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Immediate load and esthetic zone considerations to replace maxillary incisor teeth using a new zirconia implant abutment in the bone grafted anterior maxilla.

The goal of this prospective clinical study is to evaluate a new all-ceramic implant abutment made from zirconium oxide during the immediate load of dental implants placed in the block grafted anterior maxilla. This new zirconia abutment gives the clinician the opportunity to provide the patient with an all-ceramic restorative system (abutment and crown) for an optimum esthetic result and a high level of patient satisfaction. A total of 9 hydroxyapatite-coated dental implants were surgically placed in 9 patients and were immediately loaded 5 to 7 days later with a custom composite provisional restoration that was placed out of functional occlusion. Each prefabricated, natural colored zirconia abutment was shaped and connected to the implant with a titanium screw. Provisional restorations were cemented to the zirconia abutment with the use of temporary cement. Twelve weeks later, the provisional restoration was replaced with an all-ceramic restoration. Over a 52-week observation period, no abutment fractures occurred, and no abutment screw loosening was observed. No implants failed. All 9 patients reported total satisfaction regarding esthetic quality of the all-ceramic restorative system (abutment and implant). Preliminary results of this clinical study indicate that this new zirconia abutment offers the clinician and the patient exceptional strength, optimal esthetics, and simplicity. It is of important clinical significance that use of this all-ceramic abutment eliminates the well-known disadvantages of metal abutments.