Clinical performance of zirconia implant abutments luted to a titanium base - a retrospective cross-sectional study

Int J Comput Dent. 2022 Mar 24;25(1):37-45.


Aim: To evaluate the survival of implant-retained restorations fabricated on CAD/CAM-derived zirconia abutments luted to a titanium base.

Materials and methods: 153 patients who received a total of 310 dental implants (Camlog Promote plus or Xive S) and all-ceramic restorations on yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) abutments luted to a titanium base during the last 10 years were included. Patients were examined for technical complications during routine visits. Crestal bone level changes were randomly analyzed based on periapical radiographs of 75 implants.

Results: Among the included 153 patients, 17 ceramic chippings (5.5%), 6 abutment loosenings (1.9%), and 2 abutment fractures (0.6%) were identified. The mean follow-up time was 4.7 years (standard deviation [SD]: 1.94), with a follow-up period of up to 10 years (maximum). Kaplan-Meier estimation resulted in a survival rate without complications of 91.6% for the restoration and 97.4% for the abutment. There was no statistically significant difference between the two implant systems, either between implant location or regarding the complication rate of the type of restoration. For the 75 implants included in the radiographic analysis, the mean bone level change was 0.384 mm (SD: 0.242, 95% CI: 0.315 to 0.452) for the Camlog implant system and 0.585 mm (SD: 0.366, 95% CI: 0.434 to 0.736) for the Xive system (P = 0.007).

Conclusion: The results of the present retrospective study demonstrate acceptable clinical outcomes for zirconia abutments luted to a titanium base in combination with all-ceramic restorations. The assessed abutment design does not appear to have a negative impact on peri-implant hard tissue.

Keywords: implant restoration; titanium base; two-piece abutment; zirconia abutment; implant abutment.

MeSH terms

  • Cross-Sectional Studies
  • Dental Implants*
  • Humans
  • Retrospective Studies
  • Titanium* / chemistry
  • Zirconium


  • Dental Implants
  • Zirconium
  • Titanium
  • zirconium oxide