Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지
DOI QR코드

DOI QR Code

Esthetic considerations for anterior implant-supported prostheses: focus on surgical and prosthetic treatment

전치부 임플란트의 연조직 심미성을 달성하기 위한 외과적, 보철적 고려사항

  • Park, Yeon-Hee (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Ahn, Seung-Geun (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Kim, Kyoung-A (Department of Dentistry, Daejeon Konyang Medical Center, Konyang University, School of Medicine) ;
  • Seo, Jae-Min (Department of Prosthodontics, School of Dentistry, Jeonbuk National University, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital)
  • 박연희 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 안승근 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 김경아 (건양대학교 의과대학 치과학교실) ;
  • 서재민 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소)
  • Received : 2021.08.19
  • Accepted : 2021.11.23
  • Published : 2021.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

As the increased certainty of osseointegration, new parameters are now being used to assess implant success. Accordingly, patients' and clinicians' high demands and expectation for esthetics have expanded and implant-supported restorations show better esthetic outcomes. The pre-implant treatment planning process, the implant surgical steps and the post-surgery prosthetic process can affect all esthetic outcomes. Prevention of esthetic implant failures can be achieved by appropriate treatment at each stage, considering the 3 factors of alveolar bone, soft tissue, and implants. It is necessary to achieve the esthetic implant prostheses followings: minimal invasive surgery, bone augmentation, ideal 3-dimensional implant position, peri-implant soft tissue management, and provisional restorations to optimize peri-implant soft tissue architecture.

임플란트 치료에 대한 기능적 성공률이 높아짐에 따라 심미성에 대한 새로운 성공 기준이 제시되고 있다. 이에 따라 치과의사 및 환자가 가지는 심미적 기준도 높아졌으며, 임플란트 심미 수복 결과에 대한 만족도 또한 높아지고 있다. 임플란트 식립하기 전 치료계획 수립 과정, 임플란트 수술 과정, 수술 후 보철수복 과정이 모두 심미적 결과에 영향을 미칠 수 있으며, 임플란트의 심미적 실패를 예방하기 위해서는 치조골, 연조직, 그리고 임플란트의 세 가지 요소를 고려하여 각 단계마다 적절한 처치를 통해 이루어질 수 있다. 성공적인 전치부 임플란트의 연조직 심미를 얻기 위해서는 외상과 자극을 최소화하는 수술, 골이식을 통한 골조직 증강, 임플란트 식립 시 임플란트의 3차원적 위치, 필요한 경우 연조직 이식술의 시행, 임시보철물의 충분한 경과관찰과 적절한 수정을 고려해야 한다.

Keywords

References

  1. Fuentealba R, Jofre J. Esthetic failure in implant dentistry. Dent Clin North Am 2015;59:227-46. https://doi.org/10.1016/j.cden.2014.08.006
  2. Papaspyridakos P, Chen CJ, Singh M, Weber HP, Galluci GO. Success criteria in implant dentistry: a systematic review. J Dent Res 2012;91:242-8. https://doi.org/10.1177/0022034511431252
  3. Higginbotoom FL. Implant as an option in the esthetic zone. J Oral Maxillofac Surg 2005;63:33-44. https://doi.org/10.1016/j.joms.2005.05.162
  4. Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported singletooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont 1999;12:335-41.
  5. Dursun E, Lin GH, Taheri S, Chu SJ, Wang HL, Tozum TF. A comparison of esthetic features of pre-existing natural tooth versus post-implant restoration in the esthetic zone: aretrospective 12-month follow-up. Int J Oral Maxillofac Implants 2018;33:919-28. https://doi.org/10.11607/jomi.6465
  6. Wittneben JG, Wismeijer D, Bragger U, Joda T, Abou-Ayash S. Patient-reported outcome measures focusing on aesthetics of implant- and tooth-supported fixed dental prostheses: a systematic review and meta-analysis. Clin Oral Impl Res 2018;29:224-40.
  7. Misch CE. Contemporary implant dentistry. 3rd ed. St. Louis; Mosby; 2008. p. 738, 889.
  8. Thalji G, Bryington M, De Kok IJ, Cooper LF. Prosthodontic management of implant therapy. Dent Clin North Am 2014;58:207-25. https://doi.org/10.1016/j.cden.2013.09.007
  9. Fetner M, Fetner A, Koutouzis T, Clozza E, Tovar N, Sarendranath A, Coelho PG, Neiva K, Janal MN, Neiva R. The effects of subcrestal implant placement on crestal bone levels and bone-toabutment contact: a microcomputed tomographic and histologic study in dogs. Int J Oral Maxillofac Implants 2015;30:1068-75. https://doi.org/10.11607/jomi.4043
  10. Cochran DL, Bosshardt DD, Grize L, Higginbottom FL, Jones AA, Jung RE, Wieland M, Dard M. Bone response to loaded implants with nonmatching implant-abutment diameters in the canine mandible. J Periodontol 2009;80:609-17. https://doi.org/10.1902/jop.2009.080323
  11. Huang B, Meng H, Zhu W, Witek L, Tovar N, Coelho PG. Influence of placement depth on bone remodeling around tapered internal connection implants: a histologic study in dog. Clin Oral Implants Res 2015;26:942-9. https://doi.org/10.1111/clr.12384
  12. Jung RE, Jones AA, Higginbottom FL, Wilson TG, Schoolfield J, Buser D, Hammerle CHF, Cochran DL. The influence of non-matching implant and abutment diameters on radiographic crestal bone levels in dogs. J Periodontol 2008;79:260-70. https://doi.org/10.1902/jop.2008.070132
  13. Aloise JP, Curcio R, Laporta MZ, Rossi L, da Silva AMA, Rapoport A. Microbial leakage through the implant-abutment interface of morse taper implants in vitro. Clin Oral Implants Res 2010;21:328-35. https://doi.org/10.1111/j.1600-0501.2009.01837.x
  14. Koutouzis T, Fetner M, Fetner A, Lundgren T. Retrospective evaluation of crestal bone changes around implants with reduced abutment diameter placed non-submerged and at subcrestal positions: the effect of bone grafting at implant placement. J Periodontol 2011;82:234-42. https://doi.org/10.1902/jop.2010.100340
  15. Tesmer M, Wallet S, Kououzis T, Lundgren T. Bacterial colonization of the dental implant fixtureabutment interface: an in vitro study. J Periodontol 2009;80:1991-7. https://doi.org/10.1902/jop.2009.090178
  16. Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent 2006;26:9-17.
  17. Enkling N, Johren P, Klimberg V, Bayer S, Mericske- Stern R, Jepsen S. Effect of platform switching on peri-implant bone levels: a randomized clinical trial. Clin Oral Implants Res 2011;22:1185-92. https://doi.org/10.1111/j.1600-0501.2010.02090.x
  18. Farronato D, Santoro G, Canullo L, Botticelli D, Maiorana C, Lang NP. Establishment of the epithelial attachment and connective tissue adaptation to implants installed under the concept of "platform switching: a histologic study in minipigs. Clin Oral Implants Res 2012;23:90-4. https://doi.org/10.1111/j.1600-0501.2011.02196.x
  19. Elian N, Cho SC, Froum S, Smith RB, Tarnow DP. A simplified socket classification and repair technique. Pract Proced Aesthet Dent 2007;19:99-104.
  20. Gluckman H, Pontes CC, Du Toit J. Radial plane tooth position and bone wall dimensions in the anterior maxilla: a CBCT classification for immediate implant placement. J Prosthet Dent 2018;120:50-6. https://doi.org/10.1016/j.prosdent.2017.09.005
  21. Kan JY, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of the peri-implant mucosa: an evaluation of maxillary single implants in humans. J Periodontol 2003;74:557-62. https://doi.org/10.1902/jop.2003.74.4.557
  22. Katafuchi M, Weinstein BF, Leroux BG, Chen YW, Daubert DM. Restoration contour is a risk indicator for peri-implantitis: a cross-sectional radiographic analysis. J Clin Periodontol 2018;45:225-32.
  23. Rojas-Vizcaya F. Biological aspects as a rule for single implant placement. The 3A-2B rule: a clinical report. J Prosthodont 2013;22:575-80. https://doi.org/10.1111/jopr.12039
  24. Funato A, Ishikawa T. 4D implant therapy: esthetic considerations for soft-tissue management. 1st ed. Tokyo; Quintessence; 2012. p. 87, 110.
  25. Kois JC. The restorative-periodontal interface: biological parameters. Periodontol 2000 1996;11:29-38. https://doi.org/10.1111/j.1600-0757.1996.tb00180.x
  26. Becker W, Ochsenbein C, Tibbetts L, Becker BE. Alveolar bone anatomic profiles as measured from dry skulls. Clinical ramifications. J Clin Periodontol 1997;24:727-31. https://doi.org/10.1111/j.1600-051X.1997.tb00189.x
  27. Cook R, Lim K. Update on perio-prothodontics. Dent Clin North Am 2019;63:157-74. https://doi.org/10.1016/j.cden.2018.11.001
  28. Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol 2000;5:119-28. https://doi.org/10.1902/annals.2000.5.1.119
  29. Grunder U, Gracis S, Capelli M. Influence of the 3-D bone-to-implant relationship on esthetics. Int J Periodontics Restorative Dent 2005;25:113-9.
  30. Morton D, Chen ST, Martin WC, Levine RA, Buser D. Consensus statements and recommended clinical procedures regarding optimizing esthetic outcomes in implant dentistry. Int J Oral Maxillofac Implants 2014;29:216-20.
  31. Kim YK. Bone graft in immediate implantation after anterior tooth extraction. J Korean Dent Assoc 2017;55:725-32. https://doi.org/10.22974/JKDA.2017.55.10.006
  32. Lekovic V, Kenney EB, Weinlaender M, Han T, Klokkevold P, Nedic M, Orsini M. A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases. J Periodontol 1997;68:563-70. https://doi.org/10.1902/jop.1997.68.6.563
  33. Vance GS, Greenwell H, Miller RL, Hill M, Johnston H, Scheetz JP. Comparison of an allograft in an experimental putty carrier and a bovine-derived xenograft used in ridge preservation: a clinical and histologic study in humans. Int J Oral Maxillofac Implants 2004;19:491-7.
  34. Barone A, Aldini NN, Fini M, Giardino R, Calvo Guirado JL, Covani U. Xenograft versus extraction alone for ridge preservation after tooth removal: a clinical and histomorphometric study. J Periodontol 2008;79:1370-7. https://doi.org/10.1902/jop.2008.070628
  35. Wennstrom JL. Mucogingival considerations in orthodontic treatement. Semin Orthod 1996;2:46-54. https://doi.org/10.1016/S1073-8746(96)80039-9
  36. Nozawa T, Enomoto H, Tsurumaki S, Ito K. Biologic height-width ratio of the buccal supra-implant mucosa. Eur J Esthet Dent 2006;1:208-14.
  37. Canullo L, Iurlaro G, Iannello G. Double-blind randomized controlled trial study on post-extraction immediately restored implants using the switching platform concept: soft tissue response. Preliminary report. Clin Oral Implants Res 2009;20:414-20. https://doi.org/10.1111/j.1600-0501.2008.01660.x
  38. Bhola M, Neely AL, Kolhatkar S. Immediate implant placement: clinical decisions, advantages, and disadvantages. J Prosthodont 2008;17:576-81. https://doi.org/10.1111/j.1532-849X.2008.00359.x
  39. Araujo MG, Wennstrom JL, Lindhe J. Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation. Clin Oral Implants Res 2006;17:606-14. https://doi.org/10.1111/j.1600-0501.2006.01315.x
  40. Botticelli D, Persson LG, Lindhe J, Berglundh T. Bone tissue formation adjacent to implants placed in fresh extraction sockets: an experimental study in dogs. Clin Oral Implants Res 2006;17:351-8. https://doi.org/10.1111/j.1600-0501.2006.01270.x
  41. Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 5th ed. St. Lousi; Elsevier; 2016. p. 566-7.
  42. Elian N, Tabourian G, Jalbout ZN, Classi A, Cho SC, Froum S, Tarnow DP. Accurate transfer of peri-implant soft tissue emergence profile from the provisional crown to the final prosthesis using an emergence profile cast. J Esthet Restor Dent 2007;19:306-14. https://doi.org/10.1111/j.1708-8240.2007.00128.x
  43. Tsai BY. A method for obtaining peri-implant softtissue contours by using screw-retained provisional restorations as impression copings: a clinical report. J Oral Implantol 2011;37:605-9. https://doi.org/10.1563/AAID-JOI-D-10-00026.1
  44. Liu X, Liu J, Mao H, Tan J. A digital technique for replicating peri-implant soft tissue contours and the emergence profile. J Prosthet Dent 2017;118:264-7. https://doi.org/10.1016/j.prosdent.2016.11.006
  45. Jung RE, Schneider D, Ganeles J, Wismeijer D, Zwahlen M, Hammerle CH, Tahmaseb A. Computer technology applications in surgical implant dentistry: a systematic review. Int J Oral Maxillofac Implants 2009;24:92-109.
  46. Scotti R, Pellegrino G, Marchetti C, Corinaldesi G, Ciocca L. Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement: a review. Quintessence Int 2010;41:809-14.
  47. Koutrach M, Nimmo A. Preservation of existing soft-tissue contours in the transition from a tooth to an implant restoration in the esthetic zone using a flapless approach: a clinical report. J Prosthodont 2010;19:391-6. https://doi.org/10.1111/j.1532-849X.2010.00581.x
  48. Becker K, Mihatovic I, Golubovic V, Schwarz F. Impact of abutment material and dis-/re-connection on soft and hard tissue changes at implants with platform-switching. J Clin Periodontol 2012;39:774-80. https://doi.org/10.1111/j.1600-051X.2012.01911.x
  49. Alves CC, Munoz F, Cantalapiedra A, Ramos I, Neves M, Blanco J. Marginal bone and soft tissue behavior following platform switching abutment connection/disconnection- a dog model study. Clin Oral Implants Res 2015;26:983-91. https://doi.org/10.1111/clr.12385
  50. Derks J, Schaller D, Hakansson J, Wennstrom JL, Tomasi C, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: prevalence of peri-implantitis. J Dent Res 2016;95:43-9. https://doi.org/10.1177/0022034515608832
  51. Kan JY, Rungcharassaeng K. Interimplant papilla preservation in the esthetic zone: a report of six consecutive cases. Int J Periodontics Restorative Dent 2003;23:249-59.
  52. Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol 1992;63:995-6. https://doi.org/10.1902/jop.1992.63.12.995
  53. Salama H, Salama MA, Garber D, Adar P. The interproximal height of bone: a guidepost to esthetic strategies and soft tissue contours in anterior tooth replacement. Pract Periodontics Aesthet Dent 1998;10:1131-41.