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Dental implant abutment

author icon By Dr. George Ghidrai

Implant abutments are artificial devices that are connected to the dental implants after the healing process is over. The abutments are used to attach a crown, bridge, or removable denture to the implant fixtures.


implant abutment

There are two classes of abutments : prefabricated and custom made.


a. Prefabricated abutments

Prefabricated or stock abutments are manufactured in a range of sizes and shapes and are usually delivered by manufacturing companies along with the implants. From the various range of abutments, the ones that best fit the clinical case are selected.

Material

Prefabricated abutments can be made from a variety of materials, such as titanium, surgical stainless steel, gold and, more recently, zirconium.

zirconium abutments

zirconium abutments

gold abutments

gold abutments



Features

When the practitioner selects the abutments, several factors are involved :


1. The prosthesis is secured to the abutments with dental cement

In this case, the surface of the artificial abutment is smooth. The restoration is secured to the abutments with dental cement just like crowns and bridges are fixed on natural teeth.

implant supported crown fixed with dental cement

implant supported crown fixed with dental cement

The main advantage is they offer a higher aesthetic performance.


2. The prosthesis is fixed with a lag-screw

These types of restorations require artificial abutments with a threaded hole in the middle.

The restoration is secured with screws that traverse the dental crowns and attach to the threaded holes. After the screws are positioned, the holes that penetrate the crowns are sealed with a composite material.

artificial abutment with a threaded hole

artificial abutment with a threaded hole

implant crown secured with a lag-screw

the crown is secured with a lag-screw

The advantage is they are easier to maintain and change when the prosthetic fractures.


3. Removable dentures secured with special retainers

Special retainer type abutments are used to retain dentures using a male-adapter attached to the implant and a female-adapter in the denture.

special retainer abutments : male-adapters attached to the implants

the male-adapters
are attached to the implants

special retainer abutments : female-adapters are housed in the denture

the female-adapters
are housed in the denture

These types of stock abutments allow movement of the denture, but enough retention to improve the quality of life for denture wearers, compared to conventional dentures.

dental implant supported denture

removable denture secured with special retainers

Regardless of the type of adapter, the female portion of the adapter that is housed in the denture will require periodic replacement.


Angulation

An abutment is not necessarily parallel to the long axis of the implant. Angulated abutments are utilized when the implant is at a different inclination in relation to the proposed prosthesis. The main purpose in this case is to make all artificial abutments parallel to each other.

straight abutments

straight abutments

angulated abutments

angulated abutments



b. Custom made abutments

Custom made abutments are fabricated at the dental laboratory after an impression of the top of the implant is made with the adjacent teeth and gingiva. The size, shape and material depend on the clinical application.

custom made abutment

custom made abutment on a dental cast

Normally, any type of abutment can be manufactured at the dental lab : with a smooth surface, with threaded holes and all kinds of special anchoring systems for removable dentures.

Another variation is when the crown and abutment are one piece and the lag-screw traverses both to secure the one-piece structure to the internal thread on the implant.


Regardless of the type of abutment, after the abutment is attached to the implant, an impression is made and the designed restoration is constructed at the dental laboratory (see prosthetic phase).

Last review and update: May 2019



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