Soft tissue biological response to zirconia and metal implant abutments compared with natural tooth: microcirculation monitoring as a novel bioindicator.

INTRODUCTION: Zirconia is often used for implant abutments for esthetics. The aim of this clinical study was to compare the effects of zirconia and metal abutments on periimplant soft tissue. MATERIALS AND METHODS: Ten maxillary anterior implant patients, 5 with metal abutments and 5 with zirconia abutments, were enrolled in this trial. The soft tissue around the implant abutments was evaluated by 2-dimensional laser speckle imaging and thermography. The blood flow in soft tissue around natural teeth was also measured to correct for differences among the subjects. RESULTS: Significantly greater blood flow was detected in the zirconia abutment group (95.64 ± 5.17%) relative to the metal abutment group (82.25 ± 8.92%) in free gingiva (P = 0.0317). Reduced blood flow (by almost 18%) was detected in the tissue surrounding metal abutments compared with the tissue surrounding natural teeth. The surface temperature showed no significant difference for all measurements. CONCLUSIONS: These results suggest that blood flow in tissue surrounding zirconia abutments is similar to that in soft tissue around natural teeth. Moreover, zirconia abutments could be advantageous for the maintenance of immune function by improving blood circulation.

Comparison of plaque accumulation and soft-tissue blood flow with the use of full-arch implant-supported fixed prostheses with mucosal surfaces of different materials: a randomized clinical study.

OBJECTIVE: The aims of this clinical study were to determine differences in plaque accumulation and to compare the effects of reinforced composite resin and titanium on peri-implant soft-tissue and residual-ridge inflammation. MATERIAL AND METHODS: A total of 19 subjects were enrolled in this clinical trial; 10 jaws had implant-supported fixed prostheses with composite resin mucosal surfaces, 11 jaws had titanium prostheses fabricated by computer-aided design/computer-aided manufacture (CAD/CAM), and 6 jaws had acrylic resin prostheses. Plaque area indexes (PAIs) were calculated on the mucosal surfaces of prostheses, and blood flow in the mucosa was captured with two-dimensional laser speckle imaging to evaluate residual-ridge inflammation. Subjects were educated about oral hygiene and reevaluated after 3 months. RESULTS: The PAI was significantly lower on titanium mucosal surfaces than on reinforced composite resin surfaces at the initial and second measurements (initial, P = 0.0052; second, P = 0.0044). Self-curing acrylic resin surfaces did not show any significant difference when compared with reinforced resin or titanium. Blood flow was significantly lower in mucosa contacting titanium surfaces than in mucosa contacting reinforced composite resin surfaces at the initial measurement (P = 0.0330). Although subjects were instructed about plaque control after the initial measurement, PAIs indicated that the difference between the two materials could not be overcome. CONCLUSION: In terms of oral hygiene and mucosal inflammation, titanium was superior to reinforced composite resin in implant-supported fixed prostheses for edentulous subjects, and the short-term use of acrylic resin was superior to the use of reinforced composite resin.

Two-dimensional real-time blood flow and temperature of soft tissue around maxillary anterior implants.

PURPOSE: The aims of this study were to (1) evaluate the basic nature of soft tissue surrounding maxillary anterior implants by simultaneous measurements of blood flow and surface temperature and (2) analyze differences with and without bone grafting associated with implant placement to try to detect the signs of surface morphology change. MATERIALS AND METHODS: Twenty maxillary anterior implant patients, 10 bone grafting and 10 graftless, were involved in this clinical trial. Soft tissue around the implant was evaluated with 2-dimensional laser speckle imaging and a thermograph. RESULTS: Blood flow was significantly lower in attached gingiva surrounding implants in graftless patients (P = 0.0468). On the other hand, it was significantly lower in dental papillae (P = 0.0254), free gingiva (P = 0.0198), and attached gingiva (P = 0.00805) in bone graft patients. Temperature was significantly higher in free gingiva (P = 0.00819) and attached gingiva (P = 0.00593) in graftless patients, whereas it was significantly higher in dental papilla and free gingiva in implants with bone grafting. CONCLUSION: The results suggest that simultaneous measurements of soft-tissue blood flow and temperature is a useful technique to evaluate the microcirculation of soft tissue surrounding implants.