Implantes

Randomized-controlled clinical trial of
customized zirconia and titanium
implant abutments for single-tooth
implants in canine and posterior
regions: 3-year results
Anja Zembic
Irena Sailer
Ronald Ernst Jung
Christoph Hans Franz
Ha¨mmerle
Authors’ affilitations:
Anja Zembic, Irena Sailer, Ronald Ernst Jung,
Christoph Hans Franz Ha¨mmerle, Department of
Fixed and RemovableProsthodontics and Dental
Material Science, Center for Dental and Oral
Medicine, University of Zurich, Zurich,
Switzerland
Correspondence to:
Dr Irena Sailer
Department of Fixed and Removable Prosthodontics
and Dental Material Science
Center for Dental and Oral Medicine
University of Zurich
Plattenstr. 11
8032 Zurich
Switzerland
Tel.: þ41 44 634 32 52
Fax: þ41 44 634 43 05
e-mail:irena.sailer@zzmk.uzh.ch
Key words: ceramic abutments, implant abutments, survival, titanium, zirconia
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 wererandomly 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 (DE) 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: Eighteenpatients 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 titaniumabutments was observed: PPD
(meanPPDZrO2 3.2 _ 1mm, mPPDTi 3.4 _ 0.5 mm), PCR (mPCRZrO2 0.1 _ 0.2, mPCRTi
0.1 _ 0.2) and BOP (mBOPZrO2 0.4 _ 0.4, mBOPTi 0.2 _ 0.3). Furthermore, the BL was
similar at implants supporting zirconia and titanium abutments (mBLZrO2 1.7 _ 1,
dBLZrO2 1.6 _ 1; mBLTi 2 _ 1, dBLTi 2.1 _ 1). Both, zirconia and titanium abutments
induced a similar amount of discolorationof the mucosa compared with the gingiva at
natural teeth (DEZrO2 9.3 _ 3.8, DETi 6.8 _ 3.8).
Conclusions: At 3 years, zirconia and titanium abutments exhibited same survival and
technical, biological and esthetical outcomes.
Customized implant abutments are increasingly
applied for the fabrication of
implant-borne reconstructions aimed at
imitating the natural situation (Marchack
1996; Jemt1998; Henriksson & Jemt
2003). These abutments are individually
shaped according to the anatomical needs
of the respective implant site (Marchack
1996; Jemt 1998; Henriksson & Jemt
2003).
Nowadays, customized abutments can
be fabricated out of various materials like
metals or ceramics. Each type of material
has its benefits and shortcomings. Metals
Date:
Accepted 20 January2009
To cite this article:
Zembic A, Sailer I, Jung RE, Ha¨mmerle CHF.
Randomized-controlled clinical trial of customized
zirconia and titanium implant abutments for singletooth
implants in canine and posterior regions: 3-year
results.
Clin. Oral Impl. Res. 20, 2009; 802–808.
doi: 10.1111/j.1600-0501.2009.01717.x
802 c_ 2009 The Authors. Journal compilation c_ 2009 John Wiley & Sons...