A dental implant has three parts: the implant (the screw in the bone), the crown (the visible tooth), and the abutment — the connector between them. The abutment is the part patients rarely hear about but that has outsized impact on aesthetics, soft-tissue health, and the longevity of the restoration.

What an Abutment Does

The abutment screws into the implant and emerges through the gum. The crown is then either screwed into the abutment (screw-retained) or cemented onto it (cement-retained). The abutment’s shape controls the emergence profile — how the crown rises out of the gum — which largely determines whether the final result looks natural.

Stock vs. Custom Abutments

Stock (Prefabricated) Abutments

Pre-manufactured in a limited number of sizes and angulations. Less expensive, faster to deliver, appropriate for straightforward cases where anatomy cooperates.

Custom (CAD/CAM) Abutments

Designed in software to the individual patient’s soft-tissue anatomy and tooth position, then milled from titanium or zirconia. Superior aesthetics and tissue fit, especially in visible areas. Standard at our practice for nearly every case.

Titanium vs. Zirconia Abutments

Titanium — strongest, most versatile, least expensive. Can show as a gray shadow through thin gum tissue.
Zirconia — white, tooth-colored, ideal where gum tissue is thin or highly visible. More brittle than titanium, with specific design constraints.
Hybrid — titanium base bonded to a zirconia upper portion. Strength of titanium with aesthetics of zirconia. Standard for premium anterior cases.

Why Emergence Profile Matters

The emergence profile is the shape the crown takes as it rises from the implant through the gum. An implant placed deep in the bone has to traverse 3–4 mm of soft tissue before reaching the visible crown. A poorly designed emergence profile — sharp angles, over-contoured shape — creates chronic soft-tissue inflammation, visible recession, and a crown that looks too large or the wrong shape.

Screw-Retained vs. Cement-Retained

Where possible, we use screw-retained designs. The restoration can be removed for maintenance or repair, and there is no risk of residual cement causing peri-implantitis. Cement-retained restorations remain appropriate in specific anatomical situations but carry real risks.

Request a consultation to discuss your case.

Serving Patients Across Greater Boston

The Face Dental Group welcomes patients from throughout Greater Boston:

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