Forum
Implantologicum

November 19, 2025
// 16 min

The Effect of the Sealing Socket Abutment (SSA) on Hard and Soft Tissue Healing Following Molar Post-Extraction Immediate Implant Placement

Samuel
Akhondi
Gary
Finelle

Abi-Aad, H.L., et al., Insertion Torque of Variable-Thread Tapered Implants in the Posterior Maxilla: A Clinical Study. Journal of Prosthodontics, 2019. 28(2): p. e788-e794.

Abrahamsson, I., O. Carcuac, and T. Berglundh, Influence of implant geometry and osteotomy design on early bone healing: A pre-clinical in vivo study. Clin Oral Implants Res, 2021. 32(10): p. 1190-1199.

Alexopoulou, M., et al., Immediate implant in the posterior region combined with alveolar ridge preservation and sealing socket abutment: A retrospective 3D radiographic analysis. Clin Implant Dent Relat Res, 2021. 23(1): p. 61-72.

Amato, F., et al., The Role of Different Healing Abutment Sizes in Tissue Volume Preservation of Molar Sockets After Immediate Tooth Extraction and Implant Placement: A Multicenter Clinical Study. Int J Oral Maxillofac Implants, 2022. 37(5): p. 891-904.

Anitua, E., L. Piñas, and M.H. Alkhraisat, Long-Term Outcomes of Immediate Implant Placement Into Infected Sockets in Association With Immediate Loading: A Retrospective Cohort Study. J Periodontol, 2016. 87(10): p. 1135-40.

Antonacci, D., et al., Clinical effects of conventional and underprepared drilling preparation of the implant site based on bone density: A systematic review and meta-regression. J Prosthodont Res, 2023. 67(1): p. 23-34.

Araújo, M.G. and J. Lindhe, Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol, 2005. 32(2): p. 212-8.

Araújo, M.G., et al., Ridge alterations following grafting of fresh extraction sockets in man. A randomized clinical trial. Clin Oral Implants Res, 2015. 26(4): p. 407-412.

Block, M.S., et al., Prospective evaluation of immediate and delayed provisional single tooth restorations. J Oral Maxillofac Surg, 2009. 67(11 Suppl): p. 89-107.

Brunski, J.B., Avoid pitfalls of overloading and micromotion of intraosseous implants. Dent Implantol Update, 1993. 4(10): p. 77-81.

Buser, D., et al., Long-term stability of early implant placement with contour augmentation. J Dent Res, 2013. 92(12 Suppl): p. 176s-82s.

Canullo, L., et al., Soft tissue dimensional changes after alveolar ridge preservation using different sealing materials: a systematic review and network meta-analysis. Clin Oral Investig, 2022. 26(1): p. 13-39.

Cha, J.Y., et al., Multiscale analyses of the bone-implant interface. J Dent Res, 2015. 94(3): p. 482-90.

Chappuis V, Engel O, Reyes M, Shahim K, Nolte LP, Buser D. Ridge alterations post-extraction in the esthetic zone: a 3D analysis with CBCT. J Dent Res. 2013;92(12 Suppl):195S-201S.

Chow, Y.C. and H.L. Wang, Factors and techniques influencing peri-implant papillae. Implant Dent, 2010. 19(3): p. 208-19.

Corrado, F., et al., Immediate Implant and Customized Healing Abutment Promotes Tissues Regeneration: A 5-Year Clinical Report. J Oral Implantol, 2023. 49(1): p. 19-24.

Coyac, B.R., et al., A preclinical model links osseo-densification due to misfit and osseo-destruction due to stress/strain. Clin Oral Implants Res, 2019. 30(12): p. 1238-1249.

Elgendi, M.M., I.S.E. Hamdy, and H.I. Sallam, Peri-implant soft tissue conditioning of immediate posterior implants by CAD-CAM socket sealing abutments: a randomized clinical trial. BMC Oral Health, 2025. 25(1): p. 83.

Falco, A., M. Berardini, and P. Trisi, Correlation Between Implant Geometry, Implant Surface, Insertion Torque, and Primary Stability: In Vitro Biomechanical Analysis. Int J Oral Maxillofac Implants, 2018. 33(4): p. 824-830.

Feher, B., et al., Resonance frequency analysis of implants placed in condensed bone. Clin Oral Implants Res, 2021. 32(10): p. 1200-1208.

Fernandes, D., et al., Effect of customized healing abutments on the peri-implant linear and volumetric tissue changes at maxillary immediate implant sites: A 1-year prospective randomized clinical trial. Clin Implant Dent Relat Res, 2021. 23(5): p. 745-757.

Finelle, G. and S.J. Lee, Guided Immediate Implant Placement with Wound Closure by Computer-Aided Design/Computer-Assisted Manufacture Sealing Socket Abutment: Case Report. Int J Oral Maxillofac Implants, 2017. 32(2): p. e63-e67.

Finelle, G., et al., Digitalized CAD/CAM protocol for the fabrication of customized sealing socket healing abutments in immediate implants in molar sites. Int J Comput Dent, 2019. 22(2): p. 187-204.

Finelle, G., et al., Peri-implant soft tissue and marginal bone adaptation on implant with non-matching healing abutments: micro-CT analysis. Clinical Oral Implants Research, 2015. 26(4): p. e42-e46.

Finelle, G., et al., Sealing Socket Abutments (SSAs) in Molar Immediate Implants with a Digitalized CAD/CAM Protocol: Soft Tissue Contour Changes and Radiographic Outcomes After 2 Years. Int J Periodontics Restorative Dent, 2021. 41(2): p. 235-244.

Gallucci, G.O., et al., Implant placement and loading protocols in partially edentulous patients: A systematic review. Clin Oral Implants Res, 2018. 29 Suppl 16: p. 106-134.

Gallucci, G.O., et al., Innovative approach to computer-guided surgery and fixed provisionalization assisted by screw-retained transitional implants. Int J Oral Maxillofac Implants, 2015. 30(2): p. 403-10.

Gharpure, A.S., et al., Role of thin gingival phenotype and inadequate keratinized mucosa width (<2 mm) as risk indicators for peri-implantitis and peri-implant mucositis. J Periodontol, 2021. 92(12): p. 1687-1696.

Gnusins, V., et al., Chairside vs Prefabricated Sealing Socket Abutments for Posterior Immediate Implants: A Randomized Clinical Trial. Clin Implant Dent Relat Res, 2025. 27(4): p. e70076.

González-Martín, O., et al., Contour Management of Implant Restorations for Optimal Emergence Profiles: Guidelines for Immediate and Delayed Provisional Restorations. Int J Periodontics Restorative Dent, 2020. 40(1): p. 61-70.

Hadaya, D., et al., Immediate loading of a fully tapered implant with deep apical threads placed in healed alveolar ridges vs. immediate extraction sockets. Clin Oral Implants Res, 2022. 33(5): p. 501-510.

Han, J.-W., et al., Impact of profile angle of CAD-CAM abutment on the marginal bone loss of implant-supported single-tooth posterior restorations. The Journal of Prosthetic Dentistry, 2023.

Heimes, D., et al., How does dental implant macrogeometry affect primary implant stability? A narrative review. Int J Implant Dent, 2023. 9(1): p. 20.

Katafuchi, M., et al., Restoration contour is a risk indicator for peri-implantitis: A cross-sectional radiographic analysis. Journal of Clinical Periodontology, 2018. 45(2): p. 225-232.

Lages, F.S., D.W. Douglas-de Oliveira, and F.O. Costa, Relationship between implant stability measurements obtained by insertion torque and resonance frequency analysis: A systematic review. Clin Implant Dent Relat Res, 2018. 20(1): p. 26-33.

Lanis, A., et al., The Influence of Abutment Selection in the Tridimensional Implant Position: Considerations for Predictable Implant Restorative Long-Term Outcomes. J Esthet Restor Dent, 2024.

Lilet, R., et al., Immediate implant placement combining socket seal abutment and peri-implant socket filling: A prospective case series. Clin Oral Implants Res, 2022. 33(1): p. 33-44.

Menchini-Fabris, G.B., et al., A 3-year retrospective study of fresh socket implants: CAD/CAM customized healing abutment vs cover screws. Int J Comput Dent, 2020. 23(2): p. 109-117.

Monje, A., et al., Relationship Between Primary/Mechanical and Secondary/Biological Implant Stability. Int J Oral Maxillofac Implants, 2019. 34: p. s7-s23.

Monje, A., et al., The Critical Peri-implant Buccal Bone Wall Thickness Revisited: An Experimental Study in the Beagle Dog. Int J Oral Maxillofac Implants, 2019. 34(6): p. 1328–1336.

Noelken, R., et al., Clinical and esthetic outcome with immediate insertion and provisionalization with or without connective tissue grafting in presence of mucogingival recessions: A retrospective analysis with follow-up between 1 and 8 years. Clin Implant Dent Relat Res, 2018. 20(3): p. 285-293.

Olmedo-Gaya, M.V., et al., Influence of different surgical techniques on primary implant stability in the posterior maxilla: a randomized controlled clinical trial. Clin Oral Investig, 2023. 27(7): p. 3499-3508.

Pico, A., et al., Influence of abutment height and implant depth position on interproximal peri-implant bone in sites with thin mucosa: A 1-year randomized clinical trial. Clin Oral Implants Res, 2019. 30(7): p. 595-602.

Pitman, J., et al., Immediate implant placement with or without immediate provisionalization: A systematic review and meta-analysis. J Clin Periodontol, 2022. 49(10): p. 1012-1023.

Prosper, L., et al., Five-year follow-up of wide-diameter implants placed in fresh molar extraction sockets in the mandible: immediate versus delayed loading. Int J Oral Maxillofac Implants, 2010. 25(3): p. 607-12.

Puisys, A., et al., Contour angle and peri-implant tissue height: Two interrelated features of the implant supracrestal complex. Clin Exp Dent Res, 2023. 9(3): p. 418-424.

Puisys, A., et al., Immediate implant placement vs. early implant treatment in the esthetic area. A 1-year randomized clinical trial. Clin Oral Implants Res, 2022. 33(6): p. 634-655.

Puisys, A., et al., Influence of mucosal tissue height on implant crestal bone: A 10-year follow-up of a controlled clinical trial. J Dent, 2024. 148: p. 105224.

Roberts, W.E., et al., Osseous adaptation to continuous loading of rigid endosseous implants. Am J Orthod, 1984. 86(2): p. 95-111.

Roccuzzo, M., M. Aglietta, and L. Cordaro, Implant loading protocols for partially edentulous maxillary posterior sites. Int J Oral Maxillofac Implants, 2009. 24 Suppl: p. 147-57.

Romito, G.A., et al., Simultaneous Assessment of Soft and Hard Tissue Behaviors After Alveolar Ridge Preservation Using Bone Substitutes. Int J Periodontics Restorative Dent, 2022. 42(1): p. 103-111.

Seyssens, L., A. Eghbali, and J. Cosyn, A 10-year prospective study on single immediate implants. J Clin Periodontol, 2020. 47(10): p. 1248-1258.

Siegenthaler, M., et al., Anterior implant restorations with a convex emergence profile increase the frequency of recession: 12-month results of a randomized controlled clinical trial. Journal of Clinical Periodontology, 2022. 49(11): p. 1145-1157.

Smith, R.B. and D.P. Tarnow, Classification of molar extraction sites for immediate dental implant placement: technical note. Int J Oral Maxillofac Implants, 2013. 28(3): p. 911-6.

Stavropoulos, A., et al., Effect of Osteotomy Preparation on Osseointegration of Immediately Loaded, Tapered Dental Implants. Adv Dent Res, 2016. 28(1): p. 34-41.

Stocchero, M., et al., Biomechanical, Biologic, and Clinical Outcomes of Undersized Implant Surgical Preparation: A Systematic Review. Int J Oral Maxillofac Implants, 2016. 31(6): p. 1247-1263.

Strauss, F.J., et al., Wide Restorative Emergence Angle Increases Marginal Bone Loss and Impairs Integrity of the Junctional Epithelium of the Implant Supracrestal Complex: A Preclinical Study. J Clin Periodontol, 2024.

Su, H., et al., Considerations of implant abutment and crown contour: critical contour and subcritical contour. Int J Periodontics Restorative Dent, 2010. 30(4): p. 335-43.

Szmukler-Moncler, S., et al., Timing of loading and effect of micromotion on bone-dental implant interface: review of experimental literature. J Biomed Mater Res, 1998. 43(2): p. 192-203.

Tajti, P., et al., Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis. Periodontol 2000, 2024. 94(1): p. 627-638.

Tallarico, M., et al., Molar replacement with 7 mm-wide diameter implants: to place the implant immediately or to wait 4 months after socket preservation? 1 year after loading results from a randomised controlled trial. Eur J Oral Implantol, 2017. 10(2): p. 169-178.

Tavelli, L., et al., Peri-implant soft tissue phenotype modification and its impact on peri-implant health: A systematic review and network meta-analysis. J Periodontol, 2021. 92(1): p. 21-44.

Todorovic, V.S., et al., Buccal and palatal alveolar bone dimensions in the anterior maxilla: A micro-CT study. Clin Implant Dent Relat Res, 2023. 25(2): p. 261-270.

Toia, M., et al., Clinical Considerations of Adapted Drilling Protocol by Bone Quality Perception. Int J Oral Maxillofac Implants, 2017. 32(6): p. 1288-1295.

Trimpou, G., et al., Clinical performance of immediately placed and restored progressive-type implants in the esthetic zone: a prospective observational study. Int J Implant Dent, 2022. 8(1): p. 57.

Van Nimwegen, W.G., et al., Immediate implant placement and provisionalisation in the aesthetic zone. Journal of Oral Rehabilitation, 2016. 43(10): p. 745-752.

Walker, L.R., G.A. Morris, and P.J. Novotny, Implant insertional torque values predict outcomes. J Oral Maxillofac Surg, 2011. 69(5): p. 1344-9.

Weigl, P. and A. Strangio, The impact of immediately placed and restored single-tooth implants on hard and soft tissues in the anterior maxilla. Eur J Oral Implantol, 2016. 9 Suppl 1: p. S89-106.

Wittneben, J.G., et al., Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res, 2023. 34 Suppl 26: p. 266-303.

Yan, Q., et al., Soft and Hard Tissue Changes Following Immediate Placement or Immediate Restoration of Single-Tooth Implants in the Esthetic Zone: A Systematic Review and Meta-Analysis. Int J Oral Maxillofac Implants, 2016. 31(6): p. 1327-1340.

Zhou, W., et al., Placement and Loading Protocols for Single Implants in Different Locations: A Systematic Review. Int J Oral Maxillofac Implants, 2021. 36(4): p. e72-e89.