Abutment Choices for Implant-Supported Zirconia Crowns and Bridges: Discussion Topic

In general, zirconia abutments with metal-free crowns or bridges serve best in the esthetic zone. Titanium abutments are sometimes mandatory due to implant angulations in all areas, but you can achieve excellent esthetics using any combination of abutment and crown mterials. I prefer screw-retained prosthetics whenever possible for reversiblity advantages. There are situations I planned to use zirconia abutments but had to switch to titanium after the implants were placed because the thin walls of zirconia abutment or screw locations would induce a strength compromise. Of course, surrounding tissue biotype is an important factor in material selection. Thinking long-term always helps.

You can do that, but may as well do a PFM crown over the titanium because you will have to block out the gray show through of the titanium. It is easier to handle shade and probably strength is more easily mangage regarding materials with a perc. fused to metal approach.

I am a dental technician, and have produced thousands of zirconia crowns. The available translucency adds value to the aesthetics of a combination of zirconia on zirconia. If you are worried by the use of zirconia implant abutments, then try the well proven "link abutment". This is a combination of a titanium screw link into the titanium fixture with a zirconia abutment cemented over. produce a zirconia crown or bridge, and cement over the zirconia abutment. This system is very well indicated when a single central incisor crown is prescribed for one central, and an implant is determined for the other central. I suggested this treatment for my sister in law; always a danger, but a complete success! You can make this screw retained, if you fuse the porcelain directly to the zirconia abutment!

If you are placing zirconium crowns your abutments can be of Titanium, zirconium or castable. Zirconium is opaque. So there will be no difference. If you want to place porcelain free metal crowns as empress or Emax, then you would obtain better results with Zirconium abutments

As David mentioned the "link abutment" is what we call a "titanium base" in the USA. It gives you the ability to have a titanium base for strength and zirconia abutment for aesthetics. You can make a cementable abutment or screw retained. We offer something unique- a two piece stock abutment that comes apart so the lab can fire porcelain onto it and it becomes screw retained and then the two pieces are cemented onto one another.

When there are insufficiency keratinized gingiva in estectic zone select abutment and crown of zicornia is the best choice to cover the gray translucency of the implants .

The question is directed to David in ref.to "link abutment" ,how do you cement the zirconium abutment on the implant?

I am in agreement with Omar - zirconia is opaque. I have done 100's of zirconia(BruxZr) over a custom Ti abutments. This is my "standard" restoration. From the cuspid back it's hard to beat this combination.

I have used titanium abutments with zirconia "Bruxzir " crowns for a couple years now and have not experienced any problems as of yet. My understanding is that some labs are beginning to work with a more translucent version of zirconia which might be problematic in respect to gray shine through. I have not seen it with the older zirconia product.

use titanuim abutment and save your money...zirconia is very opaque... i suggest using custable abtument and Emax crown screw retained...you will have superior esth. and retrivablity. E max has a abutment solution...check it on ivoclar site.