J Periodontal Implant Sci.  2011 Dec;41(6):302-308. 10.5051/jpis.2011.41.6.302.

Gingival recontouring by provisional implant restoration for optimal emergence profile: report of two cases

Affiliations
  • 1Department of Prosthodontics, Oral Biology Research Institute, Chosun University School of Dentistry, Gwangju, Korea.
  • 2Department of Periodontology, Oral Biology Research Institute, Chosun University School of Dentistry, Gwangju, Korea. periojang@chosun.ac.kr

Abstract

PURPOSE
The emergence profile concept of an implant restoration is one of the most important factors for the esthetics and health of peri-implant soft tissue. This paper reports on two cases of gingival recontouring by the fabrication of a provisional implant restoration to produce an optimal emergence profile of a definitive implant restoration.
METHODS
After the second surgery, a preliminary impression was taken to make a soft tissue working cast. A provisional crown was fabricated on the model. The soft tissue around the implant fixture on the model was trimmed with a laboratory scalpel to produce the scalloped gingival form. Light curing composite resin was added to fill the space between the provisional crown base and trimmed gingiva. After 4 to 6 weeks, the final impression was taken to make a definitive implant restoration, where the soft tissue and tooth form were in harmony with the adjacent tooth.
RESULTS
At the first insertion of the provisional restoration, gum bleaching revealed gingival pressure. Four to six weeks after placing the provisional restoration, the gum reformed with harmony between the peri-implant gingiva and adjacent dentition.
CONCLUSIONS
Gingival recontouring with a provisional implant restoration is a non-surgical and non-procedure-sensitive method. The implant restoration with the optimal emergence profile is expected to provide superior esthetic and functional results.

Keyword

Dental implants; Dental restoration repair; Gingiva

MeSH Terms

Crowns
Dental Implants
Dental Restoration Repair
Esthetics
Gingiva
Light
Pectinidae
Tooth
Dental Implants

Figure

  • Figure 1 The maxillary first premolar was extracted and the implant was placed (A, before extraction; B, implant healed in a semi-submerged manner).

  • Figure 2 4 mm solid abutment placed.

  • Figure 3 Provisional restoration with an improper tooth contour.

  • Figure 4 Provisional restoration with a proper crown contour (A). Composite resin added extraorally to create an appropriate emergence profile (B).

  • Figure 5 The provisional restoration was placed.

  • Figure 6 An impression was taken when the change in the gingival tissue architecture was evident after 1 month of provisionalization.

  • Figure 7 Definitive implant restoration (A). Postoperative facial view of the harmonious gingival tissue complex and adjacent dentition (B).

  • Figure 8 Initial X-ray before extraction of the upper right central incisor (A). The initial image showed the original diastema between the incisors. Immediate implant placement with guided bone regeneration after extraction (B).

  • Figure 9 The maxillary left central incisor was replaced with an implant (A). Impression coping was placed to make the impression (B).

  • Figure 10 Occlusal view of soft tissue cast. Flat and bulky mesial interdental papilla existed between the incisors in the original diastema.

  • Figure 11 A temporary abutment was connected to produce the screw-retained provisional restoration.

  • Figure 12 To make a triangular formed interdental papilla and proper contoured crown, composite resin was added to the mesial base of the provisional restoration.

  • Figure 13 Provisional restoration with a natural emergence profile (A). Provisional restoration was placed for 1 month to reform the gingiva (B).

  • Figure 14 Recontoured gingival architecture by a provisional restoration.

  • Figure 15 Postoperative facial view.


Cited by  1 articles

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So-Hee Kang, Jung-Hong Ha, Myoung-Uk Jin, Sung-Kyo Kim, Young-Kyung Kim
Restor Dent Endod. 2016;41(3):210-217.    doi: 10.5395/rde.2016.41.3.210.


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