EVALUATION OF CERAMIC ABUTMENTS IN MECHANICAL, BIOLOGICAL AND ESTHETICAL PERSPECTIVE

Abstract

To date, Titanium has hold a dominant position as an abutment material in implant therapy. However, the demands for highly esthetic restorations led to the development of ceramic abutments. Currently, zirconia and alumina abutments are widely used in esthetic regions. Besides esthetics, peri-implant tissue health and mechanical strenght are also important in the selection of abutment material. The purpose of this article is evaluation of the in vivo and in vitro studies of the mechanical, biological and esthetic properties of abutment materials

Keywords

• Ceramics abutments, zirconia, alumina, mechanical strenght, bacterial adhesion, plaque accumulation, esthetics

SERAMİK ABUTMENTLERİN MEKANİK, BİYOLOJİK VE ESTETİK AÇIDAN DEĞERLENDİRİLMESİ

Abstract

Günümüze kadar titanyum, implant tedavile- rinde abutment materyali olarak hakim bir yer almaktaydı. Ancak, yüksek estetik restorasyon beklen- tileri seramik abutmentlerin gelişmesini sağlamıştır. Günümüzde, zirkonya ve alumina abutmentler estetik bölgelerde yaygın olarak kullanılmaktadır. Estetiğin dışında, implant çevresi yumuşak doku sağlığı ve mekaniksel dayanıklılık da abutment materyali seçiminde önemlidir. Bu makalenin amacı seramik abutment materyallerini; mekanik, biyolojik ve estetik özelliklerini in vivo ve in vitro açıdan inceleyen literatürlerin değerlendirilmesidir.

Keywords

• Seramik abutment, zirkonya, alumina, mekanik direnç, bakteri adezyonu, plak akümülasyonu, estetik

References

1. Blatz BM, Bergler M, Holst S, Block MS. Zirconia Abutments for Single-Tooth Implants-Rationale and Clinical Guidelines. J Oral Maxillofac Surg 2009;67:74-81.
2. Gomes AL, Montero J. Zirconia implant abutments: A review. Med Oral Patol Oral Cir Bucal 2011;16:50-5.
3. Zembic A, Sailer I, Jung RE, Hammerle CH. Randomized-controlled clinical trial of customized zirconia and titanium implant abutments for single- tooth implants in canine and posterior regions: 3- year results. Clin Oral Implants Res 2009;20:802– 8.
4. Yılmaz HG, Kurtulmuş-Yılmaz S. Farklı Abutment Materyallerinin İmplant Çevresi Dokuların Sağlığına Etkileri. Ege Üniv Diş Hek Fak Derg 2011;32:69-75.
5. Jung RE, Sailer I, Hämmerle CH, Attin T, Schmidlin P. In vitro color changes of soft tissues caused by restorative materials. Int J Periodontics Restorative Dent 2007;27:251-7.
6. Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CH, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res 2009;20:4-31.
7. Prespino V, Ingber A. Esthetic high-strength implant abutments. Part I. J Esthet Dent 1993; 5:29-36.
8. Prespino V, Ingber A. Esthetic high-strength implant abutments. Part II. J Esthet Dent 1993;5: 63-8.

9. Kohal RJ, Att W, Bachle M, Butz F. Ceramic abutments and Ceramic oral implants. An update. Periodontol 2000 2008;47:224-30.
10. Vanlıoğlu B, Özkan Y, Özkan Y. Estetik Bölgede Restorasyonlarda
11. Seramik Dayanaklar. Atatürk Üniv Diş Hek Fak Derg 2012;5:58-64. Güçlendirilmiş
12. Andersson B, Schaerer P, Simion M, Bergstrom C. Ceramic implant abutments used for short-span fixed partial dentures: a prospective 2-year multicenter study. Int J Prosthodont 1999;12:318- 24.
13. Eğilmez F, Biçer A, Ergün G. Zirkonyumla Güçlendirilmiş Seramikler ve Dental İmplantolojide Kullanımı. Cumhuriyet Üniv Diş Hek Fak Derg 2010;13:72-80.
14. Sadeq A, Cai Z, Woody RD, Miller AW. Effect of interfacial variables on ceramic adherence to cast and machined commercially pure titanium, J Prosthet Dent 2003;8:255-62.
15. Firidinoğlu K, Toksavul S, Toma M. İmplat destekli sabit protezlerde seramik abutment kullanımı. Ege Üniv Diş Hek Fak Derg 2007;28:145-50.
16. Aboushelib NM, Salameh Z. Zirconia Implant Abutment Fracture: Clinical Case Reports and Precautions for Use. Int J Prosthodont 2009;22:616-9.
17. Glauser R, Sailer I, Wohlwend A, Studer S, Schibli M, Scharer P. Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. Int J Prosthodont 2004;17:285–90.
18. Yıldırım M, Fischer H, Marx R, Edelhoff D. In Vivo Fracture Resistance of Implant-Supported All- Ceramic Restorations. J Prosthet Dent 2003;90:325-30.
19. Yıldırım M, Edelhoff D, Hanisch O, Speikermann H. Ceramic Abutments A New Era in Achieving Optimal Esthetics in Implant Dentistry. Int J Periodontics Restorative Dent 2001;20:81-9.
20. Bidra A, Rungruanganunt P. Clinical outcomes of implant abutments in the anterior region: a systematic review. J Esthet Restor Dent 2013;25:159-76.
21. Piconi C, Maccauro G. Zirconia as a ceramic biomaterial. Biomaterials 1999;20:1–25.
22. Guess PC, Att W, Strub JR. Zirconia in fixed implant prosthodontics. Clin Implant Dent Relat Res. 2012;14:633-45.
23. Sundh A, Sjögren G. A study of the bending resistance of implant-supported reinforced alümina and machined zirconia abutments and copies. Dent Mater 2008;24:611-7.
24. Kiliaridis S, Kjellberg H, Wenneberg B, Engstrom C. The relationship between maximal bite force, bite force endurance, and facial morphology during growth. A cross-sectional study. Acta Odontol Scand 1993;51:323–31.
25. Haraldson T, Carlsson GE, Ingervall B. Functional state, bite force and postural muscle activity in patients with osseointegrated oral implant bridges. Acta Odontol Scand 1979;37: 195–206.
26. Butz F, Heydecke G, Okutan M, Strub JR. Survival rate, fracture strength and failure mode of ceramic implant abutments after chewing simulation. J Oral Rehabil 2005;32:838–43.
27. Gehrke P, Dhom G, Brunner J, Wolf D, Degidi M, Piattelli A. Zirconium implant abutments:fracture strength and influence of cyclic loading on retaining-screw loosening. Quintessence Int 2006;37:19-26.
28. Henriksson K, Jemt T. Evaluation of custom-made procera ceramic abutments for single-implant tooth replacement: a prospective 1-year follow-up study. Int J Prosthodont 2003;16: 626–30.
29. Nothdurft F, Pospiech P. Prefabricated zirconium dioxide implant abutments for single-tooth replacement in the posterior region: evaluation of peri-implant tissues and superstructures after 12 months of function. Clin Oral Implants Res 2010;21:857-65.
30. Canullo L. Clinical outcome study of customized zirconia abutments for single-implant restorations. Int J Prosthodont 2007;20:489–93.
31. Hegenbarth EA. Esthetic and prosthetic considerations of Procera development on implants and teeth–a technical analysis. Appl Osseointegration Res 2004;4:22–6.
32. Andersson B, Taylor A, Lang BR, Scheller H, Scharer P, Sorensen JA, Tarnow D. Alumina ceramic implant abutments used for single-tooth replacement: a prospective 1 to 3 year multicenter study. Int J Prosthodont 2001;14:432–8.
33. Foong JK, Judge RB, Palamara JE, Swain MV. Fracture resistance of titanium and zirconia abutments: an in vitro study. J Prosthet Dent 2013:109;304-12.
34. Att W, Kurun S, Gerds T, Strub JR. Fracture resistance of single-tooth implant-supported all- ceramic restorations after exposure to the artificial mouth. J Oral Rehabil 2006;33:380–6.
35. Albosefi A, Finkelman M, Zandparsa R. An In Vitro Comparison of Fracture Load of Zirconia Custom Abutments with Internal Connection and Different Angulations and Thickness: Part I. J Prosthodont 2014;doi:10.1111/jopr.12118.
36. Pjetursson BE, Bragger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res 2007;18:97-113.
37. Abrahamsson I, Berglundh T, Glantz PO, Lindhe J. The mucosal attachment at different abutments. An experimental study in dogs. J Clin Periodontol 1998;25:721-7.
38. Tete S, Mastrangelo F, Bianchi A, Zizzari V, Scarano A. Collagen fiber orientation around machined titanium and zirconia dental implant necks: an animal study. Int J Oral Maxillofac Implants 2009;24:52-8.
39. Barwacz CA, Brogden KA, Stanford CM, Dawson DV, Recker EN, Blanchette D. Comparison of proinflammatory cytokines and bone metabolim m ediators around titanium and zirconia dental implant abutments following a minimum of 6 months of clinical function. Clin Oral İmplants Res 2014; doi: 10.1111/clr.12326.
40. Welander M, Abrahamsson I, Berglundh T. The mucosal barrier at implant abutments of different materials. Clin Oral Implants Res 2008;19:635-41.
41. Degidi M, Artese L, Scarano A, Perrotti V, Gehrke P, Piattelli A. Inflammatory infiltrate, microvessel density, nitric oxide synthase expression, vascular endothelial growth factor expression, and proliferative activity in peri-implant soft tissues around titanium and zirconium oxide healing caps. J Periodontol 2006;77:73-80.
42. Bollen CM, Papaioanno W, Van Eldere J, Schepers E, Quirynen M, van Steenberghe D. The influence of abutment surface roughness on plaque accumulation and peri-implant mucositis. Clin Oral Implants Res 1996;7:201-11.
43. Quirynen M, Papaioannou W, van Steenberghe D. Intraoral transmission and the colonization of oral hard surfaces. J Periodontol 1996;67:986-93.
44. Teughels W, Van Assche N, Sliepen I, Quirynen M. Effect of material characteristics and/or surface topography on biofilm development. Clin Oral Implants Res 2006;17:68-81.
45. Bürgers R, Gerlach T, Hahnel S, Schwarz F, Handel G, Gosau M. In vivo and in vitro biofilm formation on two different titanium implant surfaces. Clin Oral Implants Res 2010;21:156-64.
46. Salihoglu U, Boynuegri D, Engin D, Duman AN, Gokalp P, Balos K. Bacterial adhesion and colonization differences between zirconium oxide and titanium alloys: an in vivo human study. Int J Oral Maxillofac Implants 2011;26:101-7.
47. Rimondini L, Cerroni L, Carrassi A, Torricelli P. Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study. Int J Oral Maxillofac Implants 2002;17:793-98.
48. Scarano A, Piatelli M, Caputi S, Favero GA, Patelli A. Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study. J Periodontol 2004;75:292-6.
49. Rompen E, Raepsaet N, Domken O, Touati B, Van Dooren E. Soft tissue stability at the facial aspect of gingivally converging abutments in the esthetic zone: a pilot clinical study. J Prosthet Dent 2007;97:119–25.
50. Redemagni M, Cremonesi S, Garlini G, Maiorana C. Soft tissue stability with immediate implants and concave abutments. Eur J Esthet Dent 2009;4:328–37.
51. Broggini N, McManus LM, Hermann JS, Medina R, Schenk RK, Buser D, Cochran DL. Peri-implant inflammation defined by the implant-abutment interface. J Dent Res 2006;85:473-8.
52. Jansen VK, Conrads G, Richter E. Microbial leakage and marginal fit of the implant-abutment interface. Int J Oral Maxillofac Implants1997;12:527–40.
53. Lindhe J, Berglundh T, Ericsson I, Liljenberg B, Marinello C. Experimental breakdown of peri- implant and periodontal tissues. A study in the beagle dog. Clin Oral Implants Res 1992;3:9-16.
54. Yüzügüllü B, Avcı M. The implant-abutment interface of alumina and zirconia abutments. Clin Implant Dent Relat Res 2008;10:113-21.
55. Baixe S, Fauxpoint G, Arntz Y, Etienne O. Microgap between zirconia abutments and titanium implants. Int J Oral Maxillofac Implants 2010;25:455-60.
56. Jung RE, Holderegger C, Sailer I, Khraisat A, Suter A, Hammerle CH. The effect of all-ceramic and porcelain-fused-to-metal restorations on marginal peri-implant soft tissue color: a randomized controlled clinical trial. Int J Periodontics Restorative Dent 2008;28:357–65.
57. Gallucci GO, Grütter L, Nedir R, Bischof M, Belser UC. Esthetic outcomes with porcelain-fused-to- ceramic and all-ceramic single-implant crowns: a randomized clinical trial. Clin Oral Implants Res 2011;22:62–9.
58. Bressan E, Paniz G, Lops D, Corazza B, Romeo E, Favero G. Influence of abutment material on the gingival color of implant-supported all-ceramic restorations: a prospective multicenter study. Clin Oral Implants Res 2011;22:631–7.
59. van Brakel R, Noordmans HJ, Frenken J, de Roode R, de Wit GC, Cune MS. The effect of zirconia and titanium implant abutments on light reflection of the supporting soft tissues. Clin Oral Implants Res 2011;22:1172–78.
60. Happe A, Schulte-Mattler V, Fickl S, Naumann M, Zöller JE, Rothamel D. Spectrophotometric assessment of peri-implant mucosa after restoration with zirconia abutments veneered with fluorescent ceramic: a controlled, retrospective clinical study. Clin Oral Implants Res 2013; 100:28- 33.
61. Hosseini M, Worsaae N, Schiodt M, Gotfredsen KA. 3-year prospective study of implant-supported single-tooth restorations of all-ceramic and metal- ceramic materials in patients with tooth agenesis. Clin Oral Implants Res 2013;24:1078-87.