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International Journal of Esthetic Dentistry  (English Edition)
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Int J Esthet Dent 2 (2007), No. 3     2. Oct. 2007
Int J Esthet Dent 2 (2007), No. 3  (02.10.2007)

Page 296-310, PubMed:19655552


Single-Tooth Implant Reconstructions: Esthetic Factors Influencing the Decision Between Titanium and Zirconia Abutments in Anterior Regions
Sailer, Irena / Zembic, Anja / Jung, Ronald Ernst / Hämmerle, Christoph Hans Franz / Mattiola, Alessandro
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.
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