Zirconia, titanium, and polyetheretherketone implant abutments show equal long‐term clinical success—A systematic review and network meta‐analysis

IF 17.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Periodontology 2000 Pub Date : 2025-12-02 DOI:10.1111/prd.70018

Yasir Nabeel Al‐Mohammad, Caroline Kelly, Petrana Martinekova, Alexander Schulze Wenning, Szilvia Kiss‐Dala, Noémi Gede, Beáta Kerémi, Zsolt Németh, Péter Hermann, László Márk Czumbel, Krisztina Mikulás, Péter Hegyi, Anton Sculean, Gábor Varga

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引用次数: 0

Abstract

Hundreds of millions of people have one or more missing teeth. Consequently, a substantial number of patients undergo implant therapy each year. However, technical complications and soft tissue inflammation associated with the implant abutment or the type of restoration can lead to bone loss and, ultimately, implant failure. Using the methodology of network meta‐analysis to rigorously compare and contrast the clinical performance of the three commonly used abutment materials: titanium (Ti), zirconium (Zr), and polyetheretherketone (PEEK) polymer. Until May 2025, a systematic search was performed in MEDLINE (PubMed), EMBASE, Scopus, and CENTRAL to find clinical studies comparing Ti, Zr, and PEEK implant abutments. Case reports, case series, in vitro, and in vivo studies were excluded. The Risk of Bias Tool 2, ROBINS‐I, and GRADE approaches were used for quality and certainty assessment. Thirty‐four articles (950 patients) were included, with various follow‐ups. All abutments had high survival rates and no significant differences in marginal bone loss (BL), probing depth (PD), bleeding on probing (BOP), and plaque index (PI). There was no significant difference between Zr and Ti for papillary index (PAP), with a general trend toward better results in Zr, which may be of clinical significance. There was a statistically significant difference in soft tissue discoloration (ΔE) values and technical complications of Zr versus Ti [MD: −2.03, CI: −3.89 to −0.18] and [OR: 0.26, CI: 0.09 to 0.72], respectively, indicating better esthetics and fewer technical complications in Zr. Both Ti and Zr are clinically successful and biologically acceptable. PEEK abutments demonstrated comparable characteristics with both Ti and Zr. However, more studies about PEEK and cost‐effectiveness analyses should also be performed to find the best options for clinical applications. PEEK can be a good alternative to Ti and Zr abutments for single‐tooth replacement in the anterior and premolar regions.

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氧化锆，钛和聚醚醚酮种植基台显示出相同的长期临床成功-系统回顾和网络荟萃分析

数亿人有一颗或多颗牙齿缺失。因此，每年有相当数量的患者接受植入治疗。然而，与种植体基台或修复类型相关的技术并发症和软组织炎症可导致骨质流失，最终导致种植体失败。采用网络元分析的方法，严格比较和对比三种常用基台材料：钛（Ti）、锆（Zr）和聚醚醚酮（PEEK）聚合物的临床性能。直到2025年5月，在MEDLINE （PubMed）、EMBASE、Scopus和CENTRAL中进行了系统检索，以查找比较Ti、Zr和PEEK种植体基台的临床研究。排除病例报告、病例系列、体外和体内研究。使用风险偏倚工具2、ROBINS‐I和GRADE方法进行质量和确定性评估。纳入34篇文章（950例患者），并进行了各种随访。所有基牙的存活率都很高，在边缘骨丢失（BL）、探探深度（PD）、探探出血（BOP）和斑块指数（PI）方面无显著差异。Zr与Ti对乳头状指数（PAP）的测定无显著性差异，Zr总体上有较好的趋势，可能具有临床意义。Zr与Ti的软组织变色值（ΔE）和技术并发症分别有统计学差异[MD:−2.03,CI:−3.89 ~−0.18]和[OR: 0.26, CI: 0.09 ~ 0.72]，表明Zr的美观性更好，技术并发症更少。Ti和Zr在临床上是成功的，在生物学上是可接受的。PEEK基台与Ti和Zr具有可比性。然而，更多关于PEEK的研究和成本效益分析也应该进行，以找到临床应用的最佳选择。PEEK可以作为钛基牙和锆基牙的良好替代品，用于前磨牙和前磨牙区域的单牙替代。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Periodontology 2000 医学-牙科与口腔外科

CiteScore

34.10

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Periodontology 2000 is a series of monographs designed for periodontists and general practitioners interested in periodontics. The editorial board selects significant topics and distinguished scientists and clinicians for each monograph. Serving as a valuable supplement to existing periodontal journals, three monographs are published annually, contributing specialized insights to the field.