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Management of contours of soft tissue for single tooth implant restorations

In this post, I have highlighted the take away thoughts from a lecture regarding how to appropriately manage the soft tissue when placing a single tooth implant restoration.

  • Final gingival contours are often created by the general dentist and not the oral surgeon or periodontist.
  • We would rather have more soft tissue and then create a greater emergence profile, rather than less soft tissue.
  • In regards to tissue molding, when go to try in the abutment and crown , the tissue will be in the way. If you are doing any tissue molding, use a screw retained restoration. You will see blanching of the soft tissue. You will most likely need to anesthetize the patient, as it will be uncomfortable for them.
  • To know if you can get the tissue to move up, you need to look at the radiograph.
  • Frank Spear reports he uses a steroid mix on the screw, which will then express out into the gingiva to help control initial inflammation.
  • It may be best to give local anesthesia prior to any implant abutment/crown delivery for pt comfort.
  • If using anesthetic, use direct injection that blanches both the buccal and palatal tissue.
  • There are times when it may be necessary to perform a gingivectomy on an implant crown, but it is more ideal to avoid this if possible.