Glossary

In the field of implant dentistry, abutment clamp or preload, refers to the force that an implant screw has on the implant and the abutment. This force is linear and holds the components of the abutment connection together. As the abutment screw is tightened, the force used by the periodontist is transferred to both the internal threads of the implant and the threads of the abutment screw. The force “clamps” the abutment to the body of the implant, which is why it is sometimes referred to as “abutment clamp”. Although preload is measured in Newtons, there’s no ideal amount of clamping force used for abutment screws. A periodontist must follow the manufacturer’s recommendation for specific types of screws to determine how much torque to apply and how much preload is needed to clamp the abutment connection together. The force must be measured using special tools to ensure the correct amount is used.

An abutment driver is a screwdriver, much like you might find in a tool chest, although it is much smaller and designed specifically for implant dentistry. They are also called hand drivers, and are textured on the handle to provide a good grip. The tip of the abutment driver is the part of the mechanism that comes into contact with the abutment screw, and often the tip pattern will differ from manufacturer to manufacturer. Some hand drivers can only be used with certain types of abutment screws. During the dental implant procedure, the periodontist will use the abutment driver to screw the prosthetic into the internal implant. How much force applied during this part of the procedure is called preload, and how much preload is used differs between types of hardware. Too much or too little force applied can result in the failure of a dental implant, so using the right abutment driver and using it properly is critical for success.

An abutment holder for dental implants is a device that helps periodontists avoid dropping abutments into a patient’s mouth. Because abutments, abutment screws, and even abutment drivers are all very small, dropping them is a very real issue. It’s important to keep the area as clean as possible and typically the hardware is sterile. Dropping abutments can be costly, however, an abutment holder can help prevent this issue. Additionally, abutment impression coping can help accurately transfer the position of an abutment or implant in relation to the patient’s teeth. An abutment-level impression can accurately record the position of an implant at the abutment-implant interface. When used together, these tools can help periodontists optimize dental implant placement, decrease the chances of dropping abutments during a dental implant procedure, and help improve the patient’s overall outcome.

An abutment impression coping typically comes in two different types — open tray impression coping and closed tray impression coping. Although what abutment impression coping technique is used depends entirely on the periodontists preferences, many periodontists prefer closed tray impression coping versus open tray. This is because with open tray impression coping, the periodontist must be certain they can find and access the impression coping screw to be able to remove the impression. Failure to do so with an open tray may lead to the impression becoming locked in the patient’s mouth. Although a closed tray impression coping does not have this problem and is generally easier to use, open trays are considered to be more accurate, especially in cases of multiple implants that will need to be splinted in patients who are partially or fully without teeth. This accuracy makes open trays preferred by many periodontists.

Abutment mounts for teeth are prefabricated devices that serve as the connectors between the abutments and the replacement bridges, crowns or dentures. An abutment can be a portion of, attached to or built into the top of a dental implant. This section extends through the tissue of the mouth; therefore, the abutment is designed to firmly support and/or retain the patient’s prosthesis. Since there are numerous kinds of abutments available, the dental abutment mounts are typically included in the package of its coordinating abutment.

A dental abutment screw is used to secure the abutment to the dental implant. Although some patients can receive their dental implants during a single session, others will require a second surgical session: These specifics should be taken into consideration when determining which abutment and abutment mount will serve the patient better.

Types of abutments include:

• Angulated abutments/Angled abutments
• Anatomic healing abutments
• Custom abutments
• CAD/CAM abutments
• Healing abutments/Healing cuffs
• Castable abutments
• Nonangulated abutments
• Multi-unit abutments
• Prepable abutments
• Prefabricated abutments
• Transmucosal abutments
• Temporary abutments
• Zirconium dioxide abutments (standard or customized)

This refers to the step of the dental implant process in which the type of abutment that will serve the patient best is decided upon. Several factors are taken into consideration when choosing an abutment, some of which include the height of the soft tissue, the angulation of the dental implant, the planned prosthesis, interarch space, occlusal factors (e.g., antagonist teeth and parafunctional activities), phonetic considerations and esthetics. In addition, some patients will require two surgical sessions to complete their dental implant restoration. During the first surgery, these patients receive healing abutments. The healing abutments remain intact until the gum has healed around the dental implant. Once healing is complete, the final abutments and permanent prosthesis can be placed.

Types of abutments include:

• Anatomic healing abutments
• Angulated abutments/Angled abutments
• CAD/CAM abutments
• Custom abutments
• Castable abutments
• Healing abutments/Healing cuffs
• Nonangulated abutments
• Prepable abutments
• Multi-unit abutments
• Transmucosal abutments
• Prefabricated abutments
• Zirconium dioxide abutments (standard or customized)
• Temporary abutments

Syn: Platform switching

This term refers to using an abutment that has a narrower diameter than the platform of the dental implant itself. Using this method, the dentist can move the implant-abutment junction away from the platform’s edge. The goal of abutment swapping is to prevent crestal bone loss and to increase the soft tissue volume around the platform of the implant. By using an abutment that is smaller than the dental implant platform, any inflammation that occurs will be farther from the crestal bone; thus, preventing peri-implant bone loss due to inflammatory responses.

A thick crestal bone ensures that the implant remains stable and stability is essential for the long-term success of a dental implant, which is why preventing bone loss is so important. When platform switching is utilized, the bone and tissue surrounding the dental implant is preserved, helping to provide patients with exceptional aesthetic results.

See: Orientation jig

An orientation jig is a device that is created in the laboratory. This abutment transfer device is designed to correctly maintain a component’s positional relationship as it is transferred from the custom-designed cast to the patient’s mouth. Abutment transfer devices are available for use with both closed tray and open tray techniques.

A restorative dentist uses impression coping (i.e., transfer coping) to create a cast that is identical to the patient’s mouth. This cast is used to ensure that the correct position of the patient’s abutment or implant is attained at the time that it is placed. Although impression coping is appropriate for the creation of an abutment level or an implant level cast, the correct coping must be used in each circumstance (e.g., impression posts, transfer copings, etc.).