The single implant-crown complex in the aesthetic zone: Abutment selection and the treatment sequencing

Abstract

It is a great challenge for the clinician to choose a methodology, abutment design, and type of restoration in order to achieve optimal results and avoid complications in implant rehabilitations in the aesthetic zone. The great variety of materials that are coming in contact with the soft tissues (acrylic, base alloy, gold, titanium, zirconia, and recently lithium disilicate) further complicate the decision-making, and as they show different soft tissue response and color, they seem to affect the final result, especially in patients with thin biotype. This chapter will focus on the methodology of the prosthetically driven single implant placement, especially in demanding aesthetic cases, on today's knowledge of the biology of different materials and abutment selection (customized vs. prefabricated abutments, screw vs cement retained) and provide some clinical guidelines to achieve optimum aesthetic results. Finally, new approaches regarding "immediate abutment placement," "intermediate abutment placement," and digital technology for impression in combination with prefabricated CAD lithium disilicate blocks will be discussed with the help of clinical case presentations.