Clinical, radiographic and patient‐reported outcomes of zirconia and titanium implants in the posterior zone after 1 year of loading—A randomized controlled trial

• Published in: Clinical oral implants research Vol. 35; no. 11; pp. 1428 - 1439
• Main Authors: Zuercher, Anina N., Balmer, Marc, Brügger, Lily V., Thoma, Daniel S., Jung, Ronald E., Bienz, Stefan P.
• Format: Journal Article
• Language: English
• Published: Denmark 01.11.2024
• Subjects: Adult; Aged; Dental Implantation, Endosseous - methods; Dental Implants; Dental Prosthesis Design; Female; Humans; Male; Middle Aged; Patient Reported Outcome Measures; Titanium; titanium base abutment; titanium implants; Treatment Outcome; zirconia implants; Zirconium; zirconium oxide; titanium implants; zirconia implants; titanium base abutment; dental implants; zirconium oxide
• ISSN: 0905-7161; 1600-0501; 1600-0501
• DOI: 10.1111/clr.14329

Objective To assess the clinical, radiographic and patient‐reported outcomes (PROMs) of posterior zirconia and titanium implants at 1 year of implant loading. Materials and Methods Forty‐two patients with two adjacent missing teeth were enrolled in a randomized controlled trial with a within‐subject controlled design. Each patient received one zirconia (Zr) and one titanium (Ti) implant, with the mesial and distal positions randomized. The implant restoration consisted of multiple layered zirconia, with the buccal aspect veneered. In group Zr, the restoration was intraorally cemented onto the one‐piece Zr implant, whereas in group Ti, the restoration was extraorally cemented onto the titanium base abutment and intraorally screw‐retained onto the Ti implant. Examinations were performed following restoration delivery at baseline (BL) and at 1 year. Measurements included clinical parameters, radiographic outcomes (MBL) and PROMs. Results Bleeding on probing showed an increase from BL to 1 year (34 ± 30% for Zr; 25 ± 21% for Ti). MBL remained stable with minimal changes from BL to 1 year, measuring 0.1 ± 0.4 mm (mean ± SD) for Zr and −0.1 ± 0.7 mm for Ti. Veneering fractures were the most frequent technical complication and amounted to 17.5% in group Zr and 5% in group Ti (p = .100). Patients preferred Zr implants for their soft tissue color, with a significant difference in perception between patients and clinicians (p < .017). Conclusion The study showed that both Zr and Ti implants had similar clinical outcomes, despite a high prevalence of mucositis and a few technical complications. Both implant types demonstrated stable marginal bone levels and similar patient‐reported outcome measures.