Associate Professor, Prosthodontics Department, University of Bordeaux, Bordeaux, France; Saint Andre Hospital, Bordeaux University Hospital, Bordeaux, France.
Associate Professor, Prosthodontics Department, Paris Descartes University - Sorbonne Paris Cité, Paris, France; Dental Department, Henri Mondor Hospital-University Group, AP-HP (Public Assistance-Paris hospital), Creteil, France.
J Prosthet Dent. 2019 May;121(5):775-781.e1. doi: 10.1016/j.prosdent.2018.08.005. Epub 2019 Jan 5.
The success of single, anterior, implant-supported restorations relies on mechanical and esthetic outcomes. Titanium has been the most commonly used material for abutments, but zirconia is increasingly chosen for its appearance despite its unclear mechanical performance. Today, manufacturers market prefabricated, computer-aided design and computer-aided manufacturing (CAD-CAM) custom and zirconia abutments with titanium connections.
The purpose of this study was to systematically review the mechanical and esthetic outcomes of implant zirconia abutments used in the anterior region, considering the design changes of the past 5 years.
An electronic search was conducted in Medline (PubMed) for studies on zirconia abutments. All clinical studies with at least a 1-year follow-up and case series (>5 abutments) published after 2013 were included. Mechanical and esthetic outcomes were collected.
Of the 231 retrieved studies, 20 remained for quantitative analysis. Twelve described mechanical outcomes, and 15 focused on esthetics, using mainly the pink esthetic score. Five articles reported abutment fractures and no chipping. No difference was found between prefabricated and custom abutments or internal and external implant connections regarding fractures or screw loosening. All authors reported "good to excellent" esthetic integration in terms of restorations and soft-tissue color and the presence and height of papillae. The most difficult esthetic parameters to achieve were root convexity, soft-tissue color, and texture and level of mucosa.
Esthetics remain the major advantage of zirconia abutment when compared with titanium, despite reservations concerning the risk of mechanical complications. Data are lacking for zirconia abutments with titanium inserts, although the prospects for this design are promising.
单颗、前牙、种植体支持修复的成功依赖于机械和美观效果。钛一直是最常用于基台的材料，但氧化锆因其外观而越来越被选择，尽管其机械性能尚不清楚。如今，制造商销售预制的、计算机辅助设计和计算机辅助制造（CAD-CAM）定制和氧化锆基台，带有钛连接体。
本研究旨在系统回顾过去 5 年中用于前牙区的种植体氧化锆基台的机械和美观效果，考虑到设计的变化。
在 Medline（PubMed）中进行电子搜索，以查找有关氧化锆基台的研究。纳入所有至少随访 1 年且 2013 年后发表的病例系列（>5 个基台）的临床研究。收集机械和美观效果数据。
在检索到的 231 篇研究中，有 20 篇可用于定量分析。12 篇描述了机械结果，15 篇主要使用粉红色美学评分关注美学效果。有 5 篇文章报道了基台骨折和无崩瓷。预制基台和定制基台或内、外种植体连接体在骨折或螺丝松动方面没有差异。所有作者均报告在修复体和软组织颜色以及牙龈乳头的存在和高度方面，美观整合达到“良好到优秀”。实现根凸度、软组织颜色和质地以及黏膜水平最困难的美学参数。
与钛相比，氧化锆基台的主要优势仍然是美观，尽管对机械并发症的风险存在保留意见。尽管这种设计的前景很有希望，但关于带有钛插件的氧化锆基台的数据仍然缺乏。
