Do All Dental Implants Need Abutments?

Life like, dental implants mimic the natural tooth structure and function in several ways. Small and compact, these titanium posts are surgically placed into the mandible or jawbone acting as the tooth’s core more commonly referred to as the root. Only once fused with the bone can a replacement tooth then be attached.

A much debated aspect of the implant process within the dental field is whether all dental implants require abutments.

Abutments & Implants: The Connection you Need to Know

First, it would be prudent to define what dental abutments are.

Usually made out of titanium, gold or zirconia dental abutments come in multiple variations. These small connectors help hold the fake tooth which will typically be a crown, bridge or denture, in place on top of the implant.

• External Hex: The most common type of abutment and possessing a hexagonal shape on the outside that matches the implant’s hexagonal shape, these abutments are easy to attach or remove highlighting their ease of use.
• Internal Hex: In contrast, internal hex abutments have a hexagonal shape that’s hidden within the implant. These are generally less visible thanks to hexagonal shape being on the inside rather than out.
• Morse Taper: Finally, morse taper abutments fit into tapered implants as they are tapered to do so, they’re suitable for larger restorations due to their high retention strength rendering the attachment of the abutment to the implant easy and secure.

Do all dental implants require abutments?

The answer is no

Single stage implant systems for example, will have a built-in abutment that will be part of the implant itself. Reducing the number of steps required for the implant and eliminating the need for a second surgery to place the abutment, they’re designed for convenience and cost effectiveness. The abutments are not visible or removable and called a one piece.

Conversely, traditional implant systems will require the abutment to be place after the implant has fused with the bone. This two piece implant system is surgically placed in the mandible with the abutment only being place later.

This design allows for adjustment and replacements to be made if needed making the overall end result adaptable.

Abutment vs Built-In Abutment: Pros and Cons

Flexible, customizable and easily maintained, abutments are typically less expensive than built in abutments but more prone to disconnection, infection and implant failure.

Despite being slightly more expensive and limited in options, built in abutments are designed for simplicity, stability and safety, the best of abutment choice will thus depend on the situation.

Determining Abutment Need in Dental Implants

Factors that will impact dental implant abutment requirements will include implant design, location of implant as some implant systems are designed for a precise area of the mouth as well as, the patient’s own personal context.