title: The influence of customized abutments and custom metal abutments on the presence of the interproximal papilla at implants inserted in single-unit gaps: a 1-year prospective clinical study.
abstract: OBJECTIVE
  To assess and compare the papilla presence mesially and distally to dental implants restored with customized abutments and custom metal abutments in the anterior maxilla.
  
  
  METHODS
  Thirty-eight patients receiving 38 single-tooth implants, restored with 26 customized abutments and 12 custom metal abutments in the anterior maxillary region were enrolled in this study. The cases where did not existed contact point were excluded. Presence/absence of the interproximal papilla, inter-tooth-implant distance (ITD) and distance from the base of the contact point to dental crest bone of adjacent tooth (CPB) were accessed. Global P-values were determined for changes in CPB and papilla score over time (P < 0.05).
  
  
  RESULTS
  Thirty-six patients with 36 implants were available for the 12-month follow-up. The abutments and reconstruction survival rate was 100% with no fracture or crown loss. A mean mesial CPB of 5.71 ± 1.54 mm and distal CPB of 4.01 ± 1.73 mm were assessed in the customized abutment group for an overall mean papilla presence of 1.69 ± 0.46. A mean mesial CPB of 5.41 ± 1.31 mm and distal CPB of 4.77 ± 1.21 mm were assessed in the control group for an overall mean papilla presence of 1.08 ± 0.65.
  
  
  CONCLUSIONS
  The restoration of single-implants using computer-assisted design/computer-assisted manufacturing abutments appears to help maintaining a regular papillary filling although the variations of the implant positioning or the restoration/teeth relation.
authors.affiliation: Department of Oral Surgery and Implant Dentistry, Portuguese Catholic University, Viseu, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Borges
authors.affiliation: Department of Oral Surgery and Implant Dentistry, Bragança Private Medical Centre, Bragança, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Lima
authors.affiliation: Department of Oral Surgery and Implant Dentistry, Bragança Private Medical Centre, Bragança, Portugal.
authors.forename: Ágata
authors.initials: Á
authors.lastname: Carvalho
authors.affiliation: Chaves Private Medical Centre, Chaves, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Dourado
authors.affiliation: Chaves Private Medical Centre, Chaves, Portugal.
authors.forename: Vasco
authors.initials: V
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000539:Alveolar Process / Q000033:anatomy & histology; D017076:Computer-Aided Design; D003442:Crowns; D000044:Dental Abutments; D003722:Dental Alloys / Q000737:chemistry*; D059605:Dental Implant-Abutment Design; D019250:Dental Implants, Single-Tooth; D003776:Dental Porcelain / Q000737:chemistry; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000033:anatomy & histology*; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D014025:Titanium / Q000737:chemistry; D015019:Yttrium / Q000737:chemistry; D015040:Zirconium / Q000737:chemistry
chemical_list: D000497:Alloys; D003722:Dental Alloys; D006047:Gold Alloys; C493120:lithia disilicate; C499362:yttria stabilized tetragonal zirconia; D003776:Dental Porcelain; C031462:titanium alloy (TiAl6V4); D015019:Yttrium; D015040:Zirconium; D014025:Titanium; C028541:zirconium oxide
keywords: computer-assisted design; computer-assisted manufacturing; implant abutments; interproximal papilla; outcomes assessment