Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study.

PURPOSE This prospective clinical study evaluated an experimental implant abutment made of densely sintered zirconia with respect to peri-implant hard and soft tissue reaction as well as fracture resistance over time. MATERIALS AND METHODS Twenty-seven consecutively treated patients with 54 single-tooth implants were included. Zirconia abutment ingots were individually shaped and set on the implants with gold screws. All-ceramic (Empress I) crowns were cemented using a composite cement. At the 1- and 4-year examinations, reconstructions were evaluated for technical problems (fracture of abutment or crown, loosening of abutment screw). Modified Plaque and simplified Gingival Indices were recorded at implants and neighboring teeth, and peri-implant bone levels were radiographically determined. RESULTS All but 1 of the 27 patients with 53 restorations could be evaluated at 1 year, and 36 restorations in 18 patients were evaluated 4 years after abutment and crown insertion. The median observation period for the reconstructions was 49.2 months. No abutment fractures occurred. Abutment screw loosening was reported for 2 restorations at 8 months and 27 months, respectively. Mean Plaque Index was 0.4 (SD 0.6) at abutments and 0.5 (SD 0.6) at teeth; mean Gingival Index was 0.7 (SD 0.5) at abutments and 0.9 (SD 0.5) at teeth. Mean marginal bone loss measured 1.2 mm (SD 0.5) after 4 years of functional loading. CONCLUSION Zirconia abutments offered sufficient stability to support implant-supported single-tooth reconstructions in anterior and premolar regions. The soft and hard tissue reaction toward zirconia was favorable.

[1]  R. Glauser,et al.  Ceramic implant abutments for short-span FPDs: a prospective 5-year multicenter study. , 2003, The International journal of prosthodontics.

[2]  R. C. Wheeler Complete crown form and the periodontium , 1961 .

[3]  P P Binon,et al.  The effect of eliminating implant/abutment rotational misfit on screw joint stability. , 1996, The International journal of prosthodontics.

[4]  S Toreskog,et al.  A 5-year multicenter study on implant-supported single crown restorations. , 1998, The International journal of oral & maxillofacial implants.

[5]  G. Zarb,et al.  Dental implants and decision making. , 1992, Journal of dental education.

[6]  P P Binon,et al.  Evaluation of machining accuracy and consistency of selected implants, standard abutments, and laboratory analogs. , 1995, The International journal of prosthodontics.

[7]  G Zarb,et al.  The long-term efficacy of currently used dental implants: a review and proposed criteria of success. , 1986, The International journal of oral & maxillofacial implants.

[8]  A. Terano,et al.  An Experimental Study in Dogs , 1990 .

[9]  P Schärer,et al.  Zirconia posts: a new all-ceramic concept for nonvital abutment teeth. , 1995, Journal of esthetic dentistry.

[10]  P I Brånemark,et al.  A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. , 1981, International journal of oral surgery.

[11]  A. Ingber,et al.  Esthetic high-strength implant abutments. Part II. , 1993, Journal of esthetic dentistry.

[12]  N. Lang,et al.  The microbiota associated with successful or failing osseointegrated titanium implants. , 1987, Oral microbiology and immunology.

[13]  D. Tarnow,et al.  Alumina ceramic implant abutments used for single-tooth replacement: a prospective 1- to 3-year multicenter study. , 2001, The International journal of prosthodontics.

[14]  Reinhilde Jacobs,et al.  E.A.O. guidelines fo the use of diagnostic imaging in implant dentistry. A consensus workshop organized by the European Association for Osseointegration in Trinity College Dublin. , 2002, Clinical oral implants research.

[15]  G. Zarb,et al.  The longitudinal effectiveness of osseointegrated dental implants. The Toronto Study: peri-implant mucosal response. , 1992, The International journal of periodontics & restorative dentistry.

[16]  A. Ingber,et al.  Esthetic high-strength implant abutments. Part I. , 1993, Journal of esthetic dentistry.

[17]  K. Hinds Custom impression coping for an exact registration of the healed tissue in the esthetic implant restoration. , 1997, The International journal of periodontics & restorative dentistry.

[18]  B. Calès,et al.  Yttria-Stabilized Zirconia Ceramic for Improved Hip Joint Head , 1994 .

[19]  P. Branemark,et al.  Cemented single crowns on osseointegrated implants after 5 years: results from a prospective study on CeraOne. , 1998, The International journal of prosthodontics.

[20]  A. Ingber,et al.  All-ceramic implant abutments: esthetic indications. , 1996, Journal of esthetic dentistry.

[21]  A Odén,et al.  A new all-ceramic crown. A dense-sintered, high-purity alumina coping with porcelain. , 1993, Acta odontologica Scandinavica.

[22]  C P Marinello,et al.  Single-tooth replacement: some clinical aspects. , 1997, Journal of esthetic dentistry.

[23]  P. Glantz,et al.  The mucosal attachment at different abutments. An experimental study in dogs. , 1998, Journal of clinical periodontology.

[24]  K. Zeng,et al.  Flexure tests on dental ceramics. , 1996, The International journal of prosthodontics.

[25]  B Andersson,et al.  Procera AllCeram crowns followed for 5 to 10.5 years: a prospective clinical study. , 2001, The International journal of prosthodontics.

[26]  B. Andersson,et al.  Ceramic implant abutments used for short-span fixed partial dentures: a prospective 2-year multicenter study. , 1999, The International journal of prosthodontics.

[27]  P P Binon,et al.  The effect of implant/abutment hexagonal misfit on screw joint stability. , 1996, The International journal of prosthodontics.