Clinical outcome of custom healing abutments in immediate implant placement: A systematic review and meta-analysis

Custom healing abutments have been claimed to provide better esthetic and peri-implant hard and soft tissue outcomes after implant placement immediately after extraction. However, the evidence remains limited and further investigation is required.

The purpose of this systematic review was to evaluate the effect of custom healing abutments on marginal bone loss, peri-implant tissue contour, and esthetic parameters in immediate single-tooth implants.

An electronic search was performed across the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science databases to identify randomized controlled trials (RCTs) or prospective clinical trials evaluating marginal bone loss, soft tissue changes, or esthetics when using custom healing abutments in immediate single-tooth implant placement.

Six studies were included, with 5 being meta-analyses. No significant differences in buccal variations, mean total variations, bone volume variation, or total volume variation were found between custom healing abutment groups and control groups at the 4-month follow-up (P=.44); (P=.97); (P=.12), and (P=.40), respectively. Likewise, midfacial height tissue changes exhibited no significant difference between the groups at the 12-month follow-up (P=.05). Data from the 6-month and 12-month follow-up periods demonstrated no significant difference between the groups for marginal bone loss (P=.86), and (P=.17), respectively.

Providing custom healing abutments in immediately placed implants offered predictable results regarding the stability of peri-implant soft and hard tissues and esthetic outcomes. However, they do not significantly mitigate dimensional tissue changes compared with standard healing abutments.