Transmucosal abutments in the esthetic zone: Surgical and prosthetic considerations. 2023

Iñaki Gamborena, and Yoshihiro Sasaki, and Markus B Blatz
Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA.

This article describes an updated step-by-step protocol for transmucosal abutment selection and treatment sequencing after immediate implant placement in the esthetic zone. Current surgical and prosthetic concepts strive to preserve hard and soft-tissues to provide optimal esthetics at the implant-abutment interface. Consequently, restoring implants in the esthetic zone with transmucosal abutments presents a great challenge and must take into consideration implant depth, angulation, and bucco-lingual position as well as transmucosal height and space for an optimized emergence profile of the restoration and the dimensions of the anterior tooth to be restored. The proper selection of the type, shape, and dimensions of implant components and connections, determined by the product portfolio offered by the implant manufacturer, play a critical role in the ability to adequately address these challenges. This article provides an update on surgical and prosthetic workflows for single implant restorations in the esthetic zone. Following esthetic, mechanical, and biologic principles, the long-term success of implant-supported restorations in the esthetic zone is directly correlated to proper execution and sequencing of surgical and prosthetic treatment steps, especially after immediate implant placement. These steps must be critically assessed based on the current scientific evidence to achieve the desired clinical outcomes on a predictable and consistent basis. Selection of surgical and prosthetic treatment protocols to achieve ideal esthetic outcomes and emergence profiles in implant dentistry is often a great challenge, not only determined by technical and clinical skills of the provider but also by the type and dimensions of implant components and connections offered by the manufacturer. Following certain decision-making principles and workflows are key for clinical success with implant-supported restorations after immediate implant placement the esthetic zone.

UI MeSH Term Description Entries
D004955 Esthetics, Dental Skills, techniques, standards, and principles used to improve the art and symmetry of the teeth and face to improve the appearance as well as the function of the teeth, mouth, and face. (From Boucher's Clinical Dental Terminology, 4th ed, p108) Cosmetic Dentistry,Aesthetics, Dental,Dental Esthetic,Dental Esthetics,Esthetic, Dental,Cosmetic Dentistries,Dentistries, Cosmetic,Dentistry, Cosmetic
D000044 Dental Abutments Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. Abutments, Dental,Abutment, Dental,Dental Abutment
D057893 Immediate Dental Implant Loading Endosseous dental implantation where implants are fitted with an abutment or where an implant with a transmucosal coronal portion is used immediately (within 1 week) after the initial extraction. Conventionally, the implantation is performed in two stages with more than two months in between the stages. Dental Implant Loading, Immediate,Socket Shield Technique,Socket-Shield Technique,Dental Implant Loading, Early,Early Dental Implant Loading,Socket Shield Techniques,Socket-Shield Techniques,Technique, Socket Shield,Technique, Socket-Shield
D019250 Dental Implants, Single-Tooth Devices, usually alloplastic, surgically inserted into or onto the jawbone, which support a single prosthetic tooth and serve either as abutments or as cosmetic replacements for missing teeth. Single-Tooth Implants,Dental Implant, Single-Tooth,Implant, Single-Tooth Dental,Implants, Single-Tooth Dental,Single-Tooth Dental Implant,Single-Tooth Dental Implants,Dental Implant, Single Tooth,Dental Implants, Single Tooth,Implant, Single Tooth Dental,Implant, Single-Tooth,Implants, Single Tooth Dental,Implants, Single-Tooth,Single Tooth Dental Implant,Single Tooth Dental Implants,Single Tooth Implants,Single-Tooth Implant

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