A dental abutment is a critical connecting component in dental implants and bridges that links the artificial tooth (prosthesis) to the implant fixture anchored in the jawbone. This metal connector is secured to the top of the implant through screws or cement, providing structural support for the prosthesis.
The Role of Abutments
Dental abutments serve as extenders that provide the necessary height and angulation alignment between the artificial tooth and the implant. This allows the dentist to securely position the prosthesis in the ideal orientation, facilitating proper biting and chewing functions.
Additionally, the abutment creates a solid foundation onto which the prosthesis is cemented or screwed. This ensures the artificial tooth is firmly held in place for optimal performance and longevity.
What Is A Dental Implant?
To understand the role of abutments, it is important to first comprehend dental implants. Dental implants act as artificial tooth roots made of biocompatible metals like titanium. The implant is surgically embedded into the jawbone below the gums through a process called osseointegration.
Over 3-6 months, the jawbone fuses tightly to the implant surface, anchoring it firmly in place. This provides a sturdy base to mount replacement teeth onto.
Once healed, the abutment is connected to the top of the implant. This extends the anchor site above the gums, allowing the dentist to securely attach the visible artificial tooth. The abutment therefore acts as an intermediary component linking the implant and prosthesis.
Why Are Abutments Necessary?
The abutment serves multiple important functions that make it an indispensable part of dental implants:
- Retains prosthesis: It provides retention by securely fastening the crown, bridge pontics or denture teeth.
- Supports biting forces: It bears masticatory stresses, preventing force transmission to the implant.
- Permits ideal angulation: It allows the dentist to modify angles to optimize bite alignment.
- Extends implant height: It provides needed height for ideal crown positioning.
- Enables cement retention: It gives sufficient clearance between implant and prosthesis for cement.
Therefore abutments are vital for the success of implants, ensuring proper structural support and retention for replacement teeth.
What Are The Different Types Of Abutments?
There are several types of abutments available to suit the specific restorative needs of patients:
1. Healing Abutments
Healing or temporary abutments help protect implants and shape gums during the initial healing following surgery. Once osseointegration occurs, these are replaced by permanent abutments suited to support prostheses.
2. Stock Abutments
These prefabricated, standard abutments come in different angles and heights. They offer basic support for routine cases but lack customization.
3. Custom Abutments
Custom abutments are specially fabricated to match the exact position and dimensions of an implant. This enables optimal structural support and aesthetics for the new crown.
4. Angled Abutments
Angled abutments permit dentists to modify angles up to 45 degrees, allowing for ideal placement of bridges and crowns even where implants are tilted.
5. Esthetic Abutments
Constructed from ceramic, zirconia or titanium, these provide enhanced natural-looking emergence profiles that mimic gums for improved aesthetics.
6. CAD/CAM Abutments
Designed digitally, these abutments enable precision-fitting and exceptional structural durability. However, they can be expensive to fabricate.
The choice of abutment is carefully considered by dentists to provide patients the best possible functionality and aesthetics from their implant supported restoration.
What Materials Are Used To Make Abutments?
Dental abutments are commonly fabricated from metals like:
- Titanium: Strong, biocompatible and corrosion-resistant but lacks aesthetics.
- Gold alloy: Expensive but very durable with excellent aesthetics.
- Stainless steel: Highly durable though may cause allergy.
- Zirconia: Biocompatible with good aesthetics but brittle.
- Polyether ether ketone (PEEK): Strong, lightweight with some flexibility.
The material is chosen based on its mechanical properties, biocompatibility, emergence profile and cost-effectiveness to meet patient needs.
The Abutment Selection Process
The abutment selection procedure typically involves the following key steps:
Impressions: The dentist records detailed impressions of the implant site using dental putty. This enables visualization of the implant angles, depth and position.
Model pouring: The impressions are used to create a plaster model replicating the patient’s oral structures.
Abutment selection: The dentist analyzes the model, taking into account the implant location, angulation and gum contours. An abutment type offering optimal support and aesthetics is selected.
Abutment customization: For custom abutments, specifications like height, width and angle are digitally modeled on a CAD software for precision-fitting with the implant.
Abutment fabrication: Finally, the customized abutment is precision-milled by a dental laboratory and delivered for attachment to the implant.
How Is The Abutment Attached To The Implant?
Attachment of the abutment is performed by the dentist as a quick, minimally invasive procedure with local anesthesia. It involves the following steps:
Incision: A small incision is made in the gums to expose the implant screw access hole.
Abutment positioning: The abutment is correctly oriented and seated into the hexed implant socket for optimal fit.
Screw fastening: Using controlled torque, an abutment screw is inserted through the abutment channel to fix it firmly to the implant.
Suturing: The gingival flap is repositioned and sutured around the abutment to allow gradual healing around it.
Once attached, your dentist will check the abutment after 2 weeks to ensure proper healing before taking impressions for the prosthesis fabrication.
How Much Do Dental Abutments Cost?
On average, patients can expect to pay:
- Stock abutment: $500 – $1500
- Custom abutment: $800 – $3000
However, costs vary based on treatment complexity, materials used and insurance coverage. Discuss exact pricing with your dentist beforehand.
Are There Any Risks With Dental Abutments?
While generally safe, some potential risks include ():
- Abutment fracture: Cracks can develop from biting forces, requiring replacement.
- Screw loosening: Overtime screws may loosen, causing prosthesis instability or loss.
- Peri-implantitis: Inflammation around an implant can cause bone loss.
- Recession: Gums may recede with ill-fitting abutments, affecting aesthetics.
Fortunately, risks are low with precise placement using high-quality, biocompatible construction materials and diligent oral hygiene maintenance.
Caring For Your Abutment And Implant
Caring for your abutment and implant requires thorough oral hygiene:
- Brush twice daily using gentle motions and fluoride toothpaste
- Floss around the abutment daily taking care not to dislodge screws
- Use antiseptic mouthwashes to reduce bacteria and inflammation
- Have professional cleanings every 6 months to prevent plaque buildup
Also, avoid chewing excessively hard foods which may damage the implant. Report any pain, swelling or damage promptly to your dentist.
In summary, the dental abutment is an integral intermediary component that connects the implant secured in the jawbone to the visible artificial tooth replacement. It is vital for the optimal functionality and longevity of implant supported restorations. The abutment type, design and material are carefully chosen to create stable, aesthetic and long-lasting implant prosthetics that restore form and function for patients. With appropriate care and maintenance, abutment and implant restorations can last many years, providing patients an improved quality of life through confident, pain-free chewing and speech.