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Literature Reviews

The Role of the Implant Housing in Obtaining Aesthetics: Part 2. Customizing the Peri-Implant Soft Tissue

Dowell, Scott M. DDS

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The Role of the Implant Housing in Obtaining Aesthetics: Part 2. Customizing the Peri-Implant Soft Tissue Smukler H, Castellucci F, Capri D. Practical Procedures and Aesthetic Dentistry. 2003;15:487–490.

This article discusses surface contours of temporary and permanent restorations that influence the peri-implant tissue to maximize the esthetic soft tissue outcome and final emergence profile.

The author goes into great detail on how the contour of the tooth starting at the abutment–restoration interface and continuing up to the level of the contact can influence the final development of the gingiva. This discussion includes ramifications of convex and concave surfaces, both facial–lingual and inter-proximal, on gingival maturation. Convex surfaces promote movement of the gingiva apically, whereas concave surfaces encourage coronal movement of the gingiva. Included with the discussion are pictures portraying various gingival contours and their related tooth surfaces as well as photographs of models used in the process of creating acceptable gingival aesthetics. Tooth surface contours help to create the scalloped appearance of the gingival margin.

The article also recognizes that an extensive amount of the gingival contour is controlled by the underlying form of the alveolar bone. This underlying bony architecture helps to support the minor fluctuations that the tooth contours create in the tissue.

The main drive of this article is to bring to light the nuances that dictate aesthetic gingival contours around implants and strategies to create harmony within the gingival complex. Emphasis is placed on properly initiating soft tissue contact beginning with the temporary restoration in concordance with these variations in tooth structure to create aesthetic restorations.

© 2004 Lippincott Williams & Wilkins, Inc.