Peri‐implant tissue management after immediate implant placement using a customized healing abutment

Abstract

Objective The unavoidable extraction of teeth in the esthetic area can be overcome through different treatment modalities. Recently, immediate implants appeared as a minimally invasive approach to resolving these cases; however, immediate implant loading is not always possible or indicated. In these cases, an innovative approach through customized healing abutments could be used to preserve the soft tissue contour, eliminating the need for reopening surgery and the use of provisional restorations to condition the mucosal contour. Clinical Considerations The present cases describe a simplified chairside approach to use customized healing abutments for immediate implants placed after tooth extraction in the anterior and posterior areas in order to maintain the soft tissue contours while reducing the clinical steps until delivering the final restorations. Conclusions This technique seems to be effective to guide the soft tissue healing around dental implants allowing a natural emergence profile with implant‐supported restorations, reducing the number of treatment steps. Clinical Significance The use of customized healing abutments prepares soft tissue for the prosthetic stage preserving its contours and eliminating the need for reopening surgery.

Effect of customized healing abutments on the peri‐implant linear and volumetric tissue changes at maxillary immediate implant sites: A 1‐year prospective randomized clinical trial

“…The use of customized healing abutments, when an implant is inserted in a fresh extraction socket, has been described as a beneficial solution that permits to personalize the peri-implant tissues architecture. [15][16][17][18]24,25 This study demonstrated that, in the first month of treatment, the use of customized healing abutments is favorable in preventing linear and volumetric peri-implant tissue loss (Figure 5). CA group exhibited approximately half less the volumetric dimensional variation than CM group (À12.98 ± 14.53 mm 3 and À25.20 ± 17.44 mm 3 ; p = 0.049, respectively).…”

“…22,23 On the other hand, the use of customized healing abutments in IIP is a growing subject but almost limited to description of techniques and case reports in terms of scientific evidence. [15][16][17][18]24,25 Recently, an RCT from Perez and colleagues, 26 comparing customized healing abutments and standard healing abutments at IIP sites, showed favorable results in terms of papilla presence and marginal bone loss at the sites treated with customized abutments, when compared with the standard healing abutments sites. In our investigation, all the experimental sites were carefully selected and classified as type 1 extraction sockets.…”

“…14 Recently, studies evaluating the use of customized healing abutments/screws have been performed aiming to assess possible advantages associated with this treatment modality. [15][16][17][18] The utilization of a CAD/CAM technique to fabricate a perfectly adapted polymethyl methacrylate (PMMA) healing abutment aims to reproduce the precise contours of the cervical root area and maintain the soft tissue contours during osseointegration and the healing of the peri-implant mucosa. Also, they seem to provide a predictable outcome while reducing the number of surgeries, postoperative discomfort, morbidity related to open-flap technique, and the length of treatment.…”

Digital Workflow for Full‐Arch Immediate Implant Placement Using a Stackable Surgical Guide Fabricated Using SLM Technology

“…The overall treatment planning, including periodontal, surgical, 22 and prosthodontic therapy, 23–25 in addition to quality control throughout the manufacturing process, 26 contributes to the success of the treatment. The patient was satisfied with the titanium‐reinforced PMMA provisional full‐arch ISFDP due to improved function and aesthetics (Fig 5H).…”

Immediate implant in the posterior region combined with alveolar ridge preservation and sealing socket abutment: A retrospective 3D radiographic analysis

“…To cope with this anatomical consideration several authors have proposed using a customized abutment to seal the large molar socket after the immediate implant placement, and maintaining the original outline of soft tissues 21‐26 . For instance, the Sealing Socket Abutment (SSA) technique introduced by Finelle et al 2017 uses an individualized chairside‐fabricated abutment following tooth extraction to seal the surgical area and to protect the bone grafting material from the oral cavity exposure as well.…”