The use of standard zirconia abutments yield better esthetic outcomes, albeit with similar clinical behavior as titanium abutments suggests a new study published in the Journal of Clinical Periodontology
A study was done to evaluate the influence of the abutment material (zirconia vs. titanium) on the long-term aesthetic and clinical outcomes of implant-supported restorations.
In 30 patients, a single implant-supported restoration with either a zirconia or a titanium abutment was placed in the anterior maxilla (incisors, canines, and bicuspids). Aesthetic (Implant Crown Aesthetic Index or ICAI), clinical, radiographic, and patient-centred outcomes were recorded at baseline (1 month after final restoration), 1 year, and 5 years of follow-up. This study was registered in ClinicalTrials.gov (NCT02315794).

Results
Twenty-five subjects completed the follow-up visits at 1 and 5 years. ICAI values showed statistically significant better aesthetic outcomes when zirconia abutments were used compared to titanium abutments. Between 1 and 5 years, the aesthetic sub-analysis of the crown component worsened but the mucosal sub-analysis improved. There were no significant changes in bone levels, but the plaque index, bleeding on probing, and probing depths worsened in both groups.
At 5 years, standard zirconia abutments achieved better aesthetic outcomes, although with similar clinical behaviour.
Reference:
Ferrantino, L., Carrillo de Albornoz, A., & Sanz, M. (2023). Five-year outcomes of a randomized controlled clinical trial comparing single-tooth implant-supported restoration with either zirconia or titanium abutments. Journal of Clinical Periodontology, 1– 11.https://doi.org/10.1111/jcpe.13787