A Professional Newsletter from Marotta Dental Studio, Inc.
Marotta Procedure System Takes the Guesswork
Out of Implant Abutment Selection

By Steven Pigliacelli, CDT
Vice President, Marotta Dental Studio

During the past two years, implant practitioners have seen a great many changes in implant abutment designs. Several new brands have been introduced to the market; and even established systems have unveiled major improvements in the design of their abutments. While these refinements have been largely beneficial, it has also created a staggering variety of abutment shapes and sizes from which practitioners may choose. All of which only makes the crucial abutment selection process more difficult.

In a very literal sense, the success of an implant case

may rest on the choice of abutment. As the critical Interface betweenmay ultimately result from using the wrong abutment. And there are other than clinical ramifications to be considered.

Since abutments are not reusable, installing the wrong size abutments can be costly. Having to replace abutments invariably wastes valuable chairside time for the surgical specialist and/or the restorative dentist, and occasionally precipitates unpleasant controversy over who should pay for the replacements. All of which only reinforces the importance of selecting the proper abutments in the first place.

At Marotta Dental Studiometropolitan New York's most experienced lab in osseointegrated implantseach implant prosthesis is produced using the Marotta

Laboratory Procedure System. This protocol, which has gained the attention and approval of some of the most respected names in osseointegration, incorporates standard implant laboratory procedures with innovative frame designs and a simpler, more precise methodology that includes an easy, effective and scientific approach to abutment selection. Our method allows the final installation of abutments to be performed by either The surgical specialist or restorative dentist. This process has proved to be accurate and effective in at least five years of clinical trials by area dentists who report that it generally eliminates two office visits, prevents costly and time consuming miscalculations and helps them set their fees more accurately. Ideally, every implant case should be carefully pre-planned by the surgical specialist, restorative dentist and the laboratory. Given a CAT.


Using a diagnostic model and our abutment
selection procedure, this situation could have been avoided.
The abutment is too high and had to be replaced.
scan, the proper measurements and an alginate impression, we can provide surgical indexes and even make abutment recommendations from diagnostic casts prior to treatment. However without the benefit of a pre-treatment consultation, accurate determination of abutment size and type can be achieved by following a simple threestep procedure.

One of the requirements of this method is the use of healing abutments after the secondstage surgery. As their name implies, they allow the soft tissue to heal so that swollen tissue doesn't factor into the measurements for determining abutment size.

STEP 1
(Performed by either surgical specialist or restorative dentist)

Take impressions with healing abutment(s) in place to be used by the lab to make diagnostic models. To determine the height of the abutment(s) needed, use either of the following 		methods: Knowing the size of the healing abutments, you can determine where the top of the fixture is simply by measuring the amount of abutment showing above the gum and subtracting it from the size of the abutment. For example if a 4mm healing abutment is used and 2mm show above the gum, you know that the top of the implant fixture is 2mm below the gum line. Or you can remove the healing abutment(s) and measure with a plastic probe from the top of the fixture to the crest of the soft tissue to determine abutment height.

STEP 2
(Performed by the laboratory)

A diagnostic model is fabricated and mounted on an articulator to evaluate buccal, lingual, mesial and distal angles; the position of the implant to ridge and/or natural teeth; and to determine the axis hole to the occlusion and other parameters. From this information, we can help you determine the proper abutment size and type (standard or angulated), a patient treatment schedule and fees. Often at this

Marotta Studio’s abutment selection procedure can be used with all
implant systems, even when different systems are used in the samepatient.
stage and particularly with partial caseswe can also produce a provisional prosthesis from the impressions, saving you and your patient an additional office visit.

STEP 3
(Performed by surgical specialist or restorative dentist)

Install abutment(s) and X-ray or radiograph to assure abutment seating is precise and tight. These are the basics of the Marotta Procedure System's abutment selection method. It can be used with every major implant system; with casted or pre-fabricated abutments; and for cases involving		 "mixed and matched" components from different implant systems. Individual cases may, of course, require variations on this procedure. We welcome you to call our laboratory for a free consultation and to discuss the details of your specific cases. For further information, a consultation, or to arrange a study club presentation on the Marotta Procedure System's abutment selection method, please contact Leonard Marotta or Steven at 866-627-6882 or 866-Marotta.