Current evidence suggests that proper implant transmucosal contouring can significantly impact supracrestal soft tissue development and crestal bone response both in early and late stages of treatment. The macrodesign and composition of the anatomical healing abutment or temporary prosthesis used during transmucosal contouring are crucial elements for establishing biologic and prosthetic conditions that minimize early bone remodeling, improve esthetic outcomes, and reduce the possibility for future peri-implant inflammation. This article presents clinical directions on the design and fabrication processes of anatomical healing abutments or temporary prostheses for single implant sites under the interpretation of currently available scientific data.

Emerging evidence implies significant interrelations between the condition of the peri-implant tissues and the implant-abutment-prosthesis complex. A new paradigm for studying the peri-implant tissues in close interrelation with the implant-abutment-prosthesis complex in the presence of the oral biofilm is essential. The aims of this paper are to introduce the concept of the “implant supracrestal complex” (ISC) and to describe the critical elements that define it as a unique anatomical and functional system of human tissues, mechanical components, and oral bacteria/biofilm. This paper reviews recent evidence to identify the impact of design features on short-term clinical outcomes and long-term health of the peri-implant bone and soft tissues. Prosthetic-driven implant placement is a prerequisite for proper ISC design, which in turn can indirectly influence the structure and dimensions of the peri-implant soft tissues. Design features of the implantprosthesis- abutment complex, such as the emergence profile, emergence angle, and cervical margin, as well as the design of the implant-abutment and abutment-prosthesis junctions and their locations in relation to the tissues of the ISC, can have a significant impact on the maintenance of stable and healthy peri-implant tissues in the long term.