Implants can be restored several different ways, depending on the location, angulation of the implant, brand of implant, number of implants, number of pontics, and desired result. Most brands of implants can be restored with either a custom or stock abutment. Choosing between a screw- or cement-retained restoration is an important consideration to make when placing and restoring implants.
Crowns for cement-retained implant restorations are cemented to the abutment intraorally after the abutment is placed and the abutment screw has been torqued.
Abutments for cement-retained restorations can be either digitally designed custom abutments or stock abutments. Custom abutments in titanium, gold-shaded titanium or zirconia provide excellent esthetics. They can be anatomically shaped for a natural look and margins can be placed at or just below the ginigval margin to minimize issues with cement remaining.
Cement-retained restorations require a minimum interarch space of 8-9 mm. About 3 mm is needed for soft tissue, 4 mm is the minimum for the abutment height for good retention, and a minimum of 1-2 mm is needed for restoration material, depending on the material chosen. Angulation of the implant may affect the amount of interarch space needed.
Screw-retained restorations / Screwmentables
Screw-retained implant restorations are also referred to as "screwmentables" since the crown is cemented to the abutment extraorally. A screw access hole in the crown connects the abutment/crown assembly to the implant. This hole is typically closed with teflon tape and composite filling material.
Two huge advantages of screwmentables are retrievability and elimination of cement remaining. Screwmentables for single teeth are usually digitally designed custom abutments due to angulation and exit of the abutment screw.
Margins on screw-retained restorations can be placed further below the ginigval margin since the crown is cemented extraorally. This helps to minimize show through of the abutment in thin tissue.
Screw-retained restorations require a minimum interarch space of 8-9 mm. About 3 mm is needed for soft tissue, 4 mm is the minimum for the abutment height for good retention, and a minimum of 1-2 mm is needed for restoration material, depending on the material chosen. Angulation of the implant may affect the amount of interarch space needed.
Screwmentable abutments can be provided in titanium, gold-shaded titanium or zirconia depending on the manufacturer of the abutment.
Custom abutments are available from several manufacturers. Custom abutments are digitally designed and may be a single piece construction in titanium, gold-shaded titanium or zirconia, or two-piece construction with a titanium interface or base with a zirconia top. You have a choice of materials for the restoration placed on the abutment.
ArgenIS precision milled custom abutments are compatible with the leading implant systems such as AstraTech EV and TX, BioHorizons, Biomet 3i Certain, Camlog, Dentsply Friadent Xive, Hiossen, Nobel Active and Replace, Straumann and Zimmer. They are available in titanium, gold-shaded titanium, and zirconia. Another option is a Zirconia hybrid abutment with a metal implant interface and a full contour zirconia restoration.
ArgenIS screw-retained abutments can be provided with an optional Angled Screw Channel to accomodate implant angulations. ArgenIS abutments are backed by a limited warranty.
Click here for the ArgenIS Abutment RX .
Dentsply Sirona Atlantis
Manufactured to Dentsply’s exacting standards in an FDA 510(k) facility to ensure an ideal interface and fit with dental implant platforms, Atlantis Abutments give you the freedom to choose from more than 85 compatible implant connections. Atlantis patient-specific digitally designed abutments are available in titanium, gold-shaded titanium, and multiple shades of zirconia for cement-, screw- and a conometric solutions.
Angulated Screw Access (ASA), available on most interfaces in titanium and gold-shaded titanium, allows the prosthetic screw access channel to be angled up to 30° off the implant/abutment axis, for optimal esthetics, function and additional restorative flexibility.
Atlantis abutments are available for BioHorizons, Camlog, Dentsply Sirona, Hiossen, Keystone, MIS, NobelBiocare, Osstem, Straumann, and ZimVie (formerly Zimmer Biomet) implants.
A comprehensive warranty program provides a lifetime warranty on titanium and gold-shaded titanium abutments; zirconia abutments are warrantied for five-years.
Click here for the Atlantis Abutment RX .
NobelBiocare Procera abutments are individualized CAD/CAM abutments. They are fabricated in an FDA 501(k) facility from Grade 5 titanium or medical grade zirconia for lifetime durability. Procera abutments are available in titanium and zirconia in both cement- and screw-retained options. They can also be anodized in the lab for greater esthetic results.
Nobel Procera's Angulated Screw Channel (ASC) solution provides additional restorative flexibility. With the ASC you have the option to angulate the screw channel between 0 and 25° in a 360° radius. This means you can restore most situations with a screw-retained restoration and avoid known risks associated with excess cement. What’s more, the angulation allows the use of screw-retained restorations in the esthetic zone by avoiding a buccal screw access point. It provides more restorative flexibility independent of the implant position.
Procera abutments are available for all NobelBiocare implants. They are covered by an exclusive 10-year warranty.
Click here for the NobelProcera Abutment RX
Click here for Nobel Biocare Conical Connection Impression Techniques
Straumann CARES abutments are patient-specific abutments with customized emergence profile and anatomic shapes. They are available in titanium and zirconia in cement- and screw-retained options for Straumann and Neodent implants. Gold-shaded titanium is also available for abutments for Straumann implants.
With Straumann Angled Solutions (AS) you can use screw-retained prosthetics where otherwise a cemented solution would have been your only choice. They allow you to tilt the screw channel of your restorations by up to 30°, so that the screw-exit is located in its ideal position for esthetic and functional results.
Click here for the Straumann CARES Abutment RX .
Click here for Straumann Torque Guide
Straumann BL and BLX Impression Technique
Straumann TLX Impression Technique
BellaTek Abutments from ZimVie (a division of Zimmer Biomet) are anatomic patient-specific abutments and are available in titanium or titanium with gold-colored titanium nitride coating. BellaTek abutments are available for Biomet and Zimmer implants only. The BellaTek Encode Impression System is available for both Biomet and Zimmer implants. Encode cases can be sent to the lab with digital or traditional impressions.
Click here for the ZimVie Abutment RX .
Please see individual implant restoration prescription forms (available through doctor's portal) for pricing and availability details. Prescription forms without pricing are available on the RX Forms tab at the top of the home page.
Implant Supported Dentures
Screw-Retained or Fixed-Detachable Restorations
Sometimes referred to as “All-on-4®”, “SmartFix”, “ProArch” or “Teeth Express”. These are Fixed-Detachable full arch restorations.
Our removable team specializes in complex implant retained prosthetics. We can provide guidance for these cases from the initial consult to the final seating. We can consult on your case to determine the best option for your patient based on the oral environment and the patient’s desires. Final restorations can be provided in a choice of materials.
The Screw-Retained restoration can be removed only by a clinician. It is placed on a minimum of 4 implants and secured to the implants with screws. It is designed to be immediately loaded with a provisional restoration that is replaced with a permanent restoration once the implants are fully integrated. This restoration provides patients with a fixed full-arch provisional prosthesis on the day of surgery.
Learn about our Guided Solutions options
Screw-Retained Hybrid (Acrylic/Titanium wrap around)
Screw-Retained Hybrid restorations combine conventional denture teeth with a titanium CAD/CAM frame wrapped in acrylic. Hybrid restorations are available for all major implant systems. Click here for the Screw-Retained Denture RX, Titanium & Acrylic.
Your first Screw-Retained Restoration case includes complimentary chairside assistance from start to finish for educational purposes. Doctor must be present in the treatment room.
Screw-Retained permanent restorations can also be milled from monolithic zirconia. Like the conventional Acrylic & Titanium Hybrid, it is secured to the implants with screws. The All-Zirconia restoration offers increased durability by eliminating issues associated with veneered porcelain, acrylic teeth and acrylic bases. Full Zirconia Screw-Retained restorations are ideal when the interocclusal space is limited. Full Zirconia Bridges can be as short as 3 units and up to a full arch restoration.
Click here for the Screw-Retained Denture RX, Full Zirconia or Crystal Ultra .
Crystal Ultra Screw-Retained
Another option for full-arch screw-retained restoration is Crystal Ultra™, a nano-ceramic material that is formulated with a higher ratio of polymers to ceramics, making it the most durable and elastic hybrid ceramic on the market today. Crystal Ultra is the least “clacky” ceramic and is the gentlest material of all the dental ceramics and ceramic hybrids. It offers a hardness which closely matches natural dentition. By comparison, non-hybrid ceramics are harder than enamel, making them less pliable and forgiving, causing an unnatural “clacky” sound and feel when the patient bites down. Crystal Ultra is available for fixed full arch implant restorations only at this time.
Click here for the Screw-Retained Denture RX, Full Zirconia or Crystal Ultra .
Fixed-Removable Restorations (Conus, Bar Overdenture)
Fixed-Removable restorations are implant-retained. While they can be removed by the patient for hygiene, they feel fixed in the mouth to the patient. They can provide proper lip support. Types of attachments include Conus (telescopic) abutments, bar, clip or ball type attachments. Each type of attachment provides varying levels of fixture.
Bars are fabricated of titanium or cobalt-chrome using CAD/CAM methods, and connect to the implants with screws. Protocol for this restoration follows traditional denture protocol. For strength and durability, the restorations may also have a metal framework incorporated in the denture.
Bar shapes come in many different profiles. Pricing is determined by the number of implants and the type of bar profile. Please call to discuss treatment planning options for this type of restoration.
Helm Dental Laboratory has created a bundled package for all the services necessary for the ATLANTIS Conus concept and has trademarked it as SecureFit™. The SecureFit™ package includes everything needed to complete a Conus restoration. It provides fully edentulous patients with a cost-effective, implant-retained prosthesis that can be removed by the patient for cleaning. It can be placed on a minimum of four implants with proper AP spread.
Click here for the HDL SecureFit (Conus)-RX .
The concept includes patient-specific ATLANTIS Conus abutments and prefabricated SynCone caps. The ATLANTIS Conus abutments are individually designed to be parallel to each other and to precisely fit the SynCone caps. The Conus concept is available for all major implant platforms.