Computer‐aided planning of soft tissue augmentation with prosthetic guidance for the establishment of a natural mucosal contour in late implant placement

Abstract

Objective Late implant placement in volume deficient sites has been considered a challenging situation for the establishment of a natural mucosal topography. Dimensional relations of hard and soft tissues together with the prosthetic components have not been clarified in the literature. The aim of this proof‐of‐concept case report was to establish the tooth‐like appearance with virtual planning prior to surgical intervention and to calculate the ideal amount of desired soft tissue. Clinical Considerations Minimum amount of tissue reconstruction was calculated with computer‐aided soft tissue augmentation and a temporary restoration mimicking the emergence profile of a molar was fabricated for guiding the peri‐implant mucosa in the early wound healing phase. After 4 months of healing, the final restoration was completed with a screw‐retained crown‐abutment. The 2‐year follow‐up period demonstrated a stability of the mucosal margin and peri‐implant health. Conclusions A natural mucosal contour could be established with the help of virtual planning. The calculation of required tissue quantity may help clinicians for the creation of a natural appearance in late implant placement. Clinical Significance Virtual soft tissue augmentation may determine the required tissue quantity and therefore, could play an important role in the establishment of natural mucosal contour for late implant placement.

Reverse Guided Bone Regeneration (R-GBR) Digital Workflow for Atrophic Jaws Rehabilitation

“…The precision of the virtual project, comparing the starting clinical situation with the ideal prediction of the final result, is a crucial issue. The forecasting of peri-implant mucosa thickness and shape, and its interaction with the abutment and crowns to be reached at the end of treatment, can allow for predicting the surgical or prosthetic correction of the soft tissues before or after the bone reconstruction with a more accurate implant positioning [10]. Static computer-aided implantology (s-CAI) entails coupling the tissue surfaces data from intra-or extra-oral scanning with the radiographic hard tissues information from the CT to guide the seating of the fixtures.…”

“…According to a so-called fully digital protocol, two mono-edentulous sites were treated with implant insertion contextual to the bone reconstruction after pre-surgical planning of the ideal soft tissue architecture [14,15]. Another clinical case was managed by evaluating the vestibular mucosa thickness to resolve the horizontal deficit of an edentulous site with surgical soft tissue modification in combination with prosthetics tricks [10].…”