Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study (original) (raw)
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Al-Azhar Dental Journal for Girls
Statement of problem. Treatment of tooth loss in the anterior maxilla can involve difficult functional, esthetic, and psychological problems, especially in young patients with otherwise good dentition. Purpose. The purpose of this study was to provide a comparative evaluation of two different implant system (Biohorizons and Dentium) with zirconia abutment in cemented single-tooth restorations. Material and methods. This prospective study of 45 single-tooth replacements with 22 Biohorizons and 23 Dentium dental implants was performed in 30 patients. The patients were selected from the outpatients' clinic, Faculty of Dental Medicine, Al-Azhar University during the period October 2010 to October 2013. The custom zirconia abutments were fabricated. The restoration was an all ceramic crown for cementation with a framework in zirconia. The first clinical and radiographic follow up was performed one week after crown placement for all patients (baseline examination) then at four, eight and twelve months after crown placement, all patients were recalled and participated in the annual examination. Results. The clinical parameters (plaque and peri-implant gingival indexes) measured at the baseline and 1-year follow-up examination showed non significant differences in Biohorizons and Dentium and gave a satisfactory results. There is a significant difference in probing depth where the Biohorizons gave better result. The bone loss in Biohorizons was lesser than that in Dentium. The mean marginal bone loss was slightly higher (non significant) in the maxilla for both implant systems. During the 1-year follow up period, the survival rate was 100% in Biohorizons implant system and 95.6% in Dentium implants. The titanium screws that attached the abutment to implant were loosened within a few months of insertion of the permanent crown in two cases of Dentium implant. Subjectively all patients were satisfied with their single-tooth restorations supported by both dental implants. Conclusion. Within the limitation of the present study, favorable results obtained with the application of the Biohorizons implant system that supported cemented single-tooth crowns with custom zirconia abutment especially in the anterior region of the maxilla. Further studies are necessary to evaluate the long-term success.
European journal of oral implantology, 2011
To compare the biological, technical and aesthetic outcomes of single implant-supported all-ceramic versus metal-ceramic crowns. Thirty-six patients with premolar agenesis were randomly treated with 38 all-ceramic (AC) and 37 metal-ceramic (MC) implant-supported single-tooth restorations. A quasi-randomisation of consecutively included restorations in patients with one or more implants was used, i.e. a combination of parallel group (for 13 patients with one restoration) and split-mouth (for 23 patients with ≥2 restorations). All patients were recalled for baseline and 1-year followup examinations. Biological and technical outcomes, including complications, were clinically and radiographically registered. The Copenhagen Index Score and visual analogue scale (VAS) score were used to assess professional and patient-reported aesthetic outcomes, respectively, by blinded assessors. One-year after loading, no patient dropped out and no implant failed, though one MC restoration had to be re...
Clinical oral investigations, 2016
The objective of this clinical study was to evaluate the clinical performance of implant-supported zirconia crowns with a sintered veneering cap. Furthermore, the influence of the type of retention (screw-retained vs cemented single crowns) was analysed. Fifty-eight patients were accommodated with 114 implants, inserted in the molar and premolar regions. Zirconia-based crowns with a sintered veneering cap were either screw-retained (n = 53) or cemented (n = 61) on the implant. Recalls were performed every 6 months. The state of soft tissue was documented by the modified plaque and gingiva index (mPI) and sulcus bleeding index (mSBI). The restorations were evaluated for technical failures like veneering porcelain fractures, surface qualities and marginal fitting. Neither implant loss nor crown fractures occurred. After a mean clinical service time of 36.9 months, fractures of the veneering porcelain were registered in 1.8 % of the cases. The Kaplan-Meier survival probability regardin...
Statement of problem: Recently, zirconia abutments are widely replacing the gold standard titanium abutments in restoring dental implants especially in aesthetic areas due to their superior aesthetics, excellent biocompatibility and satisfactory mechanical properties. However, excessive hardness of zirconia in comparison to titanium results in wear at implant-abutment interface followed by many technical and aesthetic complications. New zirconia abutments, with titanium component at the apical portion, were developed to overcome these complications and improve their mechanical performance. Purpose: To compare the effectiveness of titanium-reinforced zirconia abutments versus pure zirconia abutments in patients restored with implant-supported single tooth restorations to improve post-insertion abutment survival and patient satisfaction. Material and methods: We searched the Cochrane Oral Health Group Trial register (25 December 2016), Cochrane Central Register of Controlled Trials (The Cochrane Library, 2016, Issue 12), MEDLINE (January 1966 to 25 December 2016) and the WHO International Clinical Trial Registry Platform (25 December 2016). We did not apply any language or date restrictions. Inclusion criteria were randomized controlled trials (RCTs) comparing titanium-reinforced zirconia abutments versus pure zirconia abutments in patients restored with implant-supported single tooth restorations. Two review authors independently assessed trials for inclusion. Risk of bias assessment, extracting the data and checking for accuracy were to be conducted by two review authors independently, and the results were to be expressed as risk ratio (RR) or mean differences (MD), together with their 95% confidence intervals (CI). The primary outcome measures were post-insertion abutment survival and patient satisfaction. Results: No eligible RCTs were identified for inclusion in the review. Conclusions: There is no evidence to support the use of titanium-reinforced zirconia abutments or pure zirconia abutments in patients restored with implant-supported single tooth restorations to improve post-insertion abutment survival and patient satisfaction. The protocol for this systematic review (One-piece versus two-piece zirconia abutments for implant-supported crowns) was registered on PROSPERO 2017:CRD42017054286 Available from http://www.crd.york.ac.uk/PROSPERO/display\_record.asp?ID=CRD42017054286.
BioMed Research International, 2016
The purpose of this randomized controlled study is to investigate the clinical results obtained over four years and incidence of complications associated withone- versustwo-piece custom made zirconia anchorages, in single tooth implant-supported restorations of the maxillary anterior region. Sixty-five patients, with a total of 74 missing maxillary teeth, were selected in the period from February 2007 to July 2010. Two different ways of custom made zirconia abutment and final prosthetic restoration were evaluated: a standard zirconia abutment associated with a pressed layer of lithium disilicate with an all-ceramic cemented restoration versus one-piece restoration with the facing porcelain fired and pressed straight to the custom made zirconia abutment. In 29 cases, the restoration consisted of an all-ceramic restoration for cementation (two pieces); in 45 cases the restoration was a screw-retained restoration (one piece). Three all-ceramic restorations broke during the observation ...
This study evaluated the clinical performance of implant supported, extra-orally cemented, monolithic zirconia crowns after a follow-up to 18 months. Thirty-one patients with 50 posterior dental implants were consecutively selected for this study. A total of 50 crowns were cemented onto titanium abutments extra-orally and then screwed to the implants with the required torque intra-orally. The patients were followed at 12 months and 18 months after placement of restorations. During the follow-up period, all restorations were evaluated according to following technical parameters: implant failure, crown fracture, screw loosening, loss of retention due to decementation, fracture of antagonist tooth or restoration. Data were analyzed using Kaplan Meier method. One implant and its corresponding crown was lost during the follow-up period, yielding a 18 months survival rate of 98%. During the study, 2 complication events were observed, including one screw loosening and one veneering porcelain chipping in an antagonist bilayered zirconia restoration. The overall success rate of the observed prosthesis was 96%. According to the results of this study, the extra-orally cemented, monolithic zirconia crowns resulted in a favorable short-term outcome for posterior implant supported restorations within this short observation time.
International Journal of Prosthodontics, 2015
The purpose of this retrospective study was to evaluate the 5-year clinical performance and failure rate of single-or multiple-unit zirconia-based crowns. Materials and Methods: A total of 148 patients (39 men and 109 women, mean age: 46.9 ± 10.6 years) treated in university and private practices with 618 single-or multiple-unit zirconia-based (Lava) crowns made on natural teeth from January 2007 to December 2008 were included. Two hundred fifty-nine anterior and 359 posterior crowns were examined. A core and/or veneer fracture that required replacement of the restoration was considered to be a failure. The cumulative survival rate (CSR) was described with Kaplan-Meier survival functions. The crowns replaced for other reasons were deemed lost to follow-up, and esthetic, functional, and biologic complications were rated. Results: At the 5-year follow-up, no zirconia core fractures were observed. Twelve veneer fractures that required crown replacement were detected. The CSR was 98.1%. There was a statistically significant difference between survival of the anterior and posterior restorations (P < .001). In total, 116 crowns experienced biologic and technical complications. The most common complications were smooth veneer fracture (4, 0.6%), loss of retention (7, 1%), staining because of smoking (24, 4%), and gingival recession (48, 8%). Conclusions: According to the 5-year CSR (98.1%) observed in this study, zirconia-based single or multiple crowns may be considered an acceptable treatment modality for the replacement of anterior and posterior teeth. Results from the current study should be supported by additional randomized clinical trials.
Quintessence international (Berlin, Germany : 1985), 2011
This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior region using a flapless approach and a custom-made zirconia-ceramic abutment and crown. The case reported illustrates the practical procedure involved in developing natural esthetics with a custom-made zirconia-ceramic prosthesis and abutment. The technique is relatively simple, can be used in a variety of clinical situations, and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores (PES) (9 ± 0.2) and white esthetic scores (WES) (7 ± 0.5) after 4 years.