Esthetic Implant Abutments In Maxillary Anterior Region

Yıl 2008, Cilt: 2 Sayı: 2, 116 - 122, 01.03.2008

Bulem Yüzügüllü Mehmet Avcı

Öz

Restoring the edentulous spaces in the anterior maxillary region is not only essential for function but also for the psychological well-being and esthetic satisfaction of the patients. Owing to their biocompatibility and high clinical success rates, osseointegrated dental implants have been widely-used for replacement of missing teeth. Until the recent developments in newer implant-abutment systems for restoring partial edentulism in esthetic regions, abutments had been usually made using titanium. Nevertheless, deterioration of soft tissue esthetics and overangulated abutments particularly toward labial as a sequel of false implant placements were among clinical problems frequently cited with the use of titanium abutments for anterior single-tooth restorations. In order to avoid such cases, abutments of different materials and fabrication techniques have been invented. This review aims to enlighten evolution of implant abutments and esthetic abutment solutions for maxillary anterior region

Anahtar Kelimeler

implant abutment, esthetics, maxilla

Maksiller Anterior Bölgede Estetik İmplant Dayanak Seçimi

Öz

Maksiller anterior bölgedeki diş eksikliklerinin giderilmesi, hasta için sadece fonksiyon değil psikolojik ve estetik açıdan da önemlidir. Diş eksikliklerinin tedavisinde osseoentegre implantların kullanımı, biyouyumlu olmaları ve klinik başarı oranlarının yüksek olması nedeniyle yaygınlaşmıştır. Estetik alanlardaki kısmi dişsizliğin restore edildiği yeni implant-dayanak sistemlerinin gelişimine kadar dayanaklar, genellikle titanyum olarak tasarlanmaktaydı. Ancak, titanyum dayanakların tek diş, özellikle anterior bölgedeki restorasyonlarda kullanılması ile yumuşak doku estetiğinde bozulma ve uygun olmayan implant yerleştirilmesinden dolayı dayanakların aşırı labiale açılanması gibi klinik problemlerden sıklıkla bahsedilmiştir. Bu sorunların giderilebilmesi amacıyla farklı materyallerden ve farklı yöntemler kullanılarak hazırlanabilen dayanak sistemleri geliştirilmiştir. Bu derleme, implant dayanak sistemlerinin gelişimini incelemek ve maksiller anterior bölgede kullanımı uygun olabilecek estetik dayanak tasarımları konusunda ışık tutabilmeyi amaçlamaktadır

Anahtar Kelimeler

implant dayanağı, estetik, maxilla

Kaynakça

• Misch CE. Contemporary Implant Dentistry. Mosby Co. 2. Baskı. St Louis, Missouri 1999 Schmitt A, Zarb GA. The longitudinal clinical effective- ness of osseointegrated dental implants for single-tooth replacement. Int J Prosthodont 1993; 6: 197-202.
• Papavasiliou G, Tripodakis APD, Kamposiora P, Strub JD, Bayne SC. Finite element analysis of ceramic abut- ment-restoration combinations for osseointegrated imp- lants. Int J Prosthodont 1996; 9: 254-260.
• Cho H, Dong K, Jin T, Oh S, Lee H, Lee J. A study on the fracture strength of implant-supported restorations using milled ceramic abutments and all-ceramic crowns. Int J Prosthodont 2002; 15: 9-13.
• Friedman JR. Five techniques for single tooth replace- ment on endosseous root-form implants. J Prosthodont Dent 1993; 69: 582-587.
• Piatelli A, Scarano A, Paolantonio M, Assenza B, Leg- hissa GC, Bonaventura GD, Catamo G, Piccolomini R. Fluids and microbial penetration in the internal part of cement-retained versus screw-retained implant-abutment connections. J Periodontol 2001; 72: 1146-1150.
• Lewis S. Anterior single-tooth implant restorations. Int J Periodont Rest Dent 1995; 15: 31-41.
• Giglio GD. Abutment selection in implant-supported fixed prosthodontics. Int J Periodont Rest Dent 1999; 19: 233-241.
• Guichet DL, Caputo AA, Choi H, Sorensen JA. Passivity of fit and marginal opening in screw- or cement-reta- ined implant fixed partial denture designs. Int J Oral Maxillofac Implants 2000; 15: 239-246.
• Kourtis SG. Selection and modification of prefabricated implant abutments according to the desired restorati- on contour: A case report. Quintessence Int 2002; 32: 383-388.
• Heydecke G, Sierraalta M, Razzoog MF. Evolution and use of aluminium oxide single-tooth implant abutments: A short review and presentation of two cases. Int J Pros- thodont 2002; 15: 488-493.
• Cody RP. Esthetics in implant dentistry-A case report using the Astra Tech Zir abutment in a maxillary anterior single tooth reconstruction. US Dentistry 2006: 27-28.
• Behr M, Rosentritt M, Lang R, Handel G. Glass fiber- reinforced abutments for dental implants. A pilot study. Clin Oral Impl Res 2001; 12: 174-178.
• Tripodakis AP, Strub JR, Kappert HF, Witkowski S. Strength and mode of failure of single implant all-cera- mic abutment restorations under static load. Int J Prost- hodont 1995; 8: 265-272.
• Andersson B, Scharer P, Massimo Simion, Bergström C. Ceramic implant abutments used for short-span fixed partial dentures: A prospective 2-year multicenter study. Int J Prosthodont 1999; 12: 318-324.
• McLean JW. The science and art of dental ceramics. Volume II Quintessence Publishing Co. Chicago, Illinois 1982. A mucosal attachment at different abutments. J Clin Perio- dontol 1998; 25: 721-727.
• Josset Y, Oum’Hamed Z, Zarrinpour A, Lorenzato M, Adnet JJ, Laurent-Maquin D. In-vitro reactions of human osteoblasts in culture with zirconia and alumina cerami- cs. J Biomed Mater Res 1999; 47: 481-493.
• Akagawa Y, Ichikawa Y, Nikai H, Tsuru H. Interface his- tology of unloaded and early loaded partially stabilized zirconia endosseous implant in initial bone healing. J Prosthet Dent 1993; 69: 599-604.
• Ardlin BI. Transformation-toughened zirconia for dental inlays, crowns and bridges: Chemical stability and effect of low-temperature aging on flexural strength and surfa- ce structure. Dent Mater 2002; 18: 590-595.
• Scarano A, Carlo FD, Quaranta M, Piattelli A. Bone response to zirconia ceramic implants: An experimen- tal study in rabbits. J of Oral Implantology 2003; 29: 8-12.
• Anusavice K. Phillips’ Science of Dental Materials 10. Baskı W.B. Saunders Company 1996: 50-69, 594.
• Schultze-Mosgau S, Schliephake H, Radespiel-Tröger M, Neukam FW. Osseointegration of endodontic en- dosseous cones. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 89: 91-98.
• Chong K, Chai J. Stength and mode of failure of unidire- ctional and bidirectional glass fiber-reinforced composi- te materials. Int J Prosthodont 2003; 16: 161-166.
• Kastenbaum F, Lewis S, Naert I, Palmquist C. The Est- hetiCone abutment: three-year results of a prospective multicenter investigation. Clin Oral Impl Res 1998; 9: 178-184.
• Wannfors K, Smedberg J. A prospective clinical eva- luation of different single-tooth restoration designs on osseointegrated implants. Clin Oral Impl Res 1999; 10: 453-458.
• Jaggers A, Simons AM, Badr SE. Abutment selection for anterior single tooth replacement. A clinical report. J Prosthet Dent 1993; 69(2): 133-135.
• Marchcack CB. A custom titanium abutment for the an- terior single-tooth implant. J Prosthet Dent 1996; 76: 288-291.
• Al-Ajmi M, Al-Abbas H, Pipko DJ. Advantageous uses of new computerized custom milled abutments in resto- ring endosseous implants. Braz J Oral Sci 2002; 1(1): 44-46.
• Yıldırım M, Edelhoff D, Hanisch O, Spiekermann H. Ce- ramic abutments-A new era in achieving optimal esthe- tics in implant dentistry. Int J Periodont Rest Dent 2000; 20: 81-91.
• Kallus T, Henry P, Jemt T, Jörneus L. Clinical evaluati- on of angulated abutments for the Brånemark system: A pilot study. Int J Oral Maxillofac Implants 1990; 5: 39-45.
• Pröbster L, Girthofer S, Groten M, Rein B. Copy-milled all-ceramic Celay-InCeram crowns for modified CeraO- ne abutments: A technical report. Int J Oral Maxillofac Implants 1996; 11: 201-204. Brodbeck U. The ZiReal Post: A new ceramic implant abutment. J Esthet Restor Dent 2003; 15: 10-24.
• Rompen E, Raepsaet N, Domken O, Touati B, Van Do- oren E. Soft tissue stability at facial aspect of gingivally- converging abutments in the esthetic zone: A pilot clini- cal study. J Prosthet Dent 2007; 97:119-125.
• Astra Tech Dental, Scientific Review , Yttrium stabilized zirconia. Feb 2007.
• Palacci P. Esthetic Implant Dentistry: Soft and Hard Tis- sue Management. Quintessence Publishing Co. 2001.
• Marchack CB, Yamashita T. Fabrication of a digitally scanned, custom-shaped abutment: A clinical report. J Prosthet Dent 2001; 85: 113-115.
• Ottl P, Piwowarczyk A, Lauer H, Hegenbarth EA. The Procera® AllCeram system. Int J Periodont Rest Dent 2000; 20: 151-161.