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Dental implant abutment


Last Updated: 10.01.2024

Author: George Ghidrai, MD  

Implant abutments are artificial devices connected to the dental implants after the healing process. 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.

Material

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

zirconia abutments

zirconia abutments

gold abutments

gold abutments



How is an implant abutment selected?

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

Let's examine these factors in more detail:


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

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

implant-supported crown fixed with dental cement

abutment and implant-supported crown
secured with dental cement

The main advantage is they offer a higher aesthetic performance.


II. The prosthesis is fixed with a lag screw

These 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.


III. 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.

implant-supported dentures adapter or retainer

Compared to conventional dentures, these abutments allow movement of the denture but enough retention to improve the quality of life for denture wearers.

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

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

dental implant-supported denture

implant-supported denture


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.

In this case, the primary purpose is to make all artificial abutments parallel.

straight abutments

straight abutments

angulated abutments

angulated abutments



b. Custom-made abutments

Custom-made abutments are fabricated at the dental laboratory after a dental 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


What is a Dental Impression?

  • A traditional dental impression is an imprint of teeth and soft tissues formed with specific impression materials used in different dentistry areas. The dental impression forms an imprint (i.e., a 'negative' mould) of teeth and soft tissues, which can then be used to create a cast of the dentition.

    dental impression

    A digital dental impression is a cutting-edge technology that enables dentists to build a computer-generated, virtual replica of the soft and hard tissues in the mouth. Digital impressions are created with optical scanning devices such as lasers.

    digital impression

Commonly, any abutment can be manufactured at the dental lab: with a smooth surface, threaded holes, and 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 (for more details, see the prosthetic phase).




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