from 01.01.2015 to 01.01.2025
Russian Federation
CSCSTI 76.29
This article presents a comprehensive analysis of digital workflows used in the design and production of custom abutments for dental implants. The relevance of the topic is due to the need to improve the accuracy and durability of prosthetic structures, especially in clinically complex cases and aesthetically significant zones. The aim of the study is to evaluate the advantages of customized CAD/CAM abutments compared to standard components in terms of fit accuracy, resistance to functional loads, corrosion resistance, and biocompatibility. The materials and methods included a comparative study of 30 standard and 30 custom abutments manufactured by milling from certified pre-milled blanks recommended by leading dental implant system manufacturers. Fit accuracy was assessed using scanning electron microscopy and 3D metrology, durability was evaluated through simulation of cyclic chewing loads, and corrosion resistance was studied under the influence of artificial saliva. Biocompatibility was assessed through histological analysis of soft tissues in the contact area with abutments. The results of the study showed a significant advantage of custom abutments, providing tighter marginal fit, reduced risk of microgaps and inflammatory complications, and improved overall structural stability. The conclusions highlight the advisability of the widespread introduction of customized CAD/CAM solutions into clinical practice. Practical recommendations have been developed for dentists, dental technicians, and manufacturers, taking into account the anatomical and functional characteristics of the prosthetic zone.
custom abutment, CAD/CAM, fit accuracy, microgap, peri-implantitis, corrosion resistance, biocompatibility, dental implantology, digital workflow, fatigue strength
1. Byon S.H., Seo J.H., Cho R.Y., Yi S.M., Kim L.K., Han H.S. et al. Finite element analysis of a new non-engaging abutment for three-unit fixed dental prostheses on implants // Bioengineering (Basel). – 2022. – Vol. 9, No. 10. – P. 483. – DOI:https://doi.org/10.3390/bioengineering9100483. – URL: https://www.mdpi.com/2306-5354/9/10/483
2. Hartman M.J.; Bus'ko I.I., Krivickaya M.Yu., per. Rabochiy process po razrabotke i izgotovleniyu individual'nogo prizhivlyayuschego abatmenta na osnove virtual'nogo plana lecheniya s dinamicheskoy navigaciey // Compendium. – 2021. – Vol. 42, No. 2. – P. 86. – URL: https://belodent.org/article/rabochiy-protsess (data obrascheniya: 14.05.2025).
3. Martynov D.V. Eksperimental'no-klinicheskoe issledovanie precizionnosti komponentov razbornyh dental'nyh implantatov: dis. ... kand. med. nauk. – Moskva, 2021. – 157 s. – URL: https://www.sechenov.ru/upload/iblock/a10/DISSERTATSIYA.pdf
4. Sysoeva S.S., Dimitrova Yu.V. Sravnitel'nyy analiz ispol'zovaniya standartnyh i individual'nyh abatmentov // Aktual'nye voprosy sovremennoy medicinskoy nauki i zdravoohraneniya: materialy VI mezhdunar. nauch.-prakt. konf., Ekaterinburg, 8–9 apr. 2021 g. – Ekaterinburg: UGMU, 2021. – T. 2. – S. 849–854. – URL: http://elib.usma.ru/handle/usma/5942
5. Naumovich S.A., Homich A.F., Sharanda V.A. i dr. Tehnologii zubnogo protezirovaniya na dental'nyh implantatah: ucheb.-metod. posobie. – 2-e izd., dop. – Minsk: BGMU, 2017. – 55 s. – URL: https://rep.bsmu.by/bitstream/handle/BSMU/16817/978-985-567-683-7.Image.Marked.pdf
6. Sharin A.N. Primenenie CAD/CAM individual'nyh abatmentov // Megastom. – URL: https://www.megastom.ru/patients/articles/primenenie-cad-cam-individualnykh-abatmentov.html (data obrascheniya: 14.05.2025).
7. Schoenbaum T.R. Profil' granicy abatmenta i ego vliyanie na periimplantatnye tkani // StomatologClub. – URL: https://stomatologclub.ru/stati/ortopediya-11/profil-granicy-abatmenta-i-ego-vliyanie-na-periimplantatnye-tkani-2230/ (data obrascheniya: 14.05.2025).
8. Nersesyan P.M. Integrirovannyy podhod k planirovaniyu protezirovaniya pacientov s defektami zubnyh ryadov s ispol'zovaniem abatmenta avtorskoy konstrukcii: dis. ... kand. med. nauk. – Ekaterinburg, 2022. – 148 s. – URL: https://psma.ru/index.php?option=com_mtree&task=att_download&link_id=351&cf_id=24
9. GOST ISO 14801-2008. Stomatologiya. Ispytanie na dinamicheskuyu ustalost' endoossal'nyh zubnyh implantatov. – Vved. 2009-07-01. – M.: Standartinform, 2008. – URL: https://docs.cntd.ru/document/1200063232
10. GOST ISO 13485-2017. Izdeliya medicinskie. Sistemy menedzhmenta kachestva. Trebovaniya dlya celey regulirovaniya. – M.: Standartinform, 2017. – URL: https://docs.cntd.ru/document/1200146167
11. Degidi M., Nold P. The impact of abutment misfit on peri-implantitis risk: clinical observations and laboratory data // J. Prosthodont. – 2020. – Vol. 29, No. 5. – P. 403–410. – DOI:https://doi.org/10.1111/jopr.13188. – URL: https://onlinelibrary.wiley.com/doi/10.1111/jopr.13188
