Custom Healing Abutment for Success


One of the most difficult things to do in dentistry is deliver an implant crown. Most people use a healing abutment that is not contoured like the natural tooth that was once in the tissue. Stock healing abutments leave a straight cylinder most of the time making it difficult to deliver the crown, and sometimes painful to deliver for the patient and practitioner. As a CEREC user these cylinder type abutments make getting a great proposal more difficult as well. Here is a solution to help get the best result with minimal design changes in the CEREC software saving precious time which equates to dollars.

Custom healing abutments have been in use a long time. However most of us don’t take the time to make one. What better way to preserve tissue than at the time of implant placement, especially in the case of immediate implants. The tissue will never be more natural than it is at that moment. Here is a case ready to restore after a 4-month healing time.

A custom abutment was fabricated at time of implant placement using acrylic or bis-acryl preserving the contours of the original tooth. At the time of the digital impression the healing abutment was removed and a scan post placed. We proceeded with normal scanning protocol with CEREC. While doing this, you should note the bleeding in the socket upon removal of the abutment as this is an indicator there is an epithelial attachment to the abutment that was torn upon removal of the abutment.  Once the scan is complete, we replace the healing abutment and have the patient return for delivery at another time. Our office does bring a patient back, but it is totally doable if you want to fabricate same day while they are in office.

The next step is to go through the software and trim the model, edit the baseline and allow the CEREC software to work its magic. As you can see, we received a great proposal from the start. Literally we bulked up one area at the margin of the ti-base and the crown. At this time, we are ready to send the crown to our lab of choice; you could also fabricate in house as normal. In this case, the crown was fabricated and luted to the ti-base and the patient returned for delivery. No soft tissue pinching, no blanching, and a very esthetic outcome. The preservation of the natural structure of tissues is very important in implant dentistry, especially in the esthetic zone. I see no better way to do this except preserving what is there naturally. If you place your own implants this is super easy to do and will save you time on the back end of the case. If you have your implants placed for you, sit down with your surgeon and explain the importance of preserving these tissues.  Everyone is striving for the same thing, great results! If you’re interested in learning how to fabricate these custom abutments contact us and we will be happy to share how it’s done.