Controlling white and pink aesthetics is important in predictably providing patients with aesthetic implant restorations. Understanding how the contours of the abutment and crown can be prescribed, manipulated, and confirmed can hold the key to success.
An ideally contoured implant abutment/crown complex needs to transition from the implant platform and emerge through the peri-implant tissues, providing the correct cervical tooth anatomy (Figure 1). Generally speaking, implant restorations have been described as overcontoured, flat or undercontoured. Overcontouring of the emergence profile tends to exert pressure upon the tissues and can result in a more apical migration of the gingival margin, while undercontouring will alleviate pressure and encourage a more coronal migration of the gingival margin.1 Knowing how and where to adjust restorative contours can be the difference between an aesthetic or deficient outcome.
It is important to define the transmucosal portion of the abutment/crown complex into two distinct zones: the critical contour (the area shaded blue in Figure 2) and the subcritical contour (the area shaded pink in Figure 2).2 The design of the critical contour should correlate to the desired gingival anatomy that is being created. The facial profile of the critical contour is particularly important in determining the height and location of the gingival zenith. The deeperlying subcritical contour influences the peri-implant soft-tissue support and thickness and, consequently, gingival colour and profile.3
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