# Impact of different abutment materials on peri-implant tissue health and esthetics in fixed prosthodontics

## TL;DR

This study compares how different abutment materials affect gum health and the appearance of dental implants over 12 months.

## Contribution

The study provides new clinical evidence on the long-term effects of titanium, zirconia, and gold alloy abutments on peri-implant tissue health and esthetics.

## Key findings

- Zirconia abutments showed the best results for gum health with lower probing depth and bleeding on probing.
- Zirconia also achieved the highest esthetic scores compared to titanium and gold alloy abutments.
- Titanium and gold alloy abutments showed intermediate or less favorable outcomes in both health and esthetics.

## Abstract

The choice of abutment material plays a critical role in peri-implant tissue health and the esthetic outcome of fixed prosthodontics.
Various materials, such as titanium, zirconia, and gold alloy, offer different mechanical and biological interactions with the
peri-implant tissues, influencing clinical outcomes. However, the long-term impact of these materials on peri-implant soft tissue
response and esthetic appearance remains debated. A randomized controlled trial was conducted involving 90 patients requiring
single-tooth implant-supported prostheses. Patients were divided into three groups, with 30 participants each receiving abutments made
of titanium, zirconia, or gold alloy. Clinical parameters such as probing depth, bleeding on probing, plaque index, and peri-implant
soft tissue thickness were recorded over 12 months. Esthetic outcomes were assessed using the pink esthetic score (PES) and white
esthetic score (WES). After 12 months, titanium abutments exhibited a mean probing depth of 2.2 ± 0.4 mm, with a bleeding on
probing (BOP) percentage of 25%. Zirconia abutments showed significantly lower peri-implant inflammation with a probing depth of 1.9
± 0.3 mm and BOP of 10%. Gold alloy abutments demonstrated intermediate values with a probing depth of 2.1 ± 0.3 mm and
BOP of 15%. Esthetic evaluation revealed that zirconia abutments provided the highest PES/WES score (mean PES = 12.5 ± 1.1,
WES = 13.2 ± 1.0), followed by gold alloy (PES = 11.8 ± 1.2, WES = 12.5 ± 1.3), and titanium (PES = 11.2 ±
1.4, WES = 11.8 ± 1.5). Zirconia abutments offer superior peri-implant soft tissue health and esthetics compared to titanium and
gold alloy abutments. Clinicians should consider zirconia as the material of choice for optimal biological and esthetic outcomes in
fixed prosthodontics. However, further long-term studies are needed to validate these findings.