Everyday Oral Surgery

Pro Tips on Posterior Immediate Implants and Custom Healing Abutments, with Dr. Rick Akin

Dec 15, 2025
Dr. Richard Akin, an innovative oral and maxillofacial surgeon from Louisiana, shares his expertise on immediate posterior implants and custom healing abutments. He highlights the evolution of his chairside techniques with bulk-fill composite for better tissue shaping. Akin stresses the importance of soft-tissue management and collaboration with restorative teams to enhance patient outcomes. He also delves into case selection nuances, the significance of wide-platform implants, and shares practical tips on grafting and surgical precision for achieving optimal results.
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ADVICE

Prioritize Insertion Torque

  • Optimize insertion torque for immediate implants to secure stability and correct position during placement.
  • Aim for firm torque (Akin prefers at least ~35 Ncm when possible) rather than mere finger-tight placement.
ADVICE

Deliver Emergence Profile Early

  • Provide anatomically tailored emergence from day one to simplify lab work and improve final restorations.
  • If worried about provisional function or patient compliance, use a custom healing abutment to deliver the same emergence benefits.
ADVICE

Protect Soft Tissue During Extractions

  • Preserve soft tissue by avoiding releasing incisions in most immediate molar cases and use periotomes and careful sectioning.
  • Keep tissues pristine to allow primary soft-tissue healing and better papilla preservation.
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