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ePaper created 2015-09-09, 12:07:54 | version 1.38.0
I review _ implant abutment _The selection of implant abutments for each individual patient case is an important part oftheimplant-prosthetictreatmentphase.Long- term clinical studies on fixed implant-supported reconstructionsshowlowtechnicalcomplication rates regarding the abutment itself.1 In this arti- cle, different implant abutment types, the various abutment materials, and their clinical indications are discussed. A clinical case presenting the step- by-steptreatmentofasingleedentulousgapwith an all-ceramic screw-retained implant crown is shown at the end of this article. _Implant abutment types Implant abutments can be either stan- dard or customised (Fig. 2). The use of a standard abutment is indicated if the im- plant is placed in an almost ideal prosthetic position. The advantages of standard abut- mentsaretimeefficiencyintheoveralltreat- ment and, therefore, shortened technical manufacturing time. Divergences between implants supporting multi-unit prostheses canbecorrectedwithangledstandardabut- ments. In the aesthetic zone, it is important that the collar height of a prefabricated abutment is not a uniform 360 degrees, as the interproximal position of the crown margin would be placed too far submucosally. Therefore, the ideal design of a standard abut- mentshouldbesimilartoatoothpreparation,fol- lowingthecontourofthegingivalmargin(Fig.1).2 Clinical limitations exist regarding the position of the implant in a vertical dimension. If the implant is placed too apically, standard abutments are not indicated, especially for screw-retained recon- structions,astheydonotprovideenoughsupport for the veneering ceramic. Fig. 1_Standard abutments made of zirconium dioxide. Fig. 2_ Abutment decision tree. Abutment selection and long-term success Author_ Dr Julia-Gabriela Wittneben, Switzerland 12 I CAD/CAM 3_2015 Fig. 2 Fig. 1