title: Single-tooth implant reconstructions: esthetic factors influencing the decision between titanium and zirconia abutments in anterior regions.
abstract: Implant-supported single crowns have become a valid alternative to conventional fixed dental prostheses due to their excellent clinical long-term results. However, along with good survival rates, esthetic factors are important for success in anterior regions. Today, several kinds of implant abutments are offered by implant manufacturers. A choice must be made between standardized and customized abutments; further, different abutment materials such as titanium or various ceramics (alumina, zirconia) are available. Finally, the reconstruction can be cemented on the abutment or screw-retained directly on the implant. When choosing an abutment for an anterior single-unit case, several factors should be considered: visibility of the region (eg, high vs low smile line); biotype of the gingiva; color of the neighboring teeth; and finally, esthetic expectations of the patient. In esthetically demanding situations, customized ceramic abutments are indicated. In patient situations with thin peri-implant soft tissues, zirconia abutments and all-ceramic crowns should be used in combination. In cases with thick mucosa, titanium can be used as the abutment material, combined with metal-ceramic crowns. In order to avoid difficulties removing excess cement, screw-retained reconstructions may be preferred; however, the screw access hole should be positioned palatal to the incisal edge.
authors: Clinic for Fixed and Removable Prosthodontics and Dental Materials, School of Dentistry, University of Zürich, Plattenstr. 11, 8032 Zurich, Switzerland. irena.sailer@zzmk.uzh.ch
authors: Irena
authors: I
authors: Sailer
authors: Anja
authors: A
authors: Zembic
authors: Ronald Ernst
authors: RE
authors: Jung
authors: Christoph Hans Franz
authors: CH
authors: Hämmerle
authors: Alessandro
authors: A
authors: Mattiola
mesh_terms: D000328:Adult; D003116:Color; D003442:Crowns; D003657:Decision Making; D000044:Dental Abutments; D019250:Dental Implants, Single-Tooth; D003764:Dental Materials / Q000737:chemistry*; D003776:Dental Porcelain / Q000737:chemistry; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology; D006801:Humans; D007180:Incisor / Q000293:injuries / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012391:Root Resorption / Q000628:therapy; D012904:Smiling; D014025:Titanium / Q000737:chemistry*; D014082:Tooth Fractures / Q000628:therapy; D014092:Tooth Root / Q000293:injuries; D019553:Tooth, Nonvital / Q000628:therapy; D055815:Young Adult; D015040:Zirconium / Q000737:chemistry*
chemical_list: D003764:Dental Materials; D003776:Dental Porcelain; D015040:Zirconium; D014025:Titanium; C028541:zirconium oxide