Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review
Identifieur interne : 002D15 ( Istex/Corpus ); précédent : 002D14; suivant : 002D16Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review
Auteurs : Avinash S. Bidra ; Patchanee RungruanganuntSource :
- Journal of Esthetic and Restorative Dentistry [ 1496-4155 ] ; 2013-06.
English descriptors
- KwdEn :
- Abutment, Abutment screw, Alumina, Alumina abutments, Andersson, Anterior abutments, Anterior region, Anterior region bidra, Bidra, Biocare, Buccal, Clin, Data extraction, Dentistry, Discoloration, Esthetic, Esthetic outcomes, Fracture, Gingival, Implant, Implant abutments, Jemt, Mandible, Maxilla, Maxillofac, Metal abutments, Mucosal, Multicenter, Procera, Prospective study, Prosthetic, Prosthodont, Restorative dentistry, Retrospective, Rungruanganunt, Sailer, Stulas, Systematic review, Titanium, Titanium abutment, Titanium abutments, Wiley periodicals, Zembic, Zirconia, Zirconia abutment, Zirconia abutments.
- Teeft :
- Abutment, Abutment screw, Alumina, Alumina abutments, Andersson, Anterior abutments, Anterior region, Anterior region bidra, Bidra, Biocare, Buccal, Clin, Data extraction, Dentistry, Discoloration, Esthetic, Esthetic outcomes, Fracture, Gingival, Implant, Implant abutments, Jemt, Mandible, Maxilla, Maxillofac, Metal abutments, Mucosal, Multicenter, Procera, Prospective study, Prosthetic, Prosthodont, Restorative dentistry, Retrospective, Rungruanganunt, Sailer, Stulas, Systematic review, Titanium, Titanium abutment, Titanium abutments, Wiley periodicals, Zembic, Zirconia, Zirconia abutment, Zirconia abutments.
Abstract
Abstract Statement of Problem The clinical outcomes of anterior implant abutments are not well reported. Purpose of the Study To systematically review the existing literature to identify survival, mechanical, biological, and esthetic outcomes of anterior implant abutments. Material and Methods An electronic search was performed using PubMed/MEDLINE with specific search terms and predetermined criteria. After application of inclusion and exclusion criteria, the final list of articles was reviewed in‐depth to meet the objectives of this review. Results Systematic application of inclusion and exclusion criteria resulted in identification of 27 studies that described outcomes of anterior implant abutments. Because of substantial heterogeneity of data, true survival, or cumulative survival of abutments could not be calculated. However, the mean failure of abutments was 1.15%, attributable to fractures restricted to ceramic abutments. Mechanical complications included abutment screw loosening, primarily restricted to external hex implants. Biological complications included fistulas and mucosal recession. Esthetic outcomes showed lesser gingival discoloration for zirconia abutments compared with metal abutments. Conclusions Minimal anterior abutment fractures have been reported and are restricted to ceramic abutments. Studies using spectrophotometry showed lesser gingival discoloration with zirconia abutments, but there is no evidence for difference in patient's esthetic satisfaction between ceramic and metal abutments.
Url:
DOI: 10.1111/jerd.12031
Links to Exploration step
ISTEX:5BC30026D15CB997933D0924FE562D0341035467Le document en format XML
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Bidra</name><affiliation><mods:affiliation>Post‐Graduate Prosthodontics, Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: avinashbidra@yahoo.com</mods:affiliation></affiliation></author><author><name sortKey="Rungruanganunt, Patchanee" sort="Rungruanganunt, Patchanee" uniqKey="Rungruanganunt P" first="Patchanee" last="Rungruanganunt">Patchanee Rungruanganunt</name><affiliation><mods:affiliation>Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:5BC30026D15CB997933D0924FE562D0341035467</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1111/jerd.12031</idno><idno type="url">https://api.istex.fr/document/5BC30026D15CB997933D0924FE562D0341035467/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002D15</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002D15</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review</title><author><name sortKey="Bidra, Avinash S" sort="Bidra, Avinash S" uniqKey="Bidra A" first="Avinash S." last="Bidra">Avinash S. Bidra</name><affiliation><mods:affiliation>Post‐Graduate Prosthodontics, Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: avinashbidra@yahoo.com</mods:affiliation></affiliation></author><author><name sortKey="Rungruanganunt, Patchanee" sort="Rungruanganunt, Patchanee" uniqKey="Rungruanganunt P" first="Patchanee" last="Rungruanganunt">Patchanee Rungruanganunt</name><affiliation><mods:affiliation>Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Esthetic and Restorative Dentistry</title><title level="j" type="alt">JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY</title><idno type="ISSN">1496-4155</idno><idno type="eISSN">1708-8240</idno><imprint><biblScope unit="vol">25</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="159">159</biblScope><biblScope unit="page" to="176">176</biblScope><biblScope unit="page-count">18</biblScope><date type="published" when="2013-06">2013-06</date></imprint><idno type="ISSN">1496-4155</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1496-4155</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abutment</term><term>Abutment screw</term><term>Alumina</term><term>Alumina abutments</term><term>Andersson</term><term>Anterior abutments</term><term>Anterior region</term><term>Anterior region bidra</term><term>Bidra</term><term>Biocare</term><term>Buccal</term><term>Clin</term><term>Data extraction</term><term>Dentistry</term><term>Discoloration</term><term>Esthetic</term><term>Esthetic outcomes</term><term>Fracture</term><term>Gingival</term><term>Implant</term><term>Implant abutments</term><term>Jemt</term><term>Mandible</term><term>Maxilla</term><term>Maxillofac</term><term>Metal abutments</term><term>Mucosal</term><term>Multicenter</term><term>Procera</term><term>Prospective study</term><term>Prosthetic</term><term>Prosthodont</term><term>Restorative dentistry</term><term>Retrospective</term><term>Rungruanganunt</term><term>Sailer</term><term>Stulas</term><term>Systematic review</term><term>Titanium</term><term>Titanium abutment</term><term>Titanium abutments</term><term>Wiley periodicals</term><term>Zembic</term><term>Zirconia</term><term>Zirconia abutment</term><term>Zirconia abutments</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Abutment</term><term>Abutment screw</term><term>Alumina</term><term>Alumina abutments</term><term>Andersson</term><term>Anterior abutments</term><term>Anterior region</term><term>Anterior region bidra</term><term>Bidra</term><term>Biocare</term><term>Buccal</term><term>Clin</term><term>Data extraction</term><term>Dentistry</term><term>Discoloration</term><term>Esthetic</term><term>Esthetic outcomes</term><term>Fracture</term><term>Gingival</term><term>Implant</term><term>Implant abutments</term><term>Jemt</term><term>Mandible</term><term>Maxilla</term><term>Maxillofac</term><term>Metal abutments</term><term>Mucosal</term><term>Multicenter</term><term>Procera</term><term>Prospective study</term><term>Prosthetic</term><term>Prosthodont</term><term>Restorative dentistry</term><term>Retrospective</term><term>Rungruanganunt</term><term>Sailer</term><term>Stulas</term><term>Systematic review</term><term>Titanium</term><term>Titanium abutment</term><term>Titanium abutments</term><term>Wiley periodicals</term><term>Zembic</term><term>Zirconia</term><term>Zirconia abutment</term><term>Zirconia abutments</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Abstract Statement of Problem The clinical outcomes of anterior implant abutments are not well reported. Purpose of the Study To systematically review the existing literature to identify survival, mechanical, biological, and esthetic outcomes of anterior implant abutments. Material and Methods An electronic search was performed using PubMed/MEDLINE with specific search terms and predetermined criteria. After application of inclusion and exclusion criteria, the final list of articles was reviewed in‐depth to meet the objectives of this review. Results Systematic application of inclusion and exclusion criteria resulted in identification of 27 studies that described outcomes of anterior implant abutments. Because of substantial heterogeneity of data, true survival, or cumulative survival of abutments could not be calculated. However, the mean failure of abutments was 1.15%, attributable to fractures restricted to ceramic abutments. Mechanical complications included abutment screw loosening, primarily restricted to external hex implants. Biological complications included fistulas and mucosal recession. Esthetic outcomes showed lesser gingival discoloration for zirconia abutments compared with metal abutments. Conclusions Minimal anterior abutment fractures have been reported and are restricted to ceramic abutments. Studies using spectrophotometry showed lesser gingival discoloration with zirconia abutments, but there is no evidence for difference in patient's esthetic satisfaction between ceramic and metal abutments.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>abutment</json:string><json:string>implant</json:string><json:string>zirconia</json:string><json:string>maxilla</json:string><json:string>alumina</json:string><json:string>implant abutments</json:string><json:string>zirconia abutments</json:string><json:string>titanium abutments</json:string><json:string>clin</json:string><json:string>data extraction</json:string><json:string>mucosal</json:string><json:string>bidra</json:string><json:string>discoloration</json:string><json:string>systematic review</json:string><json:string>titanium</json:string><json:string>wiley periodicals</json:string><json:string>rungruanganunt</json:string><json:string>anterior region bidra</json:string><json:string>mandible</json:string><json:string>maxillofac</json:string><json:string>esthetic outcomes</json:string><json:string>multicenter</json:string><json:string>restorative dentistry</json:string><json:string>anterior abutments</json:string><json:string>alumina abutments</json:string><json:string>fracture</json:string><json:string>buccal</json:string><json:string>prosthodont</json:string><json:string>zirconia abutment</json:string><json:string>biocare</json:string><json:string>andersson</json:string><json:string>dentistry</json:string><json:string>sailer</json:string><json:string>prosthetic</json:string><json:string>gingival</json:string><json:string>anterior region</json:string><json:string>abutment screw</json:string><json:string>stulas</json:string><json:string>titanium abutment</json:string><json:string>esthetic</json:string><json:string>metal abutments</json:string><json:string>prospective study</json:string><json:string>zembic</json:string><json:string>procera</json:string><json:string>jemt</json:string><json:string>retrospective</json:string><json:string>randomized</json:string><json:string>veneered</json:string><json:string>mucosal discoloration</json:string><json:string>clinician</json:string><json:string>soft tissues</json:string><json:string>denture</json:string><json:string>anterior</json:string><json:string>partial dentures</json:string><json:string>exclusion criteria</json:string><json:string>nobel biocare</json:string><json:string>ceramic abutments</json:string><json:string>practice maxilla</json:string><json:string>clinical outcomes</json:string><json:string>prospective multicenter study</json:string><json:string>prospective university maxilla</json:string><json:string>oral maxillofac implants</json:string><json:string>anterior maxilla</json:string><json:string>anterior implant abutments</json:string><json:string>soft tissue stability</json:string><json:string>porcelain</json:string><json:string>dent</json:string><json:string>complication</json:string><json:string>spectrophotometric</json:string><json:string>mucosal recession</json:string><json:string>titanium base</json:string><json:string>university maxilla</json:string><json:string>inclusion criteria</json:string><json:string>none none</json:string><json:string>cast metal</json:string><json:string>spectrophotometric measurements</json:string><json:string>cast metal abutment</json:string><json:string>single crowns</json:string><json:string>esthet dent</json:string><json:string>clinical trial</json:string><json:string>soft tissue</json:string><json:string>esthetic satisfaction</json:string><json:string>posterior regions</json:string><json:string>edentulous</json:string><json:string>implant dentistry</json:string><json:string>posterior abutments</json:string><json:string>anterior mandible</json:string><json:string>anterior implant restorations</json:string><json:string>abutment material</json:string><json:string>survival outcomes</json:string><json:string>patient satisfaction</json:string><json:string>spectrophotometric analysis</json:string><json:string>survival data</json:string><json:string>cast metal abutments</json:string><json:string>rungruanganunt table</json:string><json:string>single crown restorations</json:string><json:string>abutment fractures</json:string><json:string>connecticut health center</json:string><json:string>electronic search</json:string><json:string>clinical studies</json:string><json:string>internal connection</json:string><json:string>titanium implant abutments</json:string><json:string>treatment success</json:string><json:string>clin implant dent relat</json:string><json:string>ceramic implant abutments</json:string><json:string>osseointegrated implants</json:string><json:string>treatment outcomes</json:string><json:string>systematic reviews</json:string><json:string>oral maxillofac implants andersson</json:string><json:string>mechanical outcomes</json:string></teeft></keywords><author><json:item><name>Avinash S. Bidra BDS, MS</name><affiliations><json:string>Post‐Graduate Prosthodontics, Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</json:string><json:string>E-mail: avinashbidra@yahoo.com</json:string></affiliations></json:item><json:item><name>Patchanee Rungruanganunt DDS, MSD</name><affiliations><json:string>Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</json:string></affiliations></json:item></author><articleId><json:string>JERD12031</json:string></articleId><arkIstex>ark:/67375/WNG-CZJS9M1D-M</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>reviewArticle</json:string></originalGenre><abstract>Abstract Statement of Problem The clinical outcomes of anterior implant abutments are not well reported. Purpose of the Study To systematically review the existing literature to identify survival, mechanical, biological, and esthetic outcomes of anterior implant abutments. Material and Methods An electronic search was performed using PubMed/MEDLINE with specific search terms and predetermined criteria. After application of inclusion and exclusion criteria, the final list of articles was reviewed in‐depth to meet the objectives of this review. Results Systematic application of inclusion and exclusion criteria resulted in identification of 27 studies that described outcomes of anterior implant abutments. Because of substantial heterogeneity of data, true survival, or cumulative survival of abutments could not be calculated. However, the mean failure of abutments was 1.15%, attributable to fractures restricted to ceramic abutments. Mechanical complications included abutment screw loosening, primarily restricted to external hex implants. Biological complications included fistulas and mucosal recession. Esthetic outcomes showed lesser gingival discoloration for zirconia abutments compared with metal abutments. Conclusions Minimal anterior abutment fractures have been reported and are restricted to ceramic abutments. Studies using spectrophotometry showed lesser gingival discoloration with zirconia abutments, but there is no evidence for difference in patient's esthetic satisfaction between ceramic and metal abutments.</abstract><qualityIndicators><score>9.412</score><pdfWordCount>7435</pdfWordCount><pdfCharCount>57034</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>18</pdfPageCount><pdfPageSize>585.069 x 782.928 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>201</abstractWordCount><abstractCharCount>1538</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review</title><pmid><json:string>23773511</json:string></pmid><genre><json:string>review-article</json:string></genre><host><title>Journal of Esthetic and Restorative Dentistry</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1708-8240</json:string></doi><issn><json:string>1496-4155</json:string></issn><eissn><json:string>1708-8240</json:string></eissn><publisherId><json:string>JERD</json:string></publisherId><volume>25</volume><issue>3</issue><pages><first>159</first><last>176</last><total>18</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>REVIEW ARTICLE</value></json:item></subject></host><namedEntities><unitex><date><json:string>1970</json:string><json:string>1986</json:string><json:string>2012</json:string><json:string>2013-03-21</json:string></date><geogName></geogName><orgName><json:string>Wiley Periodicals, Inc.</json:string><json:string>University of California Los Angeles</json:string><json:string>Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, CT, USA</json:string><json:string>Retrospective University</json:string><json:string>Internal Straumann Prospective University</json:string><json:string>Prospective University</json:string><json:string>Wiley Periodicals, Inc</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Studies</json:string><json:string>Systematic</json:string><json:string>Professor</json:string><json:string>Happe</json:string><json:string>Assistant</json:string><json:string>Redemagni</json:string><json:string>Zembic</json:string><json:string>Program</json:string><json:string>Sailer</json:string><json:string>Hosseini</json:string><json:string>Jung</json:string><json:string>Gallucci</json:string><json:string>Internal</json:string><json:string>Prospective</json:string><json:string>Bressan</json:string><json:string>Brakel</json:string><json:string>Rompen</json:string></persName><placeName></placeName><ref_url></ref_url><ref_bibl><json:string>Sweden & Martina Kim et al.</json:string><json:string>Romeo et al.</json:string><json:string>Bressan et al.</json:string><json:string>Levine et al.</json:string><json:string>Sethi et al.</json:string><json:string>Sailer et al.</json:string><json:string>Ekfeldt et al.</json:string><json:string>Glauser et al.</json:string><json:string>Scheller et al.</json:string><json:string>Krennmair et al.</json:string><json:string>Jung et al.</json:string><json:string>Happe et al.</json:string><json:string>van Brakel et al.</json:string><json:string>Wolleb et al.</json:string><json:string>Rompen et al.</json:string><json:string>Lewis et al.</json:string><json:string>Cooper et al.</json:string><json:string>Chen et al.</json:string><json:string>Jemt et al.</json:string><json:string>Bianco et al.</json:string><json:string>Henry et al.</json:string><json:string>Eger et al.</json:string><json:string>De Boever et al.</json:string><json:string>Brägger et al.</json:string><json:string>Kreissl et al.</json:string><json:string>Camargos et al.</json:string><json:string>Cosyn et al.</json:string><json:string>Kim et al.</json:string><json:string>Furze et al.</json:string><json:string>Vigolo et al.</json:string><json:string>Zembic et al.</json:string><json:string>Redemagni et al.</json:string><json:string>Bae et al.</json:string><json:string>Behr et al.</json:string><json:string>Behneke et al.</json:string><json:string>Hosseini et al.</json:string><json:string>Zarone et al.</json:string><json:string>Cabello et al.</json:string><json:string>Andersson et al.</json:string><json:string>Kastenbaum et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-CZJS9M1D-M</json:string></ark><categories><wos><json:string>1 - 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Bidra, BDS, MS, University of Connecticut Health Center, 263 Farmington Avenue, L6078, Farmington, CT 06030, USA; email: avinashbidra@yahoo.com</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Patchanee</forename><surname>Rungruanganunt</surname><roleName type="degree">DDS, MSD</roleName></persName><affiliation><orgName>Department of Reconstructive Sciences</orgName><orgName>University of Connecticut Health Center</orgName><address><settlement type="city">Farmington</settlement><region>CT</region><country key="US">USA</country></address></affiliation></author><idno type="istex">5BC30026D15CB997933D0924FE562D0341035467</idno><idno type="ark">ark:/67375/WNG-CZJS9M1D-M</idno><idno type="DOI">10.1111/jerd.12031</idno><idno type="unit">JERD12031</idno><idno type="toTypesetVersion">file:JERD.JERD12031.pdf</idno></analytic><monogr><title level="j" type="main">Journal of Esthetic and Restorative Dentistry</title><title level="j" type="alt">JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY</title><idno type="pISSN">1496-4155</idno><idno type="eISSN">1708-8240</idno><idno type="book-DOI">10.1111/(ISSN)1708-8240</idno><idno type="book-part-DOI">10.1111/jerd.2013.25.issue-3</idno><idno type="product">JERD</idno><imprint><biblScope unit="vol">25</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="159">159</biblScope><biblScope unit="page" to="176">176</biblScope><biblScope unit="page-count">18</biblScope><date type="published" when="2013-06"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract style="main">
Abstract
<div xml:id="jerd12031-sec-0001" type="section"><head>Statement of Problem</head><p>The clinical outcomes of anterior implant abutments are not well reported.</p></div><div xml:id="jerd12031-sec-0002" type="section"><head>Purpose of the Study</head><p>To systematically review the existing literature to identify survival, mechanical, biological, and esthetic outcomes of anterior implant abutments.</p></div><div xml:id="jerd12031-sec-0003" type="section"><head>Material and Methods</head><p>An electronic search was performed using <hi rend="fc">PubMed</hi>/<hi rend="fc">MEDLINE</hi> with specific search terms and predetermined criteria. After application of inclusion and exclusion criteria, the final list of articles was reviewed in‐depth to meet the objectives of this review.</p></div><div xml:id="jerd12031-sec-0004" type="section"><head>Results</head><p>Systematic application of inclusion and exclusion criteria resulted in identification of 27 studies that described outcomes of anterior implant abutments. Because of substantial heterogeneity of data, true survival, or cumulative survival of abutments could not be calculated. However, the mean failure of abutments was 1.15%, attributable to fractures restricted to ceramic abutments. Mechanical complications included abutment screw loosening, primarily restricted to external hex implants. Biological complications included fistulas and mucosal recession. Esthetic outcomes showed lesser gingival discoloration for zirconia abutments compared with metal abutments.</p></div><div xml:id="jerd12031-sec-0005" type="section"><head>Conclusions</head><p>Minimal anterior abutment fractures have been reported and are restricted to ceramic abutments. Studies using spectrophotometry showed lesser gingival discoloration with zirconia abutments, but there is no evidence for difference in patient's esthetic satisfaction between ceramic and metal abutments.</p></div>
Clinical Significance
<p>For the anterior region, selection of an implant with internal connection and a customized metal abutment (titanium or cast metal) can have the least mechanical complications. Limited existing clinical data indicate reduced peri‐implant mucosal discoloration from zirconia abutments, which may be preferable over metal abutments, in patients with thinner mucosal tissues or patients with high or gummy smiles.</p></abstract><textClass><keywords rend="tocHeading1"><term>REVIEW ARTICLE</term></keywords><keywords rend="articleCategory"><term>REVIEW ARTICLE</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/5BC30026D15CB997933D0924FE562D0341035467/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body" wicri:toSee="Element #text"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component type="serialArticle" version="2.0" xml:id="jerd12031" xml:lang="en"><header><publicationMeta level="product"><doi origin="wiley">10.1111/(ISSN)1708-8240</doi><issn type="print">1496-4155</issn><issn type="electronic">1708-8240</issn><idGroup><id type="product" value="JERD"></id></idGroup><titleGroup><title sort="JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY" type="main">Journal of Esthetic and Restorative Dentistry</title><title type="short">J Esthet Restor Dent</title></titleGroup></publicationMeta><publicationMeta level="part" position="06103"><doi>10.1111/jerd.2013.25.issue-3</doi><copyright ownership="publisher">Journal compilation © 2013 Wiley Periodicals, Inc</copyright><numberingGroup><numbering number="25" type="journalVolume">25</numbering><numbering type="journalIssue">3</numbering></numberingGroup><coverDate startDate="2013-06">June 2013</coverDate></publicationMeta><publicationMeta level="unit" position="30" status="forIssue" type="reviewArticle"><doi>10.1111/jerd.12031</doi><idGroup><id type="unit" value="JERD12031"></id></idGroup><countGroup><count number="18" type="pageTotal"></count></countGroup><titleGroup><title type="tocHeading1">REVIEW ARTICLE</title><title type="articleCategory">REVIEW ARTICLE</title></titleGroup><copyright ownership="publisher">© 2013 Wiley Periodicals, Inc</copyright><eventGroup><event agent="bestset" date="2013-03-21" type="xmlCreated"></event><event type="publishedOnlineEarlyUnpaginated" date="2013-05-03"></event><event type="firstOnline" date="2013-05-03"></event><event type="publishedOnlineFinalForm" date="2013-06-17"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-30"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-02"></event></eventGroup><numberingGroup><numbering type="pageFirst">159</numbering><numbering type="pageLast">176</numbering></numberingGroup><correspondenceTo>Reprint requests: Avinash S. Bidra, BDS, MS, University of Connecticut Health Center, 263 Farmington Avenue, L6078, Farmington, CT 06030, USA; email: <email>avinashbidra@yahoo.com</email></correspondenceTo><selfCitationGroup><citation type="self" xml:id="jerd12031-cit-0074">(<journalTitle>J Esthet Restor Dent</journalTitle> <vol>25</vol>:<pageFirst>159</pageFirst>–<pageLast>176</pageLast>, <pubYear year="2013">2013</pubYear>)</citation></selfCitationGroup><linkGroup><link type="toTypesetVersion" href="file:JERD.JERD12031.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="short">Implant Abutments in the Anterior Region</title><title type="shortAuthors">Bidra and <fc>R</fc>ungruanganunt</title><title type="main">Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review</title></titleGroup><creators><creator affiliationRef="#jerd12031-aff-0001" corresponding="yes" creatorRole="author" xml:id="jerd12031-cr-0001"><personName><givenNames>Avinash S.</givenNames><familyName>Bidra</familyName><degrees>BDS, MS</degrees></personName><jobTitle>Assistant Professor and Assistant Program Director</jobTitle></creator><creator affiliationRef="#jerd12031-aff-0002" creatorRole="author" xml:id="jerd12031-cr-0002"><personName><givenNames>Patchanee</givenNames><familyName>Rungruanganunt</familyName><degrees>DDS, MSD</degrees></personName><jobTitle>Associate Professor</jobTitle></creator></creators><affiliationGroup><affiliation countryCode="US" xml:id="jerd12031-aff-0001"><orgDiv>Post‐Graduate Prosthodontics</orgDiv><orgDiv>Department of Reconstructive Sciences</orgDiv><orgName>University of Connecticut Health Center</orgName><address><city>Farmington</city> <countryPart>CT</countryPart><country>USA</country></address></affiliation><affiliation countryCode="US" xml:id="jerd12031-aff-0002"><orgDiv>Department of Reconstructive Sciences</orgDiv><orgName>University of Connecticut Health Center</orgName><address><city>Farmington</city> <countryPart>CT</countryPart><country>USA</country></address></affiliation></affiliationGroup><abstractGroup><abstract type="main"><section xml:id="jerd12031-sec-6001"><title type="main">Abstract</title><section xml:id="jerd12031-sec-0001"><title type="main">Statement of Problem</title><p>The clinical outcomes of anterior implant abutments are not well reported.</p></section><section xml:id="jerd12031-sec-0002"><title type="main">Purpose of the Study</title><p>To systematically review the existing literature to identify survival, mechanical, biological, and esthetic outcomes of anterior implant abutments.</p></section><section xml:id="jerd12031-sec-0003"><title type="main">Material and Methods</title><p>An electronic search was performed using <fc>PubMed</fc>/<fc>MEDLINE</fc> with specific search terms and predetermined criteria. After application of inclusion and exclusion criteria, the final list of articles was reviewed in‐depth to meet the objectives of this review.</p></section><section xml:id="jerd12031-sec-0004"><title type="main">Results</title><p>Systematic application of inclusion and exclusion criteria resulted in identification of 27 studies that described outcomes of anterior implant abutments. Because of substantial heterogeneity of data, true survival, or cumulative survival of abutments could not be calculated. However, the mean failure of abutments was 1.15%, attributable to fractures restricted to ceramic abutments. Mechanical complications included abutment screw loosening, primarily restricted to external hex implants. Biological complications included fistulas and mucosal recession. Esthetic outcomes showed lesser gingival discoloration for zirconia abutments compared with metal abutments.</p></section><section xml:id="jerd12031-sec-0005"><title type="main">Conclusions</title><p>Minimal anterior abutment fractures have been reported and are restricted to ceramic abutments. Studies using spectrophotometry showed lesser gingival discoloration with zirconia abutments, but there is no evidence for difference in patient's esthetic satisfaction between ceramic and metal abutments.</p></section></section><section xml:id="jerd12031-sec-1005"><title type="main">Clinical Significance</title><p>For the anterior region, selection of an implant with internal connection and a customized metal abutment (titanium or cast metal) can have the least mechanical complications. Limited existing clinical data indicate reduced peri‐implant mucosal discoloration from zirconia abutments, which may be preferable over metal abutments, in patients with thinner mucosal tissues or patients with high or gummy smiles.</p></section></abstract></abstractGroup></contentMeta></header> </component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Implant Abutments in the Anterior Region</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review</title></titleInfo><name type="personal"><namePart type="given">Avinash S.</namePart><namePart type="family">Bidra</namePart><namePart type="termsOfAddress">BDS, MS</namePart><affiliation>Post‐Graduate Prosthodontics, Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</affiliation><affiliation>E-mail: avinashbidra@yahoo.com</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Assistant Professor and Assistant Program Director</description></name><name type="personal"><namePart type="given">Patchanee</namePart><namePart type="family">Rungruanganunt</namePart><namePart type="termsOfAddress">DDS, MSD</namePart><affiliation>Department of Reconstructive Sciences, University of Connecticut Health Center, CT, Farmington, USA</affiliation><role><roleTerm type="text">author</roleTerm></role><description>Associate Professor</description></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-L5L7X3NF-P">review-article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2013-06</dateIssued><dateCreated encoding="w3cdtf">2013-03-21</dateCreated><edition>(J Esthet Restor Dent 25:159–176, 2013)</edition><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>Abstract Statement of Problem The clinical outcomes of anterior implant abutments are not well reported. Purpose of the Study To systematically review the existing literature to identify survival, mechanical, biological, and esthetic outcomes of anterior implant abutments. Material and Methods An electronic search was performed using PubMed/MEDLINE with specific search terms and predetermined criteria. After application of inclusion and exclusion criteria, the final list of articles was reviewed in‐depth to meet the objectives of this review. Results Systematic application of inclusion and exclusion criteria resulted in identification of 27 studies that described outcomes of anterior implant abutments. Because of substantial heterogeneity of data, true survival, or cumulative survival of abutments could not be calculated. However, the mean failure of abutments was 1.15%, attributable to fractures restricted to ceramic abutments. Mechanical complications included abutment screw loosening, primarily restricted to external hex implants. Biological complications included fistulas and mucosal recession. Esthetic outcomes showed lesser gingival discoloration for zirconia abutments compared with metal abutments. Conclusions Minimal anterior abutment fractures have been reported and are restricted to ceramic abutments. Studies using spectrophotometry showed lesser gingival discoloration with zirconia abutments, but there is no evidence for difference in patient's esthetic satisfaction between ceramic and metal abutments.</abstract><abstract>For the anterior region, selection of an implant with internal connection and a customized metal abutment (titanium or cast metal) can have the least mechanical complications. 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