Influence of anodized titanium abutments on the esthetics of the peri-implant soft tissue: A clinical study

Statement of problem The grayish appearance of a titanium abutment discolors the peri-implant soft tissue, especially if the gingiva is thin. Whether an anodized titanium abutment can prevent the discoloration is unclear. Purpose The purpose of this clinical study was to investigate the color change of peri-implant soft tissue surrounding a titanium abutment that had been colored by anodic oxidation. Material and methods Commercially available titanium abutments were anodized to form a gold and pink titanium abutment and formed the experimental groups. Unanodized titanium and zirconia abutment were used as the control groups. Four types of abutments were fabricated for each participant who received dental implants in the anterior maxilla. The abutments and corresponding definitive crowns were inserted, and the color of the peri-implant soft tissue and contralateral gingiva were measured with a spectrophotometer. The thickness of the peri-implant soft tissue was recorded after probing with an endodontic file. Results Eleven participants were included in this study. The color differences caused by all tested abutments were higher than the critical threshold of ΔE=3.7. The mean color difference (ΔE), from low to high, was the zirconia, pink-anodized titanium, gold-anodized titanium, and unanodized titanium abutment; their values of (ΔE) were 6.81, 7.63, 7.90, and 8.74, respectively. The mean thickness of the peri-implant soft tissue was 2.41 ±0.52 mm. Conclusions Within the limitation of the small sample size in this study, the gold-anodized and pink-anodized titanium abutment achieved better esthetics for peri-implant soft tissue than the unanodized titanium abutment. Zirconia was the optimal abutment material for the esthetic region.