Comparison of the effect of zirconia and titanium abutments on peri-implant hard and soft tissues.

Aim: The primary objective of this research was to assess and compare the impact of customized zirconia (Zr) and titanium (Ti) abutments, placed on early loaded dental implants, on both hard tissue (as measured crestal bone level) and soft tissue (as assessed by sulcular bleeding index [SBI], probing depth [PD], and Pink Esthetic Score [PES]), through clinical and radiographic evaluation.

Settings and design: This research involved a sample of 15 patients who had partially dentulous mandibular arch. Within this group, a total of 30 implants were surgically placed. Specifically, each patient received two implants in the posterior region of the mandible, and the bone density in this area was classified as D2 type. In each patient, one implant was loaded with Zr abutment and the other was loaded with Ti abutment. The bone quality in the area of implant placement was Type D2. Two groups were created for this research. Each group consisted of 15 early loaded dental implants with customized Zr abutments and customized Ti abutments respectively.

Materials and methods: Hard- and soft-tissue changes were evaluated in both the groups. Evaluation of crestal bone loss (CBL) with cone beam computed tomography and SBI, PD and PESs were evaluated by various indices at 2, 4, and 6 months postloading.

Statistical analysis used: After obtaining the readings, data were subjected to statistical analysis and comparison of quantitative data was done, paired t-test was used.

Results: The mean CBL in the Ti abutment is higher; the difference between the two groups was not statistically significant. SBI and PD for Zr were higher, but there was no statistically significant difference between the two groups. Zr had a higher PES than Ti abutment and the difference between the two groups was statistically significant. In the literature till date, the PES of Zr abutments were proven better for provisional restorations in implant prosthesis, but very few literatures support the same for the final implant restorations.

Conclusion: The study did not reveal a clear advantage of either Ti or Zr abutments over the other. Nevertheless, Zr abutments tended to produce a more favorable color response in the peri-implant mucosa and led to superior esthetic outcomes as measured by the PES.