The state of soft tissue around multi-unit abutments in case of total rehabilitation
REVIEWS
Abstract
The stability and health of soft tissues around dental implants, especially when using multi-unit abutments, in protocols for the total rehabilitation of patients with complete edentulism are critical factors for ensuring the long-term functional and aesthetic success of implant treatment, largely determining both the clinical survival of the structures themselves and the degree of patient satisfaction with the results. Multi-unit abutments offer significant clinical and technical advantages in cases of complete edentulism, including the ability to compensate for implant misalignment, raise the prosthetic platform to a more comfortable level, and simplify prosthetic stages, but their direct interaction with the peri-implant tissue complex requires a deep understanding and careful control. This review systematizes and analyzes current data on the condition of peri-implant soft tissues when using multi-unit abutments in patients undergoing total rehabilitation. The biological aspects of soft tissue complex formation and key surgical, prosthetic, and patient-associated factors affecting its condition are considered. Particular attention is paid to the clinical significance and necessity of having an adequate zone of keratinized gingiva, the influence of various loading protocols on soft tissues, the biocompatibility and mechanical properties of abutment materials, the adequacy of prosthetic constructions to ensure effective hygiene, as well as modern methods of clinical and radiological assessment of soft tissue health. Strategies for the prevention and treatment of possible complications, such as mucositis and peri-implantitis, are discussed in detail, including their early diagnosis and modern approaches to conservative and surgical management. The multifactorial nature of the problem and the imperative need for a comprehensive, individualized approach to achieve predictable, optimal, and stable long-term results in total implant prosthetics using multi-unit abutments, and the review itself is intended to promote the adoption of informed clinical decisions by clinicians.
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