Most patients in dental clinics, in deciding whether to implant teeth through implantation, know little about the procedure itself. They know nothing about abutments, about the role they play in implantation.
Of course, in a good dental clinic, they will certainly explain to the client what exactly dentists will do and what tools they will use. But the information will be superficial. It is helpful for patients to learn all about implantation before they go to the dentist. In this case, they will understand everything that the doctor will tell him.
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What is an abutment
The word abutment comes from the English abutment. It is translated as "support". Earlier in dentistry, this term was called the teeth, which became the support for bridges or bridges.
In modern dentistry, doctors try not to affect the adjacent teeth when installing prostheses. Instead, the patient's jaw implant abutmentson which prostheses are later installed. That is, the current dentistry treats the term abutment differently.
Abutment today is mediator between implant and prosthesis. It is placed on the implant. Installation can be both instantaneous and after a certain time. In the latter case, the installation of the abatment is possible only after the implant has taken root.
Why put an abutment? is he provides a quality transition from implant to prosthesis. The pin set in the jaw bone plays the role of the root, and it should be well buried and hidden in the gum. The denture is located above the gum.
Without an intermediate element, a qualitative and aesthetically correct connection of the implant and the crown is impossible. The abutment plays the role of this intermediate element. To ensure a reliable connection, an abutment is placed only after it becomes clear that the implant has successfully settled down.
How to install abutments
Abutment installation, although it belongs to the category of surgical operations, is a gentle procedure. For this reason, the element is placed under local anesthesia. First, the doctor removes the cap that covers the implant, and then screwing the abutment. Actually, this procedure ends.
The installation of the prosthesis is carried out after the gum has completely healed. It usually takes several weeks. In the case when dentists resort to transgingival express implantation, implant placement is performed through a puncture in the gum. That is, its tissues are not dissected and there is no need for suturing.
The patient feels almost no pain. Him there are no postoperative complications: hematomas, bruises and suppurations. In addition, the abutment is already embedded in the implant. This means that prosthetics can be performed directly on the day of surgery.
Abutment Types
As a rule, implant manufacturers produce for each model a whole set of abutment systems.
With an increase in the cost of the implant, the variety of abutments increases and the possibilities for their combination expand.
All abutments are divided into two types:
- standard;
- individual.
Standard are called abutments made on the template by the factory method. This is a fairly convenient option, allowing dentists to select solutions that allow you to achieve ideal results in dental prosthetics.
The advantages of standard abutments include:
- Unification. They are applicable in all clinical situations.
- Cheapness
- Large length variation.
- The presence of two values of the angle of the upper cone.
- The possibility of accurate installation.
Standard solutions have the following disadvantages:
- They do not repeat the shape of the tooth.
- Large tolerances in production.
- They can push the gums.
- Poorly supports the natural edge of the gums, forcing dentists to form it using operations.
Individual abutments
The peculiarity of individual abutments is their fitting to a specific patient. Their production is not much different from the manufacture of dental crowns. After installing the implant and its engraftment, the dentist makes a series of wax waxes and creates a model of the jaw.
It is processed by the scanner, and the received data is processed on the computer in the CAD / CAM program. A model is created on the basis of which zirconia an abutment is created. On average, it takes 7 days.
The price for such an abutment is higher, but the difference from the standard for an individual one is practically no flaws. Its advantages include:
- The ability to account for the individual characteristics of the patient. It is about the bite, the thickness of the jaw bone, etc.
- The ability to take into account the model of the implant and the bridge.
- Anatomical fit to the shape of the tooth, which allows you to make a great result from an aesthetic and physiological point of view.
- Ability to make an abutment to the size of the gums. As a result, he will not protrude over the gum. This is very important when cement is used for its installation.
- Excellent fit accuracy.
- Minimizing the risk of inflammation due to implantation and prosthetics.
- Production speed.
Only one minus - high price.
Abutment Types
Individual and standard abutments have three identical subspecies.
Gum Shaper. This type of abutment is very important in implantation. With it, doctors form the correct contour of the gums. It is used directly during the implant installation. The gum former is shaped like a cylinder, equipped with a screw.
is he made of titaniumtherefore, it is easily perceived by human tissues and almost does not wear out. The former is screwed into the pin of the implant, which acts as the root.
The installation procedure is simple and does not take much time. It should be understood that it is set only for a short time. After the implant is engraved, the gum will be opened again, and the dentist will remove the former.
Angled abutment. This subspecies allows to achieve the best aesthetic results of implantation. With its help connects the elements of the prosthesis, located at an angle. It allows you to bypass some of the physiological features of the jaw structure of the patient.
For example, the doctor is forced to put the internal implant at an angle, but the external prosthesis should stand exactly. Angled abutment helps solve this problem.
Ball Abutment. It received its name due to the rounded shape. It is used for mini-implantation. This is the most advanced prosthetic method.
The main difference between this implantation and the traditional one is the smaller size of the implant and the possibility of installing it even where the tooth was not long ago, and the bone tissue became too thin for a traditional implant.
Manufacturing materials
Abutments are made of different materials. Naturally, this greatly affects their price. Some materials are used only for the manufacture of certain types of abutments, while others are universal.
- Titanium. This is an average for the price of versatile material. It is most often used to make abutments for chewing teeth.It is reliable in terms of biocompatibility and strength. His main drawback - he is able to shine through the prosthesis. Therefore, titanium is not recommended for use in the smile zone.
- Zirconium. Has the highest price because of its qualities. Great for making abutments for a smile zone, because it does not shine through the crown.
- Plastic abutments have the most affordable price, but in terms of reliability, they are very inferior to zirconium and titanium analogues. Dentists themselves do not like them and try to put them only as a temporary solution, until the moment when the patient accumulates money for an expensive solution.
- Combined abutments consist of titanium and zirconium. This allows you to give them the reliability of the metal and the beauty of zirconium dioxide. Similar products are always made individually.
Fixation methods
It is not enough to simply screw in the abutment. It must be securely fixed, otherwise the crown may one day just fall off. To solve this problem using two methods. Both are suitable for fixing both standard and individual abutments.
Screw fixation. It is a twisting crown. For this, a hole is made in it. After mounting the shaft with the screw close up. With this type of fixation, the dentist tries to make a hole in the area of the crown, which is subjected to the lowest load.
Cement fixation. In fact, it is the gluing of the abutment to the implant with the help of special medical cement. It is resorted to when screwing is impossible because of the chance to damage the aesthetics of the prosthesis.
The only drawback of this method of fixation is the chance of a part of the cement slurry getting under the gum. Remove it from there will be impossible. Moreover, it can lead to peri-implantitis. However, if an individual abutment is used, then there will be no such problem, because it is made taking into account the height of the patient's gum.
Abutment cost
The price of these products is formed taking into account the material used, type, subspecies, angle and method of manufacture.
- the average price for a standard titanium abutment is at the level of 3,500 rubles;
- The price of anatomical titanium abutment is slightly higher: 5,800 rubles per piece;
- plastic abutment will be cheaper: from 2,000 rubles;
- individual titanium abutment has an average price of 4,500 rubles;
- The highest price for a zirconium abutment is 16,500 rubles apiece.
Prices may increasewhile increasing the angle of inclination of the abutment axis.