Choosing Abutment Materials for Dental Implants
Different materials can be used to fabricate abutments for dental implants. Some dentists prefer to use one type of abutment materials over another based on past experiences, or may recommend one material over another based on the details of a patient’s case. Current trends may also influence which type of material is most commonly chosen for abutments. There are advantages and disadvantages to using each type of abutment materials.
Zirconia is the best option for thin biotypes in esthetic zones. Zirconia has a bright white color that will not detract from the appearance of the dental implant after the crown has been placed. However, zirconia is not as strong as metal abutments, so the abutments have been known to fracture in some situations. Zirconia abutments should generally not be placed on teeth that will be put under extreme pressure. The success of zirconia implants is also dependent upon the technique of the dentist, so dentists should only recommend the material when they are completely comfortable with placing zirconia abutments.
Titanium abutments are very strong and versatile. Titanium abutments typically will not fracture, so they can be used for any tooth replacement with less concern. Titanium abutments are also highly biocompatible. However, titanium abutments may show through ceramic crowns and detract from the appearance of the restoration. Titanium abutments are generally recommended for single-unit posterior cases or for thicker biotypes.
Gold-Hue Titanium Abutments
Gold-hue titanium is very strong and biocompatible, just as titanium is. The gold coating helps to improve the esthetic appeal of the restoration, even on thinner biotypes. However, if abutment modifications are needed, the gold coating will be eliminated. Gold-hue titanium abutments are also more costly than most other types of abutments. With both titanium and gold-hue titanium abutments, the abutments are cementable only, as opposed to being screw-retainable.
E.Max abutments were just cleared in the United States in early 2014, so few dental laboratories offer E.Max options as of yet. E.Max abutments are screw retained for the posterior area, which is more user-friendly. The material is more esthetically appealing than titanium or even gold-hue titanium, but is thought to overcome the strength issues present with zirconia. More research and time is needed to adequately gauge the long-term effectiveness of E.Max abutments.
Titanium Base with Zirconia Superstructure
Abutments made from zirconia with a titanium base are stronger than zirconia abutments and more esthetically pleasing than titanium abutments. However, the zirconia may still be susceptible to fracture. Dentists may wish to use the same considerations when placing zirconia abutments with titanium bases as when placing zirconia abutments.