Direct Method

The direct method involves selecting and preparing a temporary abutment extraorally by adding a light polymerized flowable composite resin.⁵⁰ The abutment is placed intraorally, and additional composite resin is added to fill the space between the temporary abutment and the soft tissue margin (established by the natural tooth that was extracted).⁵⁰ The addition of composite resin should be performed incrementally and with caution to prevent the resin material from flowing over the implant surface.⁵⁰ The abutment is then taken out of the mouth and attached to an implant analog. Composite resin is added to the assembly to fill in voids and develop a proper emergence profile.⁵⁰ The custom-healing abutment is tried in intraorally to ensure the achievement of optimal soft tissue support.⁵⁰ Once contour is finalized, it is finished, and polished. The supramucosal extension of the temporary abutment is cut at the coronal aspect to the level of the composite resin. This technique should be implemented prior to the placement of bone graft material. Next, graft material may be placed (if necessary) and the custom healing abutment is attached to the implant. A radiograph is taken to ensure intimate seating and appropriate orientation.