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Predictable Peri-Implant Gingival Aesthetics


Learning Objectives:

This podcast presents various factors that may influence the dynamics of peri-implant gingival aesthetics in the event of a single anterior failing tooth. Upon listening to this podcast, the listener should:

  • Be aware of a surgical and prosthodontic technique suggested to facilitate predictable peri-implant aesthetics.
  • Understand the application of an ovate pontic tooth on a removable partial denture following immediate extraction and implant placement.


Bone resorption following maxillary anterior tooth extraction is common and often compromises gingival tissue levels for the implant restoration. The creation of predictable peri-implant aesthetics requires proper understanding and preservation of the osseous and gingival tissue surrounding the failing tooth. This article addresses the various factors that affect the predictability of peri-implant gingival aesthetics in anterior single-tooth replacement. The surgical and prosthodontic procedures for maintenance of peri-implant aesthetics are also presented using an ovate pontic tooth on a removable partial denture following immediate extraction and implant placement.

Related Reading:

  1. Andersson B, Odman P, Lindvall AM, Lithner B. Single-tooth restorations supported by osseointegrated implants: Results and experiences from a prospective study after 2 to 3 years. Int J Oral Maxillofac Impl 1995;10(6):702-711.
  2. Avivi-Arber L, Zarb GA. Clinical effectiveness of implant-supported single-tooth replacement: The Toronto study. Int J Oral Maxillofac Impl 1996;11(3):311-321.
  3. Cordioli G, Castagna S, Consolati E. Single-tooth implant rehabilitation: A retrospective study of 67 implants. Int J Prosthodont 1994;7(6):525-531.
  4. Jemt T, Pettersson P. A 3-year follow-up study on single implant treatment. J Dent 1993;21(4):203-208.
  5. Priest GF. Failure rates of restorations for single-tooth replacements. Int J Prosthodont 1996;9(1):38-45.
  6. Kois JC. Predictable single tooth peri-implant esthetics: Five diagnostic keys. Compend Contin Educ Dent 2001;22:199-208.
  7. Saadoun A, LeGall M, Touati B. Selection and ideal tridimensional implant position for soft tissue aesthetics. Pract Periodont Aesthet Dent 1999;11(9):1063-1072.
  8. Salama H, Salama M, Garber D, Adar P. Developing optimal peri-implant papillae within the esthetic zone: Guided soft tissue augmentation. J Esthet Dent 1995;7(3):125-129.
  9. Phillips K, Kois JC. Aesthetic peri-implant site development. The restorative connection. Dent Clin North Am 1998;42(1):57-70.
  10. Kan JYK, Rungcharassaeng K. Site development for anterior implant esthetics: The edentulous site. Compend Contin Educ Dent 2001;22:221-232.
  11. Kois J. Altering gingival levels: The restorative connection. Part I: Biologic variables. J Esthet Dent 1994;6:3-9.
  12. Kan JYK, Rungcharassaeng K. Immediate placement and provisionalization of maxillary anterior single implants: A surgical and prosthodontic rationale. Pract Periodont Aesthet Dent 2000;12(9):817-824.
  13. Esposito M, Ekestubbe A, Grondahl K. Radiological evaluation of marginal bone loss at tooth surfaces facing single BrŒnemark implants. Clin Oral Impl Res 1993;4(3):151-157.
  14. Tarnow DP, Cho SC, Wallace SS. The effect of the inter-implant distance on the height of inter-implant bone crest. J Periodontol 2000;71(4):546-549.
  15. Salama H, Salama M. The role of orthodontic extrusive remodeling in the enhancement of soft and hard tissue profiles prior to implant placement: A systematic approach to the management of extraction site defects. Int J Periodont Rest Dent 1993;13(4):312-333.


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