Customized vs Conventional Abutments in Healing Fresh Extraction Dental Sockets on Maxillary Anterior Teeth

Abstract

Aim: The aim of the present retrospective study on fresh socket implants in esthetic region was to compare customized vs standard healing abutments, evaluating alveolar bone assessment. Materials and methods: Postextractive sockets underwent immediate dental implant placement without filling the voids between the implant surface and socket wall. Width of the alveolar ridge following implant placement with or without customized abutment mimicking the look of the extracted tooth was measured on three-dimensional radiographs before and 3 years after surgery. The statistic is performed with a level of significance of 0.05. Results: In a split-mouth analysis, 22 patients were enrolled with a total of 44 selected maxillary dental implants: 14 incisives, 14 canines, and 16 premolars. An implant survival rate of 100% was reported for all implants after 36 months. 3 years after the implant placement, loss in bone width was registered both for the standard group (−2.18 ± 0.59 mm) and for the custom group (−0.08 ± 0.22 mm), even if dimensional change of the alveolar ridge following the healing procedure appeared in the custom group to be not significant with respect to the standard group. Significant differences were found between groups irrespective of tooth type (p ≤ 0.0001), and among subgroups related to the tooth type (incisor vs both canine and premolar, with p ≤ 0.0124). Conclusion: Custom procedure might help provide a seal over the surgical site to protect the coagulum and to support natural emergence profile for optimal final restorative contours, and in doing so promoting socket volume maintenance.