Effect of Customized and Prefabricated Healing Abutments on Peri-Implant Soft Tissue and Bone in Immediate Implant Sites: A Randomized Controlled Trial

Abstract

This study aimed to evaluate the effect of customized healing abutments compared to prefabricated healing abutments in immediate implant sites. Twelve patients requiring single immediate implant placement were divided into two groups: a prefabricated group received prefabricated titanium healing abutments, and a customized group received a polyetheretherketone (PEEK) customized healing abutments fabricated based on the individuals’ digital impressions. Outcomes, including peri-implant horizontal and vertical soft tissue alteration, bone level change, volume change, pain score, and pink esthetic score (PES) change, were evaluated at the 1-, 4-, and 6-month follow-ups compared to pre-extraction teeth. At the 1- and 4-month follow-ups, the customized group had a significantly lower buccal volume variation (BVv). At the 6-month follow-up, neither group showed any significant difference in the marginal bone change; however, the customized group had a significantly lower PES change and a lower pain score. In the anterior and premolar regions, the customized group showed the preservation of peri-implant buccal horizontal soft tissue and buccal volume, while in the molar regions, the preservation of papilla height and midfacial height was observed. The morphology of the customized healing abutment demonstrated a better trend in preservation of peri-implant soft tissue, esthetic outcomes, and lower patient discomfort in immediate implant sites.