Development of Custom Anatomic Healing Abutment Based on Cone-Beam Computer Tomography Measurement on Human Teeth Cross-Section

Abstract

Introduction: Nowadays, the final success of implantation is not only based on obtaining osseointegration of the implant but is also determined by achieving a satisfactory aesthetic effect of the soft tissues surrounding the implant, which can be defined as an aesthetic integration. The process of obtaining this aesthetic integration already begins at the stage of placing the healing abutment, which allows us to obtain the emergence profile necessary for our prosthetic reconstruction. Materials and Methods: The study used cone-beam computer tomography (CBCT) scans of 51 patients. The measurements of the maxillary teeth (central incisor, lateral incisor, canine, first premolar, and first molar) were performed from cross-sections of the individual teeth at the transition zone to design a custom anatomic healing abutment milled from zirconium and luted to the non-index Ti-base. Results: The obtained results allowed to design and create the shape of the anatomic healing abutment. Conclusions: The use of laboratory-produced anatomical healing abutments is possible and may allow to obtain the desired and planned emergence profiles of prosthetic restorations. In addition, it might be a method of reducing work time at the dental chair but further clinical trials are necessary.

7 Essential Elements for Successful Hard- and Soft-Tissue Regeneration in Immediate Implants with TERUPLUG®Collagen

“…Each element can be critical in achieving the final, predictable long-term An ideal healing abutment should have the threedimensional shape of the reconstructed tooth, which is called the emergence profile. As a result, if wide healing abutment is not available, we can manufacture customized healing abutment made of polyether-etherketone (PEEK) or zirconium for this purpose [49,50].…”

Effect of Customized and Prefabricated Healing Abutments on Peri-Implant Soft Tissue and Bone in Immediate Implant Sites: A Randomized Controlled Trial

“…With advances in digital dentistry, it is now possible to fabricate customized healing abutments prior to implant surgery, which can be inserted on the same day after implant placement with minor adjustments [14,15]. In this process, prototypes for creating customized healing abutments, such as patient socket dimensions, a cross-sectional area at the cementoenamel junction (CEJ) level, or the outline of the final prosthesis contour, are needed [14,16,17]. Commonly used materials include polymethylmethacrylate (PMMA) and polyetheretherketone (PEEK) [8] due to their physical and mechanical properties as provisional restorations [18].…”

Cone beam computed tomography assessment of maxillary anterior teeth cervix dimensions in healthy adults for optimal anatomic healing abutments

“…With the use of CBCT, Sun et al measured the area and perimeter of the cervical sections of natural teeth to give a reference for the design of healing abutment contour 19 . Teślak et al added measurements of the line connecting the most convex points of the mesio‐buccal and disto‐palatal and the line connecting the most convex points of the disto‐buccal and mesio‐palatal in addition to bucco‐palatal diameter and mesio‐distal diameter to describe the cervical cross‐section 20 . However, the circularly symmetrical abutments fabricated based on area and perimeter measurements could not accurately simulate the cervical shape of natural teeth due to the noticeable differences between the facial and palatal, as well as the mesial and distal tooth contours that were not considered.…”

“…19 Te slak et al added measurements of the line connecting the most convex points of the mesio-buccal and disto-palatal and the line connecting the most convex points of the disto-buccal and mesio-palatal in addition to bucco-palatal diameter and mesio-distal diameter to describe the cervical cross-section. 20 However, the circularly symmetrical abutments fabricated based on area and perimeter measurements could not accurately simulate the cervical shape of natural teeth due to the noticeable differences between the facial and palatal, as well as the mesial and distal tooth contours that were not considered. Therefore, the aim of this study was to provide more detailed measurements of the cervical contours in both cross-sections, at the cemento-enamel junction (CEJ) and 1 mm coronal to CEJ, to provide more detailed data for the prefabrication of anatomic healing abutments.…”