Virtual-designed and computer-milled implant abutments.

Computer-designed and -generated implant abutments will fundamentally change the present restorative protocols for implant dentistry. Standard implant prosthetic techniques rely on implant level impressions and costly casting technology for component fabrication. Many dentists are uncomfortable making implant level impressions and resort to time-consuming conventional techniques of intraoral abutment preparation or do not offer implants as a treatment alternative. Implant abutments generated by computer-aided design and computer-aided manufacturing (CAD/CAM) are more precise than those created using traditional casting technology. This increased accuracy has specific application to implant dentistry, where precision of components may affect implant longevity, prosthetic success, and ease of restoration. Three current CAD/CAM implant abutment systems are reviewed, including an innovative digital system which eliminates the need to make implant level impressions. After placing an encoded healing abutment, an impression is made at the healing abutment level. The resulting cast is optically scanned and, using a CAD/CAM system, a patient specific definitive abutment is created. The encoded healing abutment is not removed until delivery of the abutment and final prosthesis. The ease and precision of making implant impressions at the healing abutment level, followed by patient-specific computer-generated abutments presents several benefits: restorative dentists rely less on conventional dental techniques to restore implants, inaccuracies of casting technology are virtually eliminated, laboratory technicians are freed to concentrate on higher level activities, and ultimately dentists are more likely to embrace implants as a preferred treatment option for their patients. This cutting edge technology of computer-assisted implant impressions and computer-generated abutments will likely replace traditional implant restorative protocols and become the standard for implant dentistry in the foreseeable future.