DR. MANUEL RIBERA PRAT

MSc(ClinRes, BioMedSci), DDS, Spain; Periodontist, Implantologist – Institutos Odontologicos, Spain

Esthetic In Anterior Implants Management Of Soft Tissue

Demand of esthetics results for the patients and fixed objectives by clinicians have produced that implantology can be a specialty whose applications need a high level of requirements. When implant is collocated in the anterior part, we must create adequate conditions to achieve maximum mimetic between implant supported prosthesis and natural teeth. Classical protocols of implantology included reentry in area and always need the surgical management of periimplant tissue. Stability of the soft tissue in the emergence profile is very important. We have to achieve a natural tissue contour with harmonious gingival margin and maintaining intact papilla. We present a range of surgical modalities aimed at enhancing the appearance of peri-implant soft tissue.

Zirconium vs. Titanium Abutments

Titanium abutments have been the gold standard for the greatest time, have high fracture resistance, and are biocompatible. Implant abutments made of commercially pure titanium are well documented to be biocompatible and have sufficient mechanical properties to support long-term fixed implant-supported dental prostheses. Clinical studies demonstrated excellent survival rates for fixed implant reconstructions supported by titanium abutments and few complications: loosening of the abutment screw. However, when used in certain clinical situations, titanium abutments can create an unaesthetic blue hue in the tissues and may compromise the aesthetical result if used in conjunction with ceramic crowns. Unfortunately, for patients with thin gingival biotypes or fragile tissues, the blue hue from light reflections of titanium shines through the tissues and is unaesthetic. Currently, there are only a few available material choices for prepable abutments: titanium, alumina, and zirconia. A few years ago, Alumina was the first choice as titanium’s replacement, unfortunately in vitro try outs didn’t support this new material, and international research focus quickly switched to zirconia, as a new alternative. We will analyze the present status of the application of zirconia and titanium abutments regarding  to properties and advantatges and disadvantatges to establish the long-term success of our restorations.