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Personalized anatomical restoration abutment, from the industry called Customized Abutment, is a type of prosthetic abutment on dental implants that is manufactured individually, according to the anatomical shape of the teeth - gums and periodontal tissue of each patient, thereby providing maximum aesthetic, functional and biological compatibility of the dental implant, helping the dental implant to be more aesthetic, chew better and be more durable. Customized Abutment is considered the key to the solutionDCT humanized tooth implantation.
Personalized anatomical restoration abutment made of Zirconia (white) and titaniuma (black).
Customized abutment was born as a combination of 4 technologies: Oral Scanning Ultra, 3D Exocad Presumptive Reconstruction, 5-axis CAD/CAM and multi-layer zirconia material manufacturing technology. Multilayer layer.
Personalized restoration abutment consists of two parts, one part located in the gum called the gingival part, and the part protruding from the gum, which is the place to attach the porcelain tooth, called the tooth base.
This is a very important part, both responsible for shaping the periodontal tissue, responsible for pink aesthetics, and also plays the role of establishing a protective biological barrier. periodontal tissue and implant base below.
The inside of Customized's gums has a customized shape according to the standard structure of each tooth's alveolar point, with a finishing line that curves along the gum line. It creates a shaping framework, supporting the periodontal tissue structure, thereby re-establishing a periodontal tissue around the implant like a standard real tooth.
On the other hand, the surface of the inside of the gum is treated with Etching, creating a biophilic surface, allowing it to biologically connect by epithelial mechanism with the periodontal tissue, creating a biological space that prevents bacteria from penetrating below.
These are extremely important properties of a personal prosthetic abutment. chemistry, determines the aesthetics as well as the durability of the dental implant.
The tooth pulp is similar to the dentin of a real tooth, it is where the porcelain tooth attaches to. Unlike a commercially available prosthetic abutment that only has a circular cross-section, the tooth base of the Customized abutment is designed according to the shape of the real tooth crown, based on the analysis of the direction of force, helping the chewing process better and better protecting the porcelain tooth on the implant.
Image of the tooth base of the personalized prosthetic abutment.
>>> See details of the types of implant prosthetic abutments. in the article:Types of prosthetic abutments on dental implants.
+ First difference: Differences in anatomical shape:
The personalized anatomical restoration abutment has the same shape as the patient's tooth crown, the contour structure curves along the gum line of each tooth and each person, the diameter and length are also designed according to each person and each individual tooth.
Pre-manufactured restoration abutments (cemented abutments and screwed abutments) have only one shape: round, with only certain sizes.
Differences in shape between the two generations of restoration abutments
+ Differences 2nd: Difference in manufacturing materials:
Personalized anatomical prosthetic abutments are only manufactured from pure titanium or all Zirconia
Pre-manufactured prosthetic abutments can be manufactured from titanium or stainless steel, not made from zirconia ceramic
+ 3rd difference: Difference in manufacturing technology:
Personalized anatomical prosthetic abutments are manufactured using CAD/CAM technology
Manufactured prosthetic abutments Available are manufactured using sintering and molding technology.
+ The 4th difference: Differences in features:
Personalized anatomical restorations have the function of shaping the anatomy of the gums and periodontal tissue, establishing a biological barrier to protect the implant, and also having the function of transporting chewing forces.
Pre-manufactured prosthetic abutments only have the ability to carry chewing forces (mechanical features), are not capable of shaping gums, and are not capable of creating biological space (therefore, when inserting implants and using old-style abutments, there will be physiological bone resorption around the 2mm implant neck to create biominerals, meaning the biological space will be at the implant base, not at the prosthetic abutment). Once you know what a dental implant is you will easily choose the type of abutment that is right for you.
The clinical results are different between the 2 generations of prosthetic abutments (compared with real teeth)
These differences lead to differences in treatment effectiveness when using the above 2 generations of prosthetic abutments.
A case of using a pre-made abutment with a small constriction in the tooth neck, the gums are not inflated, causing ugly, impacted teeth. eat.
The result is replaced by a personalized anatomical restoration.
Different from the ready-made type that is mass-produced in advance, the Customized Abutment is produced after placing the implant base in the jawbone, it is calculated, designed and manufactured to be able to reconstruct the gingiva around the implant according to the anatomical standards of each tooth and each person.
Customized Abutment is performed through 5 steps:
Scanning Oral Ultra is a data collection technology based on infrared rays.
To be able to re-establish gum tissue, after the implant has been placed in the jawbone, the doctor will expose the implant and place a positioning device called Scan body at the base of the implant. Next, the doctor will use an Oral Scan machine to scan all data including teeth, gums and implant (via Scan body).
See details atTHIS VIDEO
When you lose teeth, your gums will shrink over time. When applying Customized, gingival data from Scan Oral will be transferred to Exocad, here, the gingival structure will be simulated in three-dimensional space, how to most perfectly regenerate gingival tissue in 3 spatial dimensions including: Re-establishing gingival bulge in the outer-inner direction, re-establishing gingival papillae (papillae) in the near-far direction and re-establishing the gingival contour in the vertical direction.
See details hereTHIS VIDEO
After designing a perfect gum tissue in all three dimensions, a customized one will be designed to suit the ideal gum anatomy. The prosthetic abutment is manufactured in the most suitable shape, with the role of shaping the gums according to the ideal shape designed on Exocad.
See details atTHIS VIDEO
In complicated cases, the process of shaping the gums may have to go through an indirect intermediate step: before the final customized design, the doctor will design a shaped abutment called Anatomic Healing Abutment, which plays the role of shaping the gums according to the design before producing the final anatomical restoration abutment.
The prosthetic abutment after being Personalized design according to ideal gum anatomy on Exocad will be transferred to production using CAD/CAM technology.
Different from conventional CAD/CAM technology used to produce porcelain teeth, CAD/CAM used to produce Customized Abutments is a 5-axis type (rotates in 5 spatial dimensions), the smartest robot today.
There are two types of materials used to produce Customized: pure Titanium or multi-layer Zirconia. Multilayer.
Customized Zirconia Abutment is made from round shaped Zirconia wheels, with many different colors to match the color of each person's teeth and gums.
See details atTHIS VIDEO
Currently, there are two types of personalized anatomical restorations: abutments made from pure titanium (Customized Abutment Titanium) and abutments made from Zirconia ceramic (Customized Abutment Zirconia).
Usually designed for molars. This type of abutment is cheaper than abutments made of zirconia, however it has a much higher cost than pre-made restorative abutments.
Regarding advantages: Customized titanium meets 3/4 of the criteria compared to an ideal restoration abutment: Customized titanium has very good hardness, is individually designed according to the ideal gum anatomy for each tooth, so it is able to aesthetically restore the shape of the gums in all 3 spatial dimensions: bulge, gingival papilla and gum contour. Made from titanium, it is possible to establish a gum adhesion barrier on the surface of the restoration (epithelial adhesion), preventing bacteria from the oral environment from penetrating downwards.
However, titanium restoration posts still have a drawback: because they are made from black titanium, when used for incisors or molars with thin gums, the black titanium shine will be exposed, making the color of the gums and tooth neck unnatural. To overcome this drawback, electrolysis technology is used to plate a thin layer of gold onto the titanium surface. However, this layer will prevent adhesion of the gingival epithelium to the titanium surface, leading to the loss of the protective barrier between the restoration abutment and the gums, allowing bacteria from the mouth to penetrate and destroy the underlying structures.
This is the most perfect type of restoration, achieving all 4/4 criteria of an ideal restoration. The combination of an implant placed precisely in the jawbone with Customized Zirconia and Zirconia 3D Pro Max Multilayer porcelain teeth will give the patient a perfect dental implant.
>>> See more:Criteria for an ideal prosthetic abutment.
Regarding advantages: Customized Zirconia meets all 4/4 criteria of an ideal prosthetic abutment: Very sturdy, individually designed according to ideal gum anatomy, so it is capable of reconstructing gum aesthetics. The color spectrum is diverse from white like tooth enamel, to light yellow like tooth roots or light pink of gums, so when using Customized Zirconia, it will bring about absolute gum color aesthetics. In particular, the connection between Multilayer Multilayer Zirconia and the gingiva is an "epithelial adhesion" connection, which is much firmer and more stable than the epithelial connection of the titanium surface. Because of this advantage, when using Customized Zirconia, the protective barrier between the abutment and the gingiva will be very good, ensuring that bacteria cannot penetrate from the oral environment to the underlying structures.
A case of using a personalized anatomical restoration abutment with zirconia.
The only drawback of this type of prosthetic abutment, and also the biggest obstacle that makes it difficult for it to be widely applied to patients, is its HIGH COST. Investing in a Customized Zirconia application line requires a lot of resources, both in money and people. On the other hand, Multilayer multilayer zirconia blank material has a very high price, much higher than the type used to produce porcelain teeth.
However, customized abutment is the final link that brings dental implants to perfection, overcoming all the disadvantages of this method. However, currently in Vietnam it is almost not applied, or applied very sporadically in some cases of high-end, high-paying customers, for the following two main reasons:
For customized technology to be effective, it is necessary to ensure the challenge of placing the implant post correctly in the jaw bone in all 3 spatial dimensions, and to be able to place it correctly, it is necessary to have the post placement technology. This means that a dental center that wants to effectively apply customization needs to have a technological chain system from placing the implant, copying the tooth model, designing the prosthetic abutment until producing them. This line has a very high cost and complex operation.
On the other hand, the price of pure titanium Premill and Multilayer Zirconia is also very high.
Participating in operating this technology chain chain is not simply a team of doctors like the old method. With this solution, most operations are simulated and pre-managed on a computer through a virtual reality technology system. Of course, the planning and simulation operations must still be done directly by doctors with specialized training in technology, but part of this technology chain will be handled by technology technicians and laboratory technicians.
The technological obstacles here will include two issues: How to match the understanding and treatment thinking of doctors and technicians together. And more specifically, how can doctors understand and proficiently use these somewhat complex technologies, especially older doctors, whose access to technology and innovation is often slow and difficult.
All of this leads to a consequence: the price for dental implants that patients have to pay will be higher than the current price. This makes this technology solution not commonly used in Vietnam. For more detailed information about dental implant prices, you can refer to the article "Implant pricehow much".
The application of personalized anatomical prosthetics (Customized Abutment) will bring customers the following two benefits:
1. First advantage: Perfect aesthetics:
Customized Abutment gives the patient a tooth implant that resembles a real tooth cast in both white aesthetics (tooth shape) and pink aesthetics (gums).
2. Advantage 2: Feel food better.
Shaping the periodontal and gum tissue to resemble ideal anatomy helps personalized dental implants chew more realistically. Although it cannot be equal to healthy real teeth, it can restore 85 to 90% of the chewing feeling.
3. Advantage 3: Reestablishing the biological protective barrier prevents bacteria from the oral environment from penetrating and destroying the implant base.
In addition to its role in shaping periodontal tissue like real teeth, the inside of the Customized Abutment's gums has the ability to create a direct biological bond with the periodontal tissue around it, thereby establishing a biological barrier, preventing bacteria and agents from the oral environment from penetrating below.
Compare the biological space on real teeth and the biological space on customized abutment.
4. Advantage 4: Avoid food retention, which is a very common problem with dental implant restorations:
Due to reestablishing the gum tissue according to ideal anatomy, the gingival papillae are completely revived, the gingival bulge is restored, so there are no "pits" on the outer and inner sides, black triangles in the interdental area like the old-style dental implant method.
On the other hand, to be able to apply Customized Abutment, one of the four implant placement technologies needs to be applied: 3D Guide, Robot positioning X Guide, Safe Tech or Guide Line to ensure the tooth root is correctly positioned in the jawbone in all 3 dimensions in space. Proper placement of the implant will make the dental implant chew better, more stable and more durable.
In summary: The application of Customized Abutment combined with 1 of 4 implant placement technologies will give the patient a dental implant that meets all 3 ideal factors: Good and stable chewing, beautiful aesthetics both white and pink, and lifelong longevity. To learn more about dental implants, come toLac Viet Intech Dental Clinicto be examined and consulted by our experts.
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