Effectiveness of customized healing abutments in immediate implants: a randomized clinical trial

This study evaluated the influence of a customized healing abutment (CHA) placed on immediate implants. It also assessed bone ridge volume, keratinized mucosal collar, and postoperative pain. Thirty-one patients needing tooth extraction and immediate implant were selected. Gingival papilla height, bone ridge volume, and keratinized mucosal collar thickness were measured using a millimeter periodontal probe and a dry-point caliper. A visual analog scale (VAS) was applied to determine postoperative pain. Study participants were randomly assigned to a control group (n = 15, with extraction, immediate implant placement, alveolar gap filling with a bovine bone graft, PTFE barrier, and suture) and an experimental group (n = 16, with extraction, immediate implant placement, gap filling with a bovine bone graft, and CHA). The healing abutments were prepared before surgery and customized during the procedure. The data were tabulated and statistically analyzed using the Mann-Whitney test (α = 0.05). The "changes in the papilla" outcome presented a statistical difference, and the control group showed higher values than those of the experimental group (p = 0.04). The remaining characteristics demonstrated no statistical differences between the groups (p > 0.05). CHA and the barriers exhibited similar behavior in maintaining bone ridge and keratinized mucosal thickness. CHA proved more effective than the conventional barrier in preserving the gingival papilla, with the distance measured three months post-surgery averaging 17% greater than the pre-surgical measurement.