Impact of abutment design on soft tissue health in full-mouth replacements

Full mouth replacement is the entire rehabilitation of a completely edentulous arch. Conventional complete dentures and fixed or removable implant-supported dentures are two types of full-mouth replacement. Various factors may impact full mouth replacement outcomes, including abutment design. Dental abutments are used to connect the dental implant and the prosthesis. They can be classified based on fabrication, retention mechanism, material, and microgeometry. The stability of soft and hard peri-implant tissues plays a key role in the long-term success of dental implants. Thus, it is necessary to explore the effects of abutment design on peri-implant soft tissue health. This review aims to explore current evidence about the impact of abutment designs on soft tissue health of dental implants, including full mouth replacement. Customized abutments provide superior support for soft tissue stability compared to prefabricated alternatives. Zirconia abutments may reduce tissue discoloration and marginal bone loss in select cases; however, clinical outcomes vary depending on multiple factors, including implant position, soft tissue phenotype, and surgical technique. Further high-quality, long-term clinical studies are recommended to standardize guidelines for abutment selection in full-mouth rehabilitations.