Definition

It is a prosthesis supported by a dental implant.

Implant-supported prostheses can be crowns, bridges, or complete prostheses.

Implant abutment

1. Definition:

An abutment is a metal connector that joins the prosthesis to the implant.

2. Roles:

  • Transfers the forces to the implant while minimizing the risk of surcharge and fracture
  • Participates in maintaining epithelial and connective tissues.
  • Resolves the divergence issue between the implants

3. Types:

  • Titanium abutment
  • Burn-out abutment
  • Zirconia abutment
  • Provisional abutment
  • Personalized abutment with Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM)

4. What is an implant-abutment connection?

An abutment connection is a connection between the prosthetic screw and the internal implant.

  • External connection implants:

The implant is connected to the abutment externally through the attachment screw.

The abutment-implant junction develops on the peripheral surface between the abutment and the implant.

  • Internal connection implants: 

The implant is designed with a shape that allows the abutment that joins the implant and the prosthesis, to be inserted a few millimeters inside the implant itself.

A connection is internal when the female part is located within the body of the implant.

Platform switching

Platform switching, also known as platform shifting is a method used to prevent crestal bone loss. Therefore, it helps preserve alveolar bone levels around dental implants and increases the volume of the soft tissues.

The abutment used is smaller in diameter than the implant platform.

Otherwise, the abutment is of a similar diameter. This method is known as platform matching.

Screw retained implant restoration VS cement retained implant restoration?

Cemented implant restoration

Advantages:

  • Cement retained implants are more esthetic (no need for an access hole)

Disadvantages:

  • Difficulty of dismantling
  • Risk of cement residue remaining subgingivally (risk of infection or implant failure due to excess cement).

Screw-retained implant restoration

Advantages: 

  • Indicated in case of a small prosthetic space
  • Simple technique 
  • The dismantlement is easier than cemented implant prosthesis
  • Absence of cement (no risk to the periodontal tissues)

Disadvantages: 

  • Screw access hole:
  • The axis of the implant could be disadvantageous to an ideal placement of the hole. 
  • Can be unsightly
  • Could interfere with the occlusion
  • Weakening of the ceramic
  • Risk of damaging the screw thread of the implant (after unscrewing many times during prosthesis fabrication )

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