Dental Implant Healing Abutment: Purpose and Features of the Procedure

A healing abutment plays an integral role in a dental implant. It functions as a link between the page and the installed crown, allowing for stability and versatility when it comes to orthopedic treatment.

Moreover, by ensuring the correct contour of mucosa, cosmetic defects may be eliminated and inflammatory processes can be stymied. This restricts gum tissue from constantly growing, allowing for more aesthetic prosthetic results. The success of the entire implant process relies on how effectively this root is situated, thus creating the need for dental implants with healing caps, these serve to not only replicate the gums' natural contours but also safeguard soft tissues from potentially harmful microorganisms during postoperative themes.

What is a Healing Abutment?

Modern implanted teeth are complex structures consisting of several parts. The element that joins the implant itself and the prosthesis of the tooth is called an abutment. It is a titanium construction with a cylindrical head and a threaded connection at the base. The presence of a thread allows you to securely fix this component on the implant. And due to the cylindrical shape of the outer part, a natural depression is created in the gum and the crown fits snugly against the edge of the mucous membrane. Manufacturers of implant systems, Nobel Biocare, Osstem, or Straumann, produce gingival formers in different sizes. This allows the orthopedic surgeon to choose a design taking into account individual characteristics.

The healing caps for implants in dentistry are classified according to the type of manufacture into two large groups: standard (stamped) and custom healing abutment. According to the shape and design, the following types of abutments are distinguished:

• Standard abutments—in appearance they resemble a pin, which practically does not support the gums, since they do not repeat the anatomical features of the teeth.
• Straight forms are the most common in dentistry.
• Angular abutments are connectors that span different planes, essentially when elements come together at an angle to each other.
• Spherical abutments are commonly used in removable or conditionally removable prostheses, where the right material choice plays a large part in its functionality, strength, and aesthetics once the abutment is installed.

Natural materials that can be safe for implantation into human tissue is often used as these healing abutment types.

1. Despite lacklustre performance on some occasions, plastic abutments attract customers due to their lower cost than alternative materials – they are sometimes installed as a temporary element.
2. Ceramics – perfectly imitates the natural shade of the tooth, does not cause allergies or irritation, and is used for allergies to metal.
3. The zirconium dental healing caps created by injection molding offer exceptional strength and aesthetics. Unlike some crown models, it does not allow light to come through from beneath the denture. Thanks to state-of-the-art production techniques, this specialized crown model is of the highest strength and durability for even the harshest of wear and tear.
4. Titanium material is hypoallergenic, compatible with the tissues of the human body, and is widely used in orthodontics as a durable and affordable material.

The choice of an abutment from the whole variety of models depends not only on the indications but also on the financial capabilities of the patient.

Why Do You Need a Healing Abutment?

It’s important to remember that the healing cuffs are the connecting elements between the implant and the crown, that provides secure fixation, long service life and attractive smile. This connecting element is important for the entire implant design. Without it, it’s impossible to install a crown and fix a new tooth. The implant abutment performs several key functions:

• Forms reliable support for the prosthesis.
• Increases the strength and durability of the entire product.
• Forms a smooth transition of the implant into the crown part of the tooth.
• Protects gums from dental cement.
• Creates a natural and even gingival contour.

The placement of the dental healing abutment is not a mandatory stage of implantation and can be omitted. However, it is recommended to use it when restoring teeth in the smile zone, as this will ensure maximum naturalness and similarity of the prosthesis to a natural tooth. Installing the abutment helps to recreate a smooth, beautiful gingival contour. After prosthetics, the maximum tightness of its fit to the crown is achieved.

How is the Healing Abutment Installed?

The installation of the abutment can be carried out both directly during implantation and after the engraftment of the artificial root. There are two types of installation: one-stage and two-stage.

With one-stage prosthetics, a temporary dental crown is made in the laboratory and then installed on a dental implant with an abutment in one visit to the doctor. Engraftment takes up to 6 months. After this stage, the temporary dental crown is replaced by a permanent one. With two-stage prosthetics, the dentist sets the pin, then engraftment and fixation of the implant in the bone tissue takes place. This process takes 3 to 6 months. After that, the plug is removed and a dental implant healing abutment is installed in its place.

In addition, the fixation of the connecting element is carried out in one of three ways:

• Screw. A hole is made in the crown through which the abutment is screwed. The final touch is the laying of cement material and polishing. This installation method reduces the risk of inflammation, but the screw design is prone to breakage. If damaged, simply replace it.
• Cement. The crown is fixed with cement mortar, that has place in its inner part. The disadvantage of this technique is that the cement can get under the soft tissue and cause infection.
• Conical. The modern type of attachment is the fixation of the prosthesis with a cone-shaped hole into which the abutment is inserted. The design is more reliable and does not loosen in the process of eating.

The installation of the implant healing abutment begins with local anesthesia, after which the doctor makes a tissue incision over the site of the artificial root. The next steps are to remove the plug and install the shaper. The dentist can do this manually or with a torque wrench. In the end, healing sutures are applied.

An abutment is not installed if a total prosthesis is performed in case of multiple absences of teeth or complete adentia. Also, this is not put in case of inflammation in the oral cavity, type 1 diabetes, tuberculosis, viral disease, periodontitis, insufficient stabilization of the artificial root, or its difficult engraftment. In addition, doctors recommend not to do implantation during pregnancy (especially in the first and third trimesters).

The installation of the abutment is easily tolerated by the patient, subject to all the doctor's recommendations. Most of the complications arise from the neglect of elementary rules, such as non-compliance with the doctor's recommendations (poor hygiene, deliberate injury to this area with hard food). Due to non-compliance with the above rules, bleeding, swelling, pain symptoms, an allergic reaction, as well as loosening of the former or its loss may occur.