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Atlantis abutment system

Tony Beale describes a very practical implant abutment system offering ideal solutions for difficult prosthetic situations

Figure 3: Various Atlantis abutment options

Figure 1: A screw-retained Atlantis abutment, clearly showing tooth form

Common problems with implant abutments
The growth of implant dentistry in the UK may not have been as rapid as that seen in many other European countries, but it is now at last firmly established as a recognised speciality that can offer ideal restorative solutions for many patients. This is particularly so where crown, bridge and denture cases cannot be successfully restored by more conventional methods, and where some form of artificial support for the restoration is required. Dental implant systems are based on engineering principles, and by design they need to incorporate sound mechanical properties. However, not all commercially available implant systems can satisfy all the demands required of them. Most systems do offer well-designed implants made from biocompatible materials such as titanium, which generally work well and successfully osseo-integrate with the supporting bone. It is more usual for the abutments to prove more challenging, particularly when trying to achieve an acceptable aesthetic result. Ready-made, machined abutments are produced to match the many implant fixtures now available, and are supplied in various design configurations. They usually offer a choice of angulations to suit differing clinical situations, but because there is a large degree of incompatibility between individual manufacturers abutments, and different implant systems, configurations are somewhat limited. This often restricts the options open to the technician when making the final restoration. Problems can relate to final tooth shape, the position and angulation of the placed implant, the provision of adequate material thickness for the restoration, and an inability to create ideal emergence angles. In many instances when using these ready-made abutments, the technician is forced to compromise, and may have to consider the fabrication of custom-made abutments.

Figure 2: The completed crown for this same case Figure 4: The Atlantis abutment design allows for perfect contouring

internationally recognised dental implant specialist, and was further developed by Astra and Dentsply, finally arriving in the UK about three years ago. The concept of VAD is mainly based on the final required tooth shape, and the desire to reduce the degree of compromise that is often required when using readymade abutments. It utilises proven CAD/CAM principles whereby a model of the implant site is scanned and the software then designs a tooth to fit the available space. This process is extremely useful where limited space is available, or where less than ideal placement angles exist. As VAD is patient specific, it helps produce a far more predictable and acceptable aesthetic result for the final restoration. The procedure requires the practitioner to produce a suitable impression, followed by a laboratory made soft tissue model of the implant site, in the same manner as would be usual for conventional implant restorations. Scanned images are then relayed online to the Astra laboratory in Sweden, where a design proposal for the intended Atlantis abutment is produced showing its ideal shape and contour. This design proposal can be produced within one hour, and subject to acceptance by the originating laboratory, the abutments will then be milled from a solid titanium or zirconia block. There is a choice of material to suit differing aesthetic and functional requirements, with standard titanium being most popular for posterior restorations. The other material options are goldhue (titanium-nitride coated titanium) and four different zirconia shades, which are especially suited to more aesthetically sensitive cases.

Figure 5: Use of the Atlantis abutment enables considerable cost savings to be made in the alloy used for the restoration
eliminates the need to build up custom abutments in wax from scratch, and also reduces the need to keep stocked inventories of expensive ready-made machined abutments. The resulting implant restorations will be predictable, can be made without error, and can embody the ideal characteristics of correct anatomical shape and thickness. Through the use of titanium, which has been shown to have less attraction to plaque attachment, periodontal considerations can be better served through the production of tissue-kind restorations. The need to use high-cost, gold-based alloys can also be much reduced. The images shown in this article are reproduced here by kind permission of Mark Ambridge of Ambridge Ceramics, Ripon, one of the UKs leading specialist implant and ceramic laboratories.
Optident, the Ilkley-based dental supplier, is recognised as regularly bringing innovative products and services to the attention of the UK dental profession, and is now pleased to offer the opportunity for practitioners to experience the advantages that the Atlantis abutment system can bring to their restorative procedures via Labline, Optidents comprehensive specialist laboratory service. For more information, contact Optident Ltd, International Development Centre, Valley Drive, Ilkley, LS29 8AL. Call 01943 605050, email sales@optident.co.uk or visit www.optident.co.uk.

Advantages of Atlantis abutments

Atlantis abutments, which are obviously matched to Astra fixtures, are fully compatible with Nobel Biocare, Straumann, Biomet 3i and other popular fixtures. Use of the system includes a fully comprehensive takeover warranty. In the unlikely event of failure of the restoration, Astra Tech will not only replace the abutment, but will also replace the supporting fixture and the restoration should this be due to abutment failure. These abutments have many obvious advantages that will benefit the practitioner, technician and ultimately the patient. For the practitioner, it involves very little if any change from the usual routine, and for the busy commercial laboratory it can allow skilled technicians to devote time to more exacting procedures. The VAD process virtually

Atlantis abutments and VAD

Advances in technology have enabled dental professionals to overcome many of the problems associated with the production of successful functional and aesthetic restorations. The introduction of the Astra Tech Atlantis abutment system now offers practitioners and technicians further scope to overcome most, if not all, of these problems. Atlantis is a custom abutment system that utilises VAD (Virtual Abutment Design). The initial idea for the system originated 15 years ago with Dr Scott Ganz, the