J Dent Rehabil Appl Sci.  2023 Dec;39(4):260-266. 10.14368/jdras.2023.39.4.260.

Improvement of peri-implant complications through customized prosthesis restoration allowing soft tissue space: a case report

• Song J
• Jang W
• Park C
• Yun K
• Lim HP
• Park S

• KMID: 2550435
• DOI: http://doi.org/10.14368/jdras.2023.39.4.260

Abstract

The concept of ‘Implant Supracrestal Complex (ISC)’ was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant. Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the longterm stability of the implant.

Keyword

peri-implant diseases; implant supracrestal complex (ISC); emergence angle

Figure

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  Fig. 1 Intraoral photographs. (A) Right lateral view, (B) Frontal view, (C) Left lateral view.

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  Fig. 2 Existing prosthesis.

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  Fig. 3 Periapical radiography of existing prosthesis. The emergence profile formed an angle of up to 38 degrees, especially at the connector area.

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  Fig. 4 Two weeks later by replacing the prosthesis with a healing abutment. The inflammation and bleeding including white bark around the healing abutment were observed in the soft tissue. (A) Buccal view, (B) Occlusal view, (C) Palatal view.

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  Fig. 5 CAD design of a new prosthesis. (A) The emergence profile of the crown was designed to form an emergence angle of 30 degrees based on the most concave point of the modified abutment, (B) Final fit of the provisional prosthesis on the model.

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  Fig. 6 1 week and 4 months after the provisional prosthesis was placed, it was confirmed that the redness and swelling of the gingiva around the implant gradually disappeared and the inflammation was decreased, and the gingiva regained its original luster. (A) Just after cementation, (B) 1 week later, (C) 4 months later, (D) Periapical radiography of provisional prosthesis.

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  Fig. 7 Definitive prosthesis.

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  Fig. 8 Periapical radiography of provisional prosthesis. (A) The emergence angle of the abutment and crown is close to 30 degrees based on the most concave part of the abutment, providing sufficient soft tissue space for the 26i mesial area and connection area, (B) The emergence angle was further reduced to less than 30 degrees when measured based on the implant platform, allowing more soft tissue space.

Reference

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