Custom Abutments and Stock Abutments
Implant restorations can be tricky, even for seasoned dentists. As new products are introduced, there are more options and methods of delivery to stay on top of. The two important implant abutments to understand are stock abutments and custom abutments — read below on the pros, cons, and different methods of delivery.
Stock abutments are pre-made, which lowers the cost and shortens the amount of time spent doing a dental implant. They come in standard sizes that allow for more easy delivery to your patients for bone-level and tissue-level implants. All stock implants can either be straight or angled and are typically retained by cement.
While stock implants are versatile, they are not recommended for use in the esthetic zone. The tissue may not form to the shape of the abutment, so it is difficult to match the emergence contours as well as the tissue support of other teeth.
Stock implants may work well outside the esthetic zone, however, you will not be able to precisely control the final margin placement on the crown, as it depends on the height of the abutment and the depth of the implant. This lack of precision puts your patient at a higher risk for implant failure due to peri-implantitis — a site-specific infectious disease that causes inflammation in soft tissues and bone loss around an osseointegrated implant. The margin on a stock abutment may be so subgingival that it is difficult to determine if all of the cement was properly removed. According to Inside Dentistry, “even the most diligent of clinicians may sometimes miss residual sub-gingival cement in implant cases.
Custom abutments are as their name suggests, custom-made for your patients. These abutments can be accurately milled to fit the crest of their tissue as well as made gold colored or fabricated from zirconia for a better match to their teeth. For these reasons, they are recommended for use in the esthetic zone. They will match a patient’s smile, even as gums recede.
To create a custom abutment you will start by taking an impression of your patient’s mouth. Then you will send this information to a dental laboratory that uses the impression to create an abutment that matches the shapes, contours, and emergence profile of your patient’s mouth.
There are several options for custom abutments — some are based on a coping that is cemented and some are milled from a zirconia or titanium blank.
While custom abutments may cost more, they can offer better tissue management and esthetics
First Choice Dental Labs offers authentic custom abutments through trusted manufacturers including: Densply Sirona Implants, Straumann, Nobel Biocare, Biohorizons, Zimmer, and Implant Direct. Contact us at 630-541-7666 to learn more about supplying your office with custom abutments.