Clinical and Laboratory Manual of Dental Implant Abutments

To fulfill the vision for his latest book, Dr. Hamid Shafie compiled technical information from a vast variety of sources, including implant manufacturers and designers, master dental technicians, implant researchers, and expert clinicians leading the field of implant dentistry worldwide. He and his expert contributors meticulously assembled each chapter to include only the most relevant and up-to-date content and procedures in a concise and simple format.

Dr. Shafie follows the same easy-to-read, easy-to-understand format as his best-selling textbook Clinical and Laboratory Manual of Implant Overdentures.Starting with the material science behind implant abutments, the text then describes all of the relevant abutment solutions, providing a step-by-step guide to design and manufacturing of the CAD/CAM abutments and explaining how to adjust prefabricated abutments and one-piece titanium and zirconia implants. In addition to offering the ultimate procedural guide for clinical and laboratory preparation of dental implant abutments, this textbook is filled with useful tips on clinical practice management such as sterilization, instrumentation and trouble-shooting related to implant abutments.

LIST OF CONTRIBUTORS vii

FOREWORDS viii

PREFACE xi

DEDICATIONS xii

1 Implant Abutment Materials 1
Hamid R. Shafi e and Bryan A. White

Introduction 1

Mucosal Seal 1

Pellicle Biofi lm and Periodontal Disease 2

Implant Abutment Material Related Research 3

Conclusions 14

References and Additional Reading 14

2 General Information about Implant Abutments 17
Hamid R. Shafie

Terminology 17

Stock Abutments 17

Customized Abutments 20

References and Additional Reading 22

3 Retaining Abutment Screws 23
Hamid R. Shafi e and Scott Martyna

Introduction 23

Basic Terminology 23

Abutment Screw Mechanics 24

Abutment Screw Materials 25

Special Considerations 26

Abutment Screw Failure 28

References and Additional Reading 32

4 Different Implant–Abutment Connections 33
Hamid R. Shafi e and Bryan A. White

Introduction 33

Chronological Development of Abutment Connections 33

External Hex Connections 34

Internal Connections 35

Comparison of Different Internal Connection Designs 37

Conclusions 43

References and Additional Reading 44

5 Prefabricated Implant Abutments 47
Paul P. Binon

Introduction 47

Chronological Development of Prefabricated Abutments 47

Examples of Prefabricated Abutments 49

Clinical Examples 54

References and Additional Reading 63

6 Use of CAD/CAM Technology in Custom Abutment Manufacturing 65
Julian Osorio and Robert B. Kerstein

History of CAD/CAM Technology in Prosthetic Dentistry 65

History of CAD/CAM Technology in Implant Abutment Manufacturing 66

Virtual Design and Manufacture of Abutments 69

Abutment Placement Using Sulcular Stretching 82

Clinical Examples 86

Advantages of CAD/CAM Abutments Versus Regular Cast Custom Abutments 97

Common Problems in CAD/CAM Abutment Manufacturing 99

Conclusions 100

References and Additional Reading 100

7 Relationship between Abutment Geometry and Peri-implant Tissue in Esthetic Zone Cases 102
Dean Morton Tamer Abdel-Azim and Wei-Shao Lin

Introduction 102

Provisional Restorations Prior to Implant Loading 103

Contouring the Soft Tissue with Provisional and Custom Impressions 107

Different Designs of Final Crowns Supported by Custom and Stock Abutments 111

References and Additional Reading 121

8 Instrumentation for Abutment Modifi cation and Guidelines for their Use 122
Hamid R. Shafie

Introduction 122

Extra-Oral Adjustment Techniques for a Titanium Abutment 122

Extra-Oral Adjustment Techniques for a Zirconia Abutment 125

Intra-Oral Adjustment Techniques for a Zirconia Abutment 128

References and Further Reading 132

9 Abutment Preparation Techniques for One-Piece Titanium and Zirconia Implants 133
Hamid R. Shafi e and Mary L. Ballard

Introduction 133

Material Science of One-Piece Implants 136

One-Piece Implant Macro-Geometry 138

One-Piece Implant Micro-Geometry 142

Case Selection Criteria 143

Surgical Techniques 148

One-Piece Implant Abutment Preparation Techniques 163

Principles of Loading 170

Provisionalization and Crown Fabrication 171

References and Additional Reading 175

10 Cleaning Disinfection and Sterilization Techniques for Implant Abutments 177
Hamid R. Shafie

Introduction 177

Cleaning Disinfecting and Sterilizing Implant Abutments 177

Cleaning and Sterilizing Abutment Adjustment Instruments 178

References and Additional Reading 179

INDEX 181

HAMID R. SHAFIE, DDS, CAGS, is a best-selling author and much sought-after speaker in the field of implant dentistry. He received his certificate of Advanced Graduate Studies in Prosthodontics from Boston University Goldman School of Dental Medicine. He is the director of postdoctoral implant training at Washington Hospital Center Department of Oral and Maxillofacial Surgery. Dr. Shafie currently is the President of the American Institute of Implant Dentistry, a not-for-profit teaching institution in Washington, DC. His best-selling textbook, Clinical and Laboratory manual of Implant Overdentures, is published by Wiley Blackwell.