Eleven-Year Follow-Up of a Prospective Study of Zirconia Implant Abutments Supporting Single All-Ceramic Crowns in Anterior and Premolar Regions.

BACKGROUND Clinical studies on zirconia abutments report very good survival rates and biological and technical results, but few have an observation period of more than 5 years. PURPOSE The aim of this study was to assess the long-term performance of customized zirconia implant abutments supporting all-ceramic crowns. MATERIALS AND METHODS Twenty-seven patients receiving 54 single implants were included (25 incisors, 14 canines, 15 premolars in both jaws). Yttria-stabilized zirconia abutments were screwed to the implants with a defined torque. All-ceramic crowns were adhesively cemented onto the abutments. The implants, abutments, and crowns were clinically and radiographically examined after 11 years of use. Modified United States Public Health Service (USPHS) criteria were used to assess technical outcomes: fracture of abutment/crown framework/veneering ceramic, loosening of abutment screw/crown, marginal adaptation, anatomical form, occlusal wear, and abutment fit. The biological parameters were pocket probing depth, plaque control record, bleeding on probing, papilla index, and gingival/mucosal recession at implants and neighboring natural teeth. The cumulative success rate of abutments and crowns was calculated by the Kaplan-Meier method. The results of the USPHS criteria were analyzed descriptively. RESULTS Sixteen patients with 31 zirconia abutments were examined at 11.3 (±0.9) years after implantation. No abutment or crown was lost. The cumulative success rate was 96.3% for abutments and 90.7% for crowns. Two abutment screws loosened, and three crowns exhibited minor chipping. There were no biological complications. CONCLUSIONS Customized zirconia single implant abutments exhibited excellent long-term outcomes in anterior and premolar regions.