Custom Implant Abutments

Dental implants have become so common place that I’m sure most dental practices deal with them on a daily basis. Even if you are not placing the implant, you are doing the restorative work over top of them. Working together with a knowledgable lab is important because at times implant work can get a little tricky. For the majority of cases a stock abutment from the implant manufacturer will work fine, but many times a custom manufactured abutment can improve the case and sometimes may even be a necessity. Lets discuss a few reasons why you may want to consider a custom implant abutment.

Emergence Profile-a narrow diameter implant can leave a severe emergence profile. Some manufacturers refer to this result as an “apple on a stick”. Do you get the picture? A custom abutment can create a much more natural emergence profile for the restoration or in the case of anteriors a more naturally shaped root form instead of just round.

images courtesy of Astra Tech

Over-Rotation-some implants need to be inserted and torqued so that a specific spot is facing the buccal. For example the Nobel Replace Select has an internal triangular fit. It is very obvious in the lab when these implants are over-rotated. (See the photo below). On a regular basis we see these implants over-rotated. If the restoration can be done with a straight abutment then it’s not as big of a problem. We use a stock abutment and trim all the margins to adapt to the new orientation. If the case calls for an angled abutment then a custom abutment is absolutely necessary in order to correct to rotation so the angle is proper.

 Severe Angulation or Placement-sometimes implants just end up on a difficult angle and sometimes they have to be placed in a tough to restore location. This is definitely when a custom abutment is always necessary. There is no way stock abutments will work and often we have to get very creative just to make a custom abutment.

At Oral Design we work closely with Atlantis™ by Astra Tech to create custom abutments for your cases.With Atlantis VAD™ (Virtual Abutment Design) software, abutments are uniquely designed from the final tooth shape for a more natural esthetic result. Atlantis™ abutments are available in zirconia, titanium or gold-shaded titanium. All Atlantis™ abutments are covered by a full universal warranty.

We also use our InLab CAD/CAM system to create custom zirconia abutments and at times we will even wax and cast a custom abutment in gold to get it just right.

We hope this helps you understand a little more about custom abutments. If you have more questions feel free to respond to this blog or just give us a call.