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logo 39 • the CAMLOG Partner Magazine • November 2016 22 The effect of micro-design on the health status of soft tissue Two aspects need to be discussed when looking at the surface topography of the basal region (Fig. 4) . 1. Surface topography: Whether milled in the lab or coming from centralized manufacturing, there is always a risk that the abutments are too rough in the basal region. On the other hand, surfaces which are too smooth are contraindicated. 2. Surface cleanliness: Contamination of the surface can occur in centralized manufacturing (coolants, milling chips etc.) as well as during further processing in the lab (excess adhesive, wear from rubber polishers etc.). Pre-assembled abutments can also be contaminated. This tandem of facts makes it necessary to subject all customized CAD/CAM abutments to subsequent reprocessing. This needs to follow controlled and validated processes, as described in the following. We are of the opinion that this should not only apply to customized abutments, but to all prosthetic implant components – including pre-assembled catalog items. It is the responsibility of the treatment team to assess the biocompatibility of the materials used, both from a dental and a material point of view. We have examined different abutment surfaces and observed considerable differences in manufacturing quality. The surface quality of individual abutments is to be assessed in terms of the following aspects: plaque deposit, bacterial adhesion, potential for accumulation of peri-implant mucosa. Surface topography Optimal adhesion of the peri-implant mucosa is desirable for a successful long- term result. A decisive role is played here by the surface of the implant abutment in the transmucosal region. The goal is solid adaptation of the peri-implant mucosa. However, we also know that this region is fragile and can react sensitively to toxic or mechanical influences. Using CASE STUDY Figs. 4e to 4g: After forming, the definitive zirconium oxide CAD/CAM abutments and the ceramic crowns are inserted. The protocol described in the article for ideal surface topography and surface cleanliness was applied when fabricating the customized hybrid abutments. Figs 4a to 4d: Sequences of prosthetic implant restorations for posterior teeth with customized implant components for forming the emergence profile. For us, the forming of the emergence profile with customized gingiva formers is a necessary step in the protocol on the route to an optimal esthetic result. Case study: Dr. Rafaela Jenatschke, Frankfurt a. Main / DT Carsten Fischer, Frankfurt a. Main Case study: Dr. Rafaela Jenatschke, Frankfurt a. Main / DT Carsten Fischer, Frankfurt a. Main