The influence of customized abutments and custom metal abutments on the presence of the interproximal papilla at implants inserted in single-unit gaps: a 1-year prospective clinical study

Objectives: To assess and compare the papilla presence mesially and distally to dental implants restored with customized abutments and custom metal abutments in the anterior maxilla. Material and methods: Thirty-eight patients receiving 38 single-tooth implants, restored with 26 customized abutments and 12 custom metal abutments in the anterior maxillary region were enrolled in this study. The cases where did not existed contact point were excluded. Presence/ absence of the interproximal papilla, inter-tooth-implant distance (ITD) and distance from the base of the contact point to dental crest bone of adjacent tooth (CPB) were accessed. Global P-values were determined for changes in CPB and papilla score over time (P < 0.05). Results: Thirty-six patients with 36 implants were available for the 12-month follow-up. The abutments and reconstruction survival rate was 100% with no fracture or crown loss. A mean mesial CPB of 5.71 ± 1.54 mm and distal CPB of 4.01 ± 1.73 mm were assessed in the customized abutment group for an overall mean papilla presence of 1.69 ± 0.46. A mean mesial CPB of 5.41 ± 1.31 mm and distal CPB of 4.77 ± 1.21 mm were assessed in the control group for an overall mean papilla presence of 1.08 ± 0.65. Conclusions: The restoration of single-implants using computer-assisted design/computer-assisted manufacturing abutments appears to help maintaining a regular papillary filling although the variations of the implant positioning or the restoration/teeth relation.