ABSTRACT Objective To review the biological and clinical relevance of prosthetic design, specifically the emergence profile and restorative angle in influencing peri‐implant tissue health, and to illustrate how biologically driven prosthetic modifications can resolve inflammation and support peri‐implant stability. Overview This narrative review synthesizes current evidence on the anatomy and function of the implant supracrestal complex, focusing on how restorative contour, abutment height, and emergence geometry impact soft tissue adaptation and marginal bone maintenance. It integrates recent findings from histological, clinical, and preclinical studies and highlights the role of CAD/CAM workflows in achieving biologically favorable restorations. A clinical case report illustrates the correction of peri‐implant inflammation and bone loss through the redesign of a concave, polished emergence profile on a taller titanium base. Conclusions Restorative angle and emergence profile are critical, modifiable elements of implant‐supported prostheses. When designed in accordance with biological parameters, they contribute significantly to tissue health and long‐term esthetic outcomes. Suboptimal designs may promote plaque accumulation and inflammation, even in compliant patients. Biologically oriented, digitally guided prosthetic designs represent a key strategy in preventing peri‐implant disease. Clinical Significance Long‐term peri‐implant health depends not only on surgical accuracy but also on biologically driven prosthetic design. Contours that respect the dimensions of the soft tissue complex, particularly concave, polished emergence profiles supported by adequately tall abutments, promote soft tissue stability, facilitate hygiene, and minimize the risk of inflammation or recession. While digital workflows offer precision in prosthetic design, clinicians must still apply sound biological principles and clinical judgment when planning and executing implant‐supported restorations. A biologically driven approach, based on a clear understanding of peri‐implant anatomy and guided by common sense, is essential for achieving predictable and esthetically successful outcomes.
Pirc et al. (2026) studied this question.