Comparative Study of Dental Custom CAD-CAM Implant Abutments and Dental Implant Stock Abutments

The implementation of CAD-CAM systems in dentistry has significantly influenced the evolution of dental implantology and implant-supported prosthetics within the past three decades. Implant-supported prostheses are comfortable and aesthetic. The prosthetic abutment has also faced a rapid design evolution, from the individualization of standard stock abutments offered by various manufacturers to a modern customization process using CAD-CAM technology. This paper presents a comparative study between 20 dental custom CAD-CAM implant abutments and 20 dental implant stock abutments, based on a set of measurements performed on the digital casts obtained from 24 cases of prosthetic rehabilitation on implants. The statistical analysis (Mann-Whitney U test) revealed significant differences between these two types of abutments: the incisal margin line diameter dimensions for custom abutments were significantly improved compared to standard abutments at the cervical level (U = 343.00, z = 3.868, p < 0.0005) and the incisal/occlusal level (U = 352.00, z = 4.112, p < 0.0005), while the inclination angle of the custom abutments relative to the 0-axis was significantly smaller than that of standard abutments (U = 115.50, z = -2.286, p = 0.022). The use of custom abutments leads to an increase in the final size of the abutment, an improvement in the retention of the prosthetic work, and reduces the angulation of the abutment in relation to the implant axis, thus decreasing the risk of unscrewing or fracturing the dental screw.