Dentistry Journal · Published 2026-08-05 · DOI 10.3390/dj14080484
Dragos Epistatu, Maria Teodora Epistatu, Malina Elena Meila, Valentin Daniel Sirbu, Andreea Mihaela Custura, Ioan Sirbu
<b>Background</b>: Digital workflows in implant prosthodontics continue to evolve, yet standardized protocols integrating clinician-driven abutment customization and peri-implant soft-tissue conditioning remain limited. This pilot study aimed to present and evaluate a progressive gingival digital workflow for cement-retained implant-supported restorations based on chairside adjustment of prefabricated abutments according to gingival maturation. <b>Methods</b>: A retrospective comparative study included 39 patients rehabilitated with 161 implants and followed for 24–48 months. The experimental group comprised 87 bone-level implants restored using a progressive digital workflow involving staged healing, chairside abutment customization, provisional tissue conditioning, and digital fabrication of definitive restorations. Outcomes were compared with 74 tissue-level implants restored using a conventional protocol with healing abutments and prefabricated prosthetic abutments. Clinical and radiographic outcomes included plaque index, bleeding on probing (BOP), peri-implant sulcus depth, marginal bone resorption, complications, and patient satisfaction. <b>Results</b>: Both groups demonstrated favorable clinical outcomes, with no significant differences in plaque index, gingival condition, BOP (28.74% vs. 21.62%), sulcus dimensions, or marginal bone resorption (11.49% vs. 12.16%) (<i>p</i> > 0.05). Logistic regression identified plaque accumulation, vestibular sulcus depth, and implant duration as predictors of BOP, whereas implant type was not associated with BOP or bone resorption. Patient satisfaction, assessed using a visual analog scale, was uniformly high. Most patients reported maximum scores across all domains, with only minor esthetic concerns reported by a few participants. No major prosthetic complications or screw loosening occurred during follow-up. <b>Conclusions</b>: The proposed workflow demonstrated favorable clinical performance and appears to be a feasible restorative approach. However, because implant design and restorative workflow differed simultaneously, findings should be interpreted cautiously. Larger prospective studies are needed to confirm these results.
Abstract from DOAJ. Public domain (CC0 1.0).
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Epistatu, D., Epistatu, M., Meila, M., et al. (2026). Progressive Gingival Digital Workflow with Chairside Abutment Customization for Cement-Retained Implant Restorations: A Pilot Comparative Clinical Study of Two Treatment Concepts. Dentistry Journal. https://doi.org/10.3390/dj14080484