Related Experiment Video
Updated: Jun 8, 2026
Oral Biofilm Formation on Different Materials for Dental Implants
Published on: June 24, 2018
Are ceramic and metal implant abutments performance similar?
Analia Veitz Keenan1, David Levenson
1NYU College of Dentistry, New York, USA and PEARL Network Practitioners, New York, USA.
Data Sources:
Medline, The Cochrane Library, bibliographies of identified studies and hand searching of the journals, Schweizer Monatsschrift fur Zahnmedizin (Acta Medicinae Dentium Helvetica) and Deutsche Zahnärztliche Zeitschrift and Implantologie.
Study Selection:
Randomised-controlled clinical trials, prospective and retrospective studies providing information on ceramic and metal abutments with a mean follow-up time of at least 3 years were included. Patients had to have been examined clinically at the follow-up visit.
Data Extraction And Synthesis:
Assessment of the identified studies and data abstraction were performed independently by three reviewers. Failure rates were analysed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions.
Results:
A total of 29 studies providing information on the clinical performance of the implant abutments were included in the analysis. The estimated 5-year survival rate of ceramic abutments was 99.1% [95% confidence interval (CI): 93.8-99.9%] and 97.4% (95% CI: 96-98.3%) for metal abutments. The estimated cumulative incidence of technical complications after 5 years was 6.9% (95% CI: 3.5-13.4%) for ceramic abutments and 15.9% (95% CI: 11.6-21.5%) for metal abutments. Abutment screw loosening was the most frequent technical problem, occurring at an estimated cumulative incidence after 5 years of 5.1% (95% CI: 3.3-7.7%). All-ceramic crowns supported by ceramic abutments exhibited similar annual fracture rates as metal-ceramic crowns supported by metal abutments. The cumulative incidence of biological complications after 5 years was estimated at 5.2% (95% CI: 0.4-52%) for ceramic and 7.7% (95% CI: 4.7-12.5%) for metal abutments. Aesthetic complications tended to be more frequent at metal abutments.
Conclusions:
The 5-year survival rates estimated from annual failure rates appeared to be similar for ceramic and metal abutments. The information included in this review did not provide evidence of differences for the technical and biological outcomes of ceramic and metal abutments. However, the information for ceramic abutments was limited in the number of studies and abutments analysed as well as the accrued follow-up time. Standardised methods for the analysis of abutment strength are needed.
