Abutment Selection in Implant Supported Tooth Restoration

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Abutment Selection in Implant Supported Tooth Restoration
ASIL SADIQ
Compton Implants
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Introduction
After osseointegration, the implant must be exposed through a surgical procedure and a healing abutment is placed for 2 to 4 weeks to allow gingival tissue healing and stabilization of the gingival contour and margin height.[1] The abutment selection criteria are based on implant angulation, soft tissue contours, esthetics, and the need for antirotation locking, hygienic access, and retrievability for maintenance. [2] The subgingival location of the abutment should be 1 to 2 mm from the coronal edge of the buccal gingival margin. Abutments are available in 5 different shoulder heights, ranging from 1 to 5 mm depending on the distance between the buccal gingival margin and the implant head. [1]
The ideal abutment selection should be done 15 to 30 days after implant exposure. Topical anesthetic is given to prevent tissue collapse until the measurement is done. Periodontal probe is used to measure the distance between the fixture and the gingival surface. Another way is by using an abutment selection kit, using the try-in abutment directly in the patientǃÙs mouth. Once the ideal try-in abutment is chosen, it is removed from the mouth and the corresponding connection abutment is placed [2].
CeraOne Abutments and Prosthetic options
The most frequently used abutment for single tooth restorations is the CeraOne abutment. The abutment can be placed either during the surgical procedure or following soft tissue healing. The gold abutment screw must be tightened using the torque control set at 20, 32, or 45 Ncm according to the type of the implant platform used. Clinicians have found that these abutments yield nice esthetic results and have safe, fast and easy handling. [3] The Branemark system offers many options for the crown fabrication, Ceramic cap- extremely strong, consist of 99.7% sintered AL2O3 (aluminum oxide) This process rids the coping of any porosity, provide height strength, the machined coping comes pre fitted to the CeraOne abutment and the laboratory technician needs only to modify the shape and contour by applying a special veneering porcelain. This enables highly esthetic all ceramic crown.
Gold cylinder- is also machined and preadapted to the CeraOne abutment. It is a gold alloy; with a fusing temperature between 1,400 and 1,490 degree C. this temperature enables fusion with standard gold or metalloceramic alloys. It is recommended that porcelain be applied over the metalloceramic instead of being applied directly over the abutment to avoid possible porcelain fractures due to linear thermal expansion differences. This prosthetic option allows the fabrication of a meatlloceramic crowns. Burn-out cap-this coping is already pre-fitted to the CeraOne abutment and it allows the processes of waxing and casting a custom coping for the application of the ceramic material. This prosthetic option enables the fabrication of a metalloceramic crowns. The available machined prosthetic components are having more precise and constant marginal fit than those obtained by traditional prosthetic casting. [1]
References:-
1. Osseointegraton and Esthetics in Single Tooth Rehabilitation, By Carlos Eduardo Francischone and Laercio Wonhrath Vasconcelos ( chapters 6, 8, 10, 13, 16), 2000
2. Andrea Jaggers, DDS, Alan M. Simons, DDS, and Sherif E. Badr, DDS. Abutment selection for single tooth replacement. A clinical report. The Journal of Proshtetic Dentistry; vol 69 ( 2), February 1993
3. Implant prosthodontics. Clinical and laboratory procedures. By Patrick J. Stevens, DDs, Edward J. Fredrickson, DDS, FICD, Maurice L. Gress, CDT, FNBC ( Chapter 6,7, and 13) 2000.
4. Esthetic Implant Dentistry, Soft Tissue and Hard Tissue Management. By Patrick Palacci, DDS, Ingvar Ericsson, LDS,Odont Dr (chapter Nine), 2001
5. Osseointegrated Dental Technology. By Graham E. White. (Chapter six)
6. Stefanos G. Kourtis, DDs, DR Dent. Selection and modification of prefabricated implant abutments according to the desired restoration contour: A case report. Implant Dentistry; vol 33, (5), 2002.
7. Raian K.S. Kucey, B.Sc, DDs, Ms.Ed., FRCD, FACP. And Darrel C. Fraser, RDT, CDT. The Procera Abutment__ The fifth Generation Abutment for Dental Implants. Lournal of Canadian Dental Association 2000; 66: (8) 445-9
8. Christopher B. Marchack, DDS, A custom titanium abutment for the anterior single-tooth implant: Then Journal of Prosthetic dentistry: Vol 76 (3) Septermber, 1996.