Minoru Sanda

Implant dentistry has been widely accepted as the most favorable option for restoring missing teeth. Posterior implant restoration with a wide-spreading, unnatural emergence profile seems relatively common. Although this configuration doesn’t usually affect patient satisfaction and short-term results, recent evidence suggests that an emergence angle of more than 30 degrees jeopardizes the implant’s stability, increasing the risk of peri-implantitis when combined with a convex configuration. Therefore, practitioners should strive to avoid an unnatural wide-spreading emergence profile as much as possible and should aim to optimize the emergence profile. Key factors for achieving an optimal emergence profile consist of interocclusal space, the width of the alveolar ridge, and component manipulation. Regarding interocclusal space, antagonist preparations such as crown restoration and orthodontic intrusion are effective for gaining sufficient vertical space. Additionally, the removal of the tip of the alveolar bone is also effective. For horizontal space acquisition, an atraumatic extraction of teeth and bone and/or a soft tissue grafting procedure will be indicated to widen the crest. In terms of component manipulation, practitioners must adhere to prosthodontic-driven planning by simulating the ideal prosthetic position on the patient’s CBCT images. Especially, practitioners must avoid shallower placements than planned; otherwise, the emergence profile can be compromised. At this point, practitioners should also pay attention to the anticipated emergence profile and emergence angle that the implant restoration will possess. Regarding implant selection, tissue-level implants are favorable for achieving a natural emergence profile rather than platform-switching implants, especially for molar restoration. During the prosthetic phase, practitioners need to shape the emergence profile appropriately during the provisional phase and promptly transfer the information to the technician.

Organization: Department of Prosthodontics, School of Dentistry, Showa University Position: Assistant professor QUALIFICATIONS 2010 Doctor of Dental Surgery (DDS) at Tokyo Medical and Dental University, Faculty of Dentistry (Japan) 2015 PhD in Oral Implantology and Regenerative Dental Medicine at Graduate School of Tokyo Medical and Dental University (Japan) ACADEMIC APPOINTMENT 2016 ITI scholar at University of Belgrade Faculty of Dentistry (Serbia) 2018 Assistant professor at the Dept. of Prosthodontics, Showa University MEMBERSHIPS AND COMMITTEE ASSIGNMENT International Team for Implantology (ITI) Japan Prosthodontic Society (JPS) Japanese Society of Oral Implantology (JSOI) Japan Academy of Digital Dentistry