Comparison of the Color Appearance of Peri-implant Soft Tissue with Natural Gingiva Using Anodized Pink-Neck Implants and Pink Abutments: A Prospective Clinical Trial.

PURPOSE

The aim of this study was to assess the visual effects of pink-neck implants and pink abutments with respect to the color of natural gingiva. The distribution pattern and magnitude of CIELAB color difference coordinates were studied.

MATERIALS AND METHODS

Forty subjects with a tooth in the maxillary esthetic zone deemed hopeless were recruited. Patients were randomized to either a conventional gray implant or a pink-neck implant. The hopeless tooth was removed and patients received an immediate implant along with an immediate customized provisional prosthesis. The provisional was maintained for 3 months to allow for complete healing of the implants. Two identical CAD/CAM titanium abutments only differing in color (gray and pink) were fabricated along with an all-ceramic zirconia crown. The gray abutment was delivered first with a zirconia crown, and it was replaced with the pink abutment 3 weeks later. Three weeks after insertion of each abutment with the zirconia crown, a spectrophotometer was used to collect the color of the peri-implant mucosa and natural gingiva, so the difference between the two sites could be calculated (ΔL* [difference in lightness], Δa* [difference in green-red axis], Δb* [difference in blue-yellow axis]). The natural gingiva measured was the gingiva of a contralateral or adjacent unrestored tooth. The effect of implant color and abutment on the color difference between peri-implant mucosa and natural gingiva was investigated with a linear regression model using a generalized estimating equation (GEE) approach.

RESULTS

Raw data demonstrated statistically insignificant smaller ΔL*, Δa*, Δb* between peri-implant soft tissue and natural gingiva when the implant was pink versus gray. Further, there were statistically insignificant smaller ΔL* and Δb* between peri-implant soft tissue and natural gingiva when the abutment was pink versus gray. Δa* between peri-implant soft tissue and natural gingiva was significantly smaller when using a pink abutment regardless of the implant type (P < .05).

CONCLUSION

Using an anodized pink abutment and/or a pink-neck implant minimizes the color difference observed between the peri-implant mucosa and the natural gingiva in the redness spectrum. These advances in technology assist in helping the peri-implant mucosa appear more natural by minimizing the color variance.