The effect of different abutment materials on peri‐implant tissues—A systematic review and meta‐analysis

Abstract Objectives In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri‐implant tissues after at least 1 year? Materials and Methods This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow‐up of 1 year and including at least 10 patients/group. Primary outcomes were peri‐implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta‐analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2‐tool. This review is registered in PROSPERO with the number (CRD42022376487). Results From 5129 titles, 580 abstracts were selected, and 111 full‐text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = −0.24, 95% CI: −0.65 to 0.16, alumina: MD = −0.06, 95% CI: −0.29 to 0.17) (PD: zirconia: MD = −0.06, 95% CI: −0.41 to 0.30, alumina: MD = −0.29, 95% CI: −0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material. Conclusions Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.