Do we really understand Profiling?

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Posted on By yiannis vergoullis In Implants

I still talk with people that insist that a custom emergence profile is a necessity for aesthetic reasons.
My opinion is that we can get the best aesthetic result with the worse available biologic design (ridge lap), the same like food..the more unhealthy the better it tastes. The problem is that the aesthetic result of this type of prosthesis does not last because the implant will not last.
Emergence and Cervical profile are biologically important for long term stable results. Many studies and consensus reports have established this from even back in the 90's.
The increased rates of peri-implantitis MUST make us reconsider.
Here is a case with narration as an introduction for an upcoming lecture in DentalXp that I am finalising.
I hope I will make you reconsider the importance of tissue profiling.




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5 Comments


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We understand more and more. Few years ago we hardly payed attention. Thanks to Dr Chu`s lectures, Atlanta team, Alberto Misseli, Samvel Bleyan, you and George and many other exceptional clinicians with exceptional understanding of biology we opened our eyes. Critical and subcritical zone would wait years and years until the word is spread if there wasn`t DentalXP (and social media) to open the doors.
Can`t await your XP lecture, Ioannis!
Warmly
Snjezana


Reply

You are exactly right Snjezana, it was the work of great clinicians along with their lectures on Dxp that provided motivation in looking into the subject matter in depth. DXp was and remains for me the best wducational resource. As far as SMedia, they are important in order to spread ideas fast but what really worries me is the misconception that a lot of people have about their role. FB "training" can be dangerous...Big hugs.


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Beautiful result Yiannis. Would you proceed with the same protocol on a case that has a stock healing cap? Or prefer to place the cervico device from the moment of implant placement? Thanks


Reply

Thank you Andoni! I prefer to go with the custom shape profile from the get go. I feel it is the best time for the tissue to adapt comfortably and under no pressure. To me the soft tissue is as a baloon; depending how and where you press it will adapt accordingly. You will get something and give away something. Thus, If you replace a regular healing abutment with a custom one after tissue is mattured then you will lose some height in order to expand the tissue laterally. I know that a lot of respected clinicians advocate slim healing abutment initially in order to get maximum thickness and then they push the tissue out. However, where do we really need the maximum thickness? Think of CT zone. :)


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