Proper emergence profile fabrication steps
Getting a proper emergence profile is a combination of proper implant depth and proper temporary shape placement at the proper time. It is much easier to maintain a nice emergence profile from an immediate extraction and placement rather than to rebuild one.
What a proper emergence profile looks like.
A proper anterior tooth emergence profile should have a sloping S shape.
What is the proper depth?
The zero bone loss concept likes to see 4mm of tissue or bone and tissue. This rule seems like a good one to follow when designing your emergence profile. The tissue thickness will dictate how deep one places the dental implant at time of surgery. Basically one can say place 4-5mm below the gingiva and you will comply with this zero bone loss rule.
What it should not look like.
This picture is from AACD. Rather surprising that would come from them. These result mostly from the implant not being deep enough or coming too vertical at first and ending with a 90 degree elbow. What we have seen with these sharp angle prosthesis is that they get chronic low grade gingival irritation. Would definitely expect this are to bleed like crazy in six months if you probe the facial or brush too hard there.
Check out our post on capturing your emergence profile with a custom impression coping.
How to capture the emergence profile of an implant bridge or prosthesis.
After the initial impression you can have your lab pour up the case like normal. Then remove their soft tissue moulage material. Seat your temp prosthesis on the model and inject new soft tissue moulage material under your temp. DT and Lane have a nice thread on this.
Example of a screw retained case
Constructed using non-engaging screw retained Ti temp abutment with lab fabricated temp
|Temps in place 4 months|
|View on day of impression|
|Cross sectional area of what abutment should look like for proper emergence profile|
DCT, Sutherland M. Method for developing an optimal emergence profile
using heat-polymerized provisional restorations for single-tooth
implant-supported restorations. J Prosthetic Dent 2004;91:289-292.