Effect of Customized Versus Stock Healing Abutments on Peri-Implant Soft Tissue
Esthetic Outcomes and Digital Soft Tissue Assessment of Customized Versus Stock Healing Abutments for Immediate Implants in the Maxillary Esthetic Zone: A Pilot Randomized Controlled Trial
The aim of this study is to compare customized and stock healing abutments for peri-implant soft tissue changes after immediate implant placement in the maxillary esthetic zone, and to assess the feasibility of a full-scale trial.
Study Overview
Status
Conditions
Detailed Description
Preservation of the peri-implant soft tissue contour and papillae after immediate implant placement is essential for a predictable esthetic result. If customized healing abutments provide better soft tissue outcomes than stock abutments, they could be recommended as a routine step in immediate implant placement in the esthetic zone. Because high-quality comparative evidence is lacking, the present pilot randomized trial was designed to compare the peri-implant soft tissue changes (Pink Esthetic Score at 6 months) around customized versus stock healing abutments, and to provide the feasibility data (recruitment, retention, variability of outcomes) needed to calculate the sample size of a full-scale trial.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Good general health (ASA I or II).
- Adult patients above 18 years of age.
- Males or females.
- Good oral hygiene and compliance with follow-up visits.
- Willing to sign the informed consent.
- Non-restorable (hopeless) tooth in the maxillary esthetic zone (canine to canine).
- Intact facial bone wall of the socket after extraction.
- Sufficient bone apical and palatal to the socket to achieve primary implant stability (≥ 35 Ncm).
- Presence of adjacent and opposing natural teeth.
- Healthy periodontium around adjacent teeth.
Exclusion Criteria:
- Participants with uncontrolled systemic illness.
- Pregnant or lactating females.
- Smokers.
- Concomitant participation in another study.
- Heavy bruxism habits.
- History of radiotherapy to the head and neck region or bisphosphonate therapy.
- Patients who refuse to participate.
- Acute infection or abscess at the site.
- Facial bone wall dehiscence or defect.
- Insufficient bone for primary stability.
- Active periodontal disease.
- Previous bone augmentation or implant at the same site.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Immediate implant placement with a customized healing abutment
A customized healing abutment replicating the emergence profile of the extracted tooth will be fabricated chairside using resin composite on a titanium abutment / digitally designed and milled and connected to the implant at the same surgical visit. Its design will be based on the cervical cross-section of the extracted tooth. |
Immediate implant placement with a customized healing abutment |
|
Active Comparator: Immediate implant placement with a prefabricated (stock) healing abutment.
• A prefabricated healing abutment will be selected and connected to the implant at the same surgical visit, with the screw torqued according to the manufacturer's instructions. |
Immediate implant placement with a prefabricated (stock) healing abutment. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pink Esthetic Score (PES)
Time Frame: 6 months
|
PES criteria scoring (0-14) |
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Extended Pink Esthetic Score (E-PES)
Time Frame: 6 months
|
E-PES criteria Scoring (0-18) |
6 months
|
|
Probing depth (PD)
Time Frame: 6 months
|
by peridontal probe in millimeters |
6 months
|
|
Buccal soft tissue contour
Time Frame: 6 months
|
Intraoral scan / stone cast superimposition in millimeters |
6 months
|
|
Keratinized mucosa width (KMW)
Time Frame: 6 months
|
Periodontal probe |
6 months
|
|
Marginal bone level (MBL)
Time Frame: 6 months
|
CBCT / periapical radiograph |
6 months
|
|
Digital Assesment of Buccal Mucosa
Time Frame: 6 months
|
digital scanner |
6 months
|
|
Patient Satisfaction for Esthetics
Time Frame: 6 months
|
binary questionnaire (yes/No) |
6 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 10-2026
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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