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Selection Of Abettors And Long-Term Success

Views: 239     Author: Kaylee     Publish Time: 2023-09-07      Origin: Site


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Selection Of Abettors And Long-Term Success

1.Types Of Implant Abutments

Abutments for implants might be either standard or unique. If the implant is positioned in a nearly optimal prosthetic position, the use of a conventional abutment is advised. Standard abutments have the benefit of being time-efficient in their overall treatment, which reduces the technical manufacturing time. With angled standard abutments, differences between implants supporting multiple-unit prostheses can be fixed. The interproximal position of the crown margin would be too far submucosally if the collar height of a prefabricated abutment was uniformly 360 degrees in the aesthetic zone.As a result, the best design for a typical abutment should resemble a tooth preparation and follow the gingival margin's curve. Regarding the placement of the implant in a vertical dimension, there are clinical restrictions. Standard abutments are not recommended if the implant is positioned too apically, especially for screw-retained reconstructions, since they don't offer enough support for the veneering ceramic.

An abutment can be individually positioned and angled by the doctor with the help of customization. It is also possible to customize the eventual restoration's emergence profile and future crown margin position when using a bone-level implant.In particular for screw-retained reconstructions, it enables abutments to be built to offer the best support for the veneering ceramic material. Individualization can be accomplished by employing titanium base abutments, gold abutments made using conventional lost-wax casting techniques, or CAD/CAM technology. For implants placed at the bone and tissue levels, customized abutments created using CAD/CAM technology can be composed of titanium or zirconium dioxide. They can be utilized for cement- or screw-retained bridges as well as single crowns. The use of a high-performance ceramic material is one of the advantages of the CAD/CAM abutment, which again offers several benefits, especially at esthetic sites.

No grayish shining-through will be noticeable with a white abutment in patients with a thin tissue biotype. However, titanium is an additional material option. Individualization of the abutment's angulation and design to support the veneering ceramic is another benefit.

2.Components Of Implant Abutments

Implant abutments can be made out of a variety of biomaterials. For abutments supporting provisionals, particularly for bone-level-type implants, PMMA (polymethyl methacrylate), titanium, and PEEK (polyether ether ketone) are recommended in order to tailor the emergence profile and individualize the peri-implant mucosa with soft tissue conditioning. Abutments for final restorations are typically made of titanium, gold, zirconium dioxide, or ceramics based on aluminum oxide.This article will address the clinical and histological performance of titanium and zirconium dioxide. Regarding durable and well-established behavior under functional loads for both soft and hard tissues, titanium is the biomaterial of choice. It offers good mechanical strength, biocompatibility, and corrosion resistance. As a result, it is the preferred abutment material for posterior placements. However, patients in the anterior zone have higher expectations. Mucosal thickness is significant in esthetic places. A study on animals comparing several dental materials with varying mucosal thicknesses revealed that titanium caused the most obvious color shift.

Zirconium dioxide did not cause any discernible color changes in mucosa that was between 2 and 3 mm thick. Zirconium dioxide and metal abutments performed equally well in clinical settings based on esthetic, technical, and biological outcomes, according to the existing clinical evidence and systematic reviews. Zirconium dioxide inside the titanium implant exhibits statistically much more wear than titanium abutments, according to in vitro studies. The clinical importance, however, is not yet obvious. Since using zirconium dioxide abutments every day in esthetic cases with bone-level implants starting in 2009 in our practice, we have not yet experienced any abutment fractures.

Long-term success is greatly influenced by the proper CAD/CAM design of a zirconium dioxide abutment and the caliber and accuracy of the connecting portion of the implant. Focusing on the results of histological examinations, an in vivo study reveals that the soft tissue health of the peri-implant mucosa next to zirconium dioxide and titanium abutment surfaces did not differ noticeably. Another investigation discovered that zirconium dioxide promotes faster tissue healing than titanium. Based on information from animal and human histology research, a systematic review of the literature on zirconium dioxide abutments comes to the conclusion that zirconium dioxide is just as suitable a material for dental implant abutments as titanium.Zirconium dioxide appears to have a lesser propensity for surface-bound bacterial plaque in the early phases of plaque accumulation, which is favorable.

3.Clinical Advice And Conclusion

Choosing an abutment for aesthetic sites: The abutments for implants are situated in a zone of transition where they come into contact with both the implant and the peri-implant tissues. Therefore, the selection of an abutment is crucial, particularly in a delicate area like the esthetic zone. Zirconium dioxide abutments, which can be either standard or customized depending on the prosthetic position of the implant, are recommended for single-unit reconstructions. Zirconium dioxide abutments for cement-retained bridges and gold titanium abutments for screw-retained bridges are suggested for multi-unit reconstructions.

The prosthetic position of the implant and whether one or more units need to be replaced depend mostly on the choice of abutment for posterior placements. If the prosthetic position of the implant is ideal, standard abutments are the best option for posterior sites. When the implant is not positioned in the appropriate prosthetic position, angled standard abutments, custom titanium CAD/CAM abutments, or cast abutments in gold are recommended. Standard titanium or unique gold abutments for multi-unit reconstructions are advised.


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