Single-tooth implant reconstructions: esthetic factors influencing the decision between titanium and zirconia abutments in anterior regions

Eur J Esthet Dent. 2007 Autumn;2(3):296-310.

Abstract

Implant-supported single crowns have become a valid alternative to conventional fixed dental prostheses due to their excellent clinical long-term results. However, along with good survival rates, esthetic factors are important for success in anterior regions. Today, several kinds of implant abutments are offered by implant manufacturers. A choice must be made between standardized and customized abutments; further, different abutment materials such as titanium or various ceramics (alumina, zirconia) are available. Finally, the reconstruction can be cemented on the abutment or screw-retained directly on the implant. When choosing an abutment for an anterior single-unit case, several factors should be considered: visibility of the region (eg, high vs low smile line); biotype of the gingiva; color of the neighboring teeth; and finally, esthetic expectations of the patient. In esthetically demanding situations, customized ceramic abutments are indicated. In patient situations with thin peri-implant soft tissues, zirconia abutments and all-ceramic crowns should be used in combination. In cases with thick mucosa, titanium can be used as the abutment material, combined with metal-ceramic crowns. In order to avoid difficulties removing excess cement, screw-retained reconstructions may be preferred; however, the screw access hole should be positioned palatal to the incisal edge.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Color
  • Crowns
  • Decision Making*
  • Dental Abutments*
  • Dental Implants, Single-Tooth*
  • Dental Materials / chemistry*
  • Dental Porcelain / chemistry
  • Dental Prosthesis Design*
  • Dental Prosthesis, Implant-Supported
  • Esthetics, Dental*
  • Female
  • Gingiva / anatomy & histology
  • Humans
  • Incisor / injuries
  • Incisor / pathology
  • Male
  • Middle Aged
  • Root Resorption / therapy
  • Smiling
  • Titanium / chemistry*
  • Tooth Fractures / therapy
  • Tooth Root / injuries
  • Tooth, Nonvital / therapy
  • Young Adult
  • Zirconium / chemistry*

Substances

  • Dental Materials
  • Dental Porcelain
  • Zirconium
  • Titanium
  • zirconium oxide