Within the restorative part of implant dentistry there is a lot of new terminology with which one has to become familiarised. Abutments, impression copings, analogues (or replicas), bridge and abutment screws are the most common items that will be encountered. Abutments can be broadly classified into two types:
1. Healing abutments
2. Restorative abutments.
Healing abutments are designed to allow healing of the peri-implant soft tissue once the implant has been placed. They can be screwed into the implant at the time the implant is placed (one-stage surgery) or they can be screwed into the implant at a subsequent visit, three-to-six months after placement (second-stage surgery).
The healing abutments shown in Figure 1 are all from one system, but regardless of which system you are involved with they are there to perform the same function – to allow soft-tissue healing. If an implant had been placed by a surgeon and returned to the GDP for the restoration, they would normally return with a healing abutment in position. This would then be removed prior to taking an impression of the implant head.
Restorative abutments (Fig 2) are designed to attach the restoration to the implant and can also compensate for any variation in:
• Implant position
• Implant angles
• Implant depth
• Soft-tissue contours.
There are a large variety of abutments designed for different areas of the mouth, and it is here more than anywhere else that the GDP can develop their expertise and knowledge to affect the best aesthetic and functional results for the patients within implant dentistry.
If we consider a single-tooth implant that has been placed by a trained surgeon, the patient should be returned to the referring GDP with a healing abutment in the top of the implant. The healing abutment is designed to allow soft-tissue healing in an appropriate form above the top of the implant.
Thus the healing abutment for a maxillary central incisor is usually wider than the healing abutment for a maxillary lateral incisor. Most implant companies will supply a range of diameters and heights for the various positions in the mouth.