If there are no round teeth, then why are most healing abutments round?

Editor’s Intro: Dr. Mark H. Blaisdell applauds a new era in tooth-specific, sculptable, custom healing abutments. Read more about the increased sophistication and variety in implants in his introduction to our Winter issue. 

Dental implants have been placed and restored at an increased rate since their introduction to dentistry in the 1980s. The sophistication of the implant itself has emerged during that time period. In the armamentarium of implants, we have an unlimited variety of implants that are usable in every clinical situation the doctor encounters.

As the implants themselves have been improved through the years, the restorative part of implant dentistry has not moved at the same pace in regard to making the tissue in the implant area look and feel as if the tooth had not been removed. Patients routinely complain that the implant feels fine, but they continually pack food around the implant due to the shape of the restoration and the lack of the proper emergence profile. The critical part of restoring a dental implant ends with the clinician placing the proper abutment and a functional esthetic crown.

Unfortunately, the gingival tissue is often left out of the restorative equation because there is no easy way to shape the tissue into the proper emergence profile. The best example of this is that nearly every implant company makes only round healing abutments. The question then needs to be asked, “If there are no round teeth, why do implant companies continue to make round healing abutments?”

The emergence profile of a natural tooth is made to help keep food from packing around the tooth. Clinicians must have the proper anatomical tissue shape to restore the implant to the most esthetic and functional manner. Experienced clinicians are aware of the ideal emergence profile and wish to restore the tooth to that ideal, but with a round healing abutment, that is not possible without numerous patient visits and stretching tissue to a new shape. The best time to shape tissue is when the implant is placed and the healing abutment is the shape of the specific tooth that is being replaced with an implant. This allows the tissue to grow to the shape of the gingival cuff placed as the healing abutment. With the proper emergence profile, the restorative dentist is able to create an esthetic restoration for the patient that will not pack food and feel as if the tooth had not been removed.

Dentists have waited over 30 years to have the emergence profile placed at the forefront of implant dentistry. With the advent of a tooth-specific, sculptable custom healing abutment, implant dentistry has finally moved forward in the preservation and shaping of gingival tissue to give optimal results for the patient.

Dr. Mark H. Blaisdell

Digital technology helps dentists to provide more tooth-specific treatment to implant patients. Find out how going digital opens a variety of treatment options in Dr. Little’s article, “The whole package: taking patients from implant to restorations in a multidisciplinary practice.”