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Background
Immediate Implant placement is a successful treatment option for failing teeth. Tissue remodeling that occurs post extraction is an aesthetic challenge. It is mandatory with implant placement in an extraction socket, to place a well contoured abutment with a crown, so that it is supportive to the soft tissue and helps maintain the profile of a natural tooth. The attempt should be to restrict the repeated removal of abutment during steps from impression to fitting of the final crown. The breaking of the gingival seal at the abutment collar initiates a remodeling process and changes the soft tissue profile.
Aims
To evaluate the influence of the repeated changes against the placement of a definitive abutment, on hard and soft tissue, evaluated over a 1-6-12 month period.
Methods
Two patients, one with a fractured bicuspid and other with a fractured central incisor, were planned for immediate implant placements with different loading protocols. Both implants had a placement torque of >35Ncm2. One with the fractured bicuspid was fitted with a provisional customized abutment, as the standard one did not support the socket profile. Provisional crown was given for 6 weeks. At 6 weeks the provisional crown & abutment were removed and digital scan was made using a scan body. The definitive crown was made using an innovative ceramic modified PEEK abutment with an High Impact Polymer Resin crown. Trials were taken where in each time the provisional abutment & crown were removed.The definitive crown was fitted after 8 weeks of implant placement. Follow up radiographs and probing depths recorded at day of placement & 2-6-12 months.For the patient with the incisor a final standard abutment of ceramic reinforced PEEK with a provisional crown was fitted and peri-apical radiographs and soft tissue assessments were taken at the day of placement & a follow up done after 6 -12weeks. A digital scan of the abutment was made for definitive Full Contour Zirconia crown.
Results
Peri-implant six point Periodontal Probing Depths performed at 1,3,6, 12month follow-up revealed an average in the one time abutment as Buccal 1mm, Mesio-Buccal 1mm, Disto-Buccal 1mm, Palatal 0mm, Mesio-Palatal 1mm, Disto-Palatal 1mm.The probing depths were constant throughout the study period. Peri-implant analysis of the repeated removal of abutment revealed an average PPD was B-2mm,MB-3mm,DB-3mm,P-1mm,MP-2mm,DP-3mm. It also showed an increase in probing depth after 3 months during the final restorative phase.Walking the CPITN ball ended probe showed no Bleeding on probing in the one time abutment whereas a positive BOP was observed at all intervals of evaluation in the peri-implant soft tissue where the abutment was changed.Periapical radiograph revealed no bone loss at 1 month evaluation in both abutments. There was a definitive crestal bone loss observed from the 6 weeks in the 2 stage abutment as opposed to the one time abutment where bone levels were maintained through the study period.
Conclusions
The non-removal of abutments placed at the time of surgery results in a significant reduction of the crestal bone resorption around the implant with a healthier soft tissue. It helps maintain the gingival profile from natural tooth to final implant restoration. A healthy peri-implant seal, provides a predictable aesthetic restoration.
Background
Immediate Implant placement is a successful treatment option for failing teeth. Tissue remodeling that occurs post extraction is an aesthetic challenge. It is mandatory with implant placement in an extraction socket, to place a well contoured abutment with a crown, so that it is supportive to the soft tissue and helps maintain the profile of a natural tooth. The attempt should be to restrict the repeated removal of abutment during steps from impression to fitting of the final crown. The breaking of the gingival seal at the abutment collar initiates a remodeling process and changes the soft tissue profile.
Aims
To evaluate the influence of the repeated changes against the placement of a definitive abutment, on hard and soft tissue, evaluated over a 1-6-12 month period.
Methods
Two patients, one with a fractured bicuspid and other with a fractured central incisor, were planned for immediate implant placements with different loading protocols. Both implants had a placement torque of >35Ncm2. One with the fractured bicuspid was fitted with a provisional customized abutment, as the standard one did not support the socket profile. Provisional crown was given for 6 weeks. At 6 weeks the provisional crown & abutment were removed and digital scan was made using a scan body. The definitive crown was made using an innovative ceramic modified PEEK abutment with an High Impact Polymer Resin crown. Trials were taken where in each time the provisional abutment & crown were removed.The definitive crown was fitted after 8 weeks of implant placement. Follow up radiographs and probing depths recorded at day of placement & 2-6-12 months.For the patient with the incisor a final standard abutment of ceramic reinforced PEEK with a provisional crown was fitted and peri-apical radiographs and soft tissue assessments were taken at the day of placement & a follow up done after 6 -12weeks. A digital scan of the abutment was made for definitive Full Contour Zirconia crown.
Results
Peri-implant six point Periodontal Probing Depths performed at 1,3,6, 12month follow-up revealed an average in the one time abutment as Buccal 1mm, Mesio-Buccal 1mm, Disto-Buccal 1mm, Palatal 0mm, Mesio-Palatal 1mm, Disto-Palatal 1mm.The probing depths were constant throughout the study period. Peri-implant analysis of the repeated removal of abutment revealed an average PPD was B-2mm,MB-3mm,DB-3mm,P-1mm,MP-2mm,DP-3mm. It also showed an increase in probing depth after 3 months during the final restorative phase.Walking the CPITN ball ended probe showed no Bleeding on probing in the one time abutment whereas a positive BOP was observed at all intervals of evaluation in the peri-implant soft tissue where the abutment was changed.Periapical radiograph revealed no bone loss at 1 month evaluation in both abutments. There was a definitive crestal bone loss observed from the 6 weeks in the 2 stage abutment as opposed to the one time abutment where bone levels were maintained through the study period.
Conclusions
The non-removal of abutments placed at the time of surgery results in a significant reduction of the crestal bone resorption around the implant with a healthier soft tissue. It helps maintain the gingival profile from natural tooth to final implant restoration. A healthy peri-implant seal, provides a predictable aesthetic restoration.
Background
Immediate Implant placement is a successful treatment option for failing teeth. Tissue remodeling that occurs post extraction is an aesthetic challenge. It is mandatory with implant placement in an extraction socket, to place a well contoured abutment with a crown, so that it is supportive to the soft tissue and helps maintain the profile of a natural tooth. The attempt should be to restrict the repeated removal of abutment during steps from impression to fitting of the final crown. The breaking of the gingival seal at the abutment collar initiates a remodeling process and changes the soft tissue profile.
Aims
To evaluate the influence of the repeated changes against the placement of a definitive abutment, on hard and soft tissue, evaluated over a 1-6-12 month period.
Methods
Two patients, one with a fractured bicuspid and other with a fractured central incisor, were planned for immediate implant placements with different loading protocols. Both implants had a placement torque of >35Ncm2. One with the fractured bicuspid was fitted with a provisional customized abutment, as the standard one did not support the socket profile. Provisional crown was given for 6 weeks. At 6 weeks the provisional crown & abutment were removed and digital scan was made using a scan body. The definitive crown was made using an innovative ceramic modified PEEK abutment with an High Impact Polymer Resin crown. Trials were taken where in each time the provisional abutment & crown were removed.The definitive crown was fitted after 8 weeks of implant placement. Follow up radiographs and probing depths recorded at day of placement & 2-6-12 months.For the patient with the incisor a final standard abutment of ceramic reinforced PEEK with a provisional crown was fitted and peri-apical radiographs and soft tissue assessments were taken at the day of placement & a follow up done after 6 -12weeks. A digital scan of the abutment was made for definitive Full Contour Zirconia crown.
Results
Peri-implant six point Periodontal Probing Depths performed at 1,3,6, 12month follow-up revealed an average in the one time abutment as Buccal 1mm, Mesio-Buccal 1mm, Disto-Buccal 1mm, Palatal 0mm, Mesio-Palatal 1mm, Disto-Palatal 1mm.The probing depths were constant throughout the study period. Peri-implant analysis of the repeated removal of abutment revealed an average PPD was B-2mm,MB-3mm,DB-3mm,P-1mm,MP-2mm,DP-3mm. It also showed an increase in probing depth after 3 months during the final restorative phase.Walking the CPITN ball ended probe showed no Bleeding on probing in the one time abutment whereas a positive BOP was observed at all intervals of evaluation in the peri-implant soft tissue where the abutment was changed.Periapical radiograph revealed no bone loss at 1 month evaluation in both abutments. There was a definitive crestal bone loss observed from the 6 weeks in the 2 stage abutment as opposed to the one time abutment where bone levels were maintained through the study period.
Conclusions
The non-removal of abutments placed at the time of surgery results in a significant reduction of the crestal bone resorption around the implant with a healthier soft tissue. It helps maintain the gingival profile from natural tooth to final implant restoration. A healthy peri-implant seal, provides a predictable aesthetic restoration.
Background
Immediate Implant placement is a successful treatment option for failing teeth. Tissue remodeling that occurs post extraction is an aesthetic challenge. It is mandatory with implant placement in an extraction socket, to place a well contoured abutment with a crown, so that it is supportive to the soft tissue and helps maintain the profile of a natural tooth. The attempt should be to restrict the repeated removal of abutment during steps from impression to fitting of the final crown. The breaking of the gingival seal at the abutment collar initiates a remodeling process and changes the soft tissue profile.
Aims
To evaluate the influence of the repeated changes against the placement of a definitive abutment, on hard and soft tissue, evaluated over a 1-6-12 month period.
Methods
Two patients, one with a fractured bicuspid and other with a fractured central incisor, were planned for immediate implant placements with different loading protocols. Both implants had a placement torque of >35Ncm2. One with the fractured bicuspid was fitted with a provisional customized abutment, as the standard one did not support the socket profile. Provisional crown was given for 6 weeks. At 6 weeks the provisional crown & abutment were removed and digital scan was made using a scan body. The definitive crown was made using an innovative ceramic modified PEEK abutment with an High Impact Polymer Resin crown. Trials were taken where in each time the provisional abutment & crown were removed.The definitive crown was fitted after 8 weeks of implant placement. Follow up radiographs and probing depths recorded at day of placement & 2-6-12 months.For the patient with the incisor a final standard abutment of ceramic reinforced PEEK with a provisional crown was fitted and peri-apical radiographs and soft tissue assessments were taken at the day of placement & a follow up done after 6 -12weeks. A digital scan of the abutment was made for definitive Full Contour Zirconia crown.
Results
Peri-implant six point Periodontal Probing Depths performed at 1,3,6, 12month follow-up revealed an average in the one time abutment as Buccal 1mm, Mesio-Buccal 1mm, Disto-Buccal 1mm, Palatal 0mm, Mesio-Palatal 1mm, Disto-Palatal 1mm.The probing depths were constant throughout the study period. Peri-implant analysis of the repeated removal of abutment revealed an average PPD was B-2mm,MB-3mm,DB-3mm,P-1mm,MP-2mm,DP-3mm. It also showed an increase in probing depth after 3 months during the final restorative phase.Walking the CPITN ball ended probe showed no Bleeding on probing in the one time abutment whereas a positive BOP was observed at all intervals of evaluation in the peri-implant soft tissue where the abutment was changed.Periapical radiograph revealed no bone loss at 1 month evaluation in both abutments. There was a definitive crestal bone loss observed from the 6 weeks in the 2 stage abutment as opposed to the one time abutment where bone levels were maintained through the study period.
Conclusions
The non-removal of abutments placed at the time of surgery results in a significant reduction of the crestal bone resorption around the implant with a healthier soft tissue. It helps maintain the gingival profile from natural tooth to final implant restoration. A healthy peri-implant seal, provides a predictable aesthetic restoration.