How do you preserve esthetics using tissue level implants?

For many dentists and oral/maxillofacial surgeons, the conventional tissue level implant is the trusted default for replacing missing teeth anywhere in the mouth. Obtaining an esthetic result is key.

Review our Tissue Level Implant procedure developed for the International Team for Implantology on the Touch Surgery app to learn how our oral and maxillofacial surgery key opinion leader Stephen Dover describes how to safely perform this procedure.

Key facts:

  • The Tissue Level Implant has a smooth collar that is designed to be within the supracrestal mucosal zone.
  • The widest part of the collar is the implant shoulder.
  • The clinician should determine the corono-apical position of the implant shoulder depending on the site and the esthetic relevance.
“Any error at this stage can create a cascade of problems…”

The implant shoulder should be placed deeper into the mucosa [if esthetics is important] to avoid exposure of the metal shoulder on the buccal aspect says Stephen Dover (Queen Elizabeth and Birmingham Children’s Hospitals, UK)

When esthetics is not critical the implant is placed less deeply at the mid-buccal mucosal margin:

“The rough/smooth interface, in this case, should be located 2 mm from the prospective mucosal margin as indicated by the zenith of the cervical margin of the tooth template.”

Tissue level implant
Implant insertion is stopped once a palpable increase in resistance is felt. Using a ratchet and appropriate adaptor, final positioning must be completed by hand.”

Insertion of the implant is carefully achieved using a drill at a very slow speed (15 rpm). “Implant insertion is stopped once a palpable increase in resistance is felt. Using a ratchet and appropriate adaptor, final positioning must be completed by hand.”

A healing cap is screwed into the implant, lying flush with the crestal mucosa.

“Tissue Level implants are designed to be transmucosal and allow a tension-free closure.” “Evaluate the amount of keratinized mucosa to be trimmed to allow this.”

View our new simulation – Tissue Level Implant Placement – on the Touch Surgery App and test your procedural awareness