Peri-Implant Soft Tissue Response to Monolithic Zirconia Versus Porcelain-Fused-to-Metal Implant Crowns: Histological and Clinical Outcomes of an RCT

IF 8.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2026-08-16 Epub Date: 2026-07-15 DOI:10.1111/jcpe.70169

Yifan Zhang, Sven Mühlemann, Aspasia Pachiou, Stephanie Astrid Stalder, Ronald E. Jung, Ye Lin, Daniel S. Thoma

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引用次数: 0

Abstract

Objective

To assess the peri-implant soft-tissue and hard-tissue response to monolithic zirconia (ZrO₂) compared to porcelain-fused-to-metal implant crowns (PFMs).

Methods

This report constitutes a pre-specified secondary analysis of this RCT. Eighty-three patients rehabilitated with single-tooth implants in the molar region were originally randomly assigned to receive either a ZrO₂ or a PFM restoration. At 6 months, clinical parameters (plaque control record, probing depth, bleeding on probing, width of keratinised mucosa and marginal bone level changes) were recorded at the implant site and the adjacent natural tooth. In addition, a peri-implant soft-tissue biopsy specimen was harvested between the implant site and the adjacent tooth. The number of inflammatory cells and fibroblasts/fibrocytes was evaluated within four regions of interest (oral epithelium, sulcular epithelium, junctional epithelium, connective tissue). Descriptive statistics were arrived at for all outcomes, and differences between prosthetic materials, sites and timepoints were analysed using linear mixed-effects models.

Results

The present exploratory secondary analysis included 67 patients (37 ZrO₂; 30 PFM) with complete 6-month clinical, radiographic and histological data. Clinical parameters at both implant and adjacent tooth sites remained generally stable from baseline to 6 months, with limited marginal bone level changes and comparable outcomes between groups. Histologically, mixed-effects model analysis showed that the tissue region significantly affected both the inflammatory infiltrate and the fibroblast density (p < 0.001). The crown materials did not substantially influence the histological outcomes. The distribution of inflammatory infiltrate differed between tooth and implant sites, with the highest values in the sulcular epithelium around implants and in the junctional epithelium around teeth. Fibroblast density was highest in the junctional epithelium at both sites.

Conclusion

Monolithic zirconia and PFM implant-supported single crowns resulted in comparable clinical and radiographic outcomes. The peri-implant soft-tissue response to the two restorative materials showed a greater effect of the tissue region, while the material itself had only negligible effect.

Trial Registration

ClinicalTrials.gov identifier: NCT02272491

查看原文本刊更多论文

种植体周围软组织对整体氧化锆与瓷融合金属种植冠的反应：一项RCT的组织学和临床结果。

目的比较整体氧化锆（ZrO2）与烤瓷金属烤瓷冠（PFMs）对种植体周围软组织和硬组织的影响。方法本报告是对该随机对照试验预先指定的二次分析。83例使用单牙种植体修复的患者最初被随机分配接受ZrO2或PFM修复。6个月时，记录种植体部位和邻近天然牙的临床参数（菌斑控制记录、探诊深度、探诊时出血、角化粘膜宽度和边缘骨水平变化）。此外，在种植体和邻近牙齿之间采集种植体周围软组织活检标本。在四个感兴趣的区域（口腔上皮、管状上皮、结缔组织上皮）评估炎症细胞和成纤维细胞/纤维细胞的数量。对所有结果进行描述性统计，并使用线性混合效应模型分析假体材料、部位和时间点之间的差异。结果本次探索性二次分析包括67例患者（37例ZrO2； 30例PFM），具有完整的6个月临床、影像学和组织学资料。从基线到6个月，种植体和邻近牙位的临床参数基本保持稳定，边缘骨水平变化有限，两组之间的结果可比较。组织学上，混合效应模型分析显示，组织区域对炎症浸润和成纤维细胞密度均有显著影响（p < 0.001）。冠材料对组织学结果没有实质性影响。牙和种植体部位的炎症浸润分布不同，种植体周围的沟状上皮和牙周围的连接上皮最高。两个部位的接合上皮成纤维细胞密度最高。结论整体氧化锆和金属烤瓷种植体支持的单冠的临床和影像学结果相当。两种修复材料对种植体周围软组织的反应均表现为组织区域的影响较大，而材料本身的影响可忽略不计。临床试验注册号：NCT02272491。

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

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.