Wednesday, February 21st 2018 10:21PM EST

All-Ceramic Crown: Shouldered Abutment

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Abutment Selection

1. Remove temporary or healing abutment from the implant by grasping the abutment and tapping on the handle of the grasping instrument. Alternatively, use rongeurs or forceps with a simultaneous twisting and pulling motion to remove an abutment from an implant.

2. Insert a shoulder depth gauge (260-101-380) into the well of the implant to determine the appropriate height of the shouldered abutment needed for the restoration. The horizontal markings on the shoulder depth gauge indicate the shoulder level of a seated stealth shouldered abutment. The first mark of the shoulder depth gauge corresponds to the 2.0mm shoulder height of the 5.0mm diameter stealth shouldered abutment. The second mark corresponds to the 4.0mm shoulder height, etc. If the crest of the soft tissue falls between two marks, select the shorter of the two abutment heights for an aesthetic result.

3. The 3.5mm and 4.0mm diameter stealth shouldered abutments have a shoulder height that is 0.5mm shorter or closer to the implant than the 5.0mm diameter abutments. Their heights are 1.5mm and 3.5mm. The width of the abutment is dictated by the anatomy of the interdental papillae. The abutment should support the papillae without encroaching upon them.

4. After the appropriate stealth shouldered abutment is selected, it is seated into the clean and dry well of the implant. Tap the abutment a few times in the direction of the long axis of the abutment post and implant well.

Note: All stealth shouldered abutment heads are sandblasted to facilitate the bonding of an all-ceramic crown.

Statistically, a 2.0mm diameter abutment post will move 0.1mm into the well of an implant from its initial insertion to its being definitively seated, and a 3.0mm abutment will move 0.25mm.

Keys to Success

  • To facilitate confirmation of complete seating of an all-ceramic crown, it is advisable to use the technique for making an implant level impression and for extra-orally cementing a crown.

Measurement Guide: Stealth Shouldered Abutment

The design of the Bicon abutment system is such that the hemispherical base of the abutment does not sit flush with the neck of the implant. By design, there is a space below the abutment post when the abutment is fully seated. When viewing this on a radiograph, it can be seen as a radiolucency. Please note that the post of any abutment may not be modified. Altering the abutment post in any manner or using a cementing medium will affect the frictional fit of the locking taper resulting in a potentially non-retentive abutment. The following diagram depicts the final seating of a stealth shouldered abutment as well as the method for measuring each abutment.

The width of the abutment is measured at the widest part of the abutment. The height of the stealth shouldered abutment is measured from the top of the implant to the shoulder of the abutment. The heights are 1.5, 2.0, 3.5, 4.0, 6.0 or 8.0mm, depending upon the abutment width.

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