Selection and Ideal Tridimensional Implant Position for Soft Tissue Aesthetics
Andre Saadoun, DDS, MS
This study reviews the importance of utilizing restoration-driven therapy for accurate implant placement. Upon reviewing this study, the reader will possess:
- A heightened awareness of the role of soft tissues in aesthetic implant restorations.
- An understanding of the functional and aesthetic factors that influence implant placement.
The single-unit implant-supported restoration is a reliable means of replacing a missing tooth. In order to be considered successful, an implant-supported restoration must achieve a harmonious balance between functional, aesthetic, and biological imperatives. This concept has resulted in the development of "restoration-driven implant placement," in which implants are positioned in relation to the anticipated requisites of the restorative phase rather than the availability of bone.
The development and maintenance of the aesthetic hard and soft tissue complex are important—particularly when implant treatment is performed in the aesthetic zone. The site selected for the implant must be guided in the mesiodistal, apicocoronal, and buccolingual dimensions by the anticipated restoration. The volume of the osseous support must allow the implant to be placed in the ideal situation, while the soft tissue morphology must mimic that of the adjacent teeth following the anticipated recession.
Implant selection and the interdental papilla volume (height and width) are determined by the implant's mesiodistal position. The length of the crown restoration is indicated by its buccopalatal orientation. The emergence profile and peri-implant pocket depth are influenced by the apicocoronal location. The cervical contour of the provisional restoration determines the shape of the buccal gingiva and height of the interdental papillae. Finally, the ceramic restoration must possess a form that complements the surrounding tissues, facilitates proper plaque control and occlusal function, and presents a harmonious natural appearance.
*Private practice, Paris, France
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