Customized zirconia abutments: technical complications
Background: The good long-term clinical results of dental implants are well established, under the scope of osseointegration and function. Esthetics, especially in the anterior maxilla, is another factor gaining importance nowadays. Thus, customized zirconia abutments are replacing the standardized titanium ones at these sites, since they have also very good physical properties and biocompability. However, in the clinical practice we are often dealing with failures of such ceramic abutments. These failures could be related to the type of the customized abutment, as well as other factors. High stresses at the abutment-screw- nut interface could be generated as a result of the limited degree of rotational freedom in combination with a slight misfit. This may lead to the loosening of the assembled components and eventually to fracture, at two-material zirconia abutments (e.g. Procera Zr). In the case of two-component abutments (prefabricated titanium post and custom-made zirconia coping cemented on top of that) the weak link is the cement. The failure usually involves separation of the components, without any observed fractures. Other reasons of failure are considered to be defects in the fabrication process, fractures in the green structure, sintering prestresses, or handling errors. Aim: The purpose of this poster is to present the use and the technical complications of customized zirconia abutments, through a series of clinical cases. Methods: Three customized zirconia abutments were used in three different patients, in the esthetic zone, to achieve optimal esthetics. In two cases, a two-piece abutment with internal connection (Procera Zirconia) was utilized. In the third patient, a two-component abutment with cement retention was used. Results: Failure in all three cases of customized zirconia abutments was observed because of technical complications. Consequently, there was a need to modify the treatment plan. Conclusions and clinical implications: Customized zirconia abutments exhibit good esthetic, biological and technical outcomes, and they are considered to be a widespread and viable treatment option. However, their use in different clinical cases must be carefully selected. Additionally, great attention has to be given in their manufacturing procedure and adjustment in the laboratory.
European Association of Osseointegration proceedings published in Clinical Oral Implants Research
Dentistry not elsewhere classified