Beyond the Implant: Achieving Gingival Harmony Through Strategic Prosthetic Refinement

Case Summary 🔎

This case demonstrates the critical influence of prosthetic design on peri-implant mucosal architecture over a 13-year period. By refining the temporary crown and abutment design, the peri-implant soft tissue was provided with optimal support to develop a natural emergence profile, resulting in clinically significant coronal migration of the gingival margin, often referred to as "creeping" attachment.

A Neobiotech IS-II implant was placed in the maxillary central incisor region and remained functionally and biologically stable over 10 years, with healthy peri-implant hard and soft tissues. Based on the stable tissue architecture, a new definitive restoration was fabricated with careful consideration of the papilla and gingival contour to further optimize the esthetic outcome. At the 13-year follow-up, three years after prosthetic replacement, both the implant and the definitive restoration demonstrated excellent functional stability and long-term esthetic integration, with stable peri-implant tissue levels.