The role of abutments in the formation of periodontal tissues around dental implants(Clinical study)

Abstract

Abstract:

Background and Aim of the study: The main goal of using dental implants is to restore the functional aspects of missing teeth in a way that ensures the long-term success of the restoration. The compensation is often done using premanufactured abutments, but due to the problems facing the dentist when using these abutments, from a regression in the periodontal papillae and a change in the eruption appearance of the natural tooth, Other types of abutment design methods have been used as needed, there are castable abutments as well as computer-designed abutments made using a 3D laser printer.

Therefore, the research aims to compare the cosmetic aspects of the castable and printed abutments in terms of filling the gingival papillae of the space between the implants and adjacent teeth, the eruption appearance from the gums, after fixing the final restoration with a follow-up period of one year.

Materials and Methods: The research sample consisted of 32 dental implants with the same specifications (in terms of type, length, and width) (16 implants were restored using the castable abutment and 16 implants were restored using the 3D-printed abutment). Each patient had two adjacent implants.

The aesthetic aspects were studied in terms of space-filling by papilla and the emergence profile, where 0-1-2 was given for evaluation so that 2 was the best and 0 was the worst which represents the relationship between the implant and the surrounding tissues of the opposite teeth.

 This was done by taking the photographs and the patient’s opinion during different times (directly after the fixation, three months, six months, and a year)

Result: Mann-Whitney U test showed that the percentage of the lateral and medial papilla filling of the space for the printed abutment was 100%, while for the castable abutment was 93.8%, and for the appearance of emergence profile, the Mann-Whitney U test showed that the average ranks for the printed abutment were 18, while for the cast abutment was 15, and therefore at the 95% confidence level, the significance level was greater than 0.05, and therefore there was no significant difference between the abutments from a statistical point of view.

Conclusion: Within the limitations of this research and based on the previous results, we found that the restoration of loss using abutments manufactured by a 3D laser printer and a castable abutment both gave clinically accepted cosmetic results in terms of filling the space by papillae and the emergence profile of natural tooth with a slight preference for printed abutments.

Keywords: Dental Implants,  Castable Abutments,   Laser Printed Abutments,  Gingival Papillae,  The Emergence Profile.