Custom-Made Abutments ?

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Catherine, a dental implant patient from North Carolina, asks:

I had a dental implant placed on 10/31/06. Recently, I was told by my dentist that the abutment to the dental implant does not fit properly and I was just prepped for a custom-made abutment.

However, shouldn’t the dental implant and abutment fit perfectly and shouldn’t this all be worked out before the implant is actually placed? Is it common that the abutments do not fit the implants and there is a need for custom-made abutments? If so, why? Are there specific issues I should watch out for with custom-made abutments? Thanks.

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7 Responses to “ Custom-Made Abutments ? ”

• Dr John Berne March 20th, 2007

  
  

  Catherine,
  I don’t think I would panic if I were you. Probably what has happened in your case is that the margin of the gum around the implant is not in an ideal position for a standard abutment and a custom abutment is required to have an ideal margin.
  Perhaps your dentist may have explained it to you slightly differently but there is nothing out of the ordinary to make a custom abutment when circumstances dictate.There is usually no problems with the fit of custom made abutments, so functionally they shouldn’t make any difference. They are usually a little more expensive however.

• Dr. Evan Tetelman March 20th, 2007

  
  

  Catherine,
  That’s great that you looked for an explaination. It is unlikely that the abutment did not fit the implant. Your Doc probabally did not explain his reasons clearly. More likely than not it was that the availble stock style abutments did not create the necessary flow from the implant to the area above the gums to allow your dentist to fabricate a well contoured naturally appearing crown. This is usually the reason that most of us use custom abutments. In fact I use them almost every thing to create a perfect result for my patients. You should be thrilled that your Doc noticed that a small change to a custom abutment will give both of you the result you are expecting. It usually is very little more in terms of cost and with all the time and effort you have both put in to this point it is well worth it. Best of Luck.
  Dr. Evan Tetelman
  Cleveland, Ohio

• Dwight H. Pate, D.M.D. March 21st, 2007

  
  

  Catherine,
  I agree with Dr. Tetelman. I almost allways use custom abutments. The implant could be slightly off angle or the tissue too deep for a stock abutment to be usefull, and one of these conditions is so often the case that I plan for that possibility in the very beginning. If you try to make a stock abutment work you can get a less than optimal result. It could possibly been explained in a better was so as not to leave the question in your mind about the fit of implants and abutments, but it sounds like your dentist (and you) are on the right track.
  Dr. Dwight H Pate
  Auburndale, FL

• Nna May 12th, 2007

  
  

  I would like to know who is usually paid for the cost of a custom abutment? my dentist or the laboratory that made the abutment?

• Patty Matkovic January 3rd, 2008

  
  

  Dear Implant Specialists: I am delighted with your replies to patients who are wondering why custom abutments are necessary as, according to my oral surgeon, I need this type of abutment for my front tooth.
  Have a question for all of you. For almost 2 years I have been taking Fosamax for osteoporosis and I discontinued the medication during my tooth extraction and implant procedures. My dentist who is making the custom abutment and crown says I probably will need about 2 months to heal after the abutment is placed. Do you think it’s OK for me to resume my osteoporosis medicine? Have you had problems with patients with osteoporosis and these custom abutments?

  Thanks!
  Patty

• Linda July 8th, 2008

  
  

  My dentist had custom abutments made and they weren’t long enough–he installed them anyway. One simply couldn’t hold the tooth, and the other he didn’t screw in all the way so that he could get the tooth on it, but it only held for 5 months before it turned. He refuses to fix the abutments– What can I do? Bear in mind that I already lost thousands of dollars to another dentist who used stock implants which didn’t suit my case at all, and I had to leave him–he also refused to fix the abutments.

• R. Hughes July 8th, 2008

  
  

  Dr. Tetelman is correct. As per the fit, if there is gum tissue btw the implant and abutment it would cause a poor fit. Also poor placement of the abutment by the Dr….which is an easy fix. If the custom abutment was made like a casted post and core-there could be problems. The reasons can go on as well as the solutions, but the majority are fixable.

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