Introduction: An optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes a novel workflow for one-step formation of the supra-implant emergence profile. Materials and Methods: Two randomized groups were selected. Ten control group participants received standard healing screws at the surgical stage. Ten individualized healing abutments were Computer aided Design/Computer aided Manufacturing (CAD/CAM)-fabricated out of polyether ether ketone (PEEK) restoration material in a fully digital workflow and seated at the surgical stage in the test group. The modified healing abutment shape was extracted from a virtual library. The standard triangulation language (STL) files of a premolar and a molar were obtained considering the coronal anatomy up to the cement-enamel junction (CEJ). After a healing period ranging from 1 to 3 months depending on the location of the surgical site, namely, mandible or maxilla, a digital impression was taken. The functional implant prosthodontics score (FIPS) and the numerical rating scale (NRS) of pain were recorded and compared. Results: The mean FIPS value for the test group was 9.1 ± 0.9 while the control group mean value was 7.1 ± 0.9. In the test group, pain assessment at crown placement presented a mean value of 0.5 ± 0.7. On the contrary, the control group showed a mean value of 5.5 ± 1.6. Conclusions: Patients in the test group showed higher FIPS values and lower NRS scores during the early phases compared to the control group.

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Background: Optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes the influence of the residual buccal bone thickness (BBT), measured at the time of implant placement, on the soft tissue maturation during three years of follow-up. Methods: Seventy-eight implants were enrolled in the present study. The BBT was assessed at the surgical stage and each case assigned to Group 1 (BBT values ≤0.5 mm), Group 2 (BBT values >0.5 and <1.5 mm), or Group 3 (BBT values ≥1.5 mm). Only native bone and healed sites were included. The tooth height (TH), based on the distance between the buccal free gingival margin at the zenith level and the crown incisal edge, according to the main axis of the tooth, was monitored at one, two, and three years from the final prosthodontic rehabilitation to determine any occurrence of recession or coronal repositioning of the gums over time. A Pearson Two-Tailed test was applied and the significance level set at p ≤ 0.05. Results: For BBT values ≤0.5 mm, the buccal gum at three years showed an average recession of 1.22 ± 0.41 mm. For BBT values >0.5 and <1.5 mm, the buccal gum also showed recession of 0.64 ± 0.29 mm. In contrast, for BBT values ≥1.5 mm, the buccal gum showed coronal growth of 0.77 ± 0.22 mm. The differences between the groups were significant (p ≤ 0.01) at all times. Conclusion: The BBT at the time of implant placement was found to affect the buccal gingival margin stability over three years of observation.

Background: Previous studies have suggested that mucosal height is related to the bone level and soft tissue thickness. The purpose of this pilot study was to investigate the ratio between the height and width of the tissues around single implants with a conical connection and platform switching. Methods: All patients receiving single implants (Anyridge®, MegaGen, Gyeongbuk, South Korea) and restored with single crowns, in a three-month period, were included in this study. After a provisionalization of 12 months, precision impressions were taken and stone casts were poured for measurements. For each implant, two values were collected at the buccal site: the mucosal height (MH), calculated from the vestibular shoulder of the implant to the upper gingival margin of the supra-implant tissue; and the mucosal thickness (MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. Mean, standard deviation (SD), and confidence intervals (CI 95%) for MH and MT, as well as their ratios, were calculated. Correlation between MH and MT was assessed by Pearson's correlation coefficient, with significance level set at 0.05. Results: 32 single Anyridge® implants were eligible for this evaluation. The mean MH was 3.44 mm (±1.28), the mean MT was 3.29 (±1.46). The average of the ratio between MH and MT of the supra-implant mucosa was therefore 1:1.19 (±0.55). The relation between MH and MT was statistically significant at p ≤ 0.01 (Pearson two-tailed 95% CI). Conclusions: Our study found a constant relationship between width and height of the peri-implant mucosa. However, our results are different from those of Nozawa et al., who found a ratio of 1:1.5 between height and thickness of the peri-implant tissues. This may be determined by the different sample and follow-up period, as well as by the implants used in our study.

Masticatory overload on dental implants is one of the causes of marginal bone resorption. The implant–abutment connection (IAC) design plays a critical role in the quality of the stress distribution, and, over the years, different designs were proposed. This study aimed to assess the mechanical behavior of three different types of IAC using a finite element model (FEM) analysis. Three types of two-piece implants were designed: two internal conical connection designs (models A and B) and one internal flat-to-flat connection design (model C). This three-dimensional analysis evaluated the response to static forces on the three models. The strain map, stress analysis, and safety factor were assessed by means of the FEM examination. The FEM analysis indicated that forces are transmitted on the abutment and implant’s neck in model B. In models A and C, forces were distributed along the internal screw, abutment areas, and implant’s neck. The stress distribution in model B showed a more homogeneous pattern, such that the peak forces were reduced. The conical shape of the head of the internal screw in model B seems to have a keystone role in transferring the forces at the surrounding structures. Further experiments should be carried out in order to confirm the present suppositions.