Available online 23 March 2023

Author links open overlay panel, , , AbstractStatement of problem

Providing a definitive restoration with an emergence profile matching that of the contralateral or extracted tooth should result in an esthetic peri-implant soft tissue contour. Whether a custom healing abutment improves the outcome of a bio-copied definitive restoration compared with a stock abutment is unclear.

Purpose

The purpose of this 1-year randomized clinical trial was to evaluate the peri-implant soft and hard tissues related to bio-esthetic single implant-supported restorations having a contralateral tooth-matching restorative emergence profile after peri-implant soft tissue conditioning with either custom or stock healing abutment for patients indicated for immediate implant placement.

Material and methods

Twenty-four participants indicated for immediate implant placement in the maxillary esthetic zone received bio-esthetic single implant-supported restorations after peri-implant soft tissue conditioning with either a custom healing abutment (n=12) or a stock healing abutment (n=12). The pink and white esthetic score (PES-WES) was evaluated 6 and 12 months after implant placement. Peri-implant bone changes were measured with cone beam computed tomography (CBCT) scans at the same intervals.

Results

The PES-WES showed significant difference between the 2 groups at 6 and 12 months. The CBCT scans did not show significant difference between the 2 groups.

Conclusions

The use of the bio-esthetic concept for immediate single implant placement achieved successful esthetic restorations after conditioning the peri-implant tissues using either custom or stock healing abutments. However, the use of custom healing abutments was associated with higher PES-WES values in comparison with the use of stock healing abutments.

Section snippetsMaterial and methods

The present study was conducted as a prospective, double-blinded, balanced, randomized controlled clinical trial with a parallel-group design. The study was approved under the number IRB8839-ORG10556 by the ethical committee of the Faculty of Dentistry-Alexandria University and registered at clinicaltrial.org with registration number NCT04329156. Twenty-four participants indicated for single immediate implant placement in the esthetic zone of the maxillary dental arch were selected from those

Results

Twenty-four participants met the inclusion criteria. The permuted block randomization technique with variable block size was used to allocate the participants into 2 equal groups: the custom healing abutment group (CA group) and stock healing abutment group (SA group). The CA group included 4 (33.3 %) men and 8 (66.7%) women with a mean age of 30.58 years, while the SA group included 7 (58.3%) men and 5 (41.7%) women with a mean age of 32.17 years. Each group included 17.7% smokers. The CA

Discussion

The null hypothesis regarding the esthetic outcomes was rejected but was not rejected regarding the peri-implant hard tissue. Both groups had successful esthetic restorations. Nonetheless, the need for peri-implant soft tissue conditioning with a custom healing abutment was evident through the presence of significant differences in the PES-WES values at the different intervals between the 2 groups because of the discrepancies of the soft tissue level and curvature.

The custom healing abutments

Conclusions

Based on the findings of this 1-year randomized clinical trial, the following conclusions were drawn:

1.

For clinical situations requiring immediate single implant placement, the use of the bio-esthetic IREP concept achieved successful esthetic restorations after conditioning the peri-implant tissues using either custom or stock healing abutments.

2.

The custom healing abutment was associated with higher PES-WES values than the stock healing abutment.

CRediT authorship contribution statement

Muhammed B. El-Danasory: Conceptualization, Methodology, Writing – original draft. Mohamed Moataz Khamis: Conceptualization, Methodology, Writing – review & editing. Ahmed Adel Abdel Hakim: Supervision, Writing – review & editing. Rania A. Fahmy: Resources, Supervision.

References (23)J. Cosyn et al.The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: a systematic review and meta-analysis

J Clin Periodontol

(2019)

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© 2023 by the Editorial Council for the Journal of Prosthetic Dentistry.