All-ceramic versus titanium-based implant supported restorations: Preliminary 12-months results from a randomized controlled trial

PURPOSE: The aim of the present randomized controlled study was to compare prefabricated all-ceramic, anatomically shaped healing abutments followed by all-ceramic abutments and all-ceramic crowns and prefabricated standard-shaped (round-diameter) titanium healing abutments followed by final titanium abutments restored with porcelain-fused-to-metal (PFM) implant crowns in the premolar and molar regions. MATERIALS AND METHODS: Forty-two patients received single implants restored either by all-ceramic restorations (test group, healing abutment, final abutment, and crown all made of zirconia) or conventional titanium-based restorations. Immediately after prosthetic incorporation and after 12 months of loading, implant survival, technical complications, bone loss, sulcus fluid flow rate (SFFR) as well as plaque index (PI) and implant stability (Periotest) were analyzed clinically and radiologically. RESULTS: After 12 months of loading, an implant and prosthetic survival rate of 100% was observed. Minor prosthetic complications such as chipping of ceramic veneering occurred in both groups. No statistical significant differences were observed between both groups with only a minimum of bone loss, SFFR, and PI. CONCLUSION: All-ceramic implant prostheses including a prefabricated anatomically shaped healing abutment achieved comparable results to titanium-based restorations in the posterior region. However, observational results indicate a benefit as shaping the peri-implant soft-tissue with successive provisional devices and subsequent compression of the soft tissue can be avoided.

One Abutment at One Time Concept for Platform-Switched Morse Implants: Systematic Review and Meta-Analysis

Abstract The aim of this systematic review and meta-analysis was to compare the peri-implant vertical bone loss of immediate loading of implant crowns using the one abutment at one time (AOT) protocol and implants with abutment removal (AR). This systematic review with meta-analysis was reported according to the PRISMA statement, with guidance from the Cochrane Collaboration Handbook. A total of 103 publications were identified in the PubMed database and reference lists of examined articles. After the screening of titles and abstracts, the eligibility of eight full-text articles was assessed. Five studies published between 2010 and 2015 were included in the meta-analysis. There was less peri-implant vertical bone loss at implants using an AOT protocol than at implants using AR protocol (WMD -0.19, 95% CI -0.26 to -0.13; p<0.0001; random-effects model). In conclusion, the use of the AOT protocol with platform-switched Morse implants results in less bone loss than do AR procedures, but this effect may not be clinically relevant. The preservation of marginal bone level achieved with the AOT protocol may not enhance the aesthetics. These results should be interpreted with caution.

Resumo O objetivo desta revisão sistemática e meta-análise foi comparar a perda óssea vertical em implantes de carga imediata usando o protocolo de um pilar em um único momento (AOT) e implantes com remoção de pilar (AR). Esta revisão sistemática com meta-análise foi relatada de acordo com a declaração PRISMA, com orientação do Cochrane Collaboration Handbook. Foram identificadas 103 publicações na base de dados PubMed e nas listas de referência dos artigos examinados. Após a triagem de títulos e resumos, avaliou-se a elegibilidade de oito artigos de texto completo. Cinco estudos publicados entre 2010 e 2015 foram incluídos na meta-análise. Houve menos perda óssea vertical peri-implante em implantes usando o protocolo AOT do que nos implantes usando o protocolo AR (WMD -0,19, 95% IC -0,26 a -0,13; p <0,0001, modelo de efeitos aleatórios). Em conclusão, o uso do protocolo AOT com implantes Cone Morse associados a pilares com plataforma switching resulta em menos perda óssea do que os procedimentos AR, mas esse efeito pode não ser clinicamente relevante. A preservação do nível ósseo marginal alcançado com o protocolo AOT pode não melhorar a estética. Estes resultados devem ser interpretados com cautela.