Abutment Selection Flashcards
Custom abutments
Cast
Milled zirconia
Milled titanium
Stock abutments
Solid
Prefabricated
Ti-bases
Two piece abutment
TI- bases
What type of implant restoration do most labs prefer and why
TI-bases
High strength - metal internal connection with the implant and the metal/titanium insert or base
Small dental lab to fabricate custom implant abutments without outsourcing the milling of the zirconia
Screw retained
Into the implant
Into an abutment
Screw retained - into the implant
Traditional
Screw access change (LTS)
screw retained - into an abutment
Mesio structure
Horizontal screw
Cement retained
Straight or angled
Prefab Ti, ZrO2
Customized Ti, ZrO2, Al2O3, LS2
Veneer LS2
Crown-abutment complex retention
Screw retained
Cement retained
Cement screw retained
Crown abutment complex material
PFM
ZrO2
LS2
Abutment design
Metal structure must follow some anatomical form of the teeth to be restored
Need significant thickness of crown material
Abutment for tissue level implants
Maintain at least __mm at the _______ region
Max ___ mm below gingival margin
___mm of polished collar
2
Cervical
2
1.8
Pre diagnostic data
Med hx
Clinical evaluation
Radiographic evaluation
Diagnostic wax up
Tx plan presentation
Consult with surgeons
Presurgical prep
Duplication of wax up
Thermoform fabrication
Radiographic marker placement
Delivery to surgeons
One stage
No 2nd stage (uncover) required, but torque test must be performed prior to the implant impression
Two stage
Uncovery of the implant must be performed prior to the torque test
What must be done before an implant impression can be taken
Implant cases must be torque tested and given approval for final rest
Screw retained advantages
Can be used with limited resorative space
Absence of cement under gingival tissue (periimplantitis)
Predictable retention
Retrievability
Screw retained disadvantages
Screw access compromises of occlusal function
Esthetic of access hole
cement retained advantages
Passive fit of the implant crown
Esthetics
Ideal occlusal form
Flexibility of fixture placement
Cement retained disadvantages
Subgingival cement line
Cleaning of excess cement
Crown retention
cement retained crown delivery steps
- Check contact points
- Verify radiographically
- Check occlusion
Torque abutment, teflon tape and cavit in access hole
Cement selection
Based on the retention of the crown within the abutments
Screw retained crown delivery
- Final torque abutment
- Dry access hole very well
- Pack form PTFE (teflon tape) leaving 2-3 mm space in the occlusal
- Close access hole w/ packable composite
- Check occlusion ,finished and polished
