What is an Abutment for Dental Implants?

What is a Dental Abutment?

A dental abutment is a small connector piece used in restoring the crown to the dental implant. It’s used when installing a dental crown or dental bridge to the implant. Sometimes, an abutment is used to attach a partial denture to implants.

Depending on your implant placement position and jaw, a dentist may recommend a custom abutment designed specifically for you. In other cases, prefabricated abutments are suitable.

Functions of a Dental Abutment

• Connects restorations to the implant – Abutments join the crown or other dental restorations directly to the implant.
• Post-surgery integration – Dentists fit the abutment into the implant once you’ve healed from surgery and the implant has osseointegrated or fused with the surrounding bone. 
• Supports dental bridges – For dental bridges, crowns fit on two abutments connected by replacement teeth that rest on top of the gums. Dental professionals refer to the neighboring teeth that support the prosthetic crown as pontics.
• Shapes the gums – Abutments also help shape the gums during healing. Therefore, it’s important that the dentist places the implant accurately and there’s a tight connection between the implant and abutment.

What Is a Dental Implant?

A dental implant usually consists of three components:

1. The implant — A screw-like structure that is surgically placed into the jawbone and acts like the root of the tooth
2. The abutment — A piece that provides connection between the implant and the crown
3. The crown — The prosthetic tooth

How is a Dental Implant Placed?                

The entire dental implant process involves multiple steps and can take many months to complete. This is because the bone and gums require healing time between each visit.³

Surgical Approach

There are three surgical approaches to placing and restoring implants: two-stage, one-stage, and immediate loading. 

The two-stage procedure is when only the implant is placed. Once healed, the second stage of surgery takes place. The implant is exposed to attach an abutment for securing the crown in place. 

Healing and Osseointegration

The timeframe between the first and second stage is dependent on the time it takes for the implant and the bone to fuse or osseointegrate. This is usually 2 to 3 months for the mandible and 3 to 6 months for the maxilla. 

In a one-stage procedure, the implant and healing abutment is placed at the time of surgery. After a 3 to 6-month healing period, in which the implant fuses to the bone, a permanent abutment and dental crown are placed. 

During an immediate-loading procedure, the implant, the abutment, and the temporary crown are placed in a single appointment. 

The Steps for Placing an Abutment

Placing an abutment is a minor surgical procedure usually performed under local anesthesia. 

Two-Stage Approach

In a two-stage approach, after the implant has healed and osseointegrated, the dentist makes an incision in the gum to expose the implant. Then, they attach the healing abutment to the implant before closing the incision with stitches.

After the healing abutment is in place, the gums must heal for a few weeks before the dentist can place the permanent abutment and crown.

In some cases, they may be able to place the crown on the same day as the abutment. However, it’s more common to wait until the gums have healed.

One-Stage Approach

An alternative procedure, the one-stage approach, involves fixing the implant and abutment during the same appointment.

In this case, the dentist uses a temporary healing abutment to help the gum heal around the implant. These are also called healing cuffs or caps. Healing abutments are wider than standard abutments and help make space for the crown.⁵

Once your gums are healed, and the implant is fully fused to the jawbone, the dentist unscrews the healing abutment and places the final abutment and crown in position. This one-stage approach eliminates the need to reopen the gums after the implant heals. 

Dental Implants vs. Dental Abutments

Dental professionals may use the term ‘dental implant’ to refer to the implant screw by itself or all three components that collectively form the implant. However, dental abutment refers only to the central connector between the implant screw and the crown.

Types of Dental Abutments

There are numerous types of dental abutments. Abutments can be:

• Prefabricated or custom-made
• Straight or angled
• Temporary healing abutments or permanent abutments
• Made from various materials

Material Options for Abutments

The material selected for the abutment can influence the implant’s strength and esthetics of your smile.¹

Dental abutments can be made from various materials, including:

• Titanium — This is a popular material due to its excellent properties. Titanium is robust and biocompatible, meaning it fuses readily with bone. It’s suitable for most prosthetic restorations and strong enough to use for molars.
• Zirconium — This material complements the aesthetics of dental restorations. It’s a good choice if the gum line is thin and a titanium or stainless steel abutment would show.
• Ceramic — This material is more esthetic and supports a natural-looking soft tissue emergence profile contour. 
• Stainless steel — This is a less expensive option but not as strong as titanium. It’s usually only used for teeth with little chewing force.
• Polyether ether ketone (PEEK) — This newer polymer material is an excellent alternative to zirconium. It’s light, has good aesthetics, and is biocompatible. However, it has a higher risk of fracture.²

How to Choose the Right Abutment

The abutment the dentist recommends may depend on various factors, including:

• The type of restoration
• The biting load of the tooth
• Your budget
• Any allergies
• Esthetics

According to Dr. Nandita Lilly, one of NewMouth’s in-house dentists, “There are many factors, including medical status, esthetic concerns, allergies, and the location of the implant, that determine which materials and techniques are the best for you.”

How to Care for Dental Implants

Caring for dental implants is like caring for your natural teeth. You’ll need to do the following:⁶

Brush at Least Twice Daily

When brushing your teeth, use a soft-bristle toothbrush and toothpaste. Hard toothbrushes can damage the delicate gum tissue around the implant. Make sure you brush all surfaces of the teeth, including the gumline.

While brushing, use an upward sweeping motion toward the tooth’s biting surface to help loosen and remove debris.

Floss Regularly

Use interdental brushes, dental floss, or a water flosser to clean between the teeth and under the gumline. Use them gently to avoid irritating or damaging the gums.

Visit Your Dentist for Checkups

Remember to see your dental professional at least once every six months. These appointments help keep your teeth and mouth healthy. They also allow the dentist to check your implant and the surrounding gums.