How Are Custom Abutments Made?
Throw out your ideas of manually creating the ideal crown preparation. Virtual crown preparation for a dental implant begins with designing an abutment that will allow the crown to possess all of the ideal thickness and margin characteristics that allow it to appear to emanate from the gum tissue as if it were a natural tooth.
The CAD/CAM process provides both the technician and clinician the opportunity to evaluate the virtual abutment and crown in the design phase in three dimensions and make any refinements to the final design prior to fabrication.
To create a custom abutment, the clinician begins by taking impressions of the patient’s mouth with a standard implant impression coping in place. Although it is possible to capture the spatial relationships using physical crown and bridge impressions, impressions captured via a chairside scanner allow for seamless incorporation into the laboratory’s automated workflow, eliminating processing errors.
Computer-aided design is then used to create an ideal abutment that will precisely position the margin and provide tissue support around the implant while it also allows for a final restoration to match the exact shape, contour, and emergence profile of your patient’s mouth on a 3D digital model.
Once the design is complete, the custom abutment is fabricated to include anti-rotational features from a solid block of the chosen abutment material via CAM milling, allowing it to perfectly mesh with the implant platform. The final crown can also be designed at the same time to marry with the milled abutment, eliminating lag time and the need for additional impressions with the custom abutment in place.
Custom Abutments Variations
Dental implant abutment types are available in a variety of materials including titanium, gold-toned titanium, and solid zirconia with a titanium base. Newer versions of custom abutments often incorporate milled grooves into the coronal portion of the abutment in order to improve crown retention.
To achieve a precise well-machined fit with the implant, all of the abutment options require a titanium base that accepts a standard titanium screw for retention. The coronal abutment material choice should be carefully paired with the material selected for the final restoration, taking into account the margin level.
Full Titanium Abutments
These abutments can work well for posterior crown cases or in areas where appearance is less critical. Even in cases where margins are placed subgingivally, a dark line of metal may show through the tissue. This is particularly true for patients that have thin, friable tissue. Additionally, the grey hue of the titanium metal can show through an all-ceramic crown, yielding a less than fully lifelike appearance.
Ideal for camouflaging the dark line that often presents at the margin of a crown, gold-toned titanium custom abutments are more easily masked and lend a warm hue to solid ceramic crowns. Its light-reflective property makes them an improved aesthetic option for anterior cases and for patients with light pink and thin tissue types.