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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ANECDOTE

Origins Of The Custom Abutment Technique

Dr. Richard Akin started using chairside custom healing abutments after attending a 2010 course on immediate provisionals and refining the technique over years.
He published the 'anatomic harmony abutment' concept in 2016 and still prefers bulk-fill composite on a titanium base for speed and customization.

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.

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Better implant outcomes start with how we shape tissue from day one. In this episode of Everyday Oral Surgery, host Dr. Grant Stucki welcomes return guest Dr. Richard Akin, an oral and maxillofacial surgeon from Louisiana, to explore immediate implants and the art of crafting custom healing abutments. Dr. Akin explains how years of refinement shaped his chairside method for building custom healing abutments with bulk-fill composite. This approach helps capture and maintain the natural tissue contours during healing. He shares practical lessons on case selection, torque control, and grafting, and unpacks why wide-platform implants play such a critical role in the long-term success of posterior and second molar cases. Beyond surgical precision, Dr. Akin reflects on how collaboration with restorative dentists and lab technicians helps bridge knowledge gaps, streamline workflows, and ultimately improve patient outcomes. Tune in for a masterclass in technique, teamwork, and continual learning within oral surgery!

Key Points From This Episode:

An introduction to Dr. Richard Akin, an OMS practicing in Louisiana.
How a 2010 course sparked his interest in immediate provisionals.
The evolution of his chairside custom healing abutment technique.
Using bulk-fill composite to capture patient-specific tissue contours.
Publishing the “anatomic harmony abutment” concept in 2016.
Why soft-tissue management is as critical as implant stability.
Key benefits from his custom healing abutment technique.
Dr. Akin’s full immediate implant workflow from extraction to final abutment.
Optimizing insertion torque for predictable immediate placement.
Case selection, grafting, and managing buccal gaps for success.
Preference for wide-platform implants in posterior and molar cases.
Long-term recall data showing success in second-molar implants.
Prioritizing thorough socket debridement and irrigation to achieve clean, bleeding bone.
Avoiding over-drilling through feel and control during osteotomy preparation.
Collaborating with restorative dentists and other specialists for improved patient outcomes.
The importance of actively bridging gaps between surgeons, labs, and restorative teams.
A breakdown of Dr. Akin’s approach to maxillary immediate implants.
Final reflections on teamwork, gratitude, and patient-centered care.

Links Mentioned in Today’s Episode:

Dr. Richard Akin — https://www.drakin.com/

Dr. Richard Akin on LinkedIn — https://www.linkedin.com/in/rick-akin-644aa932/

Dr. Richard Akin email — rick@drakin.com

‘A New Concept in Maintaining the Emergence Profile in Immediate Posterior Implant Placement: The Anatomic Harmony Abutment’ — https://www.researchgate.net/publication/304779134_A_New_Concept_in_Maintaining_the_Emergence_Profile_in_Immediate_Posterior_Implant_Placement_The_Anatomic_Harmony_Abutment

‘Clinical Advantages of Immediate Posterior Implants With Custom Healing Abutments: Up to 8-Year Follow-Up of 115 Cases’ — https://www.researchgate.net/publication/363099744_Clinical_Advantages_of_Immediate_Posterior_Implants_with_Custom_Healing_Abutments_Up_to_8_Year_Follow_Up_of_115_Cases

Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/

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