Soft tissue stability at the facial aspect of gingivally converging abutments in the esthetic zone: A pilot clinical study

Statement of problem. The literature indicates that 0.5 to 1.5 mm of gingival recession most often occurs within the first months after implant placement or abutment connection. Purpose. The purpose of this pilot study was to evaluate the effect of a concave transmucosal profile on the vertical stability of soft tissues at the facial aspect of dental implants. Material and methods. Fifty-four implants were placed in esthetically demanding sites in 41 patients (17 women, 24 men; age range of 23 to 62 years, mean 40.3 years; 5 smokers), primarily following a 1-stage approach. Twenty-five implants were placed immediately after extraction. Experimental concave titanium (n=49) and zirconia abutments (n=5) were used, and a provisional crown was placed at the same session. Digital photographs were made perpendicularly to the facial aspect of the teeth at abutment placement, and at 1, 3, 6, 12, 18, and 24 months, and enlarged views were subsequently analyzed by an independent examiner. Vertical changes in soft tissue levels were measured, and the definitive esthetic result was evaluated subjectively (poor to excellent). Data were analyzed with descriptive statistics. Results. Twenty-four implants were evaluated at 24 months, 20 at 18 months, and 8 at 12 months. Vertical augmentation or no recession in soft tissue was observed in 87% of the situations, and in no situation was recession greater than 0.5 mm found. The gingival level remained stable at 12, 18, and 24 months. The average esthetic outcome was rated as 4.5 (very good to excellent) on a 0- to 5-point scale. Conclusions. The concave, gingivally converging abutments used in the study allowed for above-average soft tissue outcomes.