CC BY 4.0 · Eur J Dent 2022; 16(01): 49-55
DOI: 10.1055/s-0041-1735423
Review Article

Titanium Base Abutments in Implant Prosthodontics: A Literature Review

1   Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
› Institutsangaben

Abstract

Implant abutments are essential components in restoring dental implants. Titanium base abutments were introduced to overcome issues related to existing abutments, such as the unesthetic appearance of titanium abutments and the low fracture strength of ceramic abutments. This study aimed to comprehensively review studies addressing the mechanical and clinical behaviors of titanium base abutments. A search was performed on PubMed/MEDLINE, Web of Science, Google Scholar, and Scopus databases to find articles that were published in English until December 2020 and that addressed the review purpose. A total of 33 articles fulfilled the inclusion criteria and were included for data extraction and review. In vitro studies showed that titanium base abutments had high fracture strength, adequate retention values, particularly with resin cement, and good marginal and internal fit. Although the clinical assessment of titanium base abutments was limited, they showed comparable performance with conventional abutments in short-term evaluation, especially in the anterior and premolar areas. Titanium base abutments can be considered a feasible treatment option for restoring dental implants, but long-term clinical studies are required for a better assessment.



Publikationsverlauf

Artikel online veröffentlicht:
18. November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Thieme Medical and Scientific Publishers Private Ltd
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res 2012; 23 (Suppl. 06) 2-21
  • 2 Torabinejad M, Anderson P, Bader J. et al. Outcomes of root canal treatment and restoration, implant-supported single crowns, fixed partial dentures, and extraction without replacement: a systematic review. J Prosthet Dent 2007; 98 (04) 285-311
  • 3 Arunyanak SP, Pollini A, Ntounis A, Morton D. Clinician assessments and patient perspectives of single-tooth implant restorations in the esthetic zone of the maxilla: a systematic review. J Prosthet Dent 2017; 118 (01) 10-17
  • 4 Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CHF, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res 2009; 20 (Suppl. 04) 4-31
  • 5 Hsiao C-C, Liang C-H, Shen Y-F, Hsu K-W. Retrospective comparison of posterior fixed dental prostheses supported by two different titanium abutments on tissue level implants. J Prosthet Dent 2021; 125 (06) 877-882
  • 6 Corvino E, Pesce P, Mura R, Marcano E, Canullo L. Influence of modified titanium abutment surface on peri-implant soft tissue behavior: a systematic review of in vitro studies. Int J Oral Maxillofac Implants 2020; 35 (03) 503-519
  • 7 Queiroz DA, Hagee N, Lee DJ, Zheng F. The behavior of a zirconia or metal abutment on the implant-abutment interface during cyclic loading. J Prosthet Dent 2020; 124 (02) 211-216
  • 8 Yi Y, Heo S-J, Koak J-Y, Kim S-K. Comparison of CAD/CAM abutment and prefabricated abutment in Morse taper internal type implant after cyclic loading: axial displacement, removal torque, and tensile removal force. J Adv Prosthodont 2019; 11 (06) 305-312
  • 9 Foong JKW, Judge RB, Palamara JE, Swain MV. Fracture resistance of titanium and zirconia abutments: an in vitro study. J Prosthet Dent 2013; 109 (05) 304-312
  • 10 Lee A, Okayasu K, Wang H-L. Screw- versus cement-retained implant restorations: current concepts. Implant Dent 2010; 19 (01) 8-15
  • 11 Rodriguez LC, Saba JN, Chung K-H, Wadhwani C, Rodrigues DC. In vitro effects of dental cements on hard and soft tissues associated with dental implants. J Prosthet Dent 2017; 118 (01) 31-35
  • 12 Huang Y, Wang J. Mechanism of and factors associated with the loosening of the implant abutment screw: a review. J Esthet Restor Dent 2019; 31 (04) 338-345
  • 13 Lops D, Stellini E, Sbricoli L, Cea N, Romeo E, Bressan E. Influence of abutment material on peri-implant soft tissues in anterior areas with thin gingival biotype: a multicentric prospective study. Clin Oral Implants Res 2017; 28 (10) 1263-1268
  • 14 Ramos MB, Pegoraro LF, Takamori E, Coelho PG, Silva TL, Bonfante EA. Evaluation of UCLA implant-abutment sealing. Int J Oral Maxillofac Implants 2014; 29 (01) 113-120
  • 15 Amorfini L, Storelli S, Mosca D, Scanferla M, Romeo E. Comparison of cemented vs screw-retained, customized computer-aided design/computer-assisted manufacture zirconia abutments for esthetically located single-tooth implants: a 10-year randomized prospective study. Int J Prosthodont 2018; 31 (04) 359-366
  • 16 Kraus RD, Epprecht A, Hämmerle CHF, Sailer I, Thoma DS. Cemented vs screw-retained zirconia-based single implant reconstructions: a 3-year prospective randomized controlled clinical trial. Clin Implant Dent Relat Res 2019; 21 (04) 578-585
  • 17 Thoma DS, Gamper FB, Sapata VM, Voce G, Hämmerle CHF, Sailer I. Spectrophotometric analysis of fluorescent zirconia abutments compared to “conventional” zirconia abutments: a within subject controlled clinical trial. Clin Implant Dent Relat Res 2017; 19 (04) 760-766
  • 18 Heierle L, Wolleb K, Hämmerle CH, Wiedemeier DB, Sailer I, Thoma DS. Randomized controlled clinical trial comparing cemented versus screw-retained single crowns on customized zirconia abutments: 3-year results. Int J Prosthodont 2019; 32 (02) 174-176
  • 19 Kammermeier A, Rosentritt M, Behr M, Schneider-Feyrer S, Preis V. In vitro performance of one- and two-piece zirconia implant systems for anterior application. J Dent 2016; 53: 94-101
  • 20 Stimmelmayr M, Sagerer S, Erdelt K, Beuer F. In vitro fatigue and fracture strength testing of one-piece zirconia implant abutments and zirconia implant abutments connected to titanium cores. Int J Oral Maxillofac Implants 2013; 28 (02) 488-493
  • 21 Passos SP, Linke B, Larjava H, French D. Performance of zirconia abutments for implant-supported single-tooth crowns in esthetic areas: a retrospective study up to 12-year follow-up. Clin Oral Implants Res 2016; 27 (01) 47-54
  • 22 Stimmelmayr M, Edelhoff D, Güth J-F, Erdelt K, Happe A, Beuer F. Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: a comparative in vitro study. Dent Mater 2012; 28 (12) 1215-1220
  • 23 Tribst JPM, Dal Piva AMO, Borges ALS, Bottino MA. Different combinations of CAD/CAM materials on the biomechanical behavior of a two-piece prosthetic solution. Int J Comput Dent 2019; 22 (02) 171-176
  • 24 Yilmaz B, Salaita LG, Seidt JD, McGlumphy EA, Clelland NL. Load to failure of different zirconia abutments for an internal hexagon implant. J Prosthet Dent 2015; 114 (03) 373-377
  • 25 Silva CEP, Soares S, Machado CM. et al. Effect of CAD/CAM abutment height and cement type on the retention of zirconia crowns. Implant Dent 2018; 27 (05) 582-587
  • 26 Nouh I, Kern M, Sabet AE, Aboelfadl AK, Hamdy AM, Chaar MS. Mechanical behavior of posterior all-ceramic hybrid-abutment-crowns versus hybrid-abutments with separate crowns-a laboratory study. Clin Oral Implants Res 2019; 30 (01) 90-98
  • 27 Elsayed A, Wille S, Al-Akhali M, Kern M. Comparison of fracture strength and failure mode of different ceramic implant abutments. J Prosthet Dent 2017; 117 (04) 499-506
  • 28 Gierthmuehlen PC, Berger L, Spitznagel FA. Monolithic screw-retained lithium disilicate implant crowns: preliminary data of a prospective cohort study. Int J Prosthodont 2020; 33 (03) 272-276
  • 29 Berroeta E, Zabalegui I, Donovan T, Chee W. Dynamic abutment: a method of redirecting screw access for implant-supported restorations: technical details and a clinical report. J Prosthet Dent 2015; 113 (06) 516-519
  • 30 Hu E, Petrich A, Imamura G, Hamlin C. Effect of screw channel angulation on reverse torque values of dental implant abutment screws. J Prosthodont 2019; 28 (09) 969-972
  • 31 Anitua E, Fernández-de-Retana S, Alkhraisat MH. Survival and marginal bone loss of dental implants supporting cad-cam angled channel restorations: a split-mouth retrospective study. Eur J Dent 2020; 14 (02) 194-199
  • 32 Freifrau von Maltzahn N, Bernard S, Kohorst P. Two-part implant abutments with titanium and ceramic components: Surface modification affects retention forces-an in-vitro study. Clin Oral Implants Res 2019; 30 (09) 903-909
  • 33 Wiedenmann F, Liebermann A, Spintzyk S, Eichberger M, Stawarczyk B. Influence of different cleaning procedures on tensile bond strength between zirconia abutment and titanium base. Int J Oral Maxillofac Implants 2019; 34 (06) 1318-1327
  • 34 Gehrke P, Alius J, Fischer C, Erdelt KJ, Beuer F. Retentive strength of two-piece CAD/CAM zirconia implant abutments. Clin Implant Dent Relat Res 2014; 16 (06) 920-925
  • 35 Lopes ACO, Machado CM, Bonjardim LR. et al. The effect of CAD/CAM crown material and cement type on retention to implant abutments. J Prosthodont 2019; 28 (02) e552-e556
  • 36 Adatia ND, Bayne SC, Cooper LF, Thompson JY. Fracture resistance of yttria-stabilized zirconia dental implant abutments. J Prosthodont 2009; 18 (01) 17-22
  • 37 Chun H-J, Yeo I-S, Lee J-H. et al. Fracture strength study of internally connected zirconia abutments reinforced with titanium inserts. Int J Oral Maxillofac Implants 2015; 30 (02) 346-350
  • 38 Saker S, Al-Zordk W, Özcan M. Resistance to fracture of zirconia abutments with different angulations: impact of implant platform diameter. Eur J Dent 2020; 14 (04) 517-524
  • 39 Elsayed A, Wille S, Al-Akhali M, Kern M. Effect of fatigue loading on the fracture strength and failure mode of lithium disilicate and zirconia implant abutments. Clin Oral Implants Res 2018; 29 (01) 20-27
  • 40 Moilanen P, Hjerppe J, Lassila LVJ, Närhi TO. Fracture strength and precision of fit of implant-retained monolithic zirconia crowns. J Oral Implantol 2018; 44 (05) 330-334
  • 41 Atsü SS, Aksan ME, Bulut AC. Fracture resistance of titanium, zirconia, and ceramic-reinforced polyetheretherketone implant abutments supporting CAD/CAM monolithic lithium disilicate ceramic crowns after aging. Int J Oral Maxillofac Implants 2019; 34 (03) 622-630
  • 42 Bankoğlu Güngör M, Karakoca Nemli S, Yilmaz H, Aydin C. Fracture resistance of different implant supported ceramic abutment/crown systems. Eur Oral Res 2019; 53 (02) 80-87
  • 43 Pitta J, Hicklin SP, Fehmer V, Boldt J, Gierthmuehlen PC, Sailer I. Mechanical stability of zirconia meso-abutments bonded to titanium bases restored with different monolithic all-ceramic crowns. Int J Oral Maxillofac Implants 2019; 34 (05) 1091-1097
  • 44 Adolfi D, Mendes Tribst JP, Souto Borges AL, Bottino MA. Torque maintenance capacity, vertical misfit, load to failure, and stress concentration of zirconia restorations cemented or notched to titanium bases. Int J Oral Maxillofac Implants 2020; 35 (02) 357-365
  • 45 Al-Zordk W, Elmisery A, Ghazy M. Hybrid-abutment-restoration: effect of material type on torque maintenance and fracture resistance after thermal aging. Int J Implant Dent 2020; 6 (01) 24
  • 46 Gibbs CH, Anusavice KJ, Young HM, Jones JS, Esquivel-Upshaw JF. Maximum clenching force of patients with moderate loss of posterior tooth support: a pilot study. J Prosthet Dent 2002; 88 (05) 498-502
  • 47 Buzayan MM, Yunus NB. Passive fit in screw retained multi-unit implant prosthesis understanding and achieving: a review of the literature. J Indian Prosthodont Soc 2014; 14 (01) 16-23
  • 48 Ghodsi S, Alikhasi M, Soltani N. Marginal discrepancy of single implant-supported metal copings fabricated by various CAD/CAM and conventional techniques using different materials. Eur J Dent 2019; 13 (04) 563-568
  • 49 Presotto AGC, Bhering CLB, Mesquita MF, Barão VAR. Marginal fit and photoelastic stress analysis of CAD-CAM and overcast 3-unit implant-supported frameworks. J Prosthet Dent 2017; 117 (03) 373-379
  • 50 Liu Y, Wang J. Influences of microgap and micromotion of implant-abutment interface on marginal bone loss around implant neck. Arch Oral Biol 2017; 83: 153-160
  • 51 Katsoulis J, Takeichi T, Sol Gaviria A, Peter L, Katsoulis K. Misfit of implant prostheses and its impact on clinical outcomes. Definition, assessment and a systematic review of the literature. Eur J Oral Implantol 10 (Suppl. 01) 121-138
  • 52 Jemt T. Failures and complications in 391 consecutively inserted fixed prostheses supported by Brånemark implants in edentulous jaws: a study of treatment from the time of prosthesis placement to the first annual checkup. Int J Oral Maxillofac Implants 1991; 6 (03) 270-276
  • 53 Camós-Tena R, Escuin-Henar T, Torné-Duran S. Conical connection adjustment in prosthetic abutments obtained by different techniques. J Clin Exp Dent 2019; 11 (05) e408-e413
  • 54 Ramalho IS, Bergamo ETP, Witek L, Coelho PG, Lopes ACO, Bonfante EA. Implant-abutment fit influences the mechanical performance of single-crown prostheses. J Mech Behav Biomed Mater 2020; 102: 103506
  • 55 Ramalho I, Witek L, Coelho PG, Bergamo E, Pegoraro LF, Bonfante EA. Influence of abutment fabrication method on 3D fit at the implant-abutment connection. Int J Prosthodont 2020; 33 (06) 641-647
  • 56 Korsch M, Marten S-M, Walther W, Vital M, Pieper DH, Dötsch A. Impact of dental cement on the peri-implant biofilm-microbial comparison of two different cements in an in vivo observational study. Clin Implant Dent Relat Res 2018; 20 (05) 806-813
  • 57 Joda T, Ferrari M, Brägger U. Monolithic implant-supported lithium disilicate (LS2) crowns in a complete digital workflow: a prospective clinical trial with a 2-year follow-up. Clin Implant Dent Relat Res 2017; 19 (03) 505-511
  • 58 Pamato S, Honório HM, da Costa JA, Traebert JL, Bonfante EA, Pereira JR. The influence of titanium base abutments on peri-implant soft tissue inflammatory parameters and marginal bone loss: a randomized clinical trial. Clin Implant Dent Relat Res 2020; 22 (04) 542-548
  • 59 Joda T, Brägger U. Time-efficiency analysis of the treatment with monolithic implant crowns in a digital workflow: a randomized controlled trial. Clin Oral Implants Res 2016; 27 (11) 1401-1406
  • 60 Serichetaphongse P, Chengprapakorn W, Thongmeearkom S, Pimkhaokham A. Immunohistochemical assessment of the peri-implant soft tissue around different abutment materials: a human study. Clin Implant Dent Relat Res 2020; 22 (05) 638-646
  • 61 Lin Y-T, Shen Y-F, Wei P-C, Hsu K-W. Clinical evaluation of two-piece zirconia abutments with bonded titanium inserts for implant-supported restorations. J Prosthet Dent 2020; 123 (03) 449-454
  • 62 Asgeirsson AG, Sailer I, Gamper F, Jung RE, Hämmerle CHF, Thoma DS. Veneered zirconia abutments cemented on non-original titanium bases: 1-year results of a prospective case series. Clin Oral Implants Res 2019; 30 (08) 735-744
  • 63 Linkevicius T, Linkevicius R, Alkimavicius J, Linkeviciene L, Andrijauskas P, Puisys A. Influence of titanium base, lithium disilicate restoration and vertical soft tissue thickness on bone stability around triangular-shaped implants: a prospective clinical trial. Clin Oral Implants Res 2018; 29 (07) 716-724
  • 64 Gomez-Meda R, Esquivel J, Blatz MB. The esthetic biological contour concept for implant restoration emergence profile design. J Esthet Restor Dent 2021; 33 (01) 173-184
  • 65 Martínez-Rus F, Prieto M, Salido MP, Madrigal C, Özcan M, Pradíes G. A clinical study assessing the influence of anodized titanium and zirconium dioxide abutments and peri-implant soft tissue thickness on the optical outcome of implant-supported lithium disilicate single crowns. Int J Oral Maxillofac Implants 2017; 32 (01) 156-163
  • 66 Steigmann M, Monje A, Chan H-L, Wang H-L. Emergence profile design based on implant position in the esthetic zone. Int J Periodontics Restorative Dent 2014; 34 (04) 559-563