ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title When Placing Implant Crowns, Both Metal and Ceramic Abutments Provide Excellent Functional and Esthetic Service
Clinical Question How do metal and ceramic implant abutments compare with respect to esthetic and functional properties when utilized in placement of implant crowns?
Clinical Bottom Line Various metal and ceramic implant abutments function well with respect to esthetics and function. Each implant site should guide the clinician in selecting the best one. The validity of the studies noted herein assessed both esthetic and functional concerns. Both gold and ceramic implant abutments appear to be very favorable.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21070378Bressan/201120 PatientsCase Control Study
Key resultsCeramic crowns were placed on ceramic, gold or titanium implant abutments in the anterior maxilla on twenty patients. Peri-implant soft tissue color was measured through a spectrophotometer. The abutment materials were analyzed with a statistical analysis and the normality of the quantitative variables was verified with the Shapiro-Wilk test. At 95% confidence intervals and P<0.05, the least square mean +/- standard errors were noted with the three abutment materials analyzed yielding the following: gold 8.9 +/- 0.4, titanium 11 +/- 0.4, and zirconium 8.5 +/- 0.4. All abutments showed a difference in color compared to soft tissue around natural teeth. A greater color difference (less desirable) was seen with titanium abutments and a lesser color difference (more desirable) was seen with both ceramic and gold abutments.
#2) 23725369Delben/201360 crowns equally divided among 3 different abutment typesCase Report Study
Key resultsThis study analyzed the effect of veneering materials on screw joint stability and evaluated the pre-load maintenance of abutment screws with different abutments and veneering materials. Torque/detorque was measured (p < 0.05, Fisher’s exact test) before and after mechanical cycling. Although a statistically significant difference was noted between test groups with ceramic, gold and titanium abutments, detorque reduction was observed regardless of the abutment type and veneering material. “Although the conditions of this in vitro study have not demonstrated the superiority of some material regarding the screw joint stability, the selection of abutment type and esthetic veneering material should be judicious due to its relevance to stress distribution on implants and supporting structures.”
#3) 22708959Hosseimi/201259 Patients treated with 98 implant restorationsRandomized Controlled Trial
Key resultsThis clinical study measured outcome variables of 64 all-ceramic and 34 metal-ceramic crowns placed on 52 zirconia, 21 titanium and 25 gold implant abutments. Data was gathered at baseline and 3-year follow up examinations. The survival rate for the implants was 100% and 97% for the abutments and crowns. The Copenhagen Index Score measured the aesthetic outcome and the patient reported outcomes were recorded using the OHIP-49 questionnaire. Although more marginal bone loss was registered at gold-alloy compared to zirconia abutments (P = 0.040), the biological outcomes at the zirconia and metal abutments were comparable. “The modified Plaque Index and modified Sulcus Bleeding Index were not significantly different at the three abutment materials. Patient reported outcome variables at different materials were not significantly different after 3 years."
Evidence Search http://www.ncbi.nlm.nih.gov/pubmed/?term=gold+and+ceramic+implant+abutments
Comments on
The Evidence
These three studies measured various parameters with ceramic, gold and titanium abutments regarding both function and esthetics. Standardized tests yielded useful information that can guide practitioners in selecting the best materials. Objective outcome criteria were applied in a blind fashion. Having seen success with both metal and ceramic implant abutments, they are both of great value when placing implant restorations. The requirements of each implant site should dictate the materials selected.
Applicability This information is of benefit to all practitioners placing implant restorations.
Specialty/Discipline (General Dentistry) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Ceramic, gold, and titanium abutments
ID# 2519
Date of submission: 08/03/2013spacer
E-mail richard22658@yahoo.com
Author James Moore
Co-author(s) Sathya Mahendrarajah
Co-author(s) e-mail Sathya Mahendrarajah
Faculty mentor/Co-author
Faculty mentor/Co-author e-mail
Basic Science Rationale
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