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CAD/CAM - international magazine of digital dentistry

I review _ implant abutment abutment regarding the retrieval of broken-off ceramic fragments in the implant, which can be difficult. The main advantage of this abutment type is that there is no ceramic material inside the titanium implant connection. However, the dis- advantageliesinthelackofevidenceinpublished clinical data to date. In particular, the soft-tissue reaction regard- ing the bonding gap, especially in bone-level implant cases in the aesthetic zone, remains unknown. In consequence, this type of abutment should be used with this current limitation in mind.4 However, use with soft tissue-level im- plants with a microgap above bone level might be less of a concern. An example of a soft tissue- level implant case is presented step-by-step on the following pages (Figs. 3–15). _Implant abutment material Different biomaterials are available for implant abutments. Polymethyl methacrylate (PMMA), titanium, and polyether ether ketone (PEEK) are indicated for abutments supporting provision- als—especially for bone-level-type implants—to customise the emergence profile and individu- alise the peri-implant mucosa with soft tissue conditioning.5 The materials of choice for abut- ments for final restorations are titanium, gold, zirconium dioxide, and aluminum oxide-based ceramic. Titanium and zirconium dioxide will be dis- cussedinthisarticleregardingclinicalandhisto- logical performance. Titanium is the biomaterial of choice regarding long-lasting and well docu- mented behaviour under functional loading for both soft and hard tissues. It has excellent bio- compatibility, mechanical strength, and is re- sistant to corrosion. Therefore, it is the abutment material of choice for posterior sites. However, the expectations of patients in the anterior zone are increasing. In aesthetic sites, mucosal thickness plays an important role. An animal study comparing different dental materials under different mucosal thicknesses showed that titanium induced the most prominent 14 I CAD/CAM 3_2015 Fig. 8Fig. 7 Fig. 10Fig. 9

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