Buccolingual implant position and vertical abutment finish line geometry: two strictly related factors that may influence the implant esthetic outcome

Abstract

Purpose: Three-dimensional implant positioning has always been a highly debated topic especially in the esthetic zone due to many problems related to buccal bone resorption. A new concept in implant position, dictated by changing the abutment finish line, is presented in the following article.

Materials and methods: The actual guidelines on implant position agree that in the bucco-palatal dimension, the implant should be placed more toward the palatal preserving at least 2 mm of buccal bone. However, changing the abutment finish line geometry from horizontal to vertical, the authors' geometry of choice, the surgical approach in the bucco-palatal direction has been modified accordingly to ensure final restorations that will guarantee long-term soft tissue stability.

Results: The emergence angle of the natural teeth has been the authors' guide to establish the implant position which should be located with the long axis of the implant corresponding to the incisal edge of the future restoration. Observation of the clinical results in the past years strongly supports this approach.

Conclusions: The surgical and prosthetic concepts described in this article allow the clinician to recreate a pleasant and natural-looking esthetics while the patient can easily maintain a proper hygiene around the implant. However, despite the promising clinical results obtained by the authors, further clinical and randomized researches should be realized to validate the above-proposed approach.