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Title Zirconia Implants Provide Highly Esthetic Restorations in the Anterior Maxilla
Clinical Question In patients seeking implant therapy in the esthetic zone, do zirconia-based implants provide an esthetic restoration?
Clinical Bottom Line For patients seeking implant therapy in the esthetic zone, zirconia implants provide esthetic outcomes. This is supported by a retrospective study evaluating zirconia implant-based restorations 1 year after placement and rating them on the Pink Esthetic Score (PES) and White Esthetic Score (WES) measures. This is compared to a similarly designed study examining titanium implants using the same measures.
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) 29897352Kniha/201852 patients with zirconia implant restorations in the esthetic zoneCohort Study
Key resultsFor 53 zirconia implants restored in the esthetic zone, mean PES was 8.8 and mean WES was 8.6. These rankings were provided by 12 examiners (3 OMFS, 3 orthodontists, 3 prosthodontists, and 3 dental students).
#2) 19228100Belser/200945 patients with titanium implant restorations in the esthetic zoneCohort Study
Key resultsFor 45 titanium implants restored in the esthetic zone, mean PES was 7.8 and mean WES was 6.9. Rankings were provided by 2 prosthodontists.
Evidence Search Zirconia OR Titanium AND Dental Implant AND White Esthetic Score
Comments on
The Evidence
53 zirconia implants placed in the esthetic zone received a mean score of 8.8 on the PES and 8.6 on the WES 1 year after placement. Given that the commonly acceptable clinical threshold of esthetic clinical success is 6.0 on both measures, these zirconia restorations were comfortably regarded as being esthetically acceptable. Other studies support these findings, showing that zirconia implants tend to create less peri-implant mucosal discoloration when compared to titanium implants (Thomas, 2016). Similarly designed studies evaluating titanium implant-based restorations on the PES and WES found them to also be predictably clinically acceptable in the esthetic area. The authors in both provided studies listed no conflicts of interest.
Applicability When making clinical decisions regarding restorations in the esthetic area, zirconia implants may provide clinically acceptable restorations in a predictable manner similar to titanium implants. The author of the study discusses that zirconia implants may provide esthetic outcomes superior to titanium implants, but due to lack of standardization between the comparable studies, such claims are currently unsubstantiated. Additional data is needed for long-term esthetic outcome for zirconia implant restorations. Implant restorations are also not recommended for all patients due to potential systemic limitations, restorative complications, or financial considerations. Other highly esthetic restorations are available and should be considered in these situations.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Zirconia Implant, Ceramic Implant, Titanium Implant, Esthetic Zone, Pink Esthetic Score, White Esthetic Score
ID# 3485
Date of submission: 12/01/2021spacer
E-mail esplin@uthscsa.edu
Author Kaleb C. Esplin, DDS
Co-author(s) Ellen Piehl, DMD
Co-author(s) e-mail piehl@uthscsa.edu
Faculty mentor/Co-author Dr. Georgios Kotsakis, DDS, MS
Faculty mentor/Co-author e-mail kotsakis@uthscsa.edu
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