Is Zirconia Better Than Titanium Abutments for Soft Tissue Color? A Systematic Review and Meta-analysis of Spectrophotometric Evaluation.

ABSTRACT

PURPOSE: The aim of this systematic review was to evaluate the influence of zirconia and titanium as abutment materials on peri-implant soft tissue color. MATERIALS AND METHODS: The searched electronic databases included MEDLINE/PubMed, LILACS, Web of Science, Scopus, and LIVIVO. Two types of studies were included randomized clinical trials (RCTs) and controlled clinical trials (CCTs) that compared zirconia (Zr) and titanium (Ti) abutments. The outcomes measured were as follows implant crown esthetic index, visual analog scale, esthetic index, gingiva discoloration index-spectrophotometry, papilla index, recession index, and pink esthetic score. Two reviewers selected the records, assessed quality, and extracted data of included studies independently. RESULTS: A total of 323 patients enrolled in 13 studies were included in this analysis with 11 RCTs and 2 CCTs. Due to the wide variety of methodologies used, meta-analysis was only possible for RCTs that performed spectrophotometric analysis. The use of zirconia or titanium for implant abutments does not seem to be the principal factor for influencing peri-implant soft tissue color. The meta-analysis showed no difference between zirconia and titanium abutments. CONCLUSION: This study does not support any better advantage of the use of zirconia in comparison to the use of titanium related to peri-implant tissue color.