Soft tissue response to zirconia and titanium implant abutments: an in vivo within-subject comparison

Authors

  • Ralph van Brakel,

    Corresponding author
    • Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • Gert J. Meijer,

    1. Department of Biomaterials and Periodontology, Radboud Medical Center, Nijmegen, The Netherlands
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  • Jan Willem Verhoeven,

    1. Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • John Jansen,

    1. Department of Biomaterials and Periodontology, Radboud Medical Center, Nijmegen, The Netherlands
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  • Cornelis de Putter,

    1. Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • Marco S. Cune

    1. Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius hospital, Nieuwegein, The Netherlands
    2. Department of Fixed and Removable Prosthodontics, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, The University of Groningen, Groningen, The Netherlands
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  • Conflict of interest and source of funding
  • This research was made possible by a grant from Astra Tech AB (Mölndal, Sweden), who also provided the experimental abutments without costs and by the support of the authors' institutions.
  • The authors declare that they have no conflicts of interest.

Address:

Ralph van Brakel

University Medical Centre Utrecht

PO box 85.060

3508 AB, Utrecht, The Netherlands

E-mail: rbrakel@umcutrecht.nl

Abstract

Aim

To compare the health of the soft tissues towards zirconia and titanium abutments in man, as observed using histological data.

Material and Methods

Twenty patients received two mandibular implants with either a zirconia or titanium abutment (split mouth study design, left-right randomization). After 3 months soft tissue biopsies were prepared for histological evaluation. They were subjected to blind evaluation. The number of blood vessels per surface unit and an inflammation grading scale score ranging from 1 to 4 were determined.

Results

Paired samples from 17 patients were suitable for analysis, 3 with unsevered implant-abutment connections and 14 solely containing soft tissue. All showed a well-keratinized stratified squamous epithelium which was continuous with the barrier (junctional) epithelium that faced the abutment surface. The normal epithelial build-up could be recognized with little signs of inflammation. No statistically significant difference in tissues adjacent to zirconia and titanium abutment surfaces were seen with respect to vascular density (20.5 SD 4.4 and 20.7 SD 3.2) or inflammation grading scale scores (3.2 SD 0.7 versus 3.1 SD 0.7).

Conclusion

No differences in soft tissue health were seen in peri-implant mucosa adjacent to zirconia and titanium abutment surfaces.

Ancillary