Influence of implant abutment material on the color of different ceramic crown systems

Abstract

Statement of problem: Ceramics are widely used for anterior restorations; however, clinical color reproduction still constitutes a challenge particularly when the ceramic crowns are used on titanium implant abutments.

Purpose: The purpose of this in vitro study was to investigate the effect of implant abutment material on the color of different ceramic material systems.

Material and methods: Forty disks (11×1.5 mm, shade A2) were fabricated from medium-opacity (mo) and high-translucency (ht) lithium disilicate (IPS e.max) blocks, an aluminous ceramic (VITA In-Ceram Alumina), and a zirconia (Zirkonzahn) ceramic system. Disks were fabricated to represent 3 different implant abutments (zirconia, gold-palladium, and titanium) and dentin (composite resin, A2 shade) as background (11×2 mm). Disk-shaped composite resin specimens in A2 shade were fabricated to represent the cement layer. The color measurements of ceramic specimens were made on composite resin abutment materials using a spectrophotometer. CIELab color coordinates were recorded, and the color coordinates measured on composite resin background served as the control group. Color differences (ΔE₀₀) between the control and test groups were calculated. The data were analyzed with 2-way analysis of variance (ANOVA) and compared with the Tukey HSD test (α=.05).

Results: The ceramics system, abutment material, and their interaction were significant for ΔE₀₀ values (P<.001). Clinically unacceptable results (ΔE₀₀>2.25) were observed for lithium disilicate ceramics on titanium abutments (2.46-2.50). The ΔE₀₀ values of lithium disilicate ceramics for gold-palladium and titanium abutments were significantly higher than for other groups (P<.05).

Conclusion: The color results (ΔE₀₀>2.25) of an implant-supported lithium disilicate ceramic restoration may be clinically unacceptable if it is fabricated over a titanium abutment. Zirconia may be a more suitable abutment material for implant-supported ceramic restorations.