J Adv Prosthodont.  2019 Feb;11(1):48-54. 10.4047/jap.2019.11.1.48.

All-ceramic versus titanium-based implant supported restorations: Preliminary 12-months results from a randomized controlled trial

• Weigl P
• Trimpou G
• Grizas E
• Hess P
• Nentwig GH
• Lauer HC
• Lorenz J

• KMID: 2438931
• DOI: http://doi.org/10.4047/jap.2019.11.1.48

Abstract

PURPOSE
The aim of the present randomized controlled study was to compare prefabricated all-ceramic, anatomically shaped healing abutments followed by all-ceramic abutments and all-ceramic crowns and prefabricated standard-shaped (round-diameter) titanium healing abutments followed by final titanium abutments restored with porcelain-fused-to-metal (PFM) implant crowns in the premolar and molar regions.
MATERIALS AND METHODS
Forty-two patients received single implants restored either by all-ceramic restorations (test group, healing abutment, final abutment, and crown all made of zirconia) or conventional titanium-based restorations. Immediately after prosthetic incorporation and after 12 months of loading, implant survival, technical complications, bone loss, sulcus fluid flow rate (SFFR) as well as plaque index (PI) and implant stability (Periotest) were analyzed clinically and radiologically.
RESULTS
After 12 months of loading, an implant and prosthetic survival rate of 100% was observed. Minor prosthetic complications such as chipping of ceramic veneering occurred in both groups. No statistical significant differences were observed between both groups with only a minimum of bone loss, SFFR, and PI.
CONCLUSION
All-ceramic implant prostheses including a prefabricated anatomically shaped healing abutment achieved comparable results to titanium-based restorations in the posterior region. However, observational results indicate a benefit as shaping the peri-implant soft-tissue with successive provisional devices and subsequent compression of the soft tissue can be avoided.

Keyword

Ceramic abutments; Titanium abutments; Posterior region; Soft-tissue conditioning; Ceramic sulcus former

MeSH Terms

Bicuspid
Ceramics
Crowns
Humans
Molar
Prostheses and Implants
Survival Rate
Titanium
Titanium

Figure

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  Fig. 1 Prototype zirconia healing abutments were designed and fabricated for the study. The shape mimicked the natural shape of a molar or premolar tooth after crown preparation.

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  Fig. 2 Final posterior zirconia abutments were also produced. The form and cross-section of the healing and final abutments corresponded perfectly.

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  Fig. 3 Soft tissue conditioning and clinically intact attachment to the zirconia healing abutment.

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  Fig. 4 Preconditioning of the emergence profile two weeks after the mounting of the anatomical shaped.

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  Fig. 5 Zirconia abutment corresponding to the dimension of the healing abutments avoiding any compression of the peri-implant soft tissue.

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  Fig. 6 Final crown in place.

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