The use of customized healing abutments in dental implant placement

: a systematic review of the literature and meta-analysis

Abstract

Introduction: Advancements in oral implantology is a steady pace process and
investigations constantly take place in order to achieve satisfying results in terms of function, durability and esthetic. The use of customized healing abutment (CHA) in clinical practice can follow implant placement in both anterior and posterior areas. CHA guides hard and soft tissue healing around implants, and it is considered a new method to optimize esthetic and condition soft tissue at implant site creating the desired emergence profile and favorable gingival tissue architecture. The aim of this study was to evaluate the periimplant tissues
response and treatment outcomes, after using custom healing abutments (CHA) as socket sealing option in comparison with standard healing abutments (SHA) in dental implant placement. Materials and methods: An electronic search was performed in three databases: PubMed/Medline, Web of Science and Cochrane database. The following keywords were used: “implant placement”, “dental implantation”, “dental implant”, “customized healing abutment”, “individualized healing abutment”, and “standard healing abutment”. The Boolean operators
AND and OR were used. Articles were evaluated for eligibility according to the
inclusion/exclusion criteria. Thereby, data was extracted from articles which fulfilled the inclusion criteria into predefined tables. Risk of bias assessment of included articles was evaluated using The Cochrane Risk of Bias tool 2 (RoB2). Statistical heterogeneity was measured by the Cochran Q test and Higgins I2 statistic test. A metaanalysis using the random effect model was performed and a P value of 0.05 was set for significance. Results: The present analysis included 4 randomized clinical trials., A 100% success rate was reported for all the implants with a total number of 114 patients (49 men and 65 women). The following variables were considered for the analysis: Pink Esthetic Score (PES),
marginal bone loss, papilla height and midfacial height. PES evaluation was favorable for the test group, although the marginal bone changes were less intense with the use of standard abutments. Conclusion: The use of customized healing abutments in oral implantology is a predictable treatment modality in terms of soft tissue stability and esthetic outcomes of the periimplant mucosa. The immediate placement of customized healing abutments after implant insertion does not prevent the early marginal bone changes that eventually occur, when compared with the use of standard healing abutments.

Date of Award	19 Jul 2022
Original language	English
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Tiago Borges (Supervisor)