Effect of Zirconia Thickness, Cement Color, and Titanium Implant Abutment Surface Treatment Type on the Esthetic Outcomes of High-Translucency Monolithic Zirconia.

PURPOSE

To investigate the esthetic outcomes based on the color differences in zirconia (Zr) of varying thickness, resin cement color, and types of titanium (Ti) implant surface treatments.

MATERIALS AND METHODS

Overall, 28 high-translucency monolithic zirconia (HTMZ) specimens were arranged into four groups based on Zr thickness: 1.0, 1.5, 2.0, and 2.5 mm (n = 7 per thickness). Each group was tested using two resin cement colors (clear and opaque) in combination with six surface-treated Ti groups (n = 7), including untreated titanium (UT), anodization (AN), 50-μm alumina airborne-particle abrasion followed by AN (SBAN), AN followed by 50-μm alumina airborne-particle abrasion (ANSB), 9.5% hydrofluoric acid followed by AN (HFAN), and AN followed by 9.5% hydrofluoric acid (ANHF). This created a total of 48 experimental groups, including the use of composite resin (n = 7, shade A2D) for four control groups. All specimens were measured using a spectrophotometer and subsequently compared with composite resin (control) with the corresponding Zr thickness to establish color differences. A color difference of < 2.7 was considered clinically acceptable. The data obtained were statistically analyzed using ANOVA and post hoc test (P = .05).

RESULTS

Zr thickness, resin cement color, and type of Ti implant surface treatment significantly affected the observed color differences (P < .05). When using 2.5-mm HTMZ with clear resin cement on AN, UT, SBAN, HFAN, and ANSB, the mean color differences were below the clinically acceptable values, and the 95% CIs of color differences were below the clinically acceptable values for AN, UT, and SBAN groups.

CONCLUSIONS

HTMZ with a minimum thickness of 2.5 mm and clear resin cement on AN, UT, and SBAN groups potentially result in acceptable color matching with 95% CIs.