Zirconia Ceramics Mechanical and Esthetic Outcome in Anterior Region- A Systemic Review and Meta Anaylsis

Abstract

Introduction: For the replacement of the lost tooth in the anterior region the implants are most commonly preferred. The Titanium implant is the most common with the variety of abutments. Recently the zirconia has been preferred for its esthetics. But still the mechanical outcome is unclear. With the advent of Computer-aided design and computer-aided manufacturing (CAD-CAM) custom zirconia abutments with titanium connections are readily available. Hence in this study we intend to conduct a systematic review for the esthetic and the mechanical properties in the zirconia abutments in particular to the anterior region. 

Material and methods: We conducted the search for the data from the online sources like the “EMBASE”, “Pubmed”, “Scopus” and other sources. Terms searched were zirconium, single tooth abutments and implant zirconium. The follow-up for one year was the minimum that was considered.  The data extraction and meta-analysis were based on the PRISMA guidelines. For the assessment of the risk factors and the variables the statistical analysis was done keeping p<0.05 as significant.

 Results:  Twenty studies were finalized from the 200 studies considered for the review. Twelve defined mechanical properties, and fifteen defined esthetics. Abutment fractures was seen in 5 studies.   No variation was noted in the prefabricated and custom abutments or internal and external implant connection concerning fractures or/ screw loosening. Good to excellent esthetic integration in terms of restorations and soft-tissue color and the presence and height of papillae was reported.

Conclusions: The main advantage of the zirconia abutment is the Esthetics. There are notable concerns about the mechanical properties. There is paucity of the literature regarding zirconia abutments with titanium inserts.  The predictions for these designs however look encouraging.