A new method of conclusively creating and transferring the emergence profile on single tooth immediate implant restorations: the E-merge protocol

Purpose: The purpose of this article is to propose a new protocol for the accurate transfer of the peri-implant soft tissue emergence profile (EP) using a customized healing abutment or a provisional restoration whose shape is integrated into prosthetic design software. Report: The EP of the future restoration is created extraorally with an ideally shaped customized healing abutment or a provisional crown. Before insertion, the latter is screwed into a repositionable analog placed on a specially designed device and scanned with an intraoral scanner (IOS). This reposition able analog (Straumann RB Repositionable Implant Analog, Art. no. 065.0023), whose original purpose is to keep the correct orientation of the implant platform when placed in a printed model, is already available on the market. It is an exact replica of the implant with a corresponding external index. When scanned, it allows the digital transfer of the exact implant position and index. After healing, a full-mouth impression is made with an IOS without removing the customized healing abutment or provisional restoration. The STL files issued from both impressions are merged to produce a digital model used to design the final restoration, which can be inserted at the next appointment. Conclusion: The technique described is simple, predictable, and precise. It does not require a traditional implant level impression or the use of a digital accessory such as a scan body to transfer the 3D implant position and the peri-implant gingival contour.