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Implant restorations need to be done properly

Last night I attended a meeting of the North Suburban Branch of the Chicago Dental Society of which I am a member. The presenter was Dr. M. Nader Sharifi. He is a specialist in restorative dentistry or prosthodontics. He is a well respected lecturer, who is well recognized and has given about 400 continuing education lectures to dentists.

His topic was restoring implants. His conclusions match mine. All of us want to have the restorations we place work as well as possible for the patient, long term. When placing restorations, my usual goal is to design the restoration and everything that goes with it to last until the patient is at least 150 years old or, in other words, as long as possible. With this goal in mind, we want everything to be just right with the restoration.

His primary topic involved the 2 basic types of abutments [foundations] for implant restorations. One is the standard, or prefabricated abutment, and the other is a custom abutment which is made individually for each patient and tooth.

The standard abutment is meant to be a universal, lower cost foundation which works for many different situations. ¬†Unfortunately it usually doesn’t allow for the fit of a crown or bridge to be ideal. The contours of the resulting completed restoration can and do usually allow for more food traps in the area. The cement edges are usually difficult to completely clean which leads to gum irritation and in some cases failure of the implant.

A custom abutment [foundation] allows for the least amount of food entrapment as well as cement margins which can be cleaned well when placing crowns and bridges, and over the long term by the patient.  The result is a more comfortable and trouble free restoration for you, the patient.

I use custom abutments whenever it is better for the patient. I also discuss these options with the patient when necessary.

Dr. Dave McWhinnie

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