CUSTOM ABUTMENT (CAD-CAM)

CAD-CAM custom abutments can be milled out of titanium, zirconia and a combination of titanium and zirconia for many different implant brands. Some implant manufacturers offer CAD-CAM abutments for their own products only (Straumann®, Zimmer™) and in some instances (Nobel Biocare™, Procera®) for competitors implants as well. Atlantis™ has the greatest product compatibility offering of any third party abutment manufacturer. GC's Aadva™ and Glidewell laboratories (Inclusive®) also offer custom abutments for a wide assortment of implant companies.

Laboratories with optical scanners may scan master models with special scan pegs or healing abutments and send the resulting scan files to a milling center for abutment machining. Combination (titanium/zirconia) abutments can often be produced in house with a milled zirconia abutment body and bonded to a pre machined implant/abutment interface. Tutorial videos for scanning implants can be found at CAPACADEMY.

CAD-CAM abutment manufacturers

Atlantis™

Atlantis™ zirconia

Atlantis™ produces zirconia and titanium abutments for a wide variety of implant brands. Titanium abutments can be ordered with a titanium nitride (GoldHue®) plating which gives the abutments a gold color. This may prevent a dark shadow underneath thin tissue in the esthetic zone if zirconia abutments are not an option. Zirconia abutments are 100 percent zirconia without any metal core or metal abutment to implant interface. Three shades in 10 (B1), 20 (A2) and 30 (A3) are available for zirconia abutments and the shading is through and through, not just on the surface.

Send mounted master models to Atlantis™ or scan in house with a Lava™ (3M ESPE) scanner for non splinted single unit restorations or a dental wings Series 5 scanner for multiple unit splinted restorations. A 3shape scanner may also be utilized to digitize stone models. Currently designs can only be viewed online upon request. Beginning in fall 2011 designs can be edited and modified in 3D online without the purchase of additional software ( Atlantis™ 3D Viewer/Editor manual). Scanning in house will save on shipping cost, turn around time and cost of the abutment. Upcoming implant brand compatibilities are Ankylos (released 04/03/1912).
Compatibility chart and Rx.

Biomet 3i™, Encode®

Encode® healing
abutment

Biomet 3i™ provides different avenues to produce custom abutments out of titanium and through and through zirconia. Dentists may scan Encode® healing abutments with a intraoral scanner and send the digital file to a participating laboratory or Biomet 3i™ Bella Tek™. Encode® healing abutments can also be impressed in a traditional manner. The surgeon places a Encode® healing abutment instead of a common healing abutment at the implant uncovery or immediately in a one stage implant surgery procedure. After the tissue has healed around the implant site, the treating restorative dentist takes an impression of the Encode® healing abutment, side stepping the need to remove the healing abutment and install a impression or transfer coping.

Encode® titanium

Impressions for Encode® abutments have to be exceptionally accurate and distortion free because the markings on the Encode® healing abutment for the scan process are almost imperceptible already on the Encode® abutment. Models are poured without soft tissue mulange or analogs and mounted with Adesso® Split Mounting plates on a calibrated Stratos (Ivoclar) articulator. Send models and mounting plates without the articulator to Biomet 3i™ for scanning, analog installation (robocast) and abutment fabrication.

Laboratories with a 3shape scanner can scan and design the abutment in house and transmit the design file to Biomet 3i™ Bella Tek™. The in house scan is performed with a traditional implant model generated from a fixture level impression. Scan pegs are installed on to the analog in the model and then scanned. Nobel Biocare™ and Straumann® compatibility available in the fall of 2012. Rx

GC, Aadva™

GC Aadva™ can copy a wax up or scan the master model and virtually design titanium and zirconia abutments. Zirconia custom abutments are milled through and through in zirconia in ten different shades. The Aadva™ system can mill zirconia abutments for Straumann tissue level regular neck implants in 100 percent zirconia.
Compatibility chart, Rx, Shade conversion chart.

Glidewell

Glidewell laboratories (Inclusive®) can mill titanium custom abutments and zirconia abutments with and without a metal abutment to implant interface for the most popular implant brands. Much like Atlantis, Glidewell offers two options in producing abutments. Either send mounted master models or a 3shape scan file. Glidewell specific scan pegs (purchased separately) need to be utilized for the 3shape file transfer option. Inclusive® abutments are compatible with Astra Tech, Biomet 3i™, Brånemark™, Keystone Prima™, NobelActive™, NobelReplace™, Neoss, Straumann® and Zimmer implants. Rx

Nobel Biocare™, Procera®

Wax up scan

The Procera® system has the longest track record of any custom abutment manufacturer. Only laboratories with a Procera® scanner are able to partake in the Procera® system. Production of zirconia and titanium abutments is possible for Branemark™, Replace™, Active™ Astra Tech, Straumann® (tissue level and bone level implants) and Camlog "J" series. Procera® can mill zirconia abutments for the Straumann® regular neck, tissue level implant albeit with a removable metal abutment to implant interface. All zirconia abutments for the Replace™ line of implants are milled with a removable metal abutment to implant interface.

Finished Procera®

The abutment is designed with the Procera® virtual abutment design software after scanning the master model with the scan pegs installed on the analogs. The latest Procera® system software has a improved design module capable of producing anatomically correct abutments. Sometimes it is best to wax the abutment with a plastic temp abutment to the desired shape and scan the wax up. The resulting abutment produced by Nobel Biocare™ from a wax up scan needs refinement once received from the production facility.

Straumann®, etkon

etkonĀ™ wax up

Straumann® can mill zirconia and titanium abutments only for Straumann® implants. Zirconia abutments for tissue level implants (RN, 4.8mm) require the synOcta® 1.5 abutment as an intermediary component between the implant and zirconia abutment, adding considerable height to the zirconia abutment assembly. Bone level implant zirconia abutments are machined through and through in zirconia without any intermediate components.

Abutments are produced through Straumann's proprietary scanners ES1 or CS2. Laboratories without the proprietary Straumann® scanners can send master models with incorporated analogs directly to Straumann® either with or without a prewaxed abutment and Straumann® will scan the models, design and mill the abutment out of the desired material.

Laboratories with a ES1 scanner are required to waxe up the custom abutment first and then scan the waxed up abutment. Owners of a CS2 scanner can design an abutment virtually after scanning the master model with appropriate scan bodies. Rx

Zimmer

Zimmer provides two avenues to acquire custom titanium and zirconia abutments (Patient Specific Abutment, PSA). Stone models with incorporated analogs and soft tissue may be sent directly to Zimmer or laboratories with a Zimmer distributed Zfx™ scanner scan the stone model, virtually design the abutment and send the design file directly to a Zimmer milling facility. Rx