Impact of Custom-Designed vs. Standard Titanium Healing Abutments on Peri-Implant Tissue Health in Immediate Post-Extraction Implant Sites: A Systematic Review

Abstract

This systematic review dives into the effectiveness of custom-designed healing abutments compared to standard titanium ones in helping the tissues around dental implants heal, especially when implants are placed right after a tooth is pulled. We searched major medical databases like PubMed and Cochrane up to May 2025 for studies that directly compared these two types of abutments in people. Our aim was to see how they influenced soft tissue changes, bone stability, esthetic outcomes, and even germ responses. What we found suggests that custom-made abutments tend to lead to better soft tissue results, including more stable tissue dimensions and a more natural-looking gum line. This seems to be because they're designed to perfectly guide the healing tissues, mimicking the original tooth's shape. While both types of abutments appear equally good for the implant to fuse with the bone, there wasn't a consistent, clear difference in how much bone was lost around the implant. Information on how these abutments affect bacteria was also quite limited. Despite the promising esthetic and soft tissue benefits, it's important to remember that the studies we looked at varied a lot in how they were done, which means we couldn't combine their data statistically. For clearer answers, future research really needs well-designed studies that follow consistent rules and track patients for longer periods.