Abstract: Objective To compare and analyze the effectiveness of individualized all-ceramic abutments versus individualized pure titanium abutments in combination with all-ceramic crowns for the restoration of anterior tooth loss. Methods Clinical data from 76 patients (85 missing tooth sites) with anterior tooth loss, treated at Jinshui Huici Hospital from October 2022 to August 2023, were retrospectively collected for a case-control study. Patients were divided into two groups based on the treatment method: the pure titanium group (38 patients, 41 missing tooth sites), which received individualized pure titanium abutments combined with all-ceramic crowns, and the all-ceramic group (38 cases, 44 missing tooth sites),which received individualized all-ceramic abutments combined with all-ceramic crowns. The health status of the dental implants, including the peri-implant soft tissue index and plaque index (PLI), was evaluated at different time points (1 month, 3 months, and 6 months after treatment). Additionally, quality of life was assessed before and 6 months after treatment using the oral health impact profile-14 (OHIP-14), and the satisfaction with the prosthetic restoration was measured using the red aesthetic score (PES) and white aesthetic score (WES). The incidence of complications was also compared between the groups. Results Repeated measures analysis of variance showed a significant difference in the interaction effects of peri-implant soft tissue index and PLI between the two groups at different time points (P<0.05). Analysis of the time effect indicated that both groups showed an increasing trend in the soft tissue index and PLI at 3 and 6 months after treatment (P<0.05). Group effect analysis showed that the soft tissue index and PLI were lower in the all-ceramic group than in the pure titanium group at 3 and 6 months after treatment (P<0.05). At six months after treatment, the quality of life in both groups improved, and the OHIP-14 score in the all-ceramic group was lower than in the pure titanium group (P<0.05). Satisfaction with the prosthetic restoration, as measured by PES and WES, was also significantly higher in the all-ceramic group than in the pure titanium group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion Compared with individualized pure titanium abutments, the use of individualized all-ceramic abutments combined with all-ceramic crowns in patients with anterior tooth loss results in better soft tissue health around the implant, improved quality of life, and higher patient satisfaction with the restoration.

Key words: Anterior tooth loss, Individualization, All-ceramic abutment, Pure titanium abutment, Quality of life, Satisfaction with the restoration