Bonding of soft gingival tissues with anatomical and other dental prostheses
Methods and dental prosthetics for providing soft tissue adhesion to a temporary healing abutment, or other dental prosthetic (e.g., temporary or permanent). Existing prosthetics generally do not provide any significant adhesion of the soft tissue surrounding the prosthetic, to the outer surface of the prosthetic itself. Because of the presence of gaps between such structures, or simple non-adhesion even where the structures may touch (but be free and unattached relative to one another), there is a tendency for pathogenic microbes to enter into such space between the structures, and for the soft gingival tissue to recede, particularly in patients with “thin” type periodontal tissue. The present disclosure provides materials and/or surface treatment (e.g., texturing) that ensures good bonding between the prosthetic and the soft tissue, reducing risk of infection, and reducing undesirable gingival recession surrounding the prosthetic anchored on a dental implant.
1. A method for providing increased soft tissue adhesion to a prosthesis anchored in a dental implant, the method comprising:
providing a prosthesis that is an anatomical healing abutment for promoting healing of gingival tissue around a subgingival void of a given tooth position and shaping of a gingival margin of a patient at the given tooth position, and which exhibits soft tissue adhesion during healing, the anatomical healing abutment comprising:
a cuff body having an anatomical subgingival portion extending from an implant end to the gingival margin of the patient, and an emergent crown portion extending from the subgingival portion and occlusally beyond the gingival margin of the patient; and
wherein the anatomical subgingival portion has an asymmetric cross section and an outer surface that is shaped to provide substantially custom filling of at least an emergence portion of the subgingival void where a natural tooth once emerged from the void, or where a tooth would have emerged from the void, the subgingival portion thus being shaped to anatomically fill and fully support gingival tissue around the subgingival void to prevent or minimize slump of gingival tissue into the subgingival void,
wherein at least the outer surface of the anatomical subgingival portion of the anatomical healing abutment is (i) formed from a material which accepts adhesion of the soft tissue surrounding the prosthesis; (ii) is mechanically or chemically treated at the outer surface thereof so as to accept adhesion of the soft tissue surrounding the anatomical healing abutment; or (iii) both (i) and (ii);
placing the subgingival portion of the anatomical healing abutment into the subgingival void of a given tooth position, and coupling the anatomical healing abutment into an implant disposed below the anatomical healing abutment; and
allowing the soft tissue to heal around the placed anatomical healing abutment such that the soft tissue adheres to the anatomical healing abutment, providing a seal around the anatomical healing abutment which:
reduces or prevents ingress of pathogenic microbes between the anatomical healing abutment and the soft tissue, and/or
reduces or prevents recession of the soft tissue around the anatomical healing abutment.
2. The method as recited in claim 1 , wherein the anatomical healing abutment is a temporary anatomical healing abutment, the method further comprising removing the temporary anatomical healing abutment after a healing period, wherein the soft tissue has adhered to the temporary anatomical healing abutment during the healing period, such that removal of the temporary anatomical healing abutment causes bleeding of the adhered soft tissue.
3. The method as recited in claim 2 , wherein a bond strength between the adhered soft tissue and an exterior surface of the temporary anatomical healing abutment is greater than a tensile strength of the gingival soft tissue, such that separation occurs in the soft tissue, resulting in the bleeding of the soft tissue surrounding the temporary anatomical healing abutment.
4. The method as recited in claim 1 , wherein the prosthesis is formed from an acrylic material which accepts adhesion of the soft tissue surrounding the prosthesis.
5. The method as recited in claim 4 , wherein the prosthesis is formed from a bisacrylic resin material.
6. The method as recited in claim 1 , wherein the anatomical healing abutment is a temporary anatomical healing abutment, the method further comprising removing the temporary anatomical healing abutment after a healing period, wherein the soft tissue has adhered to the temporary anatomical healing abutment during the healing period, such that removal of the temporary anatomical healing abutment causes bleeding of the adhered soft tissue upon removal of the temporary anatomical healing abutment as the seal between such healing abutment and the soft tissue is broken.
7. The method as recited in claim 6 , wherein a bond strength between the adhered soft tissue and an exterior surface of the temporary anatomical healing abutment is greater than a tensile strength of the gingival soft tissue, such that separation occurs in the soft tissue, resulting in the bleeding of the soft tissue surrounding the temporary anatomical healing abutment.
8. The method as recited in claim 1 , wherein the anatomical healing abutment is formed from an acrylic material which accepts adhesion of the soft tissue surrounding the abutment.
9. The method as recited in claim 8 , wherein the prosthesis is formed from a bisacrylic resin material.
10. The method as recited in claim 1 , wherein the exterior surface of the anatomical healing abutment has an unpolished, rough surface texture, so as to have pores or surface roughness variation in the normal direction relative to the exterior surface sized from 0.1 μm to 500 μm to promote soft tissue adhesion to the exterior surface of the anatomical healing abutment.