Case Report: Spline Engaging Shouldered Abutment
By Philippe Russe, D.D.S.
Dr. Russe has a diploma from Implantology PARIS 7 University. He is Assistant Professor
at RHEIMS University, and Researcher at the Biomaterials and Interface Institute
EA2068 RHEIMS.
Often a patient may desire a fixed restoration due to greater stability than a removable
partial denture. In the past, if there were no abutment teeth present, very few
viable options existed. But today, with the advent of dental implants, many patients
can now receive the type of dental treatment they desire. This case report highlights
the use of the Spline Engaging Shouldered Abutment (ESA). This prosthetic
option offers the strength, accuracy, and precision of indexing the abutment to
the spline on the superior aspect of the implant for which the Spline dental
implant interface is renowned. This abutment affords a clinician the option of also
engaging the abutment for single tooth, screw-retained applications or bypassing
the engagement at the abutment/prosthesis level to splint multiple units.
Case Report
An active woman in her mid-40's presented in my office with a long-span edentulous
space in the lower right posterior quadrant. After an intra-oral exam, treatment
options were discussed. The patient rejected conventional treatment with a removable
partial denture. The patient was informed about the possibility of dental implants
and a treatment plan was formulated.
While the preferred treatment for posterior edentulousness in this office is one
implant for each missing tooth, in this case it appeared that only three implants
would be possible. To optimize the biomechanics for a four-unit bridge, it was decided
to place the implants in the second premolar, first molar, and second molar areas
with a cantilevered first premolar. The implants chosen were 3.75mm diameter Spline
titanium plasma spray (TPS)-coated screws.
After the appropriate healing period, the implants were exposed with a mid-crestal
incision using care to bisect the remaining keratinized tissues. Spline
temporary gingival healing cuffs were placed after using the bone contouring tools
to remove any bony spicules or fragments. The soft tissues were then allowed to
heal around the temporary gingival cuffs.
The "step by step" will walk you through the entire procedure.
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