Reproducibility of Buccal Gingival Profile Using a Custom Pick-Up Impression Technique: A 2-Year Prospective Multicenter Study.

ABSTRACT

PURPOSE: The aim of this study was to transfer the provisional restoration emergence profile to the final implant-supported restoration and to buccal gingival margin (BGM) stability after 2 years of function. MATERIALS AND METHODS: A total of 33 patients were recruited for treatment of single gaps by means of 33 implant-supported restorations. Fixed provisional crowns were screwed to the fixture and adjusted until the complete peri-implant soft tissue maturation was achieved. After 12 weeks, a second fixture impression was taken by means of a pick-up customization technique in order to transfer the clinical aspect of the peri-implant soft tissues to the master cast. A definitive restoration was delivered. A standardized method from digital photographs was used to assess the gingival margin modification (BGM) from the provisional (P) to the definitive prosthesis installation at baseline (D0), and after 1 (D1) and 2 years (D2) of function. Also, marginal bone loss (MBL) was calculated after 1 (D1) and 2 years (D2) of definitive restoration function. RESULTS: The BGM index at the time of the final restoration installation (D0) was 0.12 ± 0.33 mm if compared with the BGM position of the provisional restoration (P); it was of 0.12 ± 0.46 mm after 1-year of follow-up (D1) and of 0.31 ± 0.21 after 2 years of function (D2). No significant difference was calculated between measurements in different follow-up visits (p > 0.05). No significant MBL was measured between the baseline (D0) and the 1-year follow-up (p = 0.816) with a mean MBL value of 0.2 ± 0.1 mm. Similar result was calculated after 2 years (p = 0.684) with a mean MBL value of 0.3 ± 0.2. CONCLUSION: A modified impression pick-up may be helpful to reproduce the gingival margin position from the provisional to the definitive restoration. Moreover, the gingival zenith position during the follow-up period seemed to be stable. CLINICAL SIGNIFICANCE: The modification of the standard impression pick-up technique may contribute to reproducing a natural emergence profile of esthetic implant prosthetic restorations (from the provisional to the definitive restoration.) With this technique, implant soft tissues stability around CAD-CAM (computer aided design-computer aided manufacturing) abutments can be easily obtained, and the customized abutment shape may better support the scalloped peri-implant soft tissues architecture, especially in anterior areas.