Prosthetic Soft Tissue Management in Esthetic Implant Restorations, Part II: Post-surgical Considerations and Impression Techniques. A Narrative Review

Objectives

This two-part review article delineates various techniques to enhance esthetic outcomes in anterior implant treatments. Part I concentrates on presurgical measures, case selection, implant placement, and restoration timing. Part II discusses postsurgical steps, the temporary restoration phase, the emergence profile contour, abutment types, and impression techniques.

Material and Methods

A comprehensive search was conducted using Medline/PubMed, Embase, Scopus, and the Cochrane Library. The primary keywords included: “Dental Implants,” “Dental Prosthesis, Implant-Supported,” “Esthetics, Dental,” “Dental Impression Techniques,” and “Tissue Management.”

Results

Initially, 1472 studies were identified, from which 187 were selected based on publication year and title relevance. After removing duplicates, 84 abstracts were reviewed in full text, culminating in 59 studies being thoroughly analyzed.

Conclusions

The decision to deliver an immediate restoration following implant insertion depends on the primary stability. However, in cases where delayed restoration is chosen, it is essential to consider the potential collapse of the soft tissue. A temporary restoration phase could be beneficial to aid in rebuilding the soft tissue. After achieving the desirable level of soft tissue, several techniques are available to achieve a precise transfer of molded gingival architecture, including customized impression coping, injection of soft material around the provisional restoration in the master cast, and digital impression.