A dental abutment is a key part of a dental implant. Made most commonly of titanium but increasingly from zirconia, the dental abutment connects the implant crown – the replacement tooth – with the implant fixture embedded in the jawbone under the gumline. It serves the dual purpose of supporting the implant crown and also creating a space around which the gums can heal. This serves an important aesthetic function: when the implant crown is installed, this shaping of the gums helps the new prosthetic tooth to visually fit in with the rest of the existing gumline. There are three main types of abutments that can be used depending on your preference, budget, and the location of the implant.
Traditional abutments
Abutments are traditionally installed as part of a three-stage process of creating a dental implant. The implant fixture is installed first, anchored into the jawbone and allowed to form a part of the bone in a process referred to as osseointegration: literally becoming one with the bone structure. When permanent abutments are used, the gums are then stitched up and allowed to heal. This process takes approximately six months. When it is time to add the abutment, the gumline will be opened up once again and the abutment will be attached to the implant fixture, creating a solid structure above the gumline upon which the implant crown will eventually rest.
Healing abutments
Another option is to use a healing abutment to help train the gums into the shape that they will eventually take once the implant crown is connected to the abutment. When healing abutments are used, the implant fixture is installed as described above, but instead of stitching the gums back together and allowing them to heal while the implant fixture merges with the bone tissue, a healing abutment is attached immediately to the implant fixture. A cuff that is slightly wider than the future implant crown is attached at the base of the abutment so that the gums are trained to heal around that new structure above the gumline. When it is time to install the implant crown, the cuff is simply removed from the abutment and the implant crown is attached in its place.
Custom-made abutments
In areas where the dental implant will be highly visible, another option to consider is a custom-made abutment, which is created specifically to fit the unique anatomy of your mouth. While these are more costly than traditional abutments, they can provide results that are worth the cost.
Which kind of abutment is right for me?
Choosing between a traditional, healing, or custom-made abutment is a personal choice that requires careful reflection and planning. Some reasons to opt for the use of a healing abutment include fewer surgeries and better aesthetic results around the gumline. Particularly when the dental implant at hand is in a highly visible location, a healing abutment or custom-made abutment can lead to better final results. If you have questions about which kind of abutment would be best for you, talk to your dentist. She or he will be able to provide the kind of personalized guidance that will help you make the right decision.