Contour Management of Implant Restorations for Optimal Emergence Profiles: Guidelines for Immediate and Delayed Provisional Restorations

Adequate management of the implant-supported restoration has become an important task when trying to obtain optimal esthetic outcomes. The transgingival area must be developed to maintain or influence the final appearance of the peri-implant soft tissues. Two distinct zones within the implant abutment/crown can be identified: the critical contour and the subcritical contour. Their design and subsequent alteration may impact the peri-implant soft tissue architecture, including the gingival margin level and zenith, labial alveolar profile, and gingival color. Defining these two areas helps clarify how to process soft tissue contours and may additionally improve the necessary communication with the laboratory. Since there are many protocols for placing implants, it is worthwhile to determine similarities in the contouring and macrodesign of their corresponding provisional restorations. Therefore, the purpose of this paper is to discern the general characteristics of the critical and subcritical contours for provisional restorations made for immediate and delayed implants in order to obtain guidelines for daily clinical practice.