Impact of Customized Healing Abutments on Peri-implant Esthetics and Bone Preservation: A Narrative Review

PES), and reduce the need for additional soft tissue grafting procedures.[13][14][15] However, despite these promising findings, the clinical evidence surrounding CHA remains inconsistent.While some studies report significant improvements in soft tissue stability and reduced marginal bone loss (MBL), others present contradictory data, particularly in long-term follow-ups.Factors such as implant placement protocols, gingival biotype, socket morphology, and grafting techniques further complicate the interpretation of outcomes.7,10,16,17 Additionally, the biological demands of immediate implant placement (IIP) require careful three-dimensional implant positioning to minimize buccal bone resorption.18,19 CHA may mitigate some of these resorptive effects by supporting the soft IntroductIonAchieving optimal functional and esthetic outcomes remains a central objective in contemporary dental implantology.[1][2][3] Recent advancements in surgical techniques and biomaterials have placed increasing emphasis on the preservation and enhancement of periimplant soft and hard tissue architecture.[4][5][6] Among the innovations contributing to this goal, healing abutments have evolved from being passive components to active modulators of peri-implant tissue healing and adaptation.7,8 Standard healing abutments (SHA), traditionally employed in implant procedures, often fail to replicate the natural emergence profile of the tooth they replace.Their uniform cylindrical design may contribute to suboptimal gingival contouring, potentially resulting in midfacial recession or compromised papilla formation.These limitations are particularly significant in esthetically demanding regions such as the anterior maxilla, where the visual outcome is as important as function.9,10 Customized healing abutments (CHA) have emerged as a solution to this challenge, offering personalized, anatomy-driven designs that guide soft tissue maturation more naturally.11,12 Manufactured through digital workflows such as computer-aided design/computer-aided manufacturing (CAD/CAM) systems or modified chairside, CHA replicates the cervical dimensions of the original tooth, thereby supporting a more favorable emergence profile.Previous studies suggest that CHA may contribute to improved esthetic parameters, such as the Pink Esthetic Score