Influence of buccal emergence profile designs on peri‐implant tissues: A randomized controlled trial

Abstract

Background: The prosthetic emergence profile design might be an important factor in postsurgical mucosal recession etiology. Therefore, a restorative buccal emergence profile designed correctly might reduce gingival margin recession.Purpose: To compare the marginal gingival level and the width/height (W/H) ratio between two profile configurations of single implant-supported restorations at molar sites.Materials and Methods: Twenty-one patients requiring a single mandibular molar tooth replacement with supracrestal mucosal thickness ≥2 mm were recruited and randomly assigned to a prosthesis buccal emergence profile design based on the buccal mucosal W/H ratio (Test Group) or maintained the original emergence profile of the healing abutment (Control Group). Assessments were made before delivery of the definitive restoration (T0), at prosthesis placement (T1), one (T2), and 12 (T3) months after loading. The gingival margin level change (4GM), initial emergence angle, buccal mucosal W/H ratio, marginal bone loss (MBL), implant failure, and complications were assessed. Results:The gingival recession in the test group (0.13 ± 0.32 mm) was significantly lower than in the control group (0.63 ± 0.38 mm) at T3 (p = 0.006). The initial emergence angle in the test group (31.4 ± 7.22 degrees) was significantly lower than the control group (40.0 ± 7.60 degrees) (p = 0.025). The W/H ratio in the test group at T2 was significantly higher than at T0 but remained stable thereafter. The W/H ratio presented a continued rising trend in the control group.Conclusions: When the initial supracrestal soft tissue thickness was ≥2 mm, a restorative emergence profile based on the W/H ratio significantly reduced gingival margin recession. An emergence angle of 32.4 degrees showed better behavior in maintaining the gingival margin than 40 degrees.

Marginal Bone Level and Biomechanical Behavior of Titanium-Indexed Abutment Base of Conical Connection Used for Single Ceramic Crowns on Morse-Taper Implant: A Clinical Retrospective Study

“…However, the abutments’ average and standard deviations were −0.61 ± 0.46 mm and −0.79 ± 0.71 mm ( p -value = 0.1574) for abutments with 3.5- and 4.5-mm diameter, respectively. Although no statistically significant differences were found, the average of the measured values was higher for the Ø4.5 mm abutments, which corroborates the findings recently published in other studies showing that the smaller emergence angle of crown decreases the possibility of peri-implant tissues recession [ 61 , 62 ].…”

In vitro efficacy of non‐surgical and surgical implant surface decontamination methods in three different defect configurations in the presence or absence of a suprastructure

“…It is easier to remove a screw‐retained suprastructure than a cemented one, and biological complications, such as those caused by remaining cement residues, can be avoided. Another conclusive aspect influencing the cleaning efficacy is the design of the emergence profile/angle in the case of an existing suprastructure 35‐37 . This promotes easier (flat angle) or more difficult (steep angle) accessibility depending on the angle between the implant axis and the crown base.…”

Soft‐tissue dimensional change following guided bone regeneration on peri‐implant defects using soft‐type block or particulate bone substitutes: 1‐year outcomes of a randomized controlled clinical trial

“…In the present study, the prosthesis design was not included in the regression model analysis. This could be pointed out as a limitation, given that the recent publications emphasize the importance of emergence profile of the abutment and crown (Yi et al, 2020;J. Wang et al, 2022).…”

“…In the present study, the prosthesis design was not included in the regression model analysis. This could be pointed out as a limitation, given that the recent publications emphasize the importance of emergence profile of the abutment and crown (Yi et al, 2020; J. Wang et al, 2022). However, considering that the design and delivery of the prosthesis were carried out in a standardized manner in the present study, the prosthetic factor was excluded from the regression analysis.…”