Uso de pilares estéticos para coroas unitárias implantossuportadas em região anterior

Estudo identifica e discute os resultados do uso de materiais cerâmicos como pilares de restaurações unitárias implantossuportadas na região anterior.

AUTORES

Pablo Soares Machado
Mestre em Ciências Odontológicas, com ênfase em Prótese Dentária – UFSM; Especialista em Prótese Dentária – Hodos RS.
Orcid: 0000-0002-7702-0013.

Fernanda Dalla Nora
Mestra em Ciências Odontológicas, com ênfase em Prótese Dentária – UFSM; Especialista em Prótese Dentária – Hodos RS.
Orcid: 0000-0002-0885-7805.

Catina Prochnow
Doutora em Ciências Odontológicas com ênfase em Prótese Dentária – UFSM; Especialista em Prótese Dentária – Hodos RS.
Orcid: 0000-0003-3649-8296.

RESUMO

Objetivo: o objetivo do presente estudo foi, através de uma revisão da literatura, identificar e discutir os resultados mecânicos, biológicos e estéticos do uso de materiais cerâmicos como pilares de restaurações unitárias implantossuportadas na região anterior. Material e métodos: a estratégia de busca constituiu-se na procura de estudos in vitro, in vivo e ensaios clínicos na base de dados PubMed, redigidos na língua inglesa, publicados nos últimos cinco anos e que avaliaram o uso de pilares cerâmicos. Os dados coletados (objetivo, material cerâmico avaliado, grupos de comparação, tipo de desfecho e achados principais) foram organizados na forma de tabela, e uma análise descritiva foi realizada. Resultados: a busca identificou 26 artigos, dos quais 17 foram incluídos na análise descritiva. Conclusão: a partir da análise descritiva dos dados obtidos, pôde-se concluir que o uso de materiais cerâmicos na confecção de pilares protéticos se mostra bastante promissor, visto que restaurações preparadas sobre estes pilares apresentaram resultados mecânicos satisfatórios e altas taxas de sucesso durante o acompanhamento clínico, além de possibilitarem um elevado grau de satisfação estética, o que é particularmente importante na região anterior.

Palavras-chave – Dentes anteriores; Pilares cerâmicos; Prótese
fixa implantossuportada; Restaurações unitárias.

ABSTRACT

Objective: the aim of the present study was, through a literature review, to identify and discuss the mechanical, biological and aesthetical results of using ceramic materials as abutments of implant-supported single crowns in the anterior region. Material and methods: the search strategy consisted of looking for in vitro, in vivo and clinical trials studies in the PubMed database, written in English, published in the last 5 years and that evaluated the use of ceramic abutments. The collected data (objectives, evaluated ceramic material, comparison groups, type of outcome and main findings were organized in a table and a descriptive analysis was performed. Results: the search identified 26 articles, of which 17 were included in the descriptive analysis. Conclusion: from the descriptive analysis of the collected data, it can be concluded that the use of ceramic materials in the fabrication of prosthetic abutments is very promising, since restorations prepared over these abutments presented satisfactory mechanical results and high success rates during clinical follow-up, and also generating a high degree of aesthetic satisfaction, which is particularly important in the anterior region.

Key words – Anterior teeth; Ceramic abutments; Fixed implantsupported prosthesis; Single restorations.

Referências

Koller M, Steyer E, Theisen K, Stagnell S, Jakse N, Payer M. Two-piece zirconia versus titanium implants after 80 months: clinical outcomes from a prospective randomized pilot trial. Clin Oral Implants Res 2020;31(4):388-96.

Bacchi A, Boccardi S, Alessandretti R, Pereira GKR. Substrate masking ability of bilayer and monolithic ceramics used for complete crowns and the effect of association with an opaque resin-based luting agent. J Prosthodont Res 2019;63(3):321-6.

Linkevicius T, Vaitelis J. The effect of zirconia or titanium as abutment material on soft peri-implant tissues: a systematic review and meta-analysis. Clin Oral Implants Res 2015;26(suppl.11):139-47.

Fretwurst T, Nelson K, Tarnow DP, Wang H-L, Giannobile WV. Is metal particle release associated with peri-implant bone destruction? An emerging concept. J Dent Res 2018;97(3):259-65.

Güler U, Budak Y, Queiroz JRC, Özcan M. Dislodgement resistance of zirconia copings cemented onto zirconia and titanium abutments. Implant Dent 2017;26(4):510-5.

Elsayed A, Wille S, Al-Akhali M, Kern M. Comparison of fracture strength and failure mode of different ceramic implant abutments. J Prosthet Dent 2017;117(4):499-506.

Naveau A, Rignon-Bret C, Wulfman C. Zirconia abutments in the anterior region: a systematic review of mechanical and esthetic outcomes. J Prosthet Dent 2019;121(5):775-81.

Kelly JR. Dental ceramics: what is this stuff anyway? J Am Dent Assoc 2008;139(suppl.:4S-7S).

Stawarczyk B, Keul C, Eichberger M, Figge D, Edelhoff D, Lümkemann N. Three generations of zirconia: from veneered to monolithic. Part I. Quintessence Int 2017;48(5):369-80.

Marchionatti AME, Aurélio IL, May LG. Does veneering technique affect the flexural strength or load-to-failure of bilayer Y-TZP? A systematic review and meta-analysis. J Prosthet Dent 2018;119(6):916-24.

Hanawa T. Zirconia versus titanium in dentistry: a review. Dent Mater J 2020;39(1):24-36.

Valenti M, Valenti A. Retrospective survival analysis of 261 lithium disilicate crowns in a private general practice. Quintessence Int 2009;40(7):573-9.

Nishioka G, Prochnow C, Firmino A, Amaral M, Bottino MA, Valandro LF et al. Fatigue strength of several dental ceramics indicated for CADCAM monolithic restorations. Braz Oral Res 2018;32:e53.

Wilson Jr. TG. The positive relationship between excess cement and peri-implant disease: a prospective clinical endoscopic study. J Periodontol 2009;80(9):1388-92.

Cárdenas R, Sánchez D, Euán R, Flores AM. Effect of fatigue loading and failure mode of different ceramic implant abutments. J Prosthet Dent 2022;127(6):875-81.

Pereira GKR, Guilardi LF, Dapieve KS, Kleverlaan CJ, Rippe MP, Valandro LF. Mechanical reliability, fatigue strength and survival analysis of new polycrystalline translucent zirconia ceramics for monolithic restorations. J Mech Behav Biomed Mater 2018;85:57-65.

Cooper LF, Stanford C, Feine J, Mcguire M. Prospective assessment of CAD/CAM zirconia abutment and lithium disilicate crown restorations: 2.4 year results. J Prosthet Dent 2016;116(1):33-9.

Chen J-Y, Pan Y-H. Zirconia implant abutments supporting single all-ceramic crowns in anterior and premolar regions: a six-year retrospective study. Biomed J 2019;42(5):358-64.

Fabbri G, Fradeani M, Dellificorelli G, De Lorenzi M, Zarone F, Sorrentino R. Clinical evaluation of the influence of connection type and restoration height on the reliability of zirconia abutments: a retrospective study on 965 abutments with a mean 6-year follow-up. Int J Periodontics Restorative Dent 2017;37(1):19-31.

Ma S, Tawse-Smith A, Brown SDK, Duncan W. Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 5-year results from a prospective single-arm clinical trial. Clin Implant Dent Relat Res 2019;21(2):344-51.

Agustín-Panadero R, Serra-Pastor B, Roig-Vanaclocha A, Fons-Font A, Solá-Ruiz MF. Fracture resistance and the mode of failure produced in metal-free crowns cemented onto zirconia abutments in dental implants. PLoS One 2019;14(8):e0220551.

Atsü SS, Aksan ME, Bulut AC. Fracture resistance of titanium, zirconia, and ceramic-reinforced polyetheretherketone implant abutments supporting CAD/CAM monolithic lithium disilicate ceramic crowns after aging. Int J Oral Maxillofac Implants 2019;34(3):622-30.

Wittneben JG, Gavric J, Belser UC, Bornstein MM, Joda T, Chappuis V et al. Esthetic and clinical performance of implant-supported all-ceramic crowns made with prefabricated or CAD/CAM zirconia abutments: a randomized, multicenter clinical trial. J Dent Res 2017;96(2):163-70.

Wittneben JG, Gavric J, Sailer I, Buser D, Wismeijer D. Clinical and esthetic outcomes of two different prosthetic workflows for implant-supported all-ceramic single crowns-3 year results of a randomized multicenter clinical trial. Clin Oral Implants Res 2020;31(5):495-505.

Belli R, Wendler M, de Ligny D, Cicconi MR, Petschelt A, Peterlik H et al. Chairside CAD/CAM materials. Part 1: measurement of elastic constants and microstructural characterization. Dent Mater 2017;33(1):84-98.

Guilardi LF, Soares P, Werner A, de Jager N, Pereira GKR, Kleverlaan CJ et al. Fatigue performance of distinct CAD/CAM dental ceramics. J Mech Behav Biomed Mater 2020;103:103540.

Laass A, Sailer I, Hüsler J, Hämmerle CHF, Thoma DS. Randomized controlled clinical trial of all-ceramic single-tooth implant reconstructions using modified zirconia abutments: results at 5 years after loading. Int J Periodontics Restorative Dent 2019;39(1):17-27.

Passos SP, Linke B, Larjava H, French D. Performance of zirconia abutments for implant-supported single-tooth crowns in esthetic areas: a retrospective study up to 12-year follow-up. Clin Oral Implants Res 2016;27(1):47-54.

Thoma DS, Sailer I, Mühlemann S, Gil A, Jung RE, Hämmerle CHF. Randomized controlled clinical study of veneered zirconia abutments for single implant crowns: clinical, histological, and microbiological outcomes. Clin Implant Dent Relat Res 2018;20(6):988-96.

Mesquita AMM, Kojima AN, Giovani EM, Saraceni CHC, Rodrigues FP. Zirconia rehabilitation focused on the emergence profile: a case report. Eur J Prosthodont Restor Dent 2016;24(2):78-85.

Barwacz CA, Stanford CM, Diehl UA, Cooper LF, Feine J, Mcguire M et al. Pink esthetic score outcomes around three implant-abutment configurations: 3-year results. Int J Oral Maxillofac Implants 2018;33(5):1126-35.

Lops D, Stellini E, Sbricoli L, Cea N, Romeo E, Bressan E. Influence of abutment material on peri-implant soft tissues in anterior areas with thin gingival biotype: a multicentric prospective study. Clin Oral Implants Res 2017;28(10):1263-8.

Peng M, Zhao W-J, Hosseini M, Zhou W-J, Xiao T, Chuan J-L. Influence of restorative materials on color of implant-supported single crowns in esthetic zone: a spectrophotometric evaluation. Biomed Res Int 2017;2017:5034358.

Vichi A, Louca C, Corciolani G, Ferrari M. Color related to ceramic and zirconia restorations: a review. Dent Mater 2011;27(1):97-108.

Crispin BJ, Okamoto SK, Globe H. Effect of porcelain crown substructures on visually perceivable Value. J Prosthet Dent 1991;66(2):209-1.