Titanium Base Abutments in Implant Prosthodontics: A Literature Review

Abstract

Implant abutments are essential components in restoring dental implants. Titanium base abutments were introduced to overcome issues related to existing abutments, such as the unesthetic appearance of titanium abutments and the low fracture strength of ceramic abutments. This study aimed to comprehensively review studies addressing the mechanical and clinical behaviors of titanium base abutments. A search was performed on PubMed/MEDLINE, Web of Science, Google Scholar, and Scopus databases to find articles that were published in English until December 2020 and that addressed the review purpose. A total of 33 articles fulfilled the inclusion criteria and were included for data extraction and review. In vitro studies showed that titanium base abutments had high fracture strength, adequate retention values, particularly with resin cement, and good marginal and internal fit. Although the clinical assessment of titanium base abutments was limited, they showed comparable performance with conventional abutments in short-term evaluation, especially in the anterior and premolar areas. Titanium base abutments can be considered a feasible treatment option for restoring dental implants, but long-term clinical studies are required for a better assessment.

Prosthetic complications with monolithic or micro‐veneered implant‐supported zirconia single‐unit, multiple‐unit, and complete‐arch prostheses on titanium base abutments: A single center retrospective study with mean follow‐up period of 72.35 months

“…5 Another alternative to achieve an adequate retention between the ti-base abutment and the prosthetic superstructure may be using chemical and mechanical surface modifications. 21 Four participants experienced two or more prosthetic complications, which were chipping (four incidents in one patient), major ceramic fracture, decementation of zirconia-ti-base hybrid abutment, screw loosening, and screw fracture. One of those four patients was a bruxist and suffered from screw loosening of multi-unit prostheses and decementation of zirconia-ti-base hybrid abutments from singleand multi-unit prostheses.…”

“…Other design modifications include the addition of non‐cylindrical, mechanically retentive elements to the ti‐base abutments to improve the bond strength with the composite resin luting cement utilized 5 . Another alternative to achieve an adequate retention between the ti‐base abutment and the prosthetic superstructure may be using chemical and mechanical surface modifications 21 …”

“…This titanium abrasion could also result in an increased micro gap at the implant‐abutment interface, component fracture or loosening, 17,18 and discoloration of the peri‐implant soft tissues 19 . To overcome these shortcomings of 1‐piece zirconia abutments, a 2‐piece design, which involves either a zirconia abutment (zirconia‐ti‐base hybrid abutment) 20,21 or a zirconia crown (hybrid zirconia crown) cemented onto a titanium base (ti‐base) abutment 22 was introduced. This design has the advantage of providing esthetic benefits of zirconia accompanied with the preferable titanium‐titanium contact at the implant‐abutment interface 12 .…”

Influence of Abutment Design on Clinical Outcome of Implant-Supported Monolithic Zirconia Crowns

“…In addition, cementing the components extraorally should reduce the possibility of excess cement and cement-induced peri-implantitis. 15,16 Zirconia (ZrO2) is a highly attractive ceramic material in prosthodontics. It is widely used to build prosthetic devices because of its good chemical properties, dimensional stability, high mechanical strength, toughness, and a Young's modulus (210 GPa) similar to that of stainless steel alloy (193 GPa).…”

“…The conical Ti base abutments had a higher debonding and a higher macromovement rate. 19 A review performed by Al-Thobity 15 reporting that several studies investigated the effect of introducing Ti base abutments into implantsupported restorations. Zirconia abutments with Ti inserts were found to have a remarkable increase in fracture resistance compared with the one-piece zirconia.…”