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

Mario Beretta, Pier Paolo Poli, Silvia Pieriboni, Sebastian Tansella, Mattia Manfredini, Marco Cicciù, Carlo Maiorana, Mario Beretta, Pier Paolo Poli, Silvia Pieriboni, Sebastian Tansella, Mattia Manfredini, Marco Cicciù, Carlo Maiorana

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.

Keywords: CAD/CAM; custom healing abutment; dental implant; emergence profile; soft tissue.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
On the left: the elaboration of the STL file from a virtual library. On the right: the anatomically modified healing abutment.
Figure 2
Figure 2
On the left: placement of the anatomically modified healing screw. On the right: placement of the standard healing screw.
Figure 3
Figure 3
On the left: tissue conditioning achieved with the anatomically modified healing screw. On the right: tissue conditioning achieved with the standard healing screw.
Figure 4
Figure 4
On the left: tissue distress at crown placement after conditioning with a standard healing screw. On the right: placement of the zirconia crown after tissue conditioning with a standard healing abutment.
Figure 5
Figure 5
Placement of the zirconia crown after tissue conditioning with the anatomically modified healing abutment.

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