Dental restoration of the dentition involves not only returning the functionality of the jaw, but also the formation of an aesthetically attractive smile. This aspect becomes especially important when restoring anterior units, for which the installation of implants is recommended. One of the significant elements that influences aesthetics is the connection between the pin and the artificial crown - the abutment - for the manufacture of which it is recommended to choose zirconium dioxide.
Advantages and disadvantages
Advantages:
- high biocompatibility of the material - does not cause allergic reactions, reduces the period of adaptation of soft tissues;
- its optical properties are close to natural teeth - it has the same color, transparency, and reflective ability;
- the smooth surface prevents the accumulation of bacterial plaque;
- supports soft tissues well, forms the correct gum contour;
- minimizes the risk of cement leakage under the gum;
- durability.
Flaws:
- the palette includes only two shade options: bright white, dark yellow;
- high cost of all-milled models.
Lack of chewing teeth, difficulty chewing food
Before
Stages
After
Specialists:
Kyalov Grigory Georgievich
Description:
The patient came to the NK clinic on recommendation. Complaints at the time of treatment were the absence of chewing teeth and difficulty chewing food.
After the initial diagnosis, the absence of teeth 17 16 15 14 24 25 26 27 25 26 35 36 37 44 45 46 47 was established. Previously, a bridge prosthesis 34-38 and tooth 48 were installed. Mobility, mobility and pain of the supporting teeth under the bridge prosthesis were noted. The patient was offered a plan for the rapid rehabilitation of the chewing group of teeth using the installation of dental implants in the area of 16 14 24 26 37 34 44 47 teeth and the production of metal-ceramic bridges supported by dental implants. Prosthetics were planned to be carried out with the determination of the optimal position of the lower jaw to create the physiological position of the temporomandibular joint.
What types are used for dental implantation?
- Standard - since personal parameters are not observed during production, the structures are not able to replicate the shape of the tooth and gums, which sometimes reveals their artificial origin.
- Individual - made from personal impressions. In this case, the anatomy of the patient’s dentofacial apparatus is taken into account to ensure a tight fit to the elements of the implantation system and gum tissue.
Standard models of zirconium abutments, manufacturers
- Nobel Biocare (Switzerland) is the main manufacturer of dental implants and components. The catalog includes superstructures made of titanium, zirconium and gold alloys.
- Astra Tech (Sweden) - creates corner and straight models using its own developed technologies. The products are perfectly combined with crowns made of any materials.
- Xive (Germany) - offers abutments made of biocompatible materials.
- Osstem (South Korea) - produces implants, superstructures and surgical instruments .
- Ankylos is a German manufacturer that produces straight and angled zirconium abutments.
- Alpha Bio is an Israeli company. The line contains a wide selection of suprastructures made of titanium and thermoplastic polymer with different methods of fixation. Zirconium is presented in a straight configuration.
- Mis is an Israeli company whose catalog includes connecting elements with a standard platform and with the possibility of switching.
Custom zirconia abutment: manufacturing and fixation
Zirconium is not noticeable under a ceramic crown, is resistant to chewing loads, and does not change its original properties throughout its service life. The material is compatible with CAD/CAM computer modeling .
Stages of installing an individual connecting element:
- After inserting the implant and attaching the plug, impressions are taken from the jaw.
- The manufactured model is scanned and transferred to the modeling program.
- An abutment is cut out from a single piece of zirconium dioxide using a computerized machine using CAD/CAM technology.
- The finished structure is fixed to the implant with cement or a screw.
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General overview
The functionality of the abutment provides for the possibility of using the product not only as a connecting link between the implant and the crown, but also as a support on which permanent prosthetic structures are fixed. Modern manufacturers offer models of different shapes and types, each of which is designed to solve a specific range of problems.
The standard classification provides for the division into template and individual types of abutments - in the first case we are talking about universal standard designs, in the second - about products made on the basis of an impression reflecting the features of the anatomical structure of the patient’s jaw. In addition, among the existing varieties, the following configurations are distinguished:
- Direct – practical to use, and recommended when implementing the classic two-stage prosthetic protocol;
- Standard – connecting elements, presented in six variations, a set of which allows you to choose the best option for any clinical picture;
- Angled – allow adjustment of the tilt of the clamp, so the doctor can change the position of the system and fix it in its natural position;
- Ball-shaped – used when installing removable prosthetic structures;
- Temporary - also known as gum formers, designed primarily to protect the system from the penetration of food particles and pathogenic microbes that can provoke the development of inflammatory processes.
The choice of model is determined by the specific anatomical structure of the dentition, as well as medical recommendations, on the basis of which a prosthetic plan is formed.
Which is better: titanium, gold or zirconium
Characteristics of structures depending on the material:
- Titanium - titanium copes well with chewing loads, however, the aesthetics of the restoration will be far from natural, since the material tends to show through the crown.
- Gold Ceramic-On is an alloy with a high gold content of 98%. The finished structure is covered with ceramic mass containing natural minerals, which gives the restoration excellent aesthetics.
- Titanium with cemented zirconia part . The frame of the structure is made of titanium and bonded to an individual zirconium component. The ability to correct the structure and color of the secondary component allows you to achieve high attractiveness when replacing teeth.
- Full zirconium . Made from a monolithic block of zirconium dioxide. Does not cause allergic reactions. Thanks to the color of the material, which is close to the natural shade of the teeth, it does not show through the crown.
- resin abutments . They are used for restoration of the smile area with temporary cement-fixed structures. They can be installed for up to 6 months during implantation treatment.
Titanium can be seen through the gum, so titanium components are primarily used in masticatory restorations. For the frontal area, it is better to use abutments made of materials whose color matches the natural color of the teeth.
Complaints about decementing of the old maxillary bridge on the left
Before
Stages
After
Specialists:
Kyalov Grigory Georgievich
Description:
When contacting our clinic, this patient complained of decementing of the old maxillary bridge on the left. Because of this, his quality of chewing food deteriorated. The patient had difficulty smiling.
After a comprehensive diagnosis of the dentition and jaws, the patient was offered the installation of dental implants in place of the destroyed teeth. And also, carry out total functional and aesthetic rehabilitation, taking into account the presence of severe abrasion of the remaining teeth and multiple abfractions (non-carious lesions). At the time of dental implantation, a temporary crown was immediately installed in our clinic (with immediate loading on the dental implants). This allowed the patient to continue effective work activities because the missing teeth were in the smile zone. After the implantation of dental implants, we proposed a scheme for functional and aesthetic rehabilitation of the dentition, which was successfully implemented with separate ceramic restorations and veneers.
IMPLANTOLOGISTS WHO INSTALL ZIRCONIUM IMPLANTS
The complexity of installing BREDENT zirconium implants is compensated by their long service life. However, this complexity does not in any way concern our patients.
The clinic’s implantologist surgeon, Dr. Petr Vladimirovich Ozerov, has 17 years of clinical experience, is a member of the Russian Dental Association and is certified by BREDENT to install zirconium implants.
The professionalism of our implantologist is recognized by a professional society.
Our clinic hosts educational courses in which Petr Vladimirovich, in lecture and practical parts, trains implantologists from the Russian Federation and the CIS in techniques for installing zirconium implants.
By choosing our clinic, you get a leading specialist in the Russian Federation, high-quality implants and the best level of service in the Russian Federation.
The implantologist has been a full member of the Russian Association of Dental Implantology since 2012.
Selection of abutments when installing zirconium dioxide crowns
Zirconium crowns are universal - they can be used with a titanium post and abutment, but from an aesthetic point of view, the best choice would be an all-zirconium design or at least a zirconium abutment.
The metal abutment is good for its strength, but the aesthetic defect can be the same as when installing metal-ceramics - the titanium part of the prosthesis through the gum and the metal abutment through the crown. Therefore, it is better to install a zirconium abutment for the front teeth - in this case, the dentures will be indistinguishable from natural teeth.
