Peri-Implant Soft Tissue Conditioning With Prefabricated Titanium Anatomic Healing Abutment Compared With Conventional Circular Healing Abutment: A Case Letter

In Case 1, soft tissue healing after applying anatomical (a, b, c) or conventional healing abutment (d, e) was compared. The anatomical healing abutment simulates a lower molar tooth neck contour (a). The emergence profile looks natural from occlusal (b) and buccal (c) views. The conventional healing abutment with a circular contour (d). The circular-shaped emergence profile after conventional abutment (e).

In Case 1, the impression was taken with the help of a closed tray impression coping with a similar gingival contour to the anatomical healing abutment (a). The impression coping fills the well-formed emergence profile (b). Polyvinyl siloxane impression with the closed tray coping was attached to a labor analog (c).

In Case 1, the missing teeth were restored with screw-retrained full-contour zirconia crowns. The clinical appearance of the peri-implant soft tissue at #30 (b) looks more natural than at #18 (a).

In Case 1, orthopantomograms after the implant placement (a) and after the crown placement (b).

In Case 2, at the #30 tooth, the crestal bone thickness was 4.35mm (a). The placed implant with simultaneous bone grafting. The implant was placed 1 mm below the lingual bone wall (b).

In Case 2, the implant was placed at the position of #30 tooth 1 mm below the lingual bone wall (a). A titanium micromesh was adapted to the augmented area (b). The titanium micromesh was covered with a resorbable collagen membrane, and then the periosteum was tightened over the grafted area (c). The mucosa was closed with single interrupted sutures (d).

In Case 2, a fistula formed on the alveolar ridge above the augmented area (a). Uncovering of the titanium micromesh (b). The infected graft particles were removed (c).

In Case 2, a connective tissue graft (CTG) was harvested from the maxillary tuberosity (a). The connective tissue graft was sutured above the augmented area. (b). An anatomic healing abutment was placed to form the emergence profile (c). The well-formed anatomic emergence profile (d, e).

In Case 2, conventional healing abutment at the #19 implant (a). Circular emergence profile shaped by the conventional healing abutment (b).

In Case 2, conventional closed tray impression post at the #19 implant (a). Full-contour zirconia crown at the #19 implant (b). Anatomically shaped closed tray impression post at the #30 implant (c). Full-contour zirconia crown at the #30 implant (d).

In Case 2, (a) an orthopantomogram was made after implantation, (b) an orthopantomogram was made after the crown placements, and (c) an orthopantomogram was made 1 year after crown placement.