Soft tissue modeling for the esthetic single-tooth implant restoration

The ability of the restorative dentist to understand and control the relation of the implant to its associated gingival tissues is extremely important in achieving the maximum esthetic result in the final restoration. The position of the gingival margin following stage-two surgery represents collapse of the gingival tissues until it finds support by the component against which it comes to rest. This component may be a healing abutment, final abutment, or provisional restoration, if placed at the same time of implant exposure. Generally, it will be a healing abutment. There is complex relation between implant position, gingival management at stage-one and stage-two surgery, the position of the gingival margin over the buccal surface of the implant compared to the adjacent natural teeth, component selection, and lip line esthetics. The therapist who understands these relations will know how to mold the gingival tissue around implants to maximize the esthetic result. This article focuses on these relations and the technique of tissue modeling with subgingival contours to create a restoration with the illusion of reality.