Main Article Content

Abstract

Background: Recent advancements in dental implant materials have highlighted zirconia as a promising alternative to traditional titanium implants. The soft tissue response is crucial for the long-term success and esthetics of dental implants. Therefore, this study aims to compare soft tissue thickness, pocket depth, bleeding on probing, and gingival color around zirconia and titanium implants. Methods: This retrospective cohort study enrolled 60 patients one year post-implant placement, conducted at King Abdulaziz University Faculty of Dentistry (KAU-FD) in Jeddah, Saudi Arabia, from April to October 2024. Soft tissue parameters (thickness, pocket depth, bleeding on probing) around zirconia and titanium implants were measured using a UNC-15 periodontal probe. Data were analyzed using IBM SPSS version 27. Results: Significant differences were found between zirconia and titanium implants in terms of soft tissue thickness (p=0.031), color (p<0.001), and bleeding on probing (p=0.004). Zirconia implants were associated with thinner soft tissue (53.8%) compared to titanium implants (73.5% thick tissue). All patients with titanium implants experienced color changes, while 82.1% of zirconia patients reported no change. Additionally, all titanium implant patients had bleeding on probing, whereas none of the zirconia implant patients did. Conclusions: Zirconia implants appear to be reliable replacements for situations wherein titanium is not a feasible choice or where aesthetics are a priority. Further research is recommended to continue exploring the long-term outcomes and potential advantages of zirconia implants in diverse patient populations.

Keywords

zirconia implant; titanium implant; peri-implant soft tissue, clinical practice, follow-up

Article Details

How to Cite
Almarghlani, A., Baamer, D., Indijani, R., Baabdullah, F., Abed, H., & Sharka, R. (2025). Evaluation of Soft Tissue Parameters around Titanium and Zirconia Implants in the Anterior Region: A retrospective Study. Journal of Contemporary Dental Sciences, 2(1), 21–26. Retrieved from https://jcds.qu.edu.sa/index.php/JCDS/article/view/2369

References

  1. Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res. 2012, 23,22–38.
  2. Sharka R, Abed H, Hector M. Oral health-related quality of life and satisfaction of edentulous patients using conventional complete dentures and implant-retained overdentures: An umbrella systematic review. Gerodontology. 2019, 36, 195–204.
  3. Bormann KH, Gellrich NC, Kniha H, Schild S, Weingart D, Gahlert M. A prospective clinical study to evaluate the performance of zir-conium dioxide dental implants in single-tooth edentulous area: 3-year follow-up. BMC Oral Health. 2018, 18, 181.
  4. Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CHF, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res. 2009, 20, 4–31.
  5. Almarghlani A, Alshali S. Survival and Fracture rates of One-Piece Zirconia Implants: A Systematic review. Cardiometry, 2022, 24, 175–81.
  6. Koller M, Steyer E, Theisen K, Stagnell S, Jakse N, Payer M. Two-piece zirconia versus titanium implants after 80 months: Clinical out-comes from a prospective randomized pilot trial. Clin Oral Implants Res. 2020, 31, 388–96.
  7. Meijer HJA, Stellingsma K, Meijndert L, Raghoebar GM. A new index for rating aesthetics of implant-supported single crowns and ad-jacent soft tissues – the Implant Crown Aesthetic Index. Clin Oral Implants Res. 2005, 16, 645–9.
  8. Sanz M, Klinge B, Alcoforado G, Bienz SP, Cosyn J, De Bruyn H, et al. Biological aspects: Summary and consensus statements of group 2. The 5th EAO Consensus Conference 2018. Clin Oral Implants Res. 2018, 18, 152–6.
  9. Sanz-Martín I, Sanz-Sánchez I, Carrillo de Albornoz A, Figuero E, Sanz M. Effects of modified abutment characteristics on peri-implant soft tissue health: A systematic review and meta-analysis. Clin Oral Implants Res. 2018, 29, 118–29.
  10. Sanon C, Chevalier J, Douillard T, Cattani-Lorente M, Scherrer SS, Gremillard L. A new testing protocol for zirconia dental implants. Dent Mater. 2015, 31, 15–25.
  11. Hashim D, Cionca N, Courvoisier DS, Mombelli A. A systematic review of the clinical survival of zirconia implants. Clin Oral Investig. 2016, 20, 1403–17.
  12. Holländer J, Lorenz J, Stübinger S, Hölscher W, Heidemann D, Ghanaati S, et al. Zirconia Dental Implants: Investigation of Clinical Parameters, Patient Satisfaction, and Microbial Contamination. Int J Oral Maxillofac Implants. 2016, 31, 855–64.
  13. Apratim A, Eachempati P, Krishnappa Salian KK, Singh V, Chhabra S, Shah S. Zirconia in dental implantology: A review. J Int Soc Prev Community Dent. 2015, 5, 147.
  14. Comisso I, Arias-Herrera S, Gupta S. Zirconium dioxide implants as an alternative to titanium: A systematic review. J Clin Exp Dent. 2021,13, e511.
  15. Schropp L, Isidor F. Papilla dimension and soft tissue level after early vs. delayed placement of single-tooth implants: 10-year results from a randomized controlled clinical trial. Clin Oral Implants Res. 2015, 26, 278–86.
  16. van Brakel R, Meijer GJ, Verhoeven JW, Jansen J, de Putter C, Cune MS. Soft tissue response to zirconia and titanium implant abutments: an in vivo within-subject comparison. J Clin Periodontol. 2012, 39, 995–1001.
  17. Thoma DS, Ioannidis A, Cathomen E, Hämmerle CHF, Hüsler J, Jung RE. Discoloration of the Peri-implant Mucosa Caused by Zirconia and Titanium Implants. Int J Periodontics Restorative Dent. 2016, 36, 39–45.
  18. Padhye NM, Calciolari E, Zuercher AN, Tagliaferri S, Donos N. Survival and success of zirconia compared with titanium implants: a systematic review and meta-analysis. Clin Oral Investig. 2023, 27, 6279–90.
  19. Wu H, Chen X, Kong L, Liu P. Mechanical and Biological Properties of Titanium and Its Alloys for Oral Implant with Preparation Tech-niques: A Review. Materials. 2023, 16, 6860.
  20. Duan C, Ye L, Zhang M, Yang L, Li C, Pan J, et al. Clinical performance of zirconium implants compared to titanium implants: a systematic review and meta-analysis of randomized controlled trials. PeerJ. 2023, 11, e15010.
  21. Halim FC, Pesce P, De Angelis N, Benedicenti S, Menini M. Comparison of the Clinical Outcomes of Titanium and Zirconia Implant Abutments: A Systematic Review of Systematic Reviews. J Clin Med. 2022, 11, 5052.
  22. de Moura Costa PV, Ferreira MS, Veríssimo C, de Torres ÉM, Valladares-Neto J, Garcia Silva MA. Is Zirconia Better Than Titanium Abutments for Soft Tissue Color? A Systematic Review and Meta-analysis of Spectrophotometric Evaluation. Int J Oral Maxillofac Implants. 2021, 36, 875–84.
  23. Ferrari M, Carrabba M, Vichi A, Goracci C, Cagidiaco M. Influence of Abutment Color and Mucosal Thickness on Soft Tissue Color. Int J Oral Maxillofac Implants. 2017, 32, 393–9.
  24. Bienz SP, Hilbe M, Hüsler J, Thoma DS, Hämmerle CHF, Jung RE. Clinical and histological comparison of the soft tissue morphology between zirconia and titanium dental implants under healthy and experimental mucositis conditions—A randomized controlled clinical trial. J Clin Periodontol. 2021, 5, 721–33.
  25. de Beus JHW, Cune MS, Slot JWA, Jensen-Louwerse C, la Bastide-van Gemert S, Meijer HJA, et al. A randomized clinical trial on zirconia versus titanium implants in maxillary single tooth replacement. Clin Oral Implants Res. 2024, 35, 630–40.
  26. Ferrantino L, Carrillo De Albornoz A, Sanz M. Five‐year outcomes of a randomized controlled clinical trial comparing single‐tooth im-plant‐supported restoration with either zirconia or titanium abutments. J Clin Periodontol. 2023, 50, 744–54.
  27. Lorenz J, Giulini N, Hölscher W, Schwiertz A, Schwarz F, Sader R. Prospective controlled clinical study investigating long‐term clinical parameters, patient satisfaction, and microbial contamination of zirconia implants. Clin Implant Dent Relat Res. 2019, 21, 263–71.
  28. Duncan WJ, Ma S, Siddiqi A, Osman RB. Zirconia versus Titanium Implants: 8-Year Follow-Up in a Patient Cohort Contrasted with Histological Evidence from a Preclinical Animal Model. Materials. 2022, 15, 5322.