Aesthetic outcomes of intraoral welding with progressive compression for soft tissue contouring of implant bridge pontics in anterior teeth

To evaluate the shaping effect of the intraoral welding framework combined with the progressive pressure technique using an ovate pontic on the soft tissue aesthetic contour of implant-supported fixed dental prostheses (ISFDPs).

The Medical Ethics Review Committee of this hospital approved this retrospective study, which was conducted on 32 patients with consecutive partial edentulous in the anterior teeth (20 males, 12 females, aged 40-68 years) who received 3- to 5-unit ISFDPs between August 2022 and March 2024. Titanium frameworks for provisional prostheses were fabricated using the intraoral welding technique and screw-retained to achieve precise passive fit. The pontics were designed into an ovate shape. A progressive pressure technique was applied by selectively adding 0.8-1 mm thick flowable resin to the tissue surface of the pontic, while ensuring the avoidance of tissue blanching. Patients have a follow-up visit every 4 weeks, and the pontics were adjusted 2-3 times as needed, to form an ovate socket in the corresponding soft tissue approximately 3 mm in depth and 2.5-3.0 mm in buccolingual curvature. Definitive restorations were delivered after the conditioning period, and patients were followed up for over 1 year. Outcome measures included mechanical complications, Pink Esthetic Score (PES), Papilla Index Score (PIS), and patient satisfaction assessed using a Visual Analogue Scale (VAS).

During the follow-up period, no mechanical complications such as screw loosening or prosthesis fracture were observed in the 32 cases. The soft tissue aesthetic outcomes were favorable, with a mean total PES of 11.97 ± 1.18, and 96.9% of the cases achieving a score ≥ 8. According to the PIS, 93.5% of the proximal sites exhibited ideal papilla fill. VAS results indicated that 90.6% of patients were satisfied with the restorative outcome.

The technique combining an intraoral welding framework with progressive pressure using an ovate pontic can precisely shape the peri-implant soft tissue contour to mimic physiological morphology, achieving an ideal aesthetic outcome.