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Biomed J. 2019 Oct;42(5):358-364. doi: 10.1016/ Epub 2019 Nov 1.

Zirconia implant abutments supporting single all-ceramic crowns in anterior and premolar regions: A six-year retrospective study.

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Department of General Dentistry, ChangGung Memorial Hospital at Taipei, Taipei, Taiwan.
Department of General Dentistry, ChangGung Memorial Hospital at Taipei, Taipei, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Dentistry, College of Medicine, China Medical University, Taichung, Taiwan. Electronic address:



Clinical studies regarding zirconia implant abutments reported good survival rates in the short-term observation period. The purpose of this study was to assess the six-year clinical performance of zirconia abutments supporting all-ceramic crowns in anterior and premolar regions.


The patients received zirconia implant abutments to support all-ceramic crowns in Chang-Gung Medical Center during the period August 2010 to August 2011 were enrolled. In the following six years of observation period after the implant-crown had finished, the clinical parameters of all of the included patients were registered on a special form. The records regarding the following variables: age, gender, implant location, the condition of edentulous site before implant placement, esthetic performance at baseline, presence or absence of technical complications, and biological outcomes were registered and scrutinized for evaluation.


Out of the 32 zirconia implant abutments and 32 all-ceramic crowns that were followed for six years. Neither abutments nor crowns were lost, yielding 100% survival rates for both zirconia abutments and crowns. The esthetic outcomes were excellent except that a score of 2 was given to two restorations. With regard to technical complications, there was one instance of abutment screw loosening, two cases of veneering ceramic chipping, one restoration with occlusal roughness, and three instances of crowns loosening. Overall, the success rates were 96.8% and 81.2% for abutments and crowns respectively. In biological performance, only 1 implant was classified in group II (satisfactory survival) in the Misch classification, while all the others were classified in group I (excellent).


Zirconia abutments supporting all-ceramic crowns demonstrated high survival rate, good biological and esthetic results. While some technical complications were frequently observed, the complication-free rates were 96.8% for abutments and 81.2% for crowns in the medium-term observation period.


All-ceramic crown; Biological complication; Esthetic performance; Technical complication; Zirconia implant abutment

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