title: Zirconia as a dental implant abutment material: a systematic review.
abstract: OBJECTIVE
  The focus of this systematic review was to assess the published data concerning zirconia dental implant abutments from various aspects.
  
  
  METHODS
  To identify suitable literature, an electronic search was performed using PubMed. The keywords "zirconia," "zirconium," "ceramic," "dental abutments," "dental implants," "plaque," and "bacteria" were included. Titles and abstracts were screened, and literature that fulfilled the inclusion criteria was selected for a full-text reading. Articles were divided into four groups: (1) studies on the mechanical properties of zirconia abutments, (2) studies on the peri-implant soft tissues around zirconia abutments, (3) studies on plaque accumulation on zirconia, and (4) clinical studies on the survival of zirconia abutments.
  
  
  RESULTS
  The initial literature search resulted in 380 articles. For groups 1 to 4, 11, 4, 7, and 3 articles satisfied the inclusion and exclusion criteria, respectively. Only 1 randomized clinical study was identified. Review of the selected articles showed that zirconia abutments were reliable in the anterior region from both biologic and mechanical points of view. Furthermore, zirconia abutments may represent a material surface less attractive for early plaque retention compared to titanium. Three clinical follow-up studies indicated that zirconia abutments could function without fracture and peri-implant lesions.
  
  
  CONCLUSIONS
  Based on the reviewed literature, zirconia has the potential to be used as a dental abutment material, although some issues have to be studied further.
authors.affiliation: New Industry Creation Hatchery Center, Tohoku University, Aoba-ku, Sendai, Japan. keisuke1@mail.tains.tohoku.ac.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nakamura
authors.forename: Taro
authors.initials: T
authors.lastname: Kanno
authors.forename: Percy
authors.initials: P
authors.lastname: Milleding
authors.forename: Ulf
authors.initials: U
authors.lastname: Ortengren
mesh_terms: D000044:Dental Abutments; D015921:Dental Implants; D003764:Dental Materials / Q000737:chemistry*; D003773:Dental Plaque / Q000209:etiology; D017267:Dental Prosthesis Design; D006801:Humans; D055595:Mechanical Phenomena; D010519:Periodontium / Q000033:anatomy & histology; D016019:Survival Analysis; D015040:Zirconium / Q000737:chemistry*
chemical_list: D015921:Dental Implants; D003764:Dental Materials; D015040:Zirconium; C028541:zirconium oxide