Custom healing abutments as an option for successful implant prosthetic.

SmartFit Abutment and Custom Healing Abutment
By: Ki-Seong Kim


Objective:

The latest CAD/CAM technology for patient-specific abutments is now gaining ground on the Korean dental market. Many implant companies are introducing CAD/CAM solution for customized abutment. With CAD/CAM abutments, the clinician can use high-quality, customized abutments with less time and effort. Fixture placement in undesirable conditions must be overcome with restorative procedures.

Usually, in such cases, cast-gold UCLA abutments have been used to make customized abutments. Note, however, that cast-gold UCLA abutments have limitations such as increased expenses, casting defects, variable quality depending on the technician’s experience, and biocompatibility. These limitations will be overcome with SmartFit abutments for Osstem implants to which CAD/CAM technology was applied.
Moreover, clinicians can control the emergence profile and subgingival contour of implant prostheses with customizable healing abutment.
Custom healing abutment can be a new option for successful implant prosthetics. In this poster, I would like to introduce two clinical cases of patient-specific SmartFit abutment and Custom healing abutment.


Study Design (Case Report):

Maxillary premolar tooth with retained root was extracted.Maxillary premolar tooth with retained root was extracted. By using surgical guide, TSIII SA fixture (4X11.5) was placed in #25 missing area.
Custom healing abutment was connected in the fixture.Custom healing abutment was connected in the fixture. Well-formed, oval-shape subgingival contour was made with soft tissue sculpting using Custom healing abutment.
Fixture-level impression with transfer impression coping was taken very quickly for preventing slumping of formed soft tissue contour.Fixture-level impression with transfer impression coping was taken very quickly for preventing slumping of formed soft tissue contour. Subgingival contour was duplicated in the impression body. And Oval shape subgingival contour over #25 fixture was shown in working model.
Patient-specific SmartFit abutment
Patient-specific SmartFit abutment was manufactured by milling process in the Osstem CAD/CAM Center.
By using the transfer jig, delivered abutment was positioned on the working model and checked. Then provisional restoration was made on the model.
Through a transfer jig, finished SmartFit abutment was positioned onto implant.
Through a transfer jig, finished SmartFit abutment was positioned onto  implant.
After the provisional period, the abutment margin was exposed using the retraction cord, and then direct abutment level impression was made.
A Porcelain-veneered metal crown was made as final prosthesis. 
A Porcelain-veneered metal crown was made as final prosthesis.
Emergence profile of #25 final prosthesis is similar to that of adjacent natural tooth restoration.
Periapical radiographs of abutment and final prosthesis.Periapical radiographs of abutment and final prosthesis.

Conclusions:

SmartFit abutment with Custom healing abutment provides an anatomically optimal emergence profile for implant prosthesis, maximizing long-term aesthetics and function. As the biggest advantages of SmartFit abutment, it overcomes the limitations of stock abutment and is a useful adjunctive tool for producing restorations that approximate natural teeth in various bad conditions.

With Custom healing abutment and SmartFit abutment for Osstem implant systems, clinicians can improve profitability by eliminating time and cost that have been spent on making cast-gold UCLA abutments.

Furthermore, they provide patients with patient-specific, customized, well-fitting abutment and brings about win-win results for both clinicians and patients.

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