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Excessive soft tissue around abutment: how to manage?

Last Updated: Apr 27, 2018

After the implant osseointegrated, I uncovered and inserted the transmucosal healing abutment. I noted that the soft tissue was high around the abutment which might complicate the final impression. What would be the best way to manage this?

8 Comments on Excessive soft tissue around abutment: how to manage?

Isavella

04/27/2018

You could replace the existing with another taller Healing abutment.

Alex Galo

04/27/2018

When I used to use Implant Direct, the implant came with a stock healing abutment but it was far too short for many cases. Now I use Hiossen. You have to order a separate healing abutment but it's much better because you definitely want your healing abutment higher than your tissue as things heal. Otherwise the gum will overgrow the healing abutment then the impression appointment turns into an exposure appointment. How tall was your healing abutment?

Don Callan

04/27/2018

Remove all the excess tissue. By leaving the excess tissue you’re creating another problem, a pocket. Do not create another problem trying to eliminate the first problem.

Aly

04/28/2018

Thank u for your advice Will it be just gingivoplasty

Dale Gerke - BDS, BScDent

04/27/2018

If you have placed a healing abutment which is not long enough, then the soft tissue will almost always attempt to grow over the abutment. Essentially in the worst case, the gingiva attempts to convert the situation to a submerged "first stage of a two stage procedure". If you replace the healing abutment with a longer one then removing tissue is not likely to be necessary. If the overgrowth is not excessive and it is possible to remove the healing abutment and place an impression coping, then mostly likely you will not need to reshape the gingiva - but rather just proceed to constructing a crown. If you are not able to easily get a longer healing abutment (or if you want to increase the emergence profile width) then I have found you can slightly roughen the healing abutment surface and place flowable resin around the top (to increase the length and width) and you will generally end up with a very acceptable healing result prior to impression. (Remember to keep resin clear of the driver hole.)

Bill McFatter

05/03/2018

That's a great idea

John Graeber

04/29/2018

use a diode or co2 laser

John Graeber

04/29/2018

use a diode laser

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