After a dentist installs the dental implant, the metal base on which the crown is mounted, known as the dental abutment, is placed. The abutment serves as the connecting point between the implant in the jawbone and the prosthetic crown. In addition to connecting the implant to the crown, the abutment also helps shape the gums as they heal around the restoration in an aesthetically pleasing way.
Dental abutments are frequently made of titanium but other materials, like gold and zirconia, are sometimes used. Materials used for the abutment affect strength and aesthetics so careful consideration should be made when choosing the correct abutment for the treatment. Because it is similar in color to natural teeth, zirconia is becoming an increasingly popular option because it is less visible than titanium and better matches the patient’s anatomy in creating a seamless transition between the gums and crown.
As previously mentioned, dental abutments can also help stimulate the regeneration of gum tissue. Also called healing cuffs, healing abutments fit over the dental implants and because of their width, allow space for the crown. While a healing abutment does not attach to the dental implant, the abutment is placed above the gums whereas the implants are place below, it serves a crucial role in effective healing.
Healing abutments can also be beneficial to use because they eliminate the need of multiple surgeries. Without using healing cuffs, the dentist will have to reopen the gumline after the implant fuses to the jawbone. This not only exposes the patient to potential infections or complications but increases the overall recovery time associated with the procedure.
How are Dental Abutments Fitted?
To successfully attach a dental implant into the jawbone, the dentist has two options. Option one involves covering up the dental abutments with gum tissue and left to heal for about six months. A second surgical procedure is then needed to open the gums, expose the abutments, allowing the crown to be fitted.
The second option involves attaching a healing abutment. The healing abutment attaches to the external end of the implant. Because the healing cuff is wider than the implant, it ensures adequate space for the crown while the gum tissue around the implant heal. Using a healing abutment is often preferable because it eliminates the need for the patient to undergo additional surgery. Once the implant fully fuses with the jawbone through osseointegration, the healing abutment is removed, and the crown is fitted on the implant. Reshaping of the gums may be needed if the space created by the healing abutment does not properly match the size of the crown.
The dentist will also have to decide whether to screw the crown to the dental abutment or cement it directly. Both methods have their advantages and disadvantages. Cement is the most common technique and while it offers the advantage of achieving passive fit easier, excess cement can lead to gum irritation. Screw retention offers predictable retrievability but the presence of screw holes could weaken the crown structure over time.