Excessive soft tissue around abutment: how to manage?

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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?

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Isavella
4/27/2018
You could replace the existing with another taller Healing abutment.
Alex Galo
4/27/2018
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
4/27/2018
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.
Dale Gerke - BDS, BScDent
4/27/2018
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.)
Aly
4/28/2018
Thank u for your advice Will it be just gingivoplasty
John Graeber
4/29/2018
use a diode or co2 laser
John Graeber
4/29/2018
use a diode laser
Bill McFatter
5/3/2018
That's a great idea