Custom CAD-CAM healing abutment and impression coping milled from a poly(methyl methacrylate) block and bonded to a titanium insert

Abstract

This article describes a technique in which a custom-made computer-aided design and computer-aided manufacturing (CAD-CAM) healing abutment milled from a poly(methyl methacrylate) (PMMA) block is fabricated and bonded to a titanium metal insert. An impression is made during dental implant surgery, and the CAD-CAM custom-made healing abutment is fabricated before second-stage surgery while appropriate healing time is allowed for the dental implant to osseointegrate. The contours of the healing abutment are based on the contours of a tentatively designed definitive prosthesis. The healing tissue obtains contours that will be compatible with the contours of the definitive prosthesis. After the milling process is complete, a titanium metal insert is bonded to the healing abutment. Placement of the custom-made CAD-CAM healing abutment at second-stage surgery allows the tissue to obtain contours similar to those of the definitive prosthesis. A custom-made CAD-CAM impression coping milled from a PMMA block and with a titanium insert is used for the definitive impression after the soft tissue has healed. This technique allows guided soft tissue healing by using a custom-made CAD-CAM healing abutment and impression coping.