Cross-sectional analysis comparing prefabricated titanium to individualized hybrid zirconia abutments for cemented zirconia based fixed dental prostheses: a critical concept assessment
Tóm tắt
Despite the differences in material properties and shapes among the different types of prefabricated titanium (pTiA) and individualized hybrid zirconia abutments (ihZiA), the biological and clinical relevance of materials and construction features remains vague. Yet, individualized ihZiA are increasingly implemented into daily routine aiming to satisfy rising expectations. The objective was to compare these two types of abutments in fixed dental prostheses (FDP). This cross-sectional study examined 462 implants in 102 patients comparing pTiA (52 patients) to ihZiA (50 patients) for FDP. These different treatment regimens were evaluated in terms of peri-implant health, radiographic bone loss, and oral-health related quality of life (OH-QoL) with special consideration of abutment type and superstructure design. ihZiA showed significantly different design features than prefabricated pTiA, but the annual bone loss in both groups did not. Visible titanium in the esthetic zone negatively impacted OHIP 14 scores. The combination of an emergence angle (EA) of < 30° and a concave emergence profile (EP) as well as gingiva thickness (p = 0.002) at the time of the prosthetic restoration significantly improved the annual peri-implant bone loss, independently of the abutment type. ihZiA showed comparable results to pTiA. To optimize the long-term outcome, not just material alone but generating adequate soft tissue thickness, minimizing the EA, and applying a concave EP seem to be the most relevant factors. To improve OH-QoL, particular attention must be paid to the esthetic zone.
Từ khóa
Tài liệu tham khảo
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.e771.
Gehrke P, Bleuel K, Fischer C, Sader R. Influence of margin location and luting material on the amount of undetected cement excess on CAD/CAM implant abutments and cement-retained zirconia crowns: an in-vitro study. BMC Oral Health. 2019;19(1):111.
Hanawa T. Zirconia versus titanium in dentistry: a review. Dent Mater J. 2020;39(1):24–36.
Totou D, Naka O, Mehta SB, Banerji S. Esthetic, mechanical, and biological outcomes of various implant abutments for single-tooth replacement in the anterior region: a systematic review of the literature. Int J Implant Dent. 2021;7(1):85.
Passos SP, Linke B, Larjava H, French D. Performance of zirconia abutments for implant-supported single-tooth crowns in esthetic areas: a retrospective study up to 12-year follow-up. Clin Oral Implant Res. 2016;27(1):47–54.
Sasada Y, Cochran DL. Implant-abutment connections: A review of biologic consequences and peri-implantitis implications. Int J Oral Maxillofac Implants. 2017;32(6):1296–307.
Joda T, Ferrari M, Gallucci GO, Wittneben JG, Brägger U. Digital technology in fixed implant prosthodontics. Periodontol. 2017;73(1):178–92.
Priest G. Virtual-designed and computer-milled implant abutments. J Oral Maxillofac Surg. 2005;63(9 Suppl 2):22–32.
Kerstein RB, Castellucci F, Osorio J. Ideal gingival form with computer-generated permanent healing abutments. Compend Contin Educ Dent. 2000;21(10):793–797, 800–791; quiz 802.
Al-Thobity AM. Titanium base abutments in implant prosthodontics: a literature review. Eur J Dent. 2022;16(1):49–55.
Stimmelmayr M, Edelhoff D, Güth JF, Erdelt K, Happe A, Beuer F. Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: a comparative in vitro study. Dent Mater. 2012;28(12):1215–20.
John MT, Miglioretti DL, LeResche L, Koepsell TD, Hujoel P, Micheelis W. German short forms of the oral health impact profile. Commun Dent Oral Epidemiol. 2006;34(4):277–88.
Gomez-Roman G, Axmann D, d’Hoedt B, Schulte W. Eine Methode zur quantitativen Erfassung und statistischen Auswertung des periimplantären Knochenabbaus. Stomatologie. 1995;92(9):463–71.
Neckel N, Wagendorf P, Sachse C, et al. Influence of implant-specific radiation doses on peri-implant hard and soft tissue: an observational pilot study. Clin Oral Implant Res. 2021;32(2):249–61.
Nesse W, Abbas F, van der Ploeg I, Spijkervet FK, Dijkstra PU, Vissink A. Periodontal inflamed surface area: quantifying inflammatory burden. J Clin Periodontol. 2008;35(8):668–73.
Hujoel PP, White BA, García RI, Listgarten MA. The dentogingival epithelial surface area revisited. J Periodontal Res. 2001;36(1):48–55.
Mombelli A, Van Oosten M, Schürch E Jr, Lang N. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987;2(4):145–51.
Muehlemann H. Patientenmotivation mit individuellem Intensivprogramm für orale Gesundheit. In: Prophylaxe. Quintessenz Berlin; 1978:137–149.
Katafuchi M, Weinstein BF, Leroux BG, Chen YW, Daubert DM. Restoration contour is a risk indicator for peri-implantitis: a cross-sectional radiographic analysis. J Clin Periodontol. 2018;45(2):225–32.
Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: case definitions and diagnostic considerations. J Periodontol. 2018;89(Suppl 1):S304-s312.
Mattheos N, Vergoullis I, Janda M, Miseli A. The implant supracrestal complex and its significance for long-term successful clinical outcomes. Int J Prosthodont. 2021;34(1):88–100.
Mattheos N, Janda M, Acharya A, Pekarski S, Larsson C. Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri-implant mucositis and peri-implantitis: a critical review. Clin Oral Implant Res. 2021;32(Suppl 21):181–202.
Yi Y, Koo KT, Schwarz F, Ben Amara H, Heo SJ. Association of prosthetic features and peri-implantitis: a cross-sectional study. J Clin Periodontol. 2020;47(3):392–403.
de Tapia B, Mozas C, Valles C, Nart J, Sanz M, Herrera D. Adjunctive effect of modifying the implant-supported prosthesis in the treatment of peri-implant mucositis. J Clin Periodontol. 2019;46(10):1050–60.
Gomez-Meda R, Esquivel J. The flat and step (F and S) pontics. Novel pontic designs for periodontally reconstructed sites. J Esthet Restor Dent. 2022;34(7):999–1004.
Korman RP. Enhancing esthetics with a fixed prosthesis utilizing an innovative pontic design and periodontal plastic surgery. J Esthet Restor Dent. 2015;27(1):13–28.
Nelson K, Hu X, Nack C, Nahles G, Mehrhof J, Nahles S. Analysis of soft tissue display during enjoyment smile. Part II: elder Caucasians. Int J Periodontics Restorative Dent. 2014;34(4):573–8.
Hu X, Nahles S, Nelson CA, Lin Y, Nelson K. Analysis of soft tissue display during enjoyment smiling: part 1–Caucasians. Int J Periodontics Restorative Dent. 2013;33(1):e9-15.
Soulami S, Slot DE, van der Weijden F. Implant-abutment emergence angle and profile in relation to peri-implantitis: a systematic review. Clin Exp Dental Res. 2022;8(4):795–806.
Tavelli L, Barootchi S, Avila-Ortiz G, Urban IA, Giannobile WV, Wang HL. Peri-implant soft tissue phenotype modification and its impact on peri-implant health: a systematic review and network meta-analysis. J Periodontol. 2021;92(1):21–44.
Berglundh T, Lindhe J. Dimension of the periimplant mucosa. Biological width revisited. J Clin Periodontol. 1996;23(10):971–3.
Linkevicius T, Linkevicius R, Alkimavicius J, Linkeviciene L, Andrijauskas P, Puisys A. Influence of titanium base, lithium disilicate restoration and vertical soft tissue thickness on bone stability around triangular-shaped implants: a prospective clinical trial. Clin Oral Implant Res. 2018;29(7):716–24.
Díaz-Sánchez M, Soto-Peñaloza D, Peñarrocha-Oltra D, Peñarrocha-Diago M. Influence of supracrestal tissue attachment thickness on radiographic bone level around dental implants: a systematic review and meta-analysis. J Periodontal Res. 2019;54(6):573–88.
Linkevicius T, Apse P, Grybauskas S, Puisys A. The influence of soft tissue thickness on crestal bone changes around implants: a 1-year prospective controlled clinical trial. Int J Oral Maxillofac Implants. 2009;24(4):712–9.
Thoma DS, Naenni N, Figuero E, et al. Effects of soft tissue augmentation procedures on peri-implant health or disease: a systematic review and meta-analysis. Clin Oral Implant Res. 2018;29(Suppl 15):32–49.
Ramanauskaite A, Becker K, Schwarz F. Clinical characteristics of peri-implant mucositis and peri-implantitis. Clin Oral Implant Res. 2018;29(6):551–6.
Dvorak G, Arnhart C, Heuberer S, Huber CD, Watzek G, Gruber R. Peri-implantitis and late implant failures in postmenopausal women: a cross-sectional study. J Clin Periodontol. 2011;38(10):950–5.
Nack C, Raguse JD, Stricker A, Nelson K, Nahles S. Rehabilitation of irradiated patients with chemically modified and conventional SLA implants: five-year follow-up. J Oral Rehabil. 2015;42(1):57–64.
Dreyer H, Grischke J, Tiede C, et al. Epidemiology and risk factors of peri-implantitis: a systematic review. J Periodont Res. 2018;53(5):657–81.
Varela-Centelles P, Bugarín-González R, Blanco-Hortas A, Varela-Centelles A, Seoane-Romero JM, Romero-Méndez A. Oral hygiene habits. Results of a population-based study. An Sist Sanit Navar. 2020;43(2):217–23.
Koszuta P, Grafka A, Koszuta A, Lopucki M, Szymanska J. Effects of selected factors on the osseointegration of dental implants. Prz Menopauzalny. 2015;14(3):184–7.
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.
Byrne G. Peri-implant marginal bone loss is minimal after 5 years of function. J Am Dental Assoc. 2015;146(1):68–9.
Etöz O, Bertl K, Kukla E, Ulm C, Ozmeric N, Stavropoulos A. How old is old for implant therapy in terms of implant survival and marginal bone levels after 5–11 years? Clin Oral Implant Res. 2021;32(3):337–48.
Chackartchi T, Romanos GE, Sculean A. Soft tissue-related complications and management around dental implants. Periodontol. 2019;81(1):124–38.
Tavelli L, Barootchi S, Majzoub J, et al. Prevalence and risk indicators of midfacial peri-implant soft tissue dehiscence at single site in the esthetic zone: A cross-sectional clinical and ultrasonographic study. J Periodontol. 2022;93(6):857–66.
Klongbunjit D, Aunmeungtong W, Khongkhunthian P. Implant-abutment screw removal torque values between customized titanium abutment, straight titanium abutment, and hybrid zirconia abutment after a million cyclic loading: an in vitro comparative study. Int J Implant Dent. 2021;7:98.
Al-Zordk W, Elmisery A, Ghazy M. Hybrid-abutment-restoration: effect of material type on torque maintenance and fracture resistance after thermal aging. Int J Implant Dent. 2020;6:24.
Waltenberger L, Wolfart S. SafetyCrown: a patient-centered, fully digital concept for immediate implant restoration following the one-abutment/one-time concept-a pilot case series of a new treatment concept. Int J Implant Dent. 2022;8:35.