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Abstract The growing esthetic demands of clinicians as well as expectations of patients regarding implants, have led to progress not only in the treatment protocols, but also in the design of implants and abutments. However, most of the results & scientific data about the clinical influence of abutment design and cementation technique on peri-implant soft tissue stability, esthetics and health have still been controversial and inconclusive. Thus, the aim of this study was to evaluate the influence of abutment design and cementation technique on the biological & esthetic outcomes around single tooth implants. Twenty-eight titanium endosseous threaded implants were placed in twenty- eight patients with twenty-eight missing teeth in the premolar maxillary region. Fourteen crowns were cemented over the abutments with the cement applied to all axial walls, seven of these crowns were cemented on closed abutments while the other seven crowns were cemented on vented abutments. The treatment protocol included three stages; surgical stage where the implants were placed, followed by the prosthetic stage which included placement of abutments of different designs, final impressions were then made & provisional crowns were fabricated and cemented. The last stage was the follow- up stage; the patients were followed up clinically within the first 48 hours at the time of provisional restoration placement (base line), then at 3 months and 6 months intervals. The clinical follow- up assessments included: a) periodontal assessments; pocket probing depth, plaque index, bleeding on probing, & soft tissue condition. b) soft tissue esthetic assessments with the pink esthetic score. Analysis of the results revealed the effect of the abutment design (vented and closed) and cementation technique (cervical only and all axial walls) on the peri-implant tissues was statistically significant difference between groups regarding all periodontal parameters except for pocket probing depth. Analysis of soft tissue esthetics including PES revealed statistically significant difference between groups with vented abutments with cement applied on the cervical 1/3 only showing the best esthetic results. This better esthetic behaviour seems to be strongly correlated to the less excessive cement extruded in this group. The common general finding regarding all groups was that all biological and esthetic outcomes were within the normal health limits, remained relatively stable throughout the six months follow up period of the study and that could be related to the atraumatic conservative surgical approach. |