Prosthetic Emergence Angles and Implant Outcomes: A Retrospective Study With at Least 5 Years of Follow‐Up

ABSTRACT Objectives The influence of prosthetic emergence angles on peri‐implant tissue stability has become a topic of growing interest. While wide emergence angles have been associated with increased marginal bone loss (MBL) and peri‐implantitis, available evidence is limited and largely based on studies using prefabricated abutments. This retrospective study aimed to evaluate the impact of customized implant‐supported fixed dental prostheses (iFDPs) emergence angles on peri‐implant MBL and peri‐implant health after a minimum of 5 years of follow‐up. Materials and Methods Patients rehabilitated with single or multiple iFDPs between 2010 and 2019 were retrospectively screened. Inclusion required a minimum follow‐up of 5 years. Clinical parameters and radiographic marginal bone loss were assessed. Emergence angles (mesial, distal, buccal, palatal/lingual) were measured and categorized as < 40°, 40°–59°, or ≥ 60°. Multivariable regression models adjusted for smoking and follow‐up duration analyzed associations between emergence angles, MBL, and peri‐implantitis. Results Fifty‐two patients with 112 implants met the inclusion criteria. Mean emergence angles were: mesial 43.9°, distal 40.6°, buccal 49.5°, and palatal 45.8°. Overall, peri‐implant tissues remained stable, with mean bone loss values ≤ 0.8 mm and mean PPD 1.8–3.9 mm over time. No significant correlation was found between emergence angle categories and MBL. Conclusion Prosthetic emergence angle did not significantly influence peri‐implant bone loss or peri‐implantitis when customized abutments were used. Individualized abutments might mitigate risks associated with wide emergence angles.