Custom impression coping for an exact registration of the healed tissue in the esthetic implant restoration.

It is well known that guided soft tissue healing with a provisional restoration is essential to obtain optimal anterior esthetics in the implant prosthesis. What is not well known is how to transfer a record of beautiful anatomically healed tissue to the laboratory. With the advent of emergence profile healing abutments and corresponding impression copings, there has been a dramatic improvement over the original 4.0-mm diameter design. This is a great improvement, however, it still does not accurately transfer a record of anatomically healed tissue, which is often triangularly shaped, to the laboratory, because the impression coping is a round cylinder. This article explains how to fabricate a "custom impression coping" that is an exact record of anatomically healed tissue for accurate duplication. This technique is significant because it allows an even closer replication of the natural dentition.