Implant Prosthodontics: A Literature Review

“…Owing to the recent introduction of titanium base abutments, few clinical studies have been conducted to assess their performance with regard to the survival and failure rates, technical and biological complications, and peri-implant soft tissue response. 57 58 59 60 61 62 63 In a prospective clinical trial, Joda et al 57 restored 44 subjects in two visits each with 50 screw-retained monolithic lithium disilicate crowns cemented extraorally to titanium bases. Most of the restorations were placed in the premolar and molar areas in both the maxillary and mandibular arches.…”

“…The results showed that gold alloy abutments had a significant increase in infiltration of inflammatory cells, such as macrophages, T-cells, and B-cells, whereas other abutments, including titanium base, presented insignificant changes in the inflammatory cell count. 60 …”

“…63 In a recent study, the infiltration of immune cells to the peri-implant soft tissue was examined after loading implants with different types of abutments, including gold alloy, titanium, zirconia, and titanium base. 60 A total of 17 patients received 20 implants in the posterior segments of the maxillary and mandibular arches. Eight weeks later, the abutments with 1 mm peri-implant soft tissues were removed and examined.…”

“…The results showed that gold alloy abutments had a significant increase in infiltration of inflammatory cells, such as macrophages, T-cells, and B-cells, whereas other abutments, including titanium base, presented insignificant changes in the inflammatory cell count. 60 Some manufacturers provide titanium base abutments with different sulcular heights to compensate for implant placement in different depth levels and variation of soft tissue heights. Multiple clinical reports have demonstrated the ability to design and fabricate ceramic abutments and crowns using titanium base to achieve the optimum emergence profile and improve the esthetic outcomes.…”

Three interfaces of the dental implant system and their clinical effects on hard and soft tissues

“…186 Therefore, the use of an abutment designed at the University of California at Los Angeles, the so-called UCLA abutment, fabricated by gold casting, a popular prosthetic option at one time, can break the soft tissue seal and increase marginal bone resorption. 187 Polyetheretherketone (PEEK) has been suggested as a material for abutments. This resin polymer is advantageous in chairside customization and gingival aesthetics, compared to metal abutments.…”