This is a dilemma that we face at almost every anterior implant restoration.

For single implant restorations in the esthetic area, we continue to have great results with a one-piece zirconia custom abutment and ceramic crown. Nonetheless, when we talk about "optimal", we are talking about a lot of the properties in the portfolio. The solution should be close in color to teeth, highly adaptable for the mucosa, strong enough to withstand chewing forces, easily replicated in most situations, and affordable for the majority of people.

We now have a plethora of options, particularly since the adoption of digital dentistry. A computerized monolithic restoration over a prefabricated titanium abutment would be my preference. The monolithic restoration would provide strong support for the mucosa as well as a pleasing hue for the adaptation. The titanium original abutment, on the other hand, would maintain the core strength of the entire complex while providing the best adaptation to the body below. The connection between the abutment and the crown, which is made of two distinct materials (titanium and zirconia), is the weakest link in this complex.

As a prosthodontist, I, too, would like a perfect solution: A new tooth-colored alloy material that can be utilized to make a single-piece abutment and crown that connects to the implant body smoothly. Finally, this sensitive alloy should be digitally producible for a wide range of applications, from single unit to multi-unit restorations. As a result, there would no longer be an abutment-crown complex, merely a superstructure with fewer mechanical failures for implants.