Dental implants are typically made of three pieces. The three parts are the dental implant itself (the part in the bone), an abutment, and the crown or teeth on the implants. There are some abutment disadvantages, and some have more than others.
An abutment for the dental implant process is needed regardless, unless the implant is a solid one-piece design. An abutment allows for the teeth or tooth to be connected to the implants. It is the part that sticks out of the gum.
That being said, most of the dental implants I use are a three-piece design, incorporating a removable dental implant abutment. Having this design makes for versatility in how the tooth, bridge, or overdenture is made. A disadvantage is that it is another piece in the system where failure can occur.
Some abutments are made of gold, titanium, or zirconia as three broad categories. There are also categories for the types of uses of the implants, such as:
- Engaging abutments
- Non-engaging abutments
- Overdenture stud abutments
- Waxable abutments (UCLA-type)
- Healing abutments
- Screw retained abutments
- Cement retained abutments
- Angled abutments
- Custom CAD/CAM abutments
I know this all sounds confusing, but the selection, manual preparation, placement or designs of your dental implant abutments are critical to success.
In my Burbank, California office, I break down the abutments into two simple categories. These are abutments that allow the crown to be cemented, or abutments that allow the dental implant crown to be held in by a screw. The screw itself sometimes can be a disadvantage because it is the smallest piece in the system. Although not often, the screw can break or loosen.
Most dental implant abutments are screwed into the implant and “torque” into place. Others are a type of press fit called a morse taper, or a combo of screws and press fits. The tightness of the connection of your abutment to the implant is one determinant whether you will lose bone around your dental implant.
Your implant dentist should have a strong understanding of when to use which abutment, and where to use each type. It should NEVER be one recipe for all patients and situations. Many dentists rely on the lab to choose the abutments; this is never a good idea, and often results in a much higher cost for you.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology/Implant Dentistry
Fellow– American Academy of Implant Dentistry