Implant Abutment
An implant abutment is responsible for connecting the implant fixture to the implant crown. Placement of the implant fixture is the first step in the dental implant process. This fixture, which is made of titanium and shaped like a post, will act as the root for your artificial new tooth; however, it will take several months for this fixture to fuse with your natural jawbone to the point where it can adequately support the chewing and biting pressures and support your new implant crown. Once the fixture is ready, the abutment is used to connect the new crown to the dental implant.
Prior to placement of your permanent crown, a healing abutment may be placed to help your gums heal around the implant site. This healing process usually takes between four to six weeks and may require following a modified diet. It will also be important to follow any specific instructions provided for cleaning around your abutment to promote healing and avoid developing an infection. Once this healing process is complete, the final abutment can be placed. If during this period you develop any of the following issues, contact your dentist:
- Abutment feels loose
- Pain in the mouth, sinuses, or jaws that is not alleviated with pain medication
- Bleeding that does not stop
- Fever over 100.4º
Type of Abutment
Depending on your specific needs, your abutment may be prefabricated or custom made. Factors that can determine which type of abutment best meets your needs include how the abutment is being placed (dental cement, lag screws, or special retainers), where the implant is being placed, and whether the abutment is being used for a crown, fixed bridge, or removable denture. If you require a custom-made abutment, it will be necessary to take an impression of the implant top to ensure it fits with the surrounding teeth and gingiva. Custom-made abutments may also be used when the crown and abutment are designed as one piece, compared to a two or three-piece implant.
For one-piece implants, the implant and abutment are fused together and the implant can be placed in one surgical procedure. This approach can be preferable as it requires fewer procedures and is more cost affordable. Most patients will receive a two or three-piece implant. In a two-piece implant, the abutment is placed using a screw, cement, or is cold welded in order to decrease microbial leakage, which can cause the implant to fail. For three-piece implants, the abutment is typically fixed with a screw butt joint that is tightened with a torque wrench, resulting in greater stability and decreased chance of complications developing. While this approach requires more procedures and tends to be costlier, the benefit is that the abutment, implant fixture and crown have improved stability.
Issues with Your Abutment
Although abutments and dental implants have a high success rate, especially when patients follow good oral hygiene habits, it is important to be aware that complications can develop and there is a possibility of implant abutment failure. If you notice any of the following issues, contact your dentist to see if a follow up appointment is necessary.
- Bite feels wrong
- Abutment or implant feels loose
- Jaw pain that does not go away with pain medication
- Prosthesis breaks, chips, or feels loose