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Advanced cosmetic and general dentistry

Height Matters. What Most Patients Don’t Know About Dental Implant Abutments and Bone Loss

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An abutment is a connector that is attached to the top of a dental implant root form. A dental crown is attached to the abutment, and it replaces the part of a natural tooth that shows above your gumline.

Implant Research Shows that Height Matters

There are various widths and heights of abutments. Each patient needs an abutment that fits the implant root and helps the implant crown fit between existing teeth without being too loose or too tight. But what about abutment height?

Diagram of dental implant phases, including 1) implant insertion in bone, 2) healing process, 3) abutment attachment, 4) crown attachment.

Dental implant phases

An Implant Abutment Study

The article “Risk Factors for Bone Loss with Dental Prosthetics,” published in the June 2019 Journal of Oral Implantology, reports findings from a study of how implant abutment height affects jawbone loss. Why are the findings significant? A dental implant root, similar to a natural tooth root, stimulates the jawbone and helps prevent shrinkage. But if an abutment is too high, it can conflict with the implant root and promote bone shrinkage. Consider the findings.

The study gathered clinical data for 57 patients who received a dental implant and prosthesis between 2014 and 2018. Panoramic x-rays were used to measure several factors:

  • Patient bone levels
  • Implant height and diameter
  • Distance between tissue anchors
  • Abutment height

Researchers also analyzed whether patient age, gender, or implant characteristics contributed to the risk of bone loss.

The Results

Researchers measured the patients’ bone levels at 6, 12, and 24 months after the abutments were placed. Abutments of 4mm in height contributed to more bone loss than abutments of 3mm or 2mm in height. Taller (4mm) abutments contribute to more bone loss for several reasons:

  • Increase stress on the gum tissue around the implant
  • Cause the attached prosthesis to rotate and cause slight implant instability
  • Increase stress on the bone while chewing

The increased stress on gum tissue and jawbone can also cause irritation, infection, and soreness.

Why were 4mm abutments used? The clinical data doesn’t reveal why doctors chose specific abutment height for each patient. But author Ömür Dereci indicates that clinicians choose abutment height according to the thickness of gum tissue around the implant abutment. The recommendation: surgically reduce the gingival thickness instead of using high abutments.

If You’re Thinking About Getting Dental Implants

If you’re thinking about having your missing teeth replaced with dental implants, you can’t select the correct abutment height to prevent jawbone loss, but you can carefully select your implant dentist. Ensure your provider has the following qualifications:

  • Extensive post-graduate training in implantology, occlusion, and bite
  • Access to 3D x-ray equipment to accurately measure bone and reveal oral cavities and other structures
  • Extensive experience in implant surgery
  • Extensive experience in restoring dental implants with crowns or an arch of denture teeth

Find at least two potential providers, schedule consultations with them, and compare your options before making a final selection.

 

Michael Szarek, DMD, a cosmetic dentist in Lowell, MA sponsors this post. His office is convenient to Dracut, Helmsford, Tewksbury, and surrounding cities.

6 Questions to Ask Yourself before Choosing Dental Implants

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If you’re reading this post, you probably know that dental implants are the most effective form of tooth replacement. That’s because they mimic natural teeth.

The components of a dental implant include:

  • Artificial root – A root form, usually made of titanium, is surgically implanted in your jawbone. It’s a simple procedure.
  • Abutment – This connector is attached to the artificial root to support a crown.
  • Dental crown – A dental crown is attached to the abutment.
Diagram of dental implant phases, including 1) implant insertion in bone, 2) healing process, 3) abutment attachment, 4) crown attachment.
Dental implant phases

Questions to Ask Yourself before Dental Implants Are Placed

1. What are the implant dentist’s qualifications?

Although many dentists offer dental implants, not all of them meet the following qualifications:

  • Post-graduate training in implantology
  • Regularly place dental implants
  • Use advanced technology, including 3-D images to ensure optimal implant placement
  • Provide natural-looking dental crowns or implant overdentures

2. What are my other options?

Dental implants are the best form of tooth replacement, but they are also the most costly. If they are not within your budget, you should be aware of the following:

  • Other options, e.g., dental bridge, partial denture, implant overdentures
  • Cost of the options
  • Longevity of your options
  • Results you can expect

3. What’s involved with getting dental implants?

Dental implants have a 98% success rate, but they require diligent oral hygiene. Ask yourself if you’re willing to do the following:

  • Brush your teeth twice daily and daily floss between them
  • Keep appointments for regular dental cleanings and checkups
  • Quit smoking or tobacco use—or avoid those habits before and after dental implant surgery to allow proper healing

4. What Are My Long-Term Goals for My Smile?

If you have multiple smile goals, dental implants can be added to the treatment plan. But timing is everything. Your dentist will let you know at what stage dental implants will be scheduled in your overall treatment. For example, if you want your teeth whitened or aligned, let you dentist know before you receive dental implants.

5. Am I Willing to Wait?

  • Surgery and healing – Receiving dental implants is a process. After the implants are placed, it takes three to four months for the implants and your jawbone to fuse and provide a solid anchor for dental crowns or dentures. Meanwhile, you will wear temporary crowns or dentures.
  • Bone grafting – If some of your teeth have been missing for an extended period, your jawbone might be shrinking. Adequate bone is needed to support dental implants. If you don’t have enough bone, grafting might be required. The grafts need to heal before dental implants are placed.

A successful outcome requires patience. Don’t expect a quick fix with dental implants.

6. Am I Willing to Consult with More than One Dentist?

Much of the success of dental implants depends on the training, skill, and experience of the dentist. We recommend that you schedule consultations with more than one dentist. Only schedule consultations with providers who have post-graduate training in implantology, years of experience in placing implants, and many patients for whom implants have been provided.

During your consultations ask each dentist about the following:

  • Advanced training and credentials
  • Years of experience
  • How many dental implant cases he or she has completed
  • Before-and-after photos of patient cases
  • Cost of the entire procedure, including surgery, bone grafting if needed, and crowns or dentures
  • How he or she ensures accurate placement (3D imaging, computer-guided placement, etc.)

Cost alone should not determine which provider you choose for dental implants. Compare all of your options and weigh them carefully.

This post is sponsored by Lowell, MA accredited cosmetic dentist Dr. Michael Szarek. Dr. Szarek’s office is convenient to the following towns:

  • Dracut, MA
  • Chelmsford, MA
  • Tewksbury, MA
  • Billerica, MA
  • Pelham, NH      
  • Westford, MA
  • Methuen, MA
  • Andover, MA
  • Lawrence, MA
  • Wilmington, MA            
  • Bedford, MA
  • North Andover, MA
  • Burlington, MA
  • Hudson, NH
  • Windham, NH