Customising the Emergence Profile of Implant Retained Fixed Dental Prostheses - a Pressing Matter
Objectives: Implant retained fixed dental prostheses (FDPs) can fulfil both the functional and aesthetic requirements of a pleasing dental reconstruction. The aesthetic requirements, however, are often compromised by a lack of attention given to the gingival architecture that will frame the prosthesis.
The use of standard implant healing abutments creates a uniformly round, rather flat gingival emergence profile. This forgoes the possibility of generating natural looking pseudo-papillae to mimic the tooth-gingiva appearance as well as risking an uncleansable prosthesis design.
Three case reports are presented to outline a process of gingival conditioning (demonstrated with both digital and conventional workflows) using customised healing abutments and simple soft tissue compression techniques.
Methods: Impressions are made and custom healing abutments fabricated, incorporating an ideal emergence profile into these abutments. These healing abutments replace the standard abutments and exert a gentle pressure on the peri-implant tissue to create a smooth, convex and aesthetic emergence profile.
Once satisfied with the gingival configuration created, a new impression is made and the definitive implant retained prosthesis is fabricated with a customised emergence profile that enhances both the resultant aesthetics and cleansability.
Results: For single tooth and short-span FDPs, the interproximal gingival downgrowth creates pseudo-papillae to mimic that of the natural tooth-to-gingiva architecture. For full arch implant prostheses, the gingival contouring completed allows the creation of a smooth, convex tissue surface for full arch implant restoration. This can greatly increase the cleansability of such prostheses and thus increase their success.
Conclusions: This clincal technique presentation highlights three cases where optimised restorative outcomes are achieved when applied to single tooth, short-span FDP and full arch implant prosthodontic reconstructions.