Connective Contour" is the unique and scientifically documented contour that increases soft tissue contact zone and volume, created when the abutment is connected to the implant. Connective Contour is also an original key feature of the Astra Tech Implant System™.
The summaries in this section highlight the understanding of soft tissue healing around and esthetics maintained by the Astra Tech Implant System.
Incidence of inter-proximal papilla between a tooth and an adjacent immediate implant placed into a fresh extraction socket: 1 -year prospective study
There have been numerous publications on the
immediate placement of single-tooth implants into
fresh extraction sockets with the purpose of preserving both the hard and soft tissue framework including the interproximal papillae in order to achieve a good esthetic result. The success of implants placed in
this manner has been very high typically > 90% and often > 95%. While some studies have questioned the ability of an implant to prevent bone resorption following extraction, numerous studies have presented data demonstrating maintenance of the interproximal papilla so long as the vertical distance from the crest of bone to the contact point did not exceed 5 mm.
Purpose: The current study was set up to assess both the vertical and horizontal distances necessary to ensure maintenance of the interproximal papilla at single-tooth implants.
Materials and Methods: Forty-six systemically healthy patients who smoked less than 10 cigarettes per day, demonstrated no evidence of parafunction and were deemed to have a thick or normal biotype were enrolled to the study for replacement of a single tooth using an immediate extraction and insertion protocol, for the placement of an Astra Tech OsseoSpeed" implant. 32 maxillary and 14 mandibular teeth were atraumatically extracted using luxators and forceps under full flap reflection, after which sockets were thoroughly curetted to remove any residual periodontal remnants. Osteotomies were prepared according to manufacturer's recommendations and the coronal margin of the implants was leveled at the crest labial bone to achieve an appropriate emergence profile. Temporary healing abutments were secured and flaps repositioned and sutured to ensure complete coverage of the residual socket defect. Temporary restorations were fabricated and secured after 8 weeks and definitive ceramometal restorations placed 3 months later. 15 restorations were based on customized Cast-Design"" abutments, 21 on prepared Profile Bi-Abutments" and 10 on zir-conia Zir-Design" abutments. All abutments were secured according to manufacturer's recommendations and either ceramo-metal or all-ceramic crowns cemented on top.
Clinical parameters assessed were gingival index, presence or absence of papilla, where less than or equal to half the papilla fill to the contact point rendered a papilla "absent". The distance from the coronal margin of the implant to the adjacent tooth (dl-T) and the distance of the peak of bone adjacent to the tooth to the contact point (dPBT-CP) were measured on digitalized (and calibrated to the known implant length) radiographs at the 12-months review. Repeat measurements were taken for 10 radiographs to determine intra-observer variability and results were subject to statistical analysis using the x2-test.
Results: All implants osseointegrated. A total of 92 interproximal sites were evaluated and the intra-observer variability was negligible. In 97% of sites the gingival index was 0. The mean dl-T for mesial and distal sites was 3.2 mm and 3.1 mm respectively and the mean dPBT-CP measured 5.6 mm for both mesial and distal sites. Using odds ratio it could be demonstrated that when dl-T was 3-4 mm the papilla was present 84% of the time, p < 0.05. By contrast when dl-T was < 3 mm it was only present 32% of the time although this was not statistically significant. With respect to dPBT-CP, when the value measured was 3-5 mm the papilla was present 80% of the time, p < 0.05, however for measurements of 6-7 mm the papilla was present only 51% of the time (NS).
Discussion and Conclusions: It is apparent from the current results that the position of an implant in an apico-coronal as well as a mesiodistal direction is critical to the maintenance of a full interproximal papilla and the accomplishment of an esthetic result. In addition it has been previously reported that immediate implant placement might yield more favorable results in this regard when compared to a delayed approach. As with previous reports this study supports the proposal that the peak of the bone related to the adjacent tooth is more influential than that related to the implant, with the distance dPBT-CP being identified for control of papilla fill.
However this is also dependent on the location of the contact point which should be 5 mm from this bone peak. The Astra Tech OsseoSpeed implant was seen to perform extremely well in the immediate single-tooth replacement scenario.
Astra Tech
BioManagement Complex 
