Dental Implant Abutments and Their Selection - A Review

Abstract

Dental implants have become the most promising and accepted prosthetic alternative to missing teeth. Innovative and technological advances in implant dentistry have improved the performance and long term prognosis of dental implants. The growing demand for dental implants has led many manufacturers to enter the industry. With this growth in implant dentistry various implant brands and their components are made available in the markets that vary in terms of design and other features. Success of implant restorations is related to various components involved with the prosthesis. Implant abutment is the link between implant and restoration; right selection of this abutment is vital for the success of implant prosthesis. There are varieties of implant abutments available in the market. Clinician should have adequate knowledge about these abutments and various factors that affect abutment selection, to choose the right one. Each implant case is different and clinician should be able to identify requirements of every individual case and choose the best suitable abutment available in the market. These abutments vary in implant abutment connection, material, type of retention, and fabrication methods. Though the ideal concept is prosthetically driven implant placement, many times anatomical features, esthetic requirements, soft tissue profile, axial load distribution, malpositioned implants, and many other patient factors do not allow ideal implant placement. Such cases can be managed by careful selection of abutments by assessing the clinical requirements, thus offering better treatment outcome. This paper is an attempt to contemplate various factors affecting abutment selection, and throw light on various implant abutments available in the market, thus guiding the clinician in abutment selection. Hence this article summarizes complete information about the implant abutments, including introduction, types, selection, and different abutments available in market. KEY WORDS Abutment Material, Implant Abutments, Implant Abutment Connection, Prosthesis Retention

Comparative Study of Dental Custom CAD-CAM Implant Abutments and Dental Implant Stock Abutments

“…The prosthetic abutment has seen a design evolution, starting from the individualization of stock abutments offered by manufacturers, until today, where they are customized with the CAD-CAM technology [ 5 , 6 ]. Before the introduction and implementation of CAD-CAM technology, there were only two types of prosthetic abutments distributed by manufacturers: stock abutments and fully calcinable or partially calcinable abutments with prefabricated interface, also known as UCLA abutments [ 7 ].…”

Evaluation of the masking ability, marginal adaptation, and fracture resistance of screw-retained lithium disilicate implant-supported crowns cemented to titanium bases versus preparable abutments

“…The results of the present study showed a greater marginal gap in the ti-basegroup when compared to the preparable abutment group. Those results contradict the claim that the combination of ti-bases together with their specially designed lithium disilicate blocks would provide better marginal adaptation than the combination of preparable abutment with regular CAD blocks [ 4 , 5 ]. However, the average of the marginal gap was considered clinically acceptable in both groups even after thermocycling and cyclic loading [ 15 , 16 ].…”

“…In case of unavailability of a scan body, abutments can be scanned directly and hence there is no need for a special implant library in the CAD software program. The limitations of using preparable abutments as an alternative to ti-bases include the need for intraoral crown cementation and the inaccessibility of the abutment shoulder scanning in case of subgingival finish lines [ 4 , 5 ].…”

Evaluation of the masking ability, marginal adaptation, and fracture resistance of screw-retained lithium disilicate implant-supported crowns cemented to titanium bases versus preparable abutments

“…Those results contradict the claim that the combination of ti-bases together with their specially designed lithium disilicate blocks would provide better marginal adaptation than the combination of preparable abutment with regular CAD blocks. 4,5 However, the average of the marginal gap was considered clinically acceptable in both groups even after thermocycling and cyclic loading. 15,16 Limitations of the present study include the in vitro design standardizing all the variables that is not possible in the clinical practice.…”

“…The limitations of using preparable abutments as an alternative to ti-bases include the need for intraoral crown cementation and the inaccessibility of nish line scanning in case of subgingival nish lines. 4,5 A specially designed ti-base and CAD block are used with the CEREC system where the block is provided with a prefabricated screw access channel having an anti-locking slot accurately tting the ti-base. 4 This combination is intended to provide extraoral cementation with high precision.…”