A digital workflow combining root submergence, a definitive intermediate abutment, and a custom 3D printed healing abutment for a natural peri-implant emergence profile.

Abstract

A digital workflow merging root submergence, immediate dental implant and definitive intermediate abutment placements, and custom healing abutment fabrication to enhance esthetic and biological outcomes in immediate implant procedures is described. The procedure involves a prosthetically driven plan on intraoral and cone beam computed tomography (CBCT) scans, digital planning using a specialized software program, the creation of a surgical guide, and the digital design of custom components. A 3-dimensionally (3D) printed healing abutment was produced by following specific protocols. The surgical phase included a root submergence technique, guided implant site preparation, immediate implant placement, and the attachment of the custom healing abutment. The approach addressed critical challenges in implant dentistry including maintaining alveolar ridge dimensions to achieve optimal esthetics, particularly when replacing anterior teeth. Advantages of the present technique included the shorter surgical procedure with no extractions, the ability to perform prosthetic procedures on the definitive intermediate abutment at the soft tissue level without exposing the implant fixture (one abutment one time concept), the creation of precisely tailored healing abutments using biocompatible photopolymerizing resins, and the elimination of the need for complex angled abutments.