Principles of preparation of prosthetic abutments

The preparation of the prosthetic abutments must meet well-defined criteria in order to allow a temporary prosthesis corrected from the occlusal-functional point of view, an interference-free maturation of the peri-implant soft tissues, and home hygiene maneuvers simply feasible for the patient both in the first days after the surgical phase, both later awaiting final restoration.

The implant technique “Functional implantology offers the operator the possibility of going to insert the fixtures where there is an adequate quantity and bone quality, without imposing constraints of parallelism and / or buccal-lingual / palatine inclination in anticipation of the subsequent prosthesization (fig 3 and 4); this important advantage in the surgical phase therefore entails that the implant abutments are not necessarily aligned according to the prosthetic requirements, and it will be precisely through the preparation that they will modify their shape and inclination so as to recreate the best possible conditions within the limits allowed by the case.

The procedure, which can be implemented immediately after the positioning of the implants and their solidarization by means of titanium bars, must take into account some elementary principles already known for the naturalization of single teeth, so as to avoid that during the functionalization period with temporary prostheses fixed these are subjected to misdirected loads during the occlusion and mastication phase, or agents according to carriers of wrongly directed forces, on pain of failure of the treatment.

Principi della preparazione dei monconi protesici
Principles of preparation of prosthetic abutments in functional implantology

Fig. 3 and 4: mandibular implant arch immediately after implant placement; in the image on the left the blue lines show the divergences of the axes of the stumps on the frontal plane, which will be reduced as much as possible with the post-surgical preparation in order to allow both the construction of the provisional prosthesis, and the functionalization of the fixtures according to vectors of forces not harmful to the osseointegration process.