Abstract
Prosthetic abutments, used as a connection between the restoration and the implant, are usually produced using titanium and other metals, which provide a reliable structure. However, the grey color from the metal abutment combined with thin gingival tissue may compromise the final treatment aesthetics. Therefore, ceramic abutments were introduced for implant-supported restorations (zirconia, alumina, zirconia/alumina). Ceramic abutments show good optical properties as well as high biocompatibility and durable aesthetics. The objective of this study was to evaluate, through a systematic literature review, the survival rate of titanium and ceramic abutments for implant-supported restorations, as well as the most frequent failure modes. The research was performed using Medline/Pubmed online database with articles published from 1999 to 2015 and the keywords: ceramics, abutment, dental implants, partial fixed denture. Sixteen clinical trial and cohort studies were selected. According to the literature, there were no significant differences for biological and radiographic indexes among metals and ceramic abutments, and among natural teeth, in 11-years prospective studies. No significant bone loss was observed between the first and the last evaluation, for both types of abutments. Alumina-based abutments had 94.7% to 100% survival rate when followed up to 7 years. Zirconia-based abutments showed similar survival rate when compared to titanium abutments (100%) after 11 years. Only in one 7-years study, the survival rate decreased to 97.6%, for zirconia-based abutments. Fracture and screw loosening were the failures modes observed for the abutments. The mechanical and biological similarity among the materials suggests that ceramic abutments are a good treatment option for implant-supported restorations.
Keywords:
ceramics; dental implants; partial fixed denture