Improving aesthetics of implant-supported restorations

Osseointegration and adhesion have dramatically improved the treatment modalities, and reinstatement of function is now achieved routinely. Aesthetics has emerged as a prerequisite to the acceptance of the final result, demanded by the patient, and the standards of excellence in prosthetic restorations. This article discusses the treatment planning criteria, including tissue augmentation, implant selection, and healing abutments; it also suggests a modification in the sequence of treatment planning by placing the provisional restoration at second-stage surgery. This "custom-guided" tissue healing serves to achieve natural aesthetics in soft tissues. The learning objective of this article is to familiarize the reader with the principles of custom-guided tissue healing and to address the aesthetic challenge.