Bittencourt Thais Camargo, Souza Picorelli Assis Neuza Maria, Ribeiro Cleide Gisele, Ferreira Cimara Fortes, Sotto-Maior Bruno Salles
Master in Comprehensive Dentistry, Department of Prosthodontics, Federal University of Juiz de For a (UFJF) College of Dentistry, Juiz de Fora, Minas Gerais, Brazil.
Associate Professor, the Department of Comprehensive Dentistry at the Federal University of Juiz de For a (UFJF), Juiz de Fora, Minas Gerais, Brazil.
J Prosthet Dent. 2023 Apr;129(4):573-581. doi: 10.1016/j.prosdent.2021.06.021. Epub 2021 Jul 30.
Long-term clinical studies are lacking on the influence of the type of abutment, titanium or zirconia, on peri-implant tissues.
The purpose of this randomized clinical trial was to evaluate peri-implant tissues with titanium or zirconia abutments.
A total of 26 single-tooth implant-supported prostheses in 14 participants were analyzed. They received either a titanium abutment with a metal-ceramic crown (TAG) or a zirconia abutment with a ceramic crown (ZAG). Data were collected immediately, at 5 months, and at a minimum of 7 years after crown delivery. The success rate, plaque and bleeding indexes, bleeding on probing, white and pink esthetic scores, and the relationships of the gingival phenotype with the pink esthetic score were analyzed. Statistical analyses were conducted with the t test for paired and independent data (α=.05).
The mean follow-up time was 95.2 ±2.6 months, showing an implant success rate of 96.7%. No statistically significant differences were found between TAG and ZAG among the time intervals evaluated for plaque or bleeding indexes (P>.05). A statistically significant difference was found for peri-implant probing depths in the mid-buccal sites between the groups at all the time intervals evaluated (TAG, P=.008; ZAG, P=.021): TAG showed an increase between 5 months (3.65 ±0.93 mm) and over 7 years (4.47 ±1.32 mm); and ZAG showed a reduction (5 months=5.22 ±1.71 mm; over 7 years=4.25 ±1.28 mm) in values. For the pink (PES) and white esthetic score (WES), ZAG (PES: immediately=6.33 ±1.41; 5 months=7.44 ±1.81; over 7 years=8.25 ±1.03; WES: immediately=7.67 ±1.50; over 7 years=8.38 ±0.74) showed higher mean values than TAG (PES: immediately=5.94 ±2.35; 5 months=6.53 ±2.15; over 7 years=7.44 ±1.81; WES: immediately=7.00 ±1.17; over 7 years=8.35 ±1.27) (P<.05). Statistically significant differences were found for gingival phenotype and for PES in TAG (P=.031), and the participants with thick phenotype showed higher PES in the 3 time intervals studied.
Zirconia abutments exhibited better results than titanium abutments in terms of the peri-implant tissues. Moreover, in those with a thin phenotype, zirconia provided improved gingival esthetics.
关于钛或氧化锆基台类型对种植体周围组织的影响，目前缺乏长期临床研究。
本随机临床试验的目的是评估钛基台或氧化锆基台的种植体周围组织。
对14名参与者的26个单颗牙种植支持式修复体进行了分析。他们分别接受了带有金属烤瓷冠的钛基台（TAG）或带有陶瓷冠的氧化锆基台（ZAG）。在戴冠后即刻、5个月以及至少7年后收集数据。分析成功率、菌斑和出血指数、探诊出血情况、白色和粉色美学评分，以及牙龈表型与粉色美学评分的关系。采用配对和独立数据的t检验进行统计分析（α = 0.05）。
平均随访时间为95.2±2.6个月，种植成功率为96.7%。在评估的菌斑或出血指数时间间隔内，TAG和ZAG之间未发现统计学显著差异（P>0.05）。在所有评估的时间间隔内，两组之间种植体颊侧中部位点的种植体周围探诊深度存在统计学显著差异（TAG，P = 0.008；ZAG，P = 0.021）：TAG在5个月（3.65±0.93mm）至7年以上（4.47±1.32mm）之间显示增加；而ZAG的值呈下降趋势（5个月 = 5.22±1.71mm；7年以上 = 4.25±1.28mm）。对于粉色美学评分（PES）和白色美学评分（WES），ZAG（PES：即刻 = 6.33±1.41；5个月 = 7.44±1.81；7年以上 = 8.25±1.03；WES：即刻 = 7.67±1.50；7年以上 = 8.38±0.74）的平均值高于TAG（PES：即刻 = 5.94±2.35；5个月 = 6.53±2.15；7年以上 = 7.44±1.81；WES：即刻 = 7.00±1.17；7年以上 = 8.35±1.27）（P<0.05）。在TAG组中，牙龈表型和PES存在统计学显著差异（P = 0.031），在研究的3个时间间隔内，厚表型参与者的PES更高。
在种植体周围组织方面，氧化锆基台比钛基台表现出更好的效果。此外，对于薄表型患者，氧化锆可改善牙龈美学。
