What is an abutment?
An abutment is a component of a dental implant. It serves as a connector between the titanium root and the prosthetic part. One part of it is screwed into the implant, while the other forms a supra-gingival base for the prosthesis (similar to a natural tooth stump). The abutment during implantation allows for proper load distribution and helps create an aesthetically pleasing gum contour.
Types of Abutments
Standard
These components are designed for routine clinical cases. They are mass-produced according to specific templates and sizes for different implants. When manufacturing standard abutments, individual features of the patient’s jaw aren’t considered, which can affect the aesthetic appearance of the gum contour and the structure’s overall look.
Custom
Custom abutments are made and adjusted according to the patient’s anatomical features. A crown on such a base will not stand out among other teeth. They are usually recommended for the smile zone.
Before starting treatment, the doctor takes an impression or image of the oral cavity.
Based on this, a model of the dental system is made (either standard or 3D).
The appropriate size and shape of the connector are determined.
It is then created using a milling machine.
The gum fits snugly against such an abutment. As a result, cement residues do not get under the gum edge after the crown is placed, and neither do plaque and pathogenic bacteria.
Types of Structures
Straight
Suitable for fixing bridgework, single restorations. Most often, straight structures (implants + abutments) are placed during prosthetics in the smile zone.
Angled
These elements are typically used when treatment follows the All-on-4 protocol. They can load zygomatic or angled implants. Angled abutments allow secure fixation of prostheses on the artificial root.
Ball-shaped
Used for securing temporary and removable dentures.
Temporary
A temporary abutment is used in the two-stage implantation process. It ensures the proper formation of the gingival contour for subsequent implant placement.
Additionally, it prevents excessive pressure on the artificial root for 4-6 months post-surgery. Therefore, lightweight temporary abutments and plastic crowns are attached to the titanium post immediately or within 2-3 days after implantation. After the osseointegration period, a permanent one replaces it (the same goes for the crown).
Materials Used
Plastic
These abutments, made from polymers, are intended only for temporary wear (up to six months).
Titanium
Titanium alloy abutments are considered to have good biocompatibility and high strength. They are commonly used for prosthetics of posterior teeth since the gray color of the metal may show through ceramic crowns/dentures, giving the mucous tissues a bluish tint, which significantly affects aesthetics.
Ceramic
Abutments made from zirconia are often used in the anterior jaw zone as connectors for ceramic or zirconia crowns. They offer high aesthetics (shades of white and yellow). This makes the orthopedic structure look natural, matching real teeth.
Zirconia, unlike titanium, is smooth and slippery, so plaque hardly accumulates on its surface. This reduces the risk of bacterial colonization and tissue inflammation around the implant.
Combined
In combined abutments, the screws are made from titanium alloys, and the caps from zirconia. The parts are then glued together. This achieves high strength, aesthetics, and reliable fixation of the item with the implant.
How is an abutment fixed?
There are two methods of attachment.
Screw Retention
The crown is connected to the abutment beforehand, outside the oral cavity. This structure is attached to the implant with a screw that passes through a pre-drilled hole. The hole in the crown is sealed with a composite material.
Cement Retention
A connector is inserted into the artificial root and securely fastened with a screw. Dental cement is used to attach the crown to the abutment.
To ensure the prosthetic structure looks good and lasts longer, all its parts must be compatible with each other. A specialist experienced in the specific clinical case should select the components. Thus, scheduling a consultation is recommended.
