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Optimizing Anterior Esthetics with Custom Healing and Restorative Components

Treatment Planning with Custom Healing and Restorative Components - Dental CE Course
Launch Course

Course Objectives (2 CE Credits)

Timothy Kosinski, DDS, MAGD

With the emergence of restorative-driven treatment planning as the optimal approach to implant therapy, custom healing and restorative components go a long way toward creating the esthetics needed to meet patient expectations. Custom healing components help to preserve the gingival contours that surround the natural tooth, while final custom abutments adhere precisely to final soft-tissue architecture, resulting in a natural emergence profile for the definitive restoration.

In this comprehensive case report on a challenging implant restoration in the esthetic zone, Dr. Timothy Kosinski illustrates how custom components and all-in-one treatment planning foster an ideal prosthetic outcome, helping to replicate the contours and margins of the original tooth. Topics include:

  • The impact of implant and prosthetic design innovations on restorative esthetics
  • Restoring an implant case to mimic the original tooth and soft tissue anatomy
  • Managing the soft tissue surrounding the implant site with custom healing components
  • Comparing the effect of stock abutments and custom abutments on prosthetic outcomes
  • Establishing ideal emergence profiles and gingival margins with custom components
  • The importance of prosthetically driven treatment planning in the anterior
  • The use of custom transfer copings in taking the final impression
  • Benefits of temporization with a custom temporary abutment and provisional crown
  • General parameters for determining implant placement in the esthetic zone
  • Maintaining periodontal health during the healing and restorative phases of treatment
  • The use of CAD/CAM technology in the design and production of custom components

Summary

As the long-term prognosis of implant therapy has become more predictable, the emphasis of treatment planning has shifted from the surgical placement of the implant to the esthetics of the final prosthetic outcome. By managing the soft tissue surrounding the implant site, custom abutments help to maintain this restorative-driven approach by establishing ideal margins and creating a natural emergence profile for the final prosthesis.

All-in-one treatment planning utilizes patient-specific, CAD/CAM-produced components throughout treatment, facilitating an outcome that is both functional and highly esthetic. This approach is especially advantageous in the anterior, where the esthetics of the final restoration are the most crucial.

CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.


References

  1. Borges T, Lima T, Carvalho A, Carvalho V. Clinical Outcome of Inter-Proximal Papilla between a Tooth and a Single Implant Treated with CAD/CAM Abutments: a Cross-Sectional Study. J Oral Maxillofac Res. 2012 Oct 1;3(3):e4.
  2. Wheeler SL, Vogel RE, Casellini R. Tissue preservation and maintenance of optimum esthetics: a clinical report. Int J Oral Maxillofac Implants. 2000 Mar-Apr;15(2):265-71.
  3. Kutkut A, Abu-Hammad O, Mitchell R. Esthetic Considerations for Reconstructing Implant Emergence Profile Using Titanium and Zirconia Custom Implant Abutments: Fifty Case Series Report. J Oral Implantol. 2015 Oct;41(5):554-61.
  4. Hinds KF. Custom impression coping for an exact registration of the healed tissue in the esthetic implant restoration. Int J Periodontics Restorative Dent. 1997 Dec;17(6):584-91.
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