Comparing the Clinical Outcome of Peri-implant Hard and Soft Tissue Treated with Immediate Individualized CAD/CAM Healing Abutments and Conventional Healing Abutments for Single-Tooth Implants in Esthetic Areas Over 12 Months: A Randomized Clinical Trial

The purpose of this study was to compare the clinical influence of immediate individualized CAD/CAM healing abutments and conventional healing abutments on peri-implant soft and hard tissue in shaping the emergence profile.Patients with a single maxillary incisor missing who accepted dental implantation were registered in this study. After implantation, individualized CAD/CAM healing abutments and regular prefabricated abutments were randomly inserted to shape the emergence profile. A radiograph was taken, and the pink esthetic score, papilla height, papilla proportion, and probing depth were recorded at 6 months after implant placement (T1), loading (T2, definitive restoration), and 1 year after loading (T3). Patient self-assessment scores were also evaluated through the visual analog scale. The data were analyzed statistically using the t test or repeated-measurements analysis of variance (ANOVA).Twenty patients were enrolled in this study, including 9 patients using individualized abutments and 11 patients using conventional abutments. The mean total marginal bone level in the individualized abutment group was 1.53 ± 0.65 mm at implant placement, 1.10 ± 0.47 mm at loading, and 0.76 ± 0.47 mm at 1 year after loading. In contrast, the mean total marginal bone level in the conventional abutment group was 0.62 ± 0.39 mm at implant placement, 0.14 ± 0.55 mm at loading, and -0.04 ± 0.53 mm at 1 year after loading. The differences between the individualized abutment group and conventional abutment group were statistically significant for the mesial and distal marginal bone level at three time points, respectively (P ≤ .05). Similarly, there were significant differences in probing depth, papilla height, and pink esthetic score between the two groups.This immediately individualized healing abutment protocol may significantly preserve the peri-implant marginal bone and soft tissue. The use of individualized CAD/CAM healing abutments for shaping the emergence profile shows better esthetic outcomes than conventional healing abutments.