A randomized trial on the aesthetic outcomes of implant-supported restorations with zirconia or titanium abutments

Aim: To evaluate the aesthetic outcomes of zirconia versus titanium abutments for single tooth implant-supported crowns in the anterior maxilla. Material & Methods: A parallel, double blind clinical trial was conducted at the Complutense University (Madrid), where 38 patients were recruited. After random allocation (via computer-generated permuted blocks), either zirconia (test) or titanium (control) abutments were placed. Intra-and inter-group differences in aesthetic (main outcome), clinical, radiographical, and patient-centred outcomes were evaluated at baseline (crown placement) and at 1-year follow-up. Results: At 1 year, 25 of the 30 randomized patients were analysed (11 test and 14 control). Using the Implant Crown Aesthetic Index (ICAI), the scoring at baseline and 1-year were 7.9 and 7.6 for the test group and 10.6 and 11.3 for the control group, respectively. These differences were not statistically significant (sample size non-contrasted). Patient satisfaction was similarly high in both groups (visual analogue scale 8.5). Furthermore, no differences were observed in the clinical or radiographical outcomes. Two abutment fractures were registered in the test group. Conclusions: The use of zirconia abutments demonstrated a tendency towards better aesthetic outcomes although the differences were not statistically significant. However, more technical complications were noted with the use of zirconia abutments.