Clinical performance of implant crowns with customized zirconia abutments: A prospective cohort study with a 4.5- to 8.8-year follow-up

Manrique Fonseca, Pedro Molinero-Mourelle, Fiona Alena Forrer, Nicole Schnider, Stefan Paul Hicklin, Martin Schimmel, Urs Brägger, Manrique Fonseca, Pedro Molinero-Mourelle, Fiona Alena Forrer, Nicole Schnider, Stefan Paul Hicklin, Martin Schimmel, Urs Brägger

Abstract

Objective: To assess the clinical and esthetic outcomes and patient satisfaction of screw-retained one-piece implant crowns fabricated with zirconia abutments after a 4.5- to 8.8-year follow-up.

Material and methods: Thirty-two patients (12 women and 20 men), who received 40 implant single crowns in anterior and premolar sites, were included in this prospective study. All restorations were based on ceramic hand-veneered customized CAD/CAM zirconia abutments. The follow-up consisted of clinical and radiological examinations. The pink esthetic score-white esthetic score (PES-WES) was used to evaluate the esthetic outcome. Patients' satisfaction was assessed via visual analog scale (VAS).

Results: Implant and prosthetic survival rates were 100% and 97.5%, respectively. Mean marginal bone loss was -0.17 mm (SD 1.16 mm). Probing depth was ≤4 mm in 98.7% and 5 mm in 1.3% of the sites; 8.3% of them were bleeding on probing positive. No technical or biological complications were observed except for one abutment fracture. The mean PES-WES scores were 7.0 and 7.1, respectively. VAS scores (10-point) of 9.41 for function and 9.26 for esthetics showed high patient satisfaction.

Conclusion: After a mean observation period of 6 years and 7 months, screw-retained implant crowns based on veneered customized CAD/CAM zirconia abutments with conical connection showed very good clinical performance and may be recommended for the replacement of missing anterior and premolar teeth. (ClinicalTrials.gov # NCT04370314).

Keywords: all-ceramic restorations; dental implant; implant crowns; one-piece implant crowns; screw-retained implant crowns; survival rate; zirconia abutments.

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

References

    1. Albrektsson, T., Zarb, G., Worthington, P., & Eriksson, A. R. (1986). The long-term efficacy of currently used dental implants: A review and proposed criteria of success. The International Journal of Oral & Maxillofacial Implants, 1(1), 11-25.Retrieved from
    1. Belser, U. C., Grutter, L., Vailati, F., Bornstein, M. M., Weber, H. P., & Buser, D. (2009). Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: A cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. Journal of Periodontology, 80(1), 140-151.
    1. Berglundh, T., Armitage, G., Araujo, M. G., Avila-Ortiz, G., Blanco, J., Camargo, P. M., Chen, S., Cochran, D., Derks, J., Figuero, E., Hämmerle, C. H. F., Heitz-Mayfield, L. J. A., Huynh-Ba, G., Iacono, V., Koo, K.-T., Lambert, F., McCauley, L., Quirynen, M., Renvert, S., … Zitzmann, N. (2018). Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Periodontology, 89(Suppl 1), S313-S318.
    1. Bressan, E., Paniz, G., Lops, D., Corazza, B., Romeo, E., & Favero, G. (2011). Influence of abutment material on the gingival color of implant-supported all-ceramic restorations: A prospective multicenter study. Clinical Oral Implants Research, 22(6), 631-637.
    1. Brunner, E., Domhof, S., & Langer, F. (2002). Nonparametric analysis of longitudinal data in factorial experiments. J. Wiley.
    1. Buser, D., Wittneben, J., Bornstein, M. M., Grutter, L., Chappuis, V., & Belser, U. C. (2011). Stability of contour augmentation and esthetic outcomes of implant-supported single crowns in the esthetic zone: 3-year results of a prospective study with early implant placement postextraction. Journal of Periodontology, 82(3), 342-349.
    1. Chappuis, V., Rahman, L., Buser, R., Janner, S. F. M., Belser, U. C., & Buser, D. (2018). Effectiveness of contour augmentation with guided bone regeneration: 10-year results. Journal of Dental Research, 97(3), 266-274.
    1. Clelland, N., Chaudhry, J., Rashid, R. G., & McGlumphy, E. (2016). Split-mouth comparison of splinted and nonsplinted prostheses on short implants: 3-year results. The International Journal of Oral & Maxillofacial Implants, 31(5), 1135-1141.
    1. Cuschieri, S. (2019). The STROBE guidelines. Saudi Journal of Anaesthesia, 13(Suppl 1), S31-S34.
    1. Dierens, M., De Bruyn, H., Kisch, J., Nilner, K., Cosyn, J., & Vandeweghe, S. (2016). Prosthetic survival and complication rate of single implant treatment in the periodontally healthy patient after 16 to 22 years of follow-up. Clinical Implant Dentistry and Related Research, 18(1), 117-128.
    1. Edelhoff, D., Schweiger, J., Prandtner, O., Stimmelmayr, M., & Guth, J. F. (2019a). Metal-free implant-supported single-tooth restorations. Part I: Abutments and cemented crowns. Quintessence International, 50(3), 176-184.
    1. Edelhoff, D., Schweiger, J., Prandtner, O., Stimmelmayr, M., & Guth, J. F. (2019b). Metal-free implant-supported single-tooth restorations. Part II: Hybrid abutment crowns and material selection. Quintessence International, 50(4), 260-269.
    1. Ekfeldt, A., Furst, B., & Carlsson, G. E. (2017). Zirconia abutments for single-tooth implant restorations: A 10- to 11-year follow-up study. Clinical Oral Implants Research, 28(10), 1303-1308.
    1. Furhauser, R., Florescu, D., Benesch, T., Haas, R., Mailath, G., & Watzek, G. (2005). Evaluation of soft tissue around single-tooth implant crowns: The pink esthetic score. Clinical Oral Implants Research, 16(6), 639-644.
    1. Gallucci, G. O., Benic, G. I., Eckert, S. E., Papaspyridakos, P., Schimmel, M., Schrott, A., & Weber, H. P. (2014). Consensus statements and clinical recommendations for implant loading protocols. The International Journal of Oral & Maxillofacial Implants, 29(Suppl), 287-290.
    1. Glauser, R., Sailer, I., Wohlwend, A., Studer, S., Schibli, M., & Scharer, P. (2004). Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. The International Journal of Prosthodontics, 17(3), 285-290.Retrieved from
    1. Hammerle, C. H., Chen, S. T., & Wilson, T. G. Jr (2004). Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. The International Journal of Oral & Maxillofacial Implants, 19(Suppl), 26-28.Retrieved from
    1. Hermann, J. S., Buser, D., Schenk, R. K., & Cochran, D. L. (2000). Crestal bone changes around titanium implants. A histometric evaluation of unloaded non-submerged and submerged implants in the canine mandible. Journal of Periodontology, 71(9), 1412-1424.
    1. Ishikawa-Nagai, S., Da Silva, J. D., Weber, H. P., & Park, S. E. (2007). Optical phenomenon of peri-implant soft tissue. Part II. Preferred implant neck color to improve soft tissue esthetics. Clinical Oral Implants Research, 18(5), 575-580.
    1. Jung, R. E., Holderegger, C., Sailer, I., Khraisat, A., Suter, A., & Hammerle, C. H. (2008). The effect of all-ceramic and porcelain-fused-to-metal restorations on marginal peri-implant soft tissue color: A randomized controlled clinical trial. The International Journal of Periodontics & Restorative Dentistry, 28(4), 357-365.Retrieved from
    1. Linkevicius, T., & Vaitelis, J. (2015). The effect of zirconia or titanium as abutment material on soft peri-implant tissues: A systematic review and meta-analysis. Clinical Oral Implants Research, 26(Suppl 11), 139-147.
    1. Meijndert, C. M., Raghoebar, G. M., Santing, H. J., Vissink, A., & Meijer, H. J. A. (2020). Performance of bone-level implants with conical connections in the anterior maxilla: A 5-year prospective cohort study. Clinical Oral Implants Research, 31(2), 173-180.
    1. Mombelli, A., van Oosten, M. A., Schurch, E. Jr, & Lang, N. P. (1987). The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiology and Immunology, 2(4), 145-151.
    1. Moraguez, O. D., & Belser, U. C. (2010). The use of polytetrafluoroethylene tape for the management of screw access channels in implant-supported prostheses. The Journal of Prosthetic Dentistry, 103(3), 189-191.
    1. Nilsson, A., Johansson, L.-A., Lindh, C., & Ekfeldt, A. (2017). One-piece internal zirconia abutments for single-tooth restorations on narrow and regular diameter implants: A 5-year prospective follow-up study. Clinical Implant Dentistry and Related Research, 19(5), 916-925.
    1. Nothdurft, F. P. (2019). All-ceramic zirconium dioxide implant abutments for single-tooth replacement in the posterior region: A 5-year outcome report. The International Journal of Prosthodontics, 32(2), 177-181.
    1. Oh, T. J., Yoon, J., Misch, C. E., & Wang, H. L. (2002). The causes of early implant bone loss: Myth or science? Journal of Periodontology, 73(3), 322-333.
    1. Rinke, S., Lattke, A., Eickholz, P., Kramer, K., & Ziebolz, D. (2015). Practice-based clinical evaluation of zirconia abutments for anterior single-tooth restorations. Quintessence International, 46(1), 19-29.
    1. Salvi, G. E., & Bragger, U. (2009). Mechanical and technical risks in implant therapy. The International Journal of Oral & Maxillofacial Implants, 24(Suppl), 69-85.Retrieved from
    1. Sasada, Y., & Cochran, D. L. (2017). Implant-abutment connections: A review of biologic consequences and peri-implantitis implications. The International Journal of Oral & Maxillofacial Implants, 32(6), 1296-1307.
    1. Schnider, N., Forrer, F. A., Bragger, U., & Hicklin, S. P. (2018). Clinical performance of one-piece, screw-retained implant crowns based on hand-veneered CAD/CAM zirconia abutments after a mean follow-up period of 2.3 years. The International Journal of Oral & Maxillofacial Implants, 33(1), 188-196.
    1. Tatarakis, N., Bashutski, J., Wang, H. L., & Oh, T. J. (2012). Early implant bone loss: Preventable or inevitable? Implant Dentistry, 21(5), 379-386.
    1. Vechiato-Filho, A. J., Pesqueira, A. A., De Souza, G. M., dos Santos, D. M., Pellizzer, E. P., & Goiato, M. C. (2016). Are zirconia implant abutments safe and predictable in posterior regions? A systematic review and meta-analysis. The International Journal of Prosthodontics, 29(3), 233-244.
    1. Wittneben, J. G., Buser, D., Salvi, G. E., Burgin, W., Hicklin, S., & Bragger, U. (2014). Complication and failure rates with implant-supported fixed dental prostheses and single crowns: A 10-year retrospective study. Clinical Implant Dentistry and Related Research, 16(3), 356-364.
    1. Wittneben, J. G., Gavric, J., Sailer, I., Buser, D., & Wismeijer, D. (2020). Clinical and esthetic outcomes of two different prosthetic workflows for implant-supported all-ceramic single crowns-3 year results of a randomized multicenter clinical trail. Clinical Oral Implants Research., 31(5), 495-505.
    1. Zembic, A., Philipp, A. O., Hammerle, C. H., Wohlwend, A., & Sailer, I. (2015). Eleven-year follow-up of a prospective study of zirconia implant abutments supporting single all-ceramic crowns in anterior and premolar regions. Clinical Implant Dentistry and Related Research, 17(Suppl 2), e417-e426.
    1. Zembic, A., Sailer, I., Jung, R. E., & Hammerle, C. H. (2009). Randomized-controlled clinical trial of customized zirconia and titanium implant abutments for single-tooth implants in canine and posterior regions: 3-year results. Clinical Oral Implants Research, 20(8), 802-808.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren