The application of individualized abutment‐crown integrated provisional restoration in optimizing the peri‐implant soft tissue contour in the esthetic zone

Zhuang, Jiabao; Wang, Yingying; Song, Yingshuang; Qu, Fang; Xu, Chun

doi:10.1111/jerd.12726

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…There are clinical situations at the time of implant placement in which it is not possible to place an immediate provisional, so a customized healing coping can be made, in which we maintain the contour of the soft tissues to reduce the number of clinical steps to give that natural emergence appearance of the restoration to be placed later [21] . With CAD-CAM technology it is possible to replicate the emergence profile of the contralateral tooth to be rehabilitated, making a customized provisional attachment with a copy of the emergence profile of the contralateral tooth, having good esthetic results in soft tissue management [22] . The emergence profile management is crucial to improve the esthetic outcome of the final restoration in the esthetic zone and this starts from the placement of the provisional, which should have a fully polished critical and subcritical profile adequate to maintain stable gingival volumes.…”

Section: Emergence Profile Managementmentioning

confidence: 99%

Untitled

2023

Int. J. Appl. Dent. Sci.

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Introduction:The goal of all dental implant therapy is to maintain the esthetics, function and stability of the restoration and the peri-implant tissues involved in the provisionalization. Objective: To analyze the literature on prosthodontic management of implant provisionalization in esthetic zones such as whether or not to perform immediate loading, emergency profile management, provisionalization techniques and management in esthetically compromised zones. Methodology: PubMed, Scopus and Google Scholar databases were reviewed to find recent articles published on the management of the provisionalization of implants with the following keywords "dental implant", "esthetic dentistry", "emergence profile", "esthetic zone", "interim prosthesis". Results: Whether or not to perform immediate loading will depend on the primary stability of the implant when it is placed and the esthetic requirements of the patient. Emergency profile management is crucial to improve the esthetic result of the final restoration in the esthetic zone and this begins with the placement of the provisional. There are several techniques for the immediate provisionalization of implants, the most popular of which is the provisionalization with a temporary crown previously fabricated in the laboratory. During the implantological intervention in the esthetic zone, the volume of the soft tissues should be maintained as well as their correct conformation around a provisional restoration, if possible. Conclusion: Currently, immediate provisionalization is preferred as long as the implantological intervention allows it. The management of the emergence profile should be taken into account since the conformation of the gingival tissues will start to be established in order to obtain an optimal esthetic result in the definitive restoration.

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Section: Emergence Profile Managementmentioning

confidence: 99%

Untitled

2023

Int. J. Appl. Dent. Sci.

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“…Effective surgical and prosthetic techniques can be used to maintain or replace those tissues in a clinical scenario, given that an esthetic result must be accomplished to fulfill the esthetic demands of patients. 1,2 Regarding the management of soft tissues, implant-supported provisional restorations can significantly contribute to an excellent outcome [3][4][5] as they provide a smoother transition to definitive restorations. 6 As for morphology, the concept of an optimized convergent abutment contour remains, 7 considering the shape for provisional or definite implant-supported restorations.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding the management of soft tissues, implant‐supported provisional restorations can significantly contribute to an excellent outcome 3–5 as they provide a smoother transition to definitive restorations 6 . As for morphology, the concept of an optimized convergent abutment contour remains, 7 considering the shape for provisional or definite implant‐supported restorations.…”

Section: Introductionmentioning

confidence: 99%

The natural CAD/CAM anterior implant single tooth restoration: A novel digital workflow

Passos

Vasconcellos

Kanashiro³

et al. 2023

J Esthet Restor Dent

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ObjectiveTo report a novel digital workflow to replace an anterior maxillary tooth lost due to trauma with an implant multilayer restoration by using the patient's extracted tooth as a final crown restoration using computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology.Clinical ConsiderationsInstead of using the patient's natural tooth as an immediate provisional restoration to achieve predictable results in terms of esthetics and soft tissue structure, a novel digital strategy was performed to obtain a natural final crown restoration by using the patient's tooth associated with a lithium disilicate customized implant abutment.ConclusionsThe perspective of using this strategic approach for implant restorative dental treatments in patients with traumatic root fractures in the anterior region has great potential as it helps to maintain the emergence profile of the natural dentition and esthetics.Clinical SignificanceOptimal esthetic outcomes are challenging in implant dentistry regarding soft tissue structure and morphology factors. Using natural teeth from surgery to deliver the final restoration might be beneficial when an anterior tooth is lost due to trauma.

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“…In implant therapy, a soft tissue seal is crucial for preventing bacterial invasion and maintaining the long-term health of peri-implant tissues [ 1 , 2 , 3 , 4 , 5 ]. Peri-implant soft tissue heals and develops during various stages of provisionalization, including implant surgery, second-stage surgery, subsequent wound healing, emergence profile formation, and tissue maturation [ 6 , 7 , 8 , 9 ]. Implant provisional restorations are typically made of polymer-based materials.…”

Section: Introductionmentioning

confidence: 99%

Disparity in the Influence of Implant Provisional Materials on Human Gingival Fibroblasts with Different Phases of Cell Settlement: An In Vitro Study

Matsuura,

Stavrou,

Komatsu

et al. 2023

IJMS

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The development of healthy peri-implant soft tissues is critical to achieving the esthetic and biological success of implant restorations throughout all stages of healing and tissue maturation, starting with provisionalization. The purpose of this study was to investigate the effects of eight different implant provisional materials on human gingival fibroblasts at various stages of cell settlement by examining initial cell attachment, growth, and function. Eight different specimens—bis-acrylic 1 and 2, flowable and bulk–fill composites, self-curing acrylic 1 and 2, milled acrylic, and titanium (Ti) alloy as a control—were fabricated in rectangular plates (n = 3). The condition of human gingival fibroblasts was divided into two groups: those in direct contact with test materials (contact experiment) and those in close proximity to test materials (proximity experiment). The proximity experiment was further divided into three phases: pre-settlement, early settlement, and late settlement. A cell culture insert containing each test plate was placed into a well where the cells were pre-cultured. The number of attached cells, cell proliferation, resistance to detachment, and collagen production were evaluated. In the contact experiment, bis-acrylics and composites showed detrimental effects on cells. The number of cells attached to milled acrylic and self-curing acrylic was relatively high, being approximately 70% and 20–30%, respectively, of that on Ti alloy. There was a significant difference between self-curing acrylic 1 and 2, even with the same curing modality. The cell retention ability also varied considerably among the materials. Although the detrimental effects were mitigated in the proximity experiment compared to the contact experiment, adverse effects on cell growth and collagen production remained significant during all phases of cell settlement for bis-acrylics and flowable composite. Specifically, the early settlement phase was not sufficient to significantly mitigate the material cytotoxicity. The flowable composite was consistently more cytotoxic than the bulk–fill composite. The harmful effects of the provisional materials on gingival fibroblasts vary considerably depending on the curing modality and compositions. Pre-settlement of cells mitigated the harmful effects, implying the susceptibility to material toxicity varies depending on the progress of wound healing and tissue condition. However, cell pre-settlement was not sufficient to fully restore the fibroblastic function to the normal level. Particularly, the adverse effects of bis-acrylics and flowable composite remained significant. Milled and self-curing acrylic exhibited excellent and acceptable biocompatibility, respectively, compared to other materials.

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The application of individualized abutment‐crown integrated provisional restoration in optimizing the peri‐implant soft tissue contour in the esthetic zone

Cited by 7 publications

References 22 publications

Untitled

Untitled

The natural CAD/CAM anterior implant single tooth restoration: A novel digital workflow

Disparity in the Influence of Implant Provisional Materials on Human Gingival Fibroblasts with Different Phases of Cell Settlement: An In Vitro Study

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