Method for Manufacturing a Custom Healing Abutment in Delayed Implantation Using Computer Technologies (CAD/CAM): A Clinical Case

A key objective of modern implantology is to achieve an aesthetic result that is as close as possible to natural, which requires preserving or restoring the volume of hard and soft tissues around the implant. The absence of a periodontal ligament causes the tissues surrounding the implant to differ from those of an intact tooth, disrupting their trophism. This leads to bone resorption and recession of the interdental papilla, which negatively affects the aesthetic outcome of the treatment. Standard healing abutments, which have a round cross-section, do not always ensure predictable soft tissue healing, especially when a natural contour is necessary. The simplest and fastest method for creating a custom abutment is a combined laboratory-intraoral technique, which produces an abutment that precisely matches the gingival contour for subsequent prosthetic restoration.

This clinical case demonstrates delayed implantation and the fabrication of custom healing abutments using CAD/CAM technologies to achieve a natural-like state of peri-implant soft tissues. A patient with secondary partial edentulism of teeth #1.4 and #1.6, requiring implant placement, underwent a subantral augmentation procedure on the right side six months prior to the intervention. At the preoperative stage, custom healing abutment blanks and a surgical template were fabricated. The use of custom healing abutments in delayed implantation allows for the formation of a natural soft tissue contour and reduces the number of clinical stages up to the final prosthetics. The described technique appears effective for managing the healing processes of peri-implant tissues, ensuring the formation of a natural emergence profile in implant-supported restorations and optimizing the stages of treatment.