2026/07/02 by Waad Kheder, Renita Rego, Marwan Mansoor Mohammed +2 · 1 voice
Dentistry · Engineering · #Dental Implant Techniques and Outcomes #Bone Tissue Engineering Materials #Dental materials and restorations
paper · pdf · doi:10.2340/biid.v13.46210
openalex publication_date 2026/07/02 · openalex created_date 2026/07/03 · openalex updated_date 2026/07/22
Background: Abutment materials play a critical role in maintaining peri-implant tissue health, influencing both biological responses and aesthetic outcomes in implant-supported restorations. With the introduction of newer materials and digital fabrication techniques, an updated evaluation of their clinical performance is warranted. Objective: This systematic review aimed to evaluate the influence of different abutment materials-titanium, zirconia, and polyether ether ketone (PEEK)-on peri-implant tissue health based on contemporary clinical evidence. Materials and Methods: A systematic literature search was conducted in PubMed and Scopus databases in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Clinical studies published between 2019 and 2026 were included to reflect current advancements in implant prosthodontics. Eligible human studies assessing the impact of abutment materials on peri-implant tissue health were selected based on predefined criteria. Risk of bias was assessed using the ROBINS-I tool. Due to heterogeneity in study design, outcome measures, and follow-up duration, a meta-analysis was not feasible, and a qualitative synthesis was performed. Results: A total of 13 studies were included. Titanium abutments demonstrated consistent performance, with stable marginal bone levels, low inflammatory response and high long-term predictability. Zirconia abutments showed comparable biological outcomes, with superior soft tissue response and aesthetic integration, particularly in anterior regions. Evidence regarding PEEK abutments was limited; however, preliminary findings suggest reduced inflammatory response and favorable biocompatibility. The included studies exhibited substantial heterogeneity in methodology and outcome reporting, limiting direct comparisons. Conclusions: Titanium remains the most reliable abutment material due to its well-established clinical performance and mechanical stability. Zirconia represents a suitable alternative in aesthetically demanding situations, offering favorable soft tissue outcomes. PEEK demonstrates promising biological potential but lacks sufficient long-term clinical evidence to support routine use. Future research should focus on well-designed, long-term comparative studies with standardized outcome measures to strengthen the evidence base and guide clinical decision-making.