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International Journal of Implant Dentistry

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Open Access 01-12-2021 | Review

Esthetic, mechanical, and biological outcomes of various implant abutments for single-tooth replacement in the anterior region: a systematic review of the literature

Authors: Dimitra Totou, Olga Naka, Shamir B. Mehta, Subir Banerji

Published in: International Journal of Implant Dentistry | Issue 1/2021

Abstract

Background

The choice of the appropriate implant abutment is a critical step for a successful outcome. Titanium abutments have demonstrated high survival rates, due to their excellent biocompatibility and high mechanical strength, although they often result in a grayish discoloration of the peri-implant mucosa. This esthetic concern culminated in the introduction of ceramic abutments. The aim of this review was to assess the esthetic, mechanical, and biological outcomes as well as the survival of the different types of abutments used for single-implant restorations in the anterior area.

Material and methods

An electronic search was conducted in Medline, Embase, and Cochrane Central databases using the appropriate Mesh terms and predetermined eligibility criteria. The quality of the studies was assessed using the ROB 2 tool. The last search was conducted on 18th of March 2020.

Results

From the 2074 records initially identified, 23 randomized controlled trials (32 publications) were included for qualitative analysis. Data were classified based on study information, specific characteristics of the intervention and comparator, and information related to the outcome measures. Seven studies exhibited an overall low risk of bias, while twelve studies raised some concerns.

Conclusions

The rate of abutment failure was low and was associated with the ceramic abutments, especially those with internal connection. Limited correlation was noted between soft tissue thickness and color difference. Titanium abutments caused significantly more discoloration to the soft tissues than ceramic abutments, while hueing (gold or pink) slightly improved their color performance. Zirconia allowed a better color match than titanium or gold abutments, still discolored slightly the soft tissues. The submucosally modified zirconia abutments exhibited encouraging results. No significant difference was reported between materials or different types of retention on recession, papillary fill, and biological outcomes.

Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res. 2012;23:2–21. https://doi.org/10.1111/j.1600-0501.2012.02547.x.CrossRefPubMed

Belser UC, Schmid B, Higginbottom F, Buser D. Outcome analysis of implant restorations located in the anterior maxilla: a review of the recent literature. Int J Oral Maxillofac Implants. 2004;19(Suppl):30–42.PubMed

Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. J Dent Res. 2012;91(3):242–8. https://doi.org/10.1177/0022034511431252.CrossRefPubMed

Cosyn J, Thoma DS, Hämmerle CH, De Bruyn H. Esthetic assessments in implant dentistry: objective and subjective criteria for clinicians and patients. Periodontol 2000. 2017;73(1):193–202. https://doi.org/10.1111/prd.12163.CrossRefPubMed

Sailer I, Zembic A, Jung RE, Hämmerle CH, Mattiola A. Single-tooth implant reconstructions: esthetic factors influencing the decision between titanium and zirconia abutments in anterior regions. Eur J Esthet Dent. 2007;2(3):296–310.PubMed

Pjetursson BE, Sailer I, Zwahlen M, Hämmerle CH. A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Part I: Single crowns. Clin Oral Implants Res. 2007;18(Suppl 3):73–85. https://doi.org/10.1111/j.1600-0501.2007.01467.x.CrossRefPubMed

Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CHF, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res. 2009;20(Suppl 4):4–31. https://doi.org/10.1111/j.1600-0501.2009.01787.x.CrossRefPubMed

Zembic A, Kim S, Zwahlen M, Kelly JR. Systematic review of the survival rate and incidence of biologic, technical, and esthetic complications of single implant abutments supporting fixed prostheses. Int J Oral Maxillofac Implants. 2014;29:Suppl:99–116. https://doi.org/10.11607/jomi.2014suppl.g2.2.CrossRef

Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res. 2008;19(2):119–30. https://doi.org/10.1111/j.1600-0501.2007.01453.x.CrossRefPubMed

10.

Park SE, Da Silva JD, Weber HP, Ishikawa-Nagai S. Optical phenomenon of peri-implant soft tissue. Part I. Spectrophotometric assessment of natural tooth gingiva and peri-implant mucosa. Clin Oral Implants Res. 2007;18(5):569–74. https://doi.org/10.1111/j.1600-0501.2007.01391.x.CrossRefPubMed

11.

Ishikawa-Nagai S, Da Silva JD, Weber HP, Park SE. Optical phenomenon of peri-implant soft tissue. Part II. Preferred implant neck color to improve soft tissue esthetics. Clin Oral Implants Res. 2007;18(5):575–80. https://doi.org/10.1111/j.1600-0501.2007.01390.x.CrossRefPubMed

12.

Jung RE, Sailer I, Hämmerle CH, Attin T, Schmidlin P. In vitro color changes of soft tissues caused by restorative materials. Int J Periodontics Restorative Dent. 2007;27(3):251–7.PubMed

13.

Jung RE, Holderegger C, Sailer I, Khraisat A, Suter A, Hämmerle CH. The effect of all-ceramic and porcelain-fused-to-metal restorations on marginal peri-implant soft tissue color: a randomized controlled clinical trial. Int J Periodontics Restorative Dent. 2008;28(4):357–65.PubMed

14.

Henriksson K, Jemt T. Evaluation of custom-made procera ceramic abutments for single-implant tooth replacement: a prospective 1-year follow-up study. Int J Prosthodont. 2003;16(6):626–30.PubMed

15.

Andersson B, Taylor A, Lang BR, Scheller H, Scharer P, Sorensen JA, et al. Alumina ceramic implant abutments used for single-tooth replacement: a prospective 1- to 3-year multicenter study. Int J Prosthodont. 2001;14(5):432–8.PubMed

16.

Hisbergues M, Vendeville S, Vendeville P. Zirconia: established facts and perspectives for a biomaterial in dental implantology. J Biomed Mater Res B Appl Biomater. 2009;88(2):519–29. https://doi.org/10.1002/jbm.b.31147.CrossRefPubMed

17.

Scarano A, Piattelli M, Caputi S, Favero GA, Piattelli A. Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study. J Periodontol. 2004;75(2):292–6. https://doi.org/10.1902/jop.2004.75.2.292.CrossRefPubMed

18.

Degidi M, Artese L, Scarano A, Perrotti V, Gehrke P, Piattelli A. Inflammatory infiltrate, microvessel density, nitric oxide synthase expression, vascular endothelial growth factor expression, and proliferative activity in peri-implant soft tissues around titanium and zirconium oxide healing caps. J Periodontol. 2006;77(1):73–80. https://doi.org/10.1902/jop.2006.77.1.73.CrossRefPubMed

19.

Nakamura K, Kanno T, Milleding P, Ortengren U. Zirconia as a dental implant abutment material: a systematic review. Int J Prosthodont. 2010;23(4):299–309.PubMed

20.

Foong JK, Judge RB, Palamara JE, Swain MV. Fracture resistance of titanium and zirconia abutments: an in vitro study. J Prosthet Dent. 2013;109(5):304–12. https://doi.org/10.1016/S0022-3913(13)60306-6.CrossRefPubMed

21.

Leutert CR, Stawarczyk B, Truninger TC, Hämmerle CH, Sailer I. Bending moments and types of failure of zirconia and titanium abutments with internal implant-abutment connections: a laboratory study. Int J Oral Maxillofac Implants. 2012;27(3):505–12.PubMed

22.

Bressan E, Paniz G, Lops D, Corazza B, Romeo E, Favero G. Influence of abutment material on the gingival color of implant-supported all-ceramic restorations: a prospective multicenter study. Clin Oral Implants Res. 2011;22(6):631–7. https://doi.org/10.1111/j.1600-0501.2010.02008.x.CrossRefPubMed

23.

Büchi DL, Sailer I, Fehmer V, Hämmerle CH, Thoma DS. All-ceramic single-tooth implant reconstructions using modified zirconia abutments: a prospective randomized controlled clinical trial of the effect of pink veneering ceramic on the esthetic outcomes. Int J Periodontics Restorative Dent. 2014;34(1):29–37. https://doi.org/10.11607/prd.1870.CrossRefPubMed

24.

Happe A, Schulte-Mattle V, Fickl S, Naumann M, Zoller JE, Rothamel D. Spectrophotometric assessment of peri-implant mucosa after restoration with zirconia abutments veneered with fluorescent ceramic: a controlled, retrospective clinical study. Clin Oral Implants Res. 2013;24:28–33. https://doi.org/10.1111/j.1600-0501.2011.02361.x.CrossRefPubMed

25.

Cao Y, Yu C, Wu Y, Li L, Li C. Long-term survival and peri-implant health of titanium implants with zirconia abutments: a systematic review and meta-analysis. J Prosthodont. 2019;28(8):883–92. https://doi.org/10.1111/jopr.13097.CrossRefPubMed

26.

Naveau A, Rignon-Bret C, Wulfman C. Zirconia abutments in the anterior region: a systematic review of mechanical and esthetic outcomes. J Prosthet Dent. 2019;121(5):775–781.e1. https://doi.org/10.1016/j.prosdent.2018.08.005.CrossRefPubMed

27.

Linkevicius T, Vaitelis J. The effect of zirconia or titanium as abutment material on soft peri-implant tissues: a systematic review and meta-analysis. Clin Oral Implants Res. 2015;26(Suppl 11):139–47. https://doi.org/10.1111/clr.12631.CrossRefPubMed

28.

de Medeiros RA, Vechiato-Filho AJ, Pellizzer EP, Mazaro JV, dos Santos DM, Goiato MC. Analysis of the peri-implant soft tissues in contact with zirconia abutments: an evidence-based literature review. J Contemp Dent Pract. 2013;14(3):567–72. https://doi.org/10.5005/jp-journals-10024-1364.CrossRefPubMed

29.

Bidra AS, Rungruanganunt P. Clinical outcomes of implant abutments in the anterior region: a systematic review. J Esthet Restor Dent. 2013;25(3):159–76. https://doi.org/10.1111/jerd.12031.CrossRefPubMed

30.

Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Plos Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentral

31.

Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. https://doi.org/10.1136/bmj.l4898.CrossRefPubMed

32.

Zembic A, Sailer I, Jung RE, Hämmerle CH. Randomized-controlled clinical trial of customized zirconia and titanium implant abutments for single-tooth implants in canine and posterior regions: 3-year results. Clin Oral Implants Res. 2009;20(8):802–8. https://doi.org/10.1111/j.1600-0501.2009.01717.x.CrossRefPubMed

33.

Sailer I, Zembic A, Jung RE, Siegenthaler D, Holderegger C, Hämmerle CH. Randomized controlled clinical trial of customized zirconia and titanium implant abutments for canine and posterior single-tooth implant reconstructions: preliminary results at 1 year of function. Clin Oral Implants Res. 2009;20(3):219–25. https://doi.org/10.1111/j.1600-0501.2008.01636.x.CrossRefPubMed

34.

Zembic A, Bösch A, Jung RE, Hämmerle CH, Sailer I. Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions. Clin Oral Implants Res. 2013;24(4):384–90. https://doi.org/10.1111/clr.12044.CrossRefPubMed

35.

Bösch A, Jung RE, Sailer I, Goran B, Hämmerle CH, Thoma DS. Single-tooth replacement using dental implants supporting all-ceramic and metal-based reconstructions: results at 18 months of loading. Int J Periodontics Restorative Dent. 2018;38(2):173–9. https://doi.org/10.11607/prd.2846.CrossRefPubMed

36.

van Brakel R, Meijer GJ, Verhoeven JW, Jansen J, de Putter C, Cune MS. Soft tissue response to zirconia and titanium implant abutments: an in vivo within-subject comparison. J Clin Periodontol. 2012;39(10):995–1001. https://doi.org/10.1111/j.1600-051X.2012.01931.x.CrossRefPubMed

37.

den Hartog L, Raghoebar GM, Slater JJ, Stellingsma K, Vissink A, Meijer HJ. Single-tooth implants with different neck designs: a randomized clinical trial evaluating the aesthetic outcome. Clin Implant Dent Relat Res. 2013;15(3):311–21. https://doi.org/10.1111/j.1708-8208.2011.00372.x.CrossRef

38.

Rieder D, Eggert J, Krafft T, Weber HP, Wichmann MG, Heckmann SM. Impact of placement and restoration timing on single-implant esthetic outcome - a randomized clinical trial. Clin Oral Implants Res. 2016;27(2):e80–6. https://doi.org/10.1111/clr.12539.CrossRefPubMed

39.

Furze D, Byrne A, Donos N, Mardas N. Clinical and esthetic outcomes of single-tooth implants in the anterior maxilla. Quintessence Int. 2012;43(2):127–34.PubMed

40.

Montero J, Manzano G, Beltran D, Lynch CD, Suarez-Garcia M, Castillo-Oyague R. Clinical evaluation of the incidence of prosthetic complications in implant crowns constructed with UCLA castable abutments. A cohort follow-up study. J Dent. 2012;40(12):1081–9. https://doi.org/10.1016/j.jdent.2012.09.001.CrossRefPubMed

41.

Schwarz S, Schroder C, Hassel A, Bomicke W, Rammelsberg P. Survival and chipping of zirconia-based and metal-ceramic implant-supported single crowns. Clin Implant Dent Relat Res. 2012;14(Suppl 1):e119–25. https://doi.org/10.1111/j.1708-8208.2011.00388.x.CrossRefPubMed

42.

Hosseini M, Worsaae N, Schiodt M, Gotfredsen K. A 3-year prospective study of implant-supported, single-tooth restorations of all-ceramic and metal-ceramic materials in patients with tooth agenesis. Clin Oral Implants Res. 2013;24(10):1078–87. https://doi.org/10.1111/j.1600-0501.2012.02514.x.CrossRefPubMed

43.

Fenner N, Hämmerle CH, Sailer I, Jung RE. Long-term clinical, technical, and esthetic outcomes of all-ceramic vs. titanium abutments on implant supporting single-tooth reconstructions after at least 5 years. Clin Oral Implants Res. 2016;27(6):716–23. https://doi.org/10.1111/clr.12654.CrossRefPubMed

44.

Kim A, Campbell SD, Viana MA, Knoernschild KL. Abutment material effect on peri-implant soft tissue color and perceived esthetics. J Prosthodont. 2016;25(8):634–40. https://doi.org/10.1111/jopr.12360.CrossRefPubMed

45.

Peng M, Zhao W, Hosseini M, Zhou W, Xiao T, Chuan J. Influence of restorative materials on color of implant-supported single crowns in esthetic zone: a spectrophotometric evaluation. Biomed Res Int. 2017;2017:5034358–7. https://doi.org/10.1155/2017/5034358.CrossRefPubMedPubMedCentral

46.

Asgeirsson AG, Sailer I, Gamper F, Jung RE, Hämmerle CH, Thoma DS. Veneered zirconia abutments cemented on non-original titanium bases: 1-year results of a prospective case series. Clin Oral Implants Res. 2019;30(8):735–44. https://doi.org/10.1111/clr.13457.CrossRefPubMed

47.

Thoma DS, Brandenberg F, Fehmer V, Büchi DL, Hämmerle CH, Sailer I. Randomized controlled clinical trial of all-ceramic single tooth implant reconstructions using modified zirconia abutments: radiographic and prosthetic results at 1 year of loading. Clin Implant Dent Relat Res. 2016;18(3):462–72. https://doi.org/10.1111/cid.12333.CrossRefPubMed

48.

Brandenberg FD, Sailer I, Fehmer V, Büchi DL, Hämmerle CH, Thoma DS. Randomized controlled clinical pilot study of all-ceramic single-tooth implant reconstructions: clinical and microbiological outcomes at one year of loading. Clin Oral Implants Res. 2017;28(4):406–13. https://doi.org/10.1111/clr.12813.CrossRefPubMed

49.

Eisner B, Naenni N, Hüsler J, Hämmerle CH, Thoma DS, Sailer I. Three-year results of a randomized controlled clinical trial using submucosally veneered and unveneered zirconia abutments supporting all-ceramic single-implant crowns. Int J Periodontics Restorative Dent. 2018;38(5):645–52. https://doi.org/10.11607/prd.3669.CrossRefPubMed

50.

Laass A, Sailer I, Hüsler J, Hämmerle CH, Thoma DS. Randomized controlled clinical trial of all-ceramic single-tooth implant reconstructions using modified zirconia abutments: results at 5 years after loading. Int J Periodontics Restorative Dent. 2019;39(1):17–27. https://doi.org/10.11607/prd.3792.CrossRefPubMed

51.

Gallucci GO, Grütter L, Nedir R, Bischof M, Belser UC. Esthetic outcomes with porcelain-fused-to-ceramic and all-ceramic single-implant crowns: a randomized clinical trial. Clin Oral Implants Res. 2011;22(1):62–9. https://doi.org/10.1111/j.1600-0501.2010.01997.x.CrossRefPubMed

52.

Gallucci GO, Grütter L, Chuang S, Belser UC. Dimensional changes of peri-implant soft tissue over 2 years with single-implant crowns in the anterior maxilla. J Clin Periodontol. 2011;38(3):293–9. https://doi.org/10.1111/j.1600-051X.2010.01686.x.CrossRefPubMed

53.

Heierle L, Wolleb K, Hämmerle CH, Wiedemeier DB, Sailer I, Thoma DS. Randomized controlled clinical trial comparing cemented versus screw-retained single crowns on customized zirconia abutments: 3-year results. Int J Prosthodont. 2019;32(2):174–6. https://doi.org/10.11607/ijp.6080.CrossRefPubMed

54.

Thoma DS, Wolleb K, Bienz SP, Wiedemeier D, Hämmerle CH, Sailer I. Early histological, microbiological, radiological, and clinical response to cemented and screw-retained all-ceramic single crowns. Clin Oral Implants Res. 2018;29(10):996–1006. https://doi.org/10.1111/clr.13366.CrossRefPubMed

55.

Thoma DS, Brandenberg F, Fehmer V, Knechtle N, Hämmerle CH, Sailer I. The esthetic effect of veneered zirconia abutments for single-tooth implant reconstructions: a randomized controlled clinical trial. Clin Implant Dent Relat Res. 2016;18(6):1210–7. https://doi.org/10.1111/cid.12388.CrossRefPubMed

56.

Thoma DS, Sailer I, Mühlemann S, Gil A, Jung RE, Hämmerle CH. Randomized controlled clinical study of veneered zirconia abutments for single implant crowns: clinical, histological, and microbiological outcomes. Clin Implant Dent Relat Res. 2018;20(6):988–96. https://doi.org/10.1111/cid.12674.CrossRefPubMed

57.

Kraus RD, Epprecht A, Hämmerle CH, Sailer I, Thoma DS. Cemented vs screw-retained zirconia-based single implant reconstructions: a 3-year prospective randomized controlled clinical trial. Clin Implant Dent Relat Res. 2019;21(4):578–85. https://doi.org/10.1111/cid.12735.CrossRefPubMed

58.

Wittneben JG, Gavric J, Belser UC, Bornstein MM, Joda T, Chappuis V, et al. Esthetic and clinical performance of implant-supported all-ceramic crowns made with prefabricated or CAD/CAM zirconia abutments: a randomized, multicenter clinical trial. J Dent Res. 2017;96(2):163–70. https://doi.org/10.1177/0022034516681767.CrossRefPubMed

59.

Wittneben JG, Gavric J, Sailer I, Buser D, Wismeijer D. Clinical and esthetic outcomes of two different prosthetic workflows for implant-supported all-ceramic single crowns—3 year results of a randomized multicenter clinical trial. Clin Oral Impl Res. 2020;31(5):495–505. https://doi.org/10.1111/clr.13586.CrossRef

60.

Patil R, den Hartog L, van Heereveld C, Jagdale A, Dilbaghi A, Cune M. Comparison of two different abutment designs on marginal bone loss and soft tissue development. Int J Oral Maxillofac Implants. 2014;29(3):675–81. https://doi.org/10.11607/jomi.3363.CrossRefPubMed

61.

Patil R, den Hartog L, Dilbaghi A, de Jong B, Kerdijk W, Cune MS. Papillary fill response in single-tooth implants using abutments of different geometry. Clin Oral Implants Res. 2016;27(12):1506–10. https://doi.org/10.1111/clr.12594.CrossRefPubMed

62.

Patil R, Gresnigt MM, Mahesh K, Dilbaghi A, Cune MS. Esthetic evaluation of anterior single-tooth implants with different abutment designs-patients’ satisfaction compared to dentists’ observations. J Prosthodont. 2017;26(5):395–8. https://doi.org/10.1111/jopr.12423.CrossRefPubMed

63.

Gil MS, Ishikawa-Nagai S, Elani HW, Da Silva JD, Kim DM, Tarnow D, et al. A prospective clinical trial to assess the optical efficacy of pink neck implants and pink abutments on soft tissue esthetics. J Esthet Restor Dent. 2017;29(6):409–15. https://doi.org/10.1111/jerd.12309.CrossRefPubMed

64.

Gil MS, Ishikawa-Nagai S, Elani HW, Da Silva JD, Kim DM, Tarnow D, et al. Comparison of the color appearance of peri-implant soft tissue with natural gingiva using anodized pink-neck implants and pink abutments: a prospective clinical trial. Int J Oral Maxillofac Implants. 2019;34(3):752–8. https://doi.org/10.11607/jomi.6318.CrossRefPubMed

65.

Bittner N, Schulze-Spate U, Cleber S, Da Silva JD, Kim DM, Tarnow D, et al. Comparison of peri-implant soft tissue color with the use of pink-neck vs gray implants and abutments based on soft tissue thickness: a 6-month follow-up study. Int J Prosthodont. 2020;33(1):29–38. https://doi.org/10.11607/ijp.6205.CrossRefPubMed

66.

Hosseini M, Worsaae N, Schiodt M, Gotfredsen K. A 1-year randomised controlled trial comparing zirconia versus metal-ceramic implant supported single-tooth restorations. Eur J Oral Implantol. 2011;4(4):347–61.PubMed

67.

Carrillo de Albornoz A, Vignoletti F, Ferrantino L, Cardenas E, De Sanctis M, Sanz M. A randomized trial on the aesthetic outcomes of implant-supported restorations with zirconia or titanium abutments. J Clin Periodontol. 2014;41(12):1161–9. https://doi.org/10.1111/jcpe.12312.CrossRefPubMed

68.

Baldini N, D’Elia C, Clementini M, Carrillo de Albornoz A, Sanz M, De Sanctis M. Esthetic outcomes of single-tooth implant-supported restorations using metal-ceramic restorations with zirconia or titanium abutments: a randomized controlled clinical study. Int J Periodontics Restorative Dent. 2016;36(4):e59–66. https://doi.org/10.11607/prd.2599.CrossRefPubMed

69.

Paolantoni G, Marenzi G, Blasi A, Mignogna J, Sammartino G. Findings of a four-year randomized controlled clinical trial comparing two-piece and one-piece zirconia abutments supporting single prosthetic restorations in maxillary anterior region. Biomed Res Int. 2016;2016:8767845–6. https://doi.org/10.1155/2016/8767845.CrossRefPubMedPubMedCentral

70.

Lops D, Stellini E, Sbricoli L, Cea N, Romeo E, Bressan E. Influence of abutment material on peri-implant soft tissues in anterior areas with thin gingival biotype: a multicentric prospective study. Clin Oral Implants Res. 2017;28(10):1263–8. https://doi.org/10.1111/clr.12952.CrossRefPubMed

71.

Martinez-Rus F, Prieto M, Salido MP, Madrigal C, Ozcan M, Pradies G. A Clinical study assessing the influence of anodized titanium and zirconium dioxide abutments and peri-implant soft tissue thickness on the optical outcome of implant-supported lithium disilicate single crowns. Int J Oral Maxillofac Implants. 2017;32(1):156–63. https://doi.org/10.11607/jomi.5258.CrossRefPubMed

72.

Thoma DS, Gamper FB, Sapata VM, Voce G, Hämmerle CH, Sailer I. Spectrophotometric analysis of fluorescent zirconia abutments compared to “conventional” zirconia abutments: a within subject controlled clinical trial. Clin Implant Dent Relat Res. 2017;19(4):760–6. https://doi.org/10.1111/cid.12488.CrossRefPubMed

73.

Amorfini L, Storelli S, Mosca D, Scanferla M, Romeo E. Comparison of cemented vs screw-retained, customized computer-aided design/computer-assisted manufacture zirconia abutments for esthetically located single-tooth implants: a 10-year randomized prospective study. Int J Prosthodont. 2018;31(4):359–66. https://doi.org/10.11607/ijp.5305.CrossRefPubMed

74.

Koutouzis T, Adeinat B, Ali A. The influence of abutment macro-design on clinical and radiographic peri-implant tissue changes for guided, placed, and restored implants: a 1-year randomized controlled trial. Clin Oral Implants Res. 2019;30(9):882–91. https://doi.org/10.1111/clr.13493.CrossRefPubMed

75.

Johnston WM, Kao EC. Assessment of appearance match by visual observation and clinical colorimetry. J Dent Res. 1989;68(5):819–22. https://doi.org/10.1177/00220345890680051301.CrossRefPubMed

76.

Gracis S, Michalakis K, Vigolo P, Vult von Steyern P, Zwahlen M, Sailer I. Internal vs. external connections for abutments/reconstructions: a systematic review. Clin Oral Implants Res. 2012;23(Suppl 6):202–16. https://doi.org/10.1111/j.1600-0501.2012.02556.x.CrossRefPubMed

77.

Truninger TC, Stawarczyk B, Leutert CR, Sailer TR, Hämmerle CH, Sailer I. Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation. Clin Oral Implants Res. 2012;23(1):12–8. https://doi.org/10.1111/j.1600-0501.2010.02141.x.CrossRefPubMed

78.

Mühlemann S, Truninger TC, Stawarczyk B, Hämmerle CH, Sailer I. Bending moments of zirconia and titanium implant abutments supporting all-ceramic crowns after aging. Clin Oral Implants Res. 2014;25(1):74–81. https://doi.org/10.1111/clr.12192.CrossRefPubMed

79.

Hjerppe J, Narhi T, Fröberg K, Vallittu P, Lassila L. Effect of shading the zirconia framework on biaxial strength and surface microhardness. Acta Odontol Scand. 2008;66(5):262–7. https://doi.org/10.1080/00016350802247123.CrossRefPubMed

80.

Sailer I, Mühlemann S, Zwahlen M, Hämmerle CH, Schneider D. Cemented and screw-retained implant reconstructions: a systematic review of the survival and complication rates. Clin Oral Implants Res. 2012;23(Suppl 6):163–201. https://doi.org/10.1111/j.1600-0501.2012.02538.x.CrossRefPubMed

81.

Mustafa K, Wennerberg A, Arvidson K, Messelt EB, Haag P, Karlsson S. Influence of modifying and veneering the surface of ceramic abutments on cellular attachment and proliferation. Clin Oral Implants Res. 2008;19(11):1178–87. https://doi.org/10.1111/j.1600-0501.2008.01560.x.CrossRefPubMed

82.

Vetromilla BM, Brondani LP, Pereira-Cenci T, Bergoli CD. Ifluence of different implant-abutment connection designs on the mechanical and biological behavior of single-tooth implants in the maxillary esthetic zone: a systematic review. J Prosthet Dent. 2019;121(3):398–403. https://doi.org/10.1016/j.prosdent.2018.05.007.CrossRefPubMed

Title: Esthetic, mechanical, and biological outcomes of various implant abutments for single-tooth replacement in the anterior region: a systematic review of the literature
Authors: Dimitra Totou
Olga Naka
Shamir B. Mehta
Subir Banerji
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Implant Dentistry / Issue 1/2021
Electronic ISSN: 2198-4034
DOI: https://doi.org/10.1186/s40729-021-00370-7

At a glance: The STEP trials

Springer Medicine

Esthetic, mechanical, and biological outcomes of various implant abutments for single-tooth replacement in the anterior region: a systematic review of the literature

Abstract

Background

Material and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Material and methods

Results

Conclusions

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