Peri-implant tissue management after immediate implant placement using a customized healing abutment

Edwin Ruales-Carrera, Patrícia Pauletto, Karin Apaza-Bedoya, Claudia A M Volpato, Mutlu Özcan, César A M Benfatti, Edwin Ruales-Carrera, Patrícia Pauletto, Karin Apaza-Bedoya, Claudia A M Volpato, Mutlu Özcan, César A M Benfatti

Abstract

Objective: The unavoidable extraction of teeth in the esthetic area can be overcome through different treatment modalities. Recently, immediate implants appeared as a minimally invasive approach to resolving these cases; however, immediate implant loading is not always possible or indicated. In these cases, an innovative approach through customized healing abutments could be used to preserve the soft tissue contour, eliminating the need for reopening surgery and the use of provisional restorations to condition the mucosal contour.

Clinical considerations: The present cases describe a simplified chairside approach to use customized healing abutments for immediate implants placed after tooth extraction in the anterior and posterior areas in order to maintain the soft tissue contours while reducing the clinical steps until delivering the final restorations.

Conclusions: This technique seems to be effective to guide the soft tissue healing around dental implants allowing a natural emergence profile with implant-supported restorations, reducing the number of treatment steps.

Clinical significance: The use of customized healing abutments prepares soft tissue for the prosthetic stage preserving its contours and eliminating the need for reopening surgery.

Keywords: customized healing abutment; emergence profile; immediate placement; soft tissue management.

© 2019 Wiley Periodicals, Inc.

References

REFERENCES

    1. Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005;32:212-218.
    1. Jung RE, Ioannidis A, Hämmerle CHF, Thoma DS. Alveolar ridge preservation in the esthetic zone. Periodontol 2000. 2018;77:165-175.
    1. MacBeth N, Trullenque-Eriksson A, Donos N, Mardas N. Hard and soft tissue changes following alveolar ridge preservation: a systematic review. Clin Oral Implants Res. 2017;28:982-1004.
    1. Linkevicius T, Puisys A, Steigmann M, Vindasiute E, Linkeviciene L. Influence of vertical soft tissue thickness on crestal bone changes around implants with platform switching: a comparative clinical study. Clin Implant Dent Relat Res. 2015;17:1228-1236.
    1. Linkevicius T, Apse P, Grybauskas S, Puisys A. The influence of soft tissue thickness on crestal bone changes around implants: a 1-year prospective controlled clinical trial. Int J Oral Maxillofac Implants. 2009;24(4):712-719.
    1. Hämmerle CHF, Tarnow D. The etiology of hard- and soft-tissue deficiencies at dental implants: a narrative review. J Clin Periodontol. 2018;45:S267-S277.
    1. Araujo MG, Lindhe J. Peri-implant health. J Clin Periodontol. 2018;45:S230-S236.
    1. Broggini N, McManus LM, Hermann JS, et al. Peri-implant inflammation defined by the implant-abutment interface. J Dent Res. 2006;85:473-478.
    1. Fickl S, Zuhr O, Wachtel H, Bolz W, Huerzeler M. Tissue alterations after tooth extraction with and without surgical trauma: a volumetric study in the beagle dog. J Clin Periodontol. 2008;35:356-363.
    1. Chappuis V, Araújo MG, Buser D. Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites. Periodontol 2000. 2017;73:73-83.
    1. Barone A, Rispoli L, Vozza I, Quaranta A, Covani U. Immediate restoration of single implants placed immediately after tooth extraction. J Periodontol. 2006;77:1914-1920.
    1. Passoni BB, Marques de Castro DS, de Araújo MA, de Araújo CD, Piatelli A, Benfatti CA. Influence of immediate/delayed implant placement and implant platform on the peri-implant bone formation. Clin Oral Implants Res. 2016;27:1376-1383.
    1. Slagter KW, Hartog L, Bakker NA, Vissink A, Meijer HJ, Raghoebar GM. Immediate placement of dental implants in the esthetic zone: a systematic review and pooled analysis. J Periodontol. 2014;85:e241-e250.
    1. Van Nimwegen WG, Goené RJ, Van Daelen ACL, Stellingsma K, Raghoebar GM, Meijer HJ. Immediate implant placement and provisionalisation in the aesthetic zone. J Oral Rehabil. 2016;43:745-752.
    1. Block MS, Mercante DE, Lirette D, Mohamed W, Ryser M, Castellon P. Prospective evaluation of immediate and delayed provisional single tooth restorations. J Oral Maxillofac Surg. 2009;67:89-107.
    1. Ottoni JMP, Oliveira ZFL, Mansini R, Cabral AM. Correlation between placement torque and survival of single-tooth implants. Int J Oral Maxillofac Implants. 2005;20(5):769-776.
    1. Kokovic V, Jung R, Feloutzis A, Todorovic VS, Jurisic M, Hämmerle CHF. Immediate vs. early loading of SLA implants in the posterior mandible: 5-year results of randomized controlled clinical trial. Clin Oral Implants Res. 2014;25:e114-e119.
    1. Baltayan S, Pi-Anfruns J, Aghaloo T, Moy PK. The predictive value of resonance frequency analysis measurements in the surgical placement and loading of endosseous implants. J Oral Maxillofac Surg. 2016;74:1145-1152.
    1. Chrcanovic BR, Albrektsson T, Wennerberg A. Immediate nonfunctional versus immediate functional loading and dental implant failure rates: a systematic review and meta-analysis. J Dent. 2014;42:1052-1059.
    1. Moraschini V, Porto Barboza E. Immediate versus conventional loaded single implants in the posterior mandible: a meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg. 2016;45:85-92.
    1. Branemark P-I. Osseointegration and its experimental background. J Prosthet Dent. 1983;50:399-410.
    1. Albrektsson T, Brånemark P-I, Hansson H-A, Lindström J. Osseointegrated titanium implants: requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52:155-170.
    1. Chu SJ, Salama MA, Salama H, et al. The dual-zone therapeutic concept of managing immediate implant placement and provisional restoration in anterior extraction sockets. Compend Contin Educ Dent. 2012;33:524-532.
    1. Su H, González-Martín O, Weisgold A, Lee E. Considerations of implant abutment and crown contour: critical contour and subcritical contour. Int J Periodontics Restorative Dent. 2010;30(4):335-343.
    1. Silthampitag P, Chaijareenont P, Tattakorn K, Banjongprasert C, Takahashi H, Arksornnukit M. Effect of surface pretreatments on resin composite bonding to PEEK. Dent Mater J. 2016;35:668-674.
    1. Alshhrani WM, Al Amri MD. Customized CAD-CAM healing abutment for delayed loaded implants. J Prosthet Dent. 2016;116:176-179.
    1. Proussaefs P. Use of CAD/CAM healing abutment immediately after dental implant placement for the non-esthetic zone: a guided soft tissue healing technique. J Oral Implantol. 2016;42:189-193.
    1. Proussaefs P. Custom CAD-CAM healing abutment and impression coping milled from a poly (methyl methacrylate) block and bonded to a titanium insert. J Prosthet Dent. 2016;116:657-662.
    1. Stumpel LJ, Wadhwani C. A customized healing abutment for immediate and delayed implant cases. Compend Contin Educ Dent. 2017;38:672-678.
    1. Bhola M, Neely AL, Kolhatkar S. Immediate implant placement: clinical decisions, advantages, and disadvantages. J Prosthodont. 2008;17:576-581.
    1. Berberi AN, Noujeim ZN, Kanj WH, Mearawi RJ, Salameh ZA. Immediate placement and loading of maxillary single-tooth implants: a 3-year prospective study of marginal bone level. J Contemp Dent Pract. 2014;15:202-208.
    1. Akin R. A new concept in maintaining the emergence profile in immediate posterior implant placement: the anatomic harmony abutment. J Oral Maxillofac Surg. 2016;74:2385-2392.
    1. Vela X, Méndez V, Rodríguez X, Segalà M, Gil JA. Soft tissue remodeling technique as a non-invasive alternative to second implant surgery. Eur J Esthet Dent. 2012;7:36-47.
    1. Saito H, Chu SJ, Reynolds MA, Tarnow DP. Provisional restorations used in immediate implant placement provide a platform to promote peri-implant soft tissue healing: a pilot study. Int J Periodontics Restorative Dent. 2016;36:47-52.
    1. Trimpou G, Weigl P, Krebs M, Parvini P, Nentwig GH. Rationale for esthetic tissue preservation of a fresh extraction socket by an implant treatment concept simulating a tooth replantation. Dent Traumatol. 2010;26:105-111.
    1. Lee J, Lee J-B, Koo K-T, Seol YJ, Lee YM. Flap management in alveolar ridge preservation: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2018;33:613-621.
    1. Tarnow DP, Chu SJ, Salama MA, et al. Flapless postextraction socket implant placement in the esthetic zone: part 1. The effect of bone grafting and/or provisional restoration on facial-palatal ridge dimensional change-a retrospective cohort study. Int J Periodontics Restorative Dent. 2014;34:323-331.
    1. Chu SJ, Hochman MN, Tan-Chu JH, Mieleszko AJ, Tarnow DP. A novel prosthetic device and method for guided tissue preservation of immediate postextraction socket implants. Int J Periodontics Restor Dent. 2014;34:s9-s17.
    1. Zhang S, Wang S, Song Y. Immediate loading for implant restoration compared with early or conventional loading: a meta-analysis. J Craniomaxillofacial Surg. 2017;45:793-803.
    1. Crespi R, Capparé P, Crespi G, Gastaldi G, Romanos G, Gherlone E. Tissue remodeling in immediate versus delayed prosthetic restoration in fresh socket implants in the esthetic zone: four-year follow-up. Int J Periodontics Restorative Dent. 2018;38:s97-s103.
    1. Norton MR. The influence of insertion torque on the survival of immediately placed and restored single-tooth implants. Int J Oral Maxillofac Implants. 2011;26(6):1333-1343.
    1. Clavijo V, de Carvalho PFM. Cicatrizador Personalizado-Detalhes que fazem a diferença. Clínica-Int J Brazilian Dent. 2016;12:200-204.
    1. Koutouzis T, Richardson J, Lundgren T. Comparative soft and hard tissue responses to titanium and polymer healing abutments. J Oral Implantol. 2011;37:174-182.

Source: PubMed

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