Systematic review of peri-implant conditions and aesthetic outcomes of customized versus conventional healing abutments

Purpose: Customized healing abutments are utilized to enhance aesthetics and peri-implant soft and hard tissue health, and play a crucial role in the implant-prosthetic workflow. This systematic review was performed to assess and compare the clinical outcomes of customized healing abutments with conventional ones.

Methods: The review was registered with PROSPERO (ID: CRD42024532449) and followed the PRISMA-guidelines. The PICO-question addressed was: "In patients with dental implants, do customized healing abutments result in beneficial peri-implant conditions compared with conventional healing abutments?" Clinical trials involving immediate and late implant placement that compared different healing abutments based on quantifiable outcomes were included. The "PubMed", "PubMed Central", "Cochrane Library", and "Web of Science databases" were screened for eligible studies until 4/20/2024.

Results: Of 1,396 titles retrieved, 5 studies met the inclusion criteria and were analyzed. The included studies showed a low risk of bias as assessed by the RoB2 tool and Joanna Briggs Institute Critical Assessment questionnaire. Compared to conventional healing abutments, customized abutments were associated with a trend toward better clinical outcomes in peri-implant soft and hard tissue, as well as aesthetics. Several results within the cohorts using customized healing abutments showed significantly improved values in soft and hard tissue results as well as aesthetic parameters. Importantly, none of the included studies reported biological or aesthetic disadvantages associated with the use of customized healing abutments.

Conclusions: Customized healing abutments maintain stability of peri-implant hard and soft tissue. However, further studies with larger sample sizes and longer follow-up periods are needed to validate these findings.