Once you have completed the healing process following placement of your dental implant fixture, the final step is to connect the bridge, denture, or crown to the implant fixture using an implant abutment. These abutments can either be prefabricated or custom made. To learn more about each type of abutment, refer to the following overview. If you would like to learn more about whether you are a good candidate for dental implants, and if so, what type of implant is best suited to your needs, contact your periodontist for a consultation.
Custom Made Abutments
Designing a custom-made abutment requires first making an impression of the top of the implant to naturally fit with the surrounding gingiva and teeth. The material, shape, and size will vary depending on what type of implant is needed and may include special anchoring systems for patients who are having removable dentures placed. A custom-made abutment may also be designed with the crown and abutment as one piece, after which a special screw can be used to secure the implant. Following attachment of the implant, another impression is made and sent to the laboratory to design a restoration that looks and feels natural and is customized to your unique mouth. Once this prosthesis is finished, it will be placed and tested to ensure the bite is correct and that the tooth feels natural and comfortable, after which the crown is screwed or cemented to the abutment and the dental implant process will be complete.
Prefabricated abutments range in shape, size and type. The most common material type for abutments are zirconium, gold, steel, and titanium, with titanium being the most commonly used because of its biocompatibility and strength. More recently, zirconium abutments have been used, as this material can provide improved aesthetic outcome by eliminating the issue of hiding the metal color of the abutment.
There are several factors that will determine what type of abutment is best suited for you, including whether you are getting a removable denture, fixed bridge, or crown, whether the abutment is going to be attached with special retainers, lag screws, or dental cement, and where in the mouth the implant is being placed.
If removable dentures are being placed, a special retainer abutment will be used with a male and female adapter that attach the denture and implant together. This design provides stability while allowing for the denture to move, which results in improved functionality and comfort compared to traditional dentures.
Other restorations may be secured with a lag screw. The lag screw is positioned through the dental crown into a threaded hole in the abutment. Once the screws are properly positioned, the hole in the crown is sealed. Two of the biggest benefits to this type of abutment and crown are that maintenance is much easier compared to removable dentures and if the prosthetic fractures, they are easier to replace. If the implant is able to be placed using dental cement, an abutment with a smooth surface is used onto which the restoration is secured, which results in an aesthetically pleasing, easy to manage restoration.