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Video Details
Laser Microtextured Implant Abutments: Advantages of Connective Tissue Attachment

Description:
The science of laser microtexturing of implants and abutments is discussed. Clinical uses of this technology and benefits that it affords the clinician. Increased bone and soft tissue stability are described and documented with 14 year results.

Date Added:
1/6/2014

Author(s):

Jeffrey Babushkin, DDS Jeffrey Babushkin, DDS
Dr. Babushkin is committed to ongoing professional development in order to continually expand and refine his professional, clinical and technological skills and insight. He re...
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Questions & Comments
Warren Jones - (2/14/2014 4:13 PM)

Excellent case presentation and very informative

jeffrey Babushkin - (4/30/2013 9:37 PM)

Bassam thanks for question. The margin placement on the mesostructure is 1 mm sub gingival buccaly , 1/2 mm interproximally and equigingivally palatally. That's the benefit of a custom abutment which is the only abutment that I would cement retain a restoration.

Bassam Algheryafi - (4/29/2013 2:32 PM)

Dr.Babushkin, Thanks for sharing this Great principle of enhancement CT attachment onto the abutment. In the very last case, assuming you used resin cement to bond the final crown onto the custom abutment;which is a very sensitive procedure especially over implants, how did you manage to completely isolate and etch the subgingival finish line of the custom abutment and avoid leaving excess cement behind?

Charles Schwimer - (4/27/2013 5:29 PM)

Jeffrey. I cited the Magnusson article because connective tissue is not a protective barrier for teeth (and most likely not for implants either). However junctional epithelium is a protective barrier (first line of defense) for implants and teeth. Therefore, I feel is important to realize that it can be effective up to 4-5mm. The real question of comparison is whether the connective tissue attachment to a micro surface is equal to (or superior to) the presence of circular fibers at the abutment level after the junctional epithelial breaks down. In health it shouldn't matter. Thank you for such a wonderful topic of discussion. Chuck.

jeffrey Babushkin - (4/27/2013 12:21 PM)

Henry thank you for viewing my presentation and commenting. I agree that we should minimize the connecting reconnecting as much as possible, however I have not seen that result in a negative sequelae. It may be possible in the near future to accurately receive a final abutment that is contoured precisely but one truely doesn't know how the soft tissue will respond to it. In my hands the predictability of having a contoured provisional in a "dress rehearsal" prior to fabricating my final abutment is still my personal gold standard.

jeffrey Babushkin - (4/27/2013 12:16 PM)

Charles thank you for your kind words. The research you are citing from 1983 does not compare the connective tissue attachment that can be achieved with laser micro texturing to a hemidesmosomal attachment. We do know that this long junctional epithelial attachment is tenuous at best. I believe that you should stack the deck as much as possible in your favor to achieve stability. We shall monitor this over time and report back in the near future. Thanks again.

Chris Lee - (4/27/2013 3:36 AM)

Still no consensus on appropriateness of final abutment placement immediately at first surgery (Salama, one abutment/one time), v delayed final abutment provision. What are the thoughts out there.

Einar Haugen - (4/27/2013 12:27 AM)

This was a brilliant presentation! Very good and informative pictures all the way, and many good ideas for improving the quality implant restorations. Thank you

henry salama - (4/26/2013 10:16 AM)

Excellent presentation Jeff. Well thought out and delineated. The question for clinicians is the logistics of going from the surgical phase to the restorative. When should the final abutments be placed to ensure the most coronal position of the CT attachment to the abutment, i.e. how many connections & disconnections of healing caps/impression/temporary components etc. can the biology tolerate to make use of the benefit of CT attachment? This is where I feel the concept of 'One Abutment/One Time' may be called for when possible.

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