What you need to know about implant abutments

By May 1, 2017Blog

How important are implant cases to your practice? Possibly more than you think. The dental implant market is expected to grow at a rate of 9.7 percent annually until 2020, with $7.8 billion spent on implants worldwide in 2020 alone, according to Persistence Market Research.

The importance of implant cases to your practice

By that same year, up to 30 percent of tooth-loss patients in the United States will seek implants, twice the penetration implants had in 2011, according to Straumann.

As of 2010, only 18-20 percent of dentists placed implants, but implant dentists place 55-60 implants a year, according to Straumann. Based on a modest average cost of $2,500 per case, that represents a six-figure bump in revenue for doctors.

While the economics are clear, choosing the correct technology and abutments can be confusing.  So, which abutment is right for you?

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Custom Abutments: What you need to know

For many years, customizing abutments was a tedious and difficult process. Technicians modified stock abutments provided by manufacturers to fit patient needs. While these modified abutments offered a better fit than their out-of-the-box counterparts, they were still a long way from the ideal fit and form modern custom abutments provide.

With improvements in milling technology and CAD systems, fabricating custom abutments has become an increasingly cost-effective alternative to stock abutments. The advances in milling capabilities expanded treatment options, and many doctors aren’t up to date on the advantages of each type of abutment. Without the knowledge of their options, it’s difficult to make informed decision during case planning. It’s important to understand the pros and cons of each type.

Custom Compatible Abutments

As CAD/CAM technology improved, it opened the door for laboratories to fabricate abutments independent from manufacturers’ systems. Designed and fabricated by CAD/CAM technicians to perfectly match patients’ periodontal demands and gingival contours, custom compatible abutments are milled to exacting precision.

Because they’re not customized by the manufacturer, custom compatible abutments must be specifically designed to integrate with the implant platform upon which they interface. Most laboratories have the capability to produce compatible abutments at a fraction of the cost of a corresponding genuine manufacturer’s model.

Implant manufacturers claim using compatible abutments voids their warranty, though the legal standing of that claim is still uncertain. With success rates for implants that are properly cared for by patients about 98 percent, the most common predictors of implant failure are smoking, diabetes, estrogen therapy, bruxism or radiation treatment, according to the National Institutes of Health.

Advantages

  • Conforms to every patient’s specific anatomical needs
  • Lower cost puts implant therapy within reach of more patients
  • Final abutment produced in house, speeding turn times

Here’s a video featuring Dr. Michael DiTolla where he contrasts the differences between custom and stock abutments based on a specific case.

Genuine Manufacturer Abutments

Manufacturers traditionally developed abutments to interface with their implants. While stock abutments were acceptable out of the box in some treatments, many prosthodontists and technicians made post-manufacturer adjustments to their size and angulation to improve performance, gingival contours and esthetics.

With the power of CAD/CAM technology allowing for individualized fabrication, most major implant manufacturers now offer customized abutments. While this allows doctors to place genuine patient-specific abutments, they’re typically more expensive and require longer to fabricate because laboratories must collaborate with manufacturers.

Advantages:

  • Maintains manufacturer’s original warranty on implants
  • Guaranteed perfect interface with implant platform
  • Produced by certified FDA 510(k) compliant manufacturers

Here is a quick overview of stock abutments and their pros/cons from Darin Dichter D.M.D. at Spear Eduction:

 

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