THE NATURAL PROFILE ABUTMENT TECHNIQUE
INDICATIONS:

The Natural Profile Abutment is suitable for single tooth and multiple tooth restorations. It may be utilized with either a direct or an indirect technique and it may be retrievable or cemented. This product and all procducts mentioned on this page are available from Impla-Med.

COMPONENT LIST:
Natural Profile Abutment
Temporary Healing Abutment
Impression Screw
Prosthetic Screw (Hexed)
Implant Replica (Titanium)

HEALING ABUTMENTS & ABUTMENT SIZES:

Diameter Margin Height
5mm 1,2,3, or 4mm
6mm 1,2,3, or 4mm
7mm 1,2,3, or 4mm
Site selection is analyzed and a determination is made as to the type of treatment indicated. Often among consideration would be a conventional fixed bridge or an implant retained restoration.

In the example that we will follow here, a missing mandibular second bicuspid will be replaced with an implant supported restoration utilizing the Natural Profile Abutment System. The technique, however, is totally applicable to multiple tooth restorations.
An external hex implant, either a cylinder or a screw, is placed in the optimum position relative to the final restoration. It is important that the head of the implant be sufficiently below the gingival level of the adjacent teeth in order to develop the proper emergence profile. If the implant head is sitting too high, it will be difficult, if not impossible, to develop the proper contours.

Particular attention should also be paid to the bucco-lingual and the mesio-distal placement of the implant.
A temporary healing abutment of the exact same diameter and tissue height as the final natural profile abutment is placed at second stage surgery. This temporary healing abutment will allow the gingival tissues to heal and the maintenance of the emergence profile space to allow for proper contouring of the final restoration. The healing abutment is left in place for four to six weeks where possible.

After complete healing, the temporary healing abutment is removed and the natural abutment with the impression screw is placed securely on the implant. A confirming x-ray is necessary at this point to determine complete seating of the abutment on the implant. An impression may then be made with the crown and bridge impression material of choice.

The Natural abutment is removed from the mouth, placed on a Titanium Implant Replica (ILRT) and reseated into the impression. A master cast is then poured using the appropriate die stone.

A soft tissue cast is recommended.







The Impression screw may then be removed and the prosthetic screw substituted. The abutment is prepared to simulate the preparation of a natural tooth for a full crown restoration.

The soft tissue portion of the working cast can be removed to facilitate this procedure.







The final restoration may then be completed using conventional laboratory techniques. If it is desired to have a retrievable restoration, a screw-access hole may be left in the occlusal surface of the completed restoration.

The technique is compatible with any crown and bridge materials. Porcelain-fused-to-metal is recommended.


The abutment and the final restoration are returned to the mouth for try-in and evaluation. All adjustments are made and the restoration is cemented with the cement of choice.

If the decision is made to provisionally cement the restoration, it must be remembered that the cement bond between metal and metal surfaces is not very strong. The patient should be cautioned about possible cement failure and dislodgement of the restoration.
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©Copyright S. Robert Davidoff 1996-1999