Peri-Implant Soft Tissue Conditioning by Means of Customized Healing Abutment: A Randomized Controlled Clinical Trial

Abstract

Introduction: An optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes a novel workflow for one-step formation of the supra-implant emergence profile. Materials and Methods: Two randomized groups were selected. Ten control group participants received standard healing screws at the surgical stage. Ten individualized healing abutments were Computer aided Design/Computer aided Manufacturing (CAD/CAM)-fabricated out of polyether ether ketone (PEEK) restoration material in a fully digital workflow and seated at the surgical stage in the test group. The modified healing abutment shape was extracted from a virtual library. The standard triangulation language (STL) files of a premolar and a molar were obtained considering the coronal anatomy up to the cement-enamel junction (CEJ). After a healing period ranging from 1 to 3 months depending on the location of the surgical site, namely, mandible or maxilla, a digital impression was taken. The functional implant prosthodontics score (FIPS) and the numerical rating scale (NRS) of pain were recorded and compared. Results: The mean FIPS value for the test group was 9.1 ± 0.9 while the control group mean value was 7.1 ± 0.9. In the test group, pain assessment at crown placement presented a mean value of 0.5 ± 0.7. On the contrary, the control group showed a mean value of 5.5 ± 1.6. Conclusions: Patients in the test group showed higher FIPS values and lower NRS scores during the early phases compared to the control group.

Correlation between Buccal Bone Thickness at Implant Placement in Healed Sites and Buccal Soft Tissue Maturation Pattern: A Prospective Three-Year Study

“…Nowadays, aesthetic outcome plays a fundamental role in oral implantology [2]. Thus, current research has turned its attention to the parameters that determine the aesthetic success of rehabilitation [10].…”

“…Certainly, the height of the soft tissue around a dental implant is key in determining a natural aesthetic result [28], as no rehabilitation showing recessions can be considered an aesthetic achievement [28]. Accordingly, the amounts of hard and soft tissue around a dental implant are clearly very important [2]. However, the current literature does not indicate a clear relationship between those two variables.…”

“…The aesthetic of the prosthesis and tissues has been identified as closely linked to the satisfaction of both patients and clinicians [1]. While implant rehabilitation in the aesthetic zone is a common treatment, the aesthetic and functional outcomes and variables affecting peri-implant tissue maturation still remain important topics of research [2]. Accordingly, what are the variables that can influence the aesthetic outcome of implant rehabilitation?…”

“…Accordingly, what are the variables that can influence the aesthetic outcome of implant rehabilitation? One of the main factors is the tridimensional position of the fixture, as described in previous literature [3][4][5], along with the quality and quantity of both hard and soft tissue [2]. Studies by Linkevicius et al have focused on the importance of a thick or thin biotype to improve immediate implant success and prevent future mucosal recession [6], as soft tissue will always adapt to the condition of the local setting [7,8].…”

The use of PEEK in digital prosthodontics: A narrative review

“…Polyetheretherketone (PEEK) is a linear, aromatic, semi-crystalline thermoplastic, high performance polymer recently used in dentistry as a framework material for metal-free fixed dental prostheses [1,2], removable dental prostheses [3], implant-supported fixed prostheses [4], implant-retained overdentures [5], endocrowns [6] and resin bonded fixed dental prostheses [7]. It has been also used for the manufacturing of dental implants [8], implant abutments [9], healing abutments [10] and occlusal splints [11]. PEEK is a material with high biocompatibility, good mechanical properties, high temperature resistance, chemical stability, polishability, good wear resistance, low plaque affinity and high bond strength with veneering composites and luting cements.…”