Abutment (dentistry)

Image:Ceramic Abutment.jpg

Image:Ceramic Abutment Crown.jpg

Dental bridge abutments are made such that the path of insertion of the teeth involved is nearly parallel with each other.

Partial denture abutments{{cite journal|last1=Al-Sinaidi |first1=Aljoharah|last2=Preethanath |first2=Reghunathan S.|title=The effect of fixed partial dentures on periodontal status of abutment teeth|journal=King Saud University Journal of Dental Sciences|year=2013|issn=2210-8157|doi=10.1016/j.ksujds.2013.11.001|volume=5|issue=2|pages=104–108|doi-access=free}} are unique in that they may incorporate elements such as rest seats, guide planes, and recontouring.

These are usually called prosthetic implant abutments and are responsible for making the connection between the prosthesis and the implant.Cardoso AC, Junior WA, Vasconcellos DK, Souza DC. O passo-a-passo da prótese sobre implantes – Da 2ª etapa cirúrgica à reabilitação oral. São Paulo: Santos;

2007. p. 41-63 e p. 271-182. These abutments can be made from a variety of materials, such as titanium, surgical stainless steel, gold and zirconia.

The adjacent images show how a ceramic abutment can enhance a ceramic crown by giving it a more lifelike appearance. Ceramic abutments have to be used with care, since their compressive strength is nowhere near that of titanium, gold or other noble metals. Most clinicians feel more comfortable using a metal prosthetic abutment in the posterior molar areas, due to the increased masticatory forces present in these areas.

An abutment is not necessarily parallel to the long axis of the implant. It is utilized when the implant is at a different inclination in relation to the proposed prosthesis. Most crowns and fixed partial dentures have a cemented or screw-retained fixation on the abutment.

Image:Fractured abutment screws 3 implants.jpg

In a three-piece implant the abutment is fixed on the implant with a screw butt joint.{{cite journal|last1=Shin|first1=Hyon-Mo|last2=Huh|first2=Jung-Bo|last3=Yun|first3=Mi-Jeong|last4=Jeon|first4=Young-Chan|last5=Chang|first5=Brian Myung|last6=Jeong|first6=Chang-Mo|title=Influence of the implant-abutment connection design and diameter on the screw joint stability|journal=The Journal of Advanced Prosthodontics|volume=6|issue=2|year=2014|pages=126–32|issn=2005-7806|doi=10.4047/jap.2014.6.2.126|pmc=4024557|pmid=24843398}} This screw needs to be tightened to a predetermined torque with a dental torque wrench, in order to avoid screw loosening during chewing, which can often create a counter-clockwise torque on the implant–abutment interface, encouraging the abutment screw to come loose. This can largely be prevented with proper screw design and torquing of the abutment.

In a two-piece implant the abutment is morse tapered or [Note: Titanium metal does not cold weld|weldguru.com] on the implant. Microbial leakage and colonization between the implant and the abutments can result in inflammatory reactions and crestal bone loss. Morse taper conical abutments showed a cumulative implant survival rate of 98.23%{{cite journal|last1=Mangano |first1=Carlo|last2=Mangano |first2=Francesco |last3=Shibli |first3=Jamil A.|last4=Tettamanti|first4=Lucia |last5=Figliuzzi|first5=Michele |last6=d'Avila|first6=Susana |last7=Sammons|first7=Rachel L.|last8=Piattelli|first8=Adriano|title=Prospective Evaluation of 2,549 Morse Taper Connection Implants: 1- to 6-Year Data|journal=Journal of Periodontology|volume=82|issue=1|year=2011|pages=52–61|issn=0022-3492|doi=10.1902/jop.2010.100243|pmid=20653436}} in terms of seal performance, microgap formation, torque maintenance, and abutment stability.{{cite journal|last1=Schmitt|first1=Christian M.|last2=Nogueira-Filho|first2=Getulio|last3=Tenenbaum|first3=Howard C.|last4=Lai|first4=Jim Yuan|last5=Brito|first5=Carlos|last6=Döring|first6=Hendrik|last7=Nonhoff|first7=Jörg|title=Performance of conical abutment (Morse Taper) connection implants: A systematic review|journal=Journal of Biomedical Materials Research Part A|volume=102|issue=2|year=2014|pages=552–574|issn=1549-3296|doi=10.1002/jbm.a.34709|pmid=23533139}}

A one-piece implant incorporates the trans-mucosal abutment as an integral part of the implant.{{cite journal |vauthors=Froum SJ, Cho SC, Elian N |title=Survival rate of one-piece dental implants placed with a flapless or flap protocol--a randomized, controlled study: 12-month results |journal=Int J Periodontics Restorative Dent |volume=31 |issue=6 |pages=591–601 |year=2011 |pmid=22140661|display-authors=etal}} This type of implant is often used with a flapless procedure and immediate loading (the crown is placed a short time after placing the implant).{{cite journal|last1=Sato|first1=Junichi|last2=Watanabe|first2=Goro|last3=Ando|first3=Masami|last4=Shimoo|first4=Yoshiaki|last5=Shizukuda|first5=Kazushige|last6=Kimura|first6=Tomonori|last7=Kobayashi|first7=Mariko|title=A prospective multicenter study of immediate function of 1-piece implants: A 3-year follow-up report|journal=The Journal of Prosthetic Dentistry|year=2014|issn=0022-3913|doi=10.1016/j.prosdent.2014.03.001|volume=112|issue=4|pages=784–791|pmid=24882598}}

An impression is taken from the implant site using conventional impression materials or digital scanning.{{Cite web|title=Guide to Dental Impressions|url=https://blog.pro-craft.com/guide-to-dental-impressions|access-date=2025-03-17|work=blog.pro-craft.com}} This impression serves as a template for the fabrication of the abutment and the final prosthesis.{{Cite web|title=Comparison of digital and conventional impression techniques: evaluation of patients’ perception, treatment comfort, effectiveness and clinical outcomes|url=https://bmcoralhealth.biomedcentral.com/articles/10.1186/1472-6831-14-10|access-date=2025-03-17|work=bmcoralhealth.biomedcentral.com}}{{Cite web|title=How to Capture an Accurate Digital Impression for Implant Cases|url=https://glidewelldental.com/company/blog/how-to-capture-an-accurate-digital-impression-for-implant-cases|access-date=2025-03-17|work=glidewelldental.com}}{{Cite web|title=How to Select the Perfect Abutment for Your Dental Implant: A Comprehensive Guide|url=https://uniqa.dental/articles/how-to-select-abutment-for-implant-guide/|access-date=2025-03-17|work=uniqa.dental}} Based on the treatment plan, the implantologist selects the appropriate type and design of the abutment, taking into consideration factors such as aesthetics, functional requirements, and the patient's anatomical features. The chosen abutment is carefully installed onto the implant and secured in place. Depending on the abutment system, a fastening screw or a special attachment mechanism may be used to connect to the implant.{{Cite web|title=In vitro assessment of internal implant-abutment connections with different cone angles under static loading using synchrotron-based radiation|url=https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-024-04156-2|access-date=2025-03-17|work=bmcoralhealth.biomedcentral.com}}{{Cite web|title=Abutments for Implants|url=https://agourahillscosmeticdentists.com/abutments-for-implants/|access-date=2025-03-17|work=agourahillscosmeticdentists.com}}{{Cite web|title=Dental implant abutment|url=https://infodentis.com/dental-implants/abutment.php|access-date=2025-03-17|work=infodentis.com}} The abutment screw is tightened, ensuring a reliable and stable connection between the abutment and the implant. To ensure proper alignment and load distribution within the restoration, occlusal adjustment may be performed. Immediately after screwing in the metal components, a healing abutment is embedded. The healing abutments are the primary mounted component, after which the patient transitions to one of the types of abutments. In some cases, after the implant is initially placed, a healing abutment is installed. It helps shape the soft tissues during the healing phase and is later replaced with the final abutment once the desired gum contours are achieved.

• Multi-unit abutment

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• [https://web.archive.org/web/20100107033353/http://www.perio.org/consumer/2mb.htm Dental Implant Options]

Category:Dentistry

Titanium metal is not suitable to be cold welded weldguru.com