IMPLANT AND A DENTAL PROSTHESIS

FIELD OF THE APPLICATION

[ 0001 ] The present application relates to custom abutments for dental implants.

BACKGROUND

[ 0002 ] It is well known that dentition may become compromised, for example over time due to poor hygiene or suddenly as a result of trauma. In view of such conditions, dental prostheses may figure among treatment options indicated for the restoration of characteristics typical of healthy teeth. Some such treatment options involve using one or more dental implants to fixedly attach a dental prosthesis to a maxillo facial bony structure of a subject to assist in restoring masticatory function. However, components interfacing the dental prosthesis to the dental implant may in some cases encroach surrounding gingival tissue, which is known to undesirably affect the treatment outcome. Clinical management of inflammatory response of the surrounding gingival tissue may in some cases be needed, and may involve surgical intervention in handling the transgingival prosthetic components or in reworking the prosthesis to alleviate tissue encroachment. Improvements are therefore desirable.

SUMMARY

[ 0003 ] In accordance with a first embodiment, there is provided a custom abutment for coupling a dental implant to a dental prosthesis, the custom abutment comprising an implant- side end configured to be fastenable to the dental implant, a prosthesis-side end disposed opposite the implant-side end about a prosthesis-coupling axis, a custom contour disposed between the implant-side end and the prosthesis-side end and having a shape being a negative of the gingival recess specific to a patient, and an abutment socket extending inwardly from the prosthesis-side end along the prosthesis-coupling axis and configured to be fastenable to a retention device complementary to the dental prosthesis to fasten the custom abutment to the dental prosthesis via the retention device.

[0004] In accordance with second embodiment, there is provided an abutment system for coupling a dental prosthesis to a dental implant and to a gingival profile surrounding the dental implant, the abutment system comprising: an abutment body having an implant-side end fastenable to the dental implant, a custom contour spaced away from the implant-side end, the custom contour having a shape complementary to that of the gingival profile, a prosthesis-side end opposite the implant-side end and spaced away from the custom contour, and an abutment socket extending inward the prosthesis-side end and structured to receive a retention device to fasten the abutment body thereto; the abutment body being attachable to the dental prosthesis via the retention device upon being fastened thereto and the implant-side end being fastened to the dental implant.

[0005] Further in accordance with the second embodiment, for instance, a retention device has a retention root receivable by the abutment socket to fasten the retention device to the abutment body, and a retention implement disposed opposite the retention root and structured complementarily to a housing of the dental prosthesis so as to be receivable thereby to attach the retention device to the dental prosthesis.

[0006] Still further in accordance with the second embodiment, for instance, at least one alternate device has an alternate root structured complementarily to the abutment socket so as to be receivable thereby absent the retention device to fasten the at least one alternate device to the abutment body, and an alternate implement disposed opposite the alternate root, the alternate implement having an outer shape distinct from that of the retention implement. [0007] Still further in accordance with the second embodiment, for instance, the at least one alternate device is an alternate retention device, the alternate implement being structured complementarily to an alternate housing of the dental prosthesis so as to be receivable thereby to fasten the alternate retention device to the dental prosthesis.

[0008] Still further in accordance with the second embodiment, for instance, the abutment body has an annular platform surrounding the abutment socket, the annular platform defining the prosthesis-side end; and the at least one alternate device has an annular base disposed between the alternate root and the alternate implement, the annular base laying onto the annular platform upon the at least one alternate device being fastened to the abutment body.

[0009] Still further in accordance with the second embodiment, for instance, the abutment body defines an abutment channel along the implant-coupling axis in communication between inside the abutment socket and outside the implant-side end, the abutment channel arranged to receive an implant fastener via the abutment socket such that the abutment body is engageable with the implant fastener received thereby to fasten the abutment body to the dental implant.

[0010] Still further in accordance with the second embodiment, for instance, the at least one alternate device is an installation tool including a shank disposed on the alternate base opposite the alternate root and a grip connected to the shank and spaced from the alternate base, the installation tool defining a passage extending inward of a peripheral wall of the shank and throughout the alternate root via the alternate base, the passage arranged to communicate with the abutment socket upon the installation tool being fastened to the abutment body and to receive the implant fastener at an angle relative to the implant-coupling axis. [0011] Still further in accordance with the second embodiment, for instance, the abutment socket extends along a prosthesis-coupling axis, the coupling device disposed about the prosthesis-coupling axis upon being fastened to the abutment body.

[0012] Still further in accordance with the second embodiment, for instance, the prosthesis-coupling axis extends at an angle relative to the implant-coupling axis, the prosthesis-coupling axis and the implant-coupling axis laying coplanar in an orientation plane, the first body portion having an anti-rotational feature aligned with the orientation plane.

[0013] Still further in accordance with the second embodiment, for instance, the abutment body has an abutment platform surrounding the abutment socket about the prosthesis coupling axis, the abutment platform defining the prosthesis- side end of the abutment body.

[0014] Still further in accordance with the second embodiment, for instance, the coupling base defines a flange having an outer edge contiguous with that of the abutment platform.

[0015] Still further in accordance with the second embodiment, for instance, the third body portion constricts as it extends away from the custom contour toward the abutment platform.

[0016] In accordance with a third embodiment, there is provided a dental abutment system comprising : a set of abutment attachments including at least one coupling device and an impression transfer device; an abutment body extending between an implant-side end opposite a prosthesis-side end, the abutment body having an implant-specific body portion extending away from the implant-side end, a custom body portion extending between the implant-specific body portion and the prosthesis-side end, the abutment body defining an abutment socket extending inside the custom body portion inward from the prosthesis-side end, the abutment socket structured such that any one abutment attachment of the set is interchangeably fastenable to the abutment body via the abutment socket; and an analog device extending between a model-side end opposite a prosthesis-side end, the analog device defining an analog socket extending inside thereof inward from the prosthesis-side end, the analog socket structured such that the any one abutment attachment is interchangeably fastenable to the analog device via the analog socket.

[0017] Further in accordance with the third embodiment, for instance, the abutment body has an abutment platform surrounding the abutment socket, the abutment platform defining the prosthesis-side end of the abutment body; and the any one abutment attachment of the set has a root structured complementarily to the abutment socket so as to be receivable thereby to fasten the any one abutment attachment to the abutment body, a base disposed on the root and arranged to lay onto the abutment platform upon fastening the any one abutment attachment to the abutment body, and an implement projecting from the base opposite the root.

[0018] Still further in accordance with the third embodiment, for instance, the base of the at least one coupling device is arranged to seal the abutment socket upon the at least one coupling device being fastened, the implement of the at least one coupling device structured complementarily to a housing of the dental prosthesis so as to be receivable thereby to fasten the at least one coupling device to the dental prosthesis.

[0019] Still further in accordance with the third embodiment, for instance, the set of abutment attachments includes a scanning device having a 3D datum feature indicative of a position of the abutment body upon the scanning device being fastened to the abutment body. [0020] Still further in accordance with the third embodiment, for instance, the set of abutment attachments includes a healing cap, the base of the healing cap arranged so as to seal the abutment socket upon the healing cap being fastened, the implement of the healing cap shaped so as to fill out a desired space adjacent the base opposite the root.

[0021] Still further in accordance with the third embodiment, for instance, the healing cap has a 3D datum feature indicative of a position of the abutment body upon the healing cap being fastened to the abutment body.

[0022] In accordance with a fourth embodiment, there is provided a dental abutment system comprising : a set of abutment attachments including an installation tool and at least one coupling device fastenable to a dental prosthesis; and an abutment body extending between an implant-side end opposite a prosthesis-side end, the abutment body having an implant- specific body portion extending away from the implant-side end, a custom body portion extending between the implant-specific body portion and the prosthesis-side end, the abutment body defining an abutment socket extending inside the custom body portion inward from the prosthesis-side end, the abutment socket structured such that any one abutment attachment of the set of abutment attachments is interchangeably fastenable to the abutment body via the abutment socket; at least one abutment attachment of the set having a 3D datum feature indicative of a position of the abutment body upon the at least one abutment attachment being fastened to the abutment body.

[0023] Further in accordance with the fourth embodiment, for instance, the set of abutment attachments includes a healing cap structured so as to seal the abutment socket upon the healing cap being fastened to the abutment body, the healing cap having the 3D datum feature. [0024] Still further in accordance with the fourth embodiment, for instance, the installation tool includes: a first portion having a root receivable by the abutment socket to fasten the installation tool to the abutment body and a hollow base adjacent the root; a second portion detachable from the first portion, the second portion having a shank extending from the base opposite the root; and a healing cap portion attachable to the first portion upon the second portion being detached, the healing cap portion being arranged to seal the base, the installation tool defining a passage extending inward of a peripheral wall of the shank and throughout the root via the base, the passage arranged to communicate with the abutment socket upon the installation tool being fastened to the abutment body and sized to allow insertion of an implant fastener therethrough toward the abutment socket.

[0025] In accordance with the fifth embodiment, there is provided a method of making a dental prosthesis, the method comprising: obtaining an abutment-level model indicative of a dental arch shape, a custom dental abutment shape and a desired prosthesis shape; selecting a coupling device based on the abutment-level model; and defining a shape of the dental prosthesis based on the abutment-level model and the selected coupling device.

[0026] Further in accordance with the fifth embodiment, for instance, an abutment socket may be positioned relative to at least one of the dental arch shape and the desired prosthesis shape so as to define the custom dental abutment shape.

[0027] Still further in accordance with the fifth embodiment, for instance, an implant-level model may be obtained to be indicative of the dental arch shape, a dental implant shape and the desired prosthesis shape; and the custom dental abutment shape may be defined based on at least one of the dental arch shape, the dental implant shape and the desired prosthesis shape. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] Fig. 1 is an assembly view of a custom abutment according to embodiments of the present technology, the custom abutment shown relative to a dental implant, a retention device and a prosthesis;

[0029] Fig. 2 is a perspective view of the custom abutment and the retention device of Fig. 1, shown relative to an implant fastener;

[0030] Fig. 3 is a schematic cross-section view of the custom abutment of Fig. 1, shown fastened to the dental implant via the implant fastener of Fig 2;

[0031] Fig. 4 is a set of attachment devices of an abutment system according to embodiments of the present technology;

[0032] Fig. 5 is an elevation view of an abutment installation tool and of an implant fastener driver of the abutment system according to embodiments of the present technology;

[0033] Fig. 6 is an assembly view of the custom abutment of Fig. 1, of the implant fastener of Fig. 3, and of the abutment installation tool and the implant abutment driver of Fig. 5;

[0034] Fig. 7 is an elevation view of an impression transfer device, of an attachment installation tool and of an abutment replica of the abutment system according to embodiments of the present technology;

[0035] Fig. 8 is a schematic assembly view of the custom abutment of Fig. 1 and of the impression transfer device of Fig. 7, the custom abutment shown joined to the dental implant;

[0036] Fig. 9 is a schematic view of the assembly of Fig. 8 embedded in impression material; [0037] Fig. 10 is a schematic view of a second portion of the impression transfer device of Fig. 7 embedded in the impression material and detached from a first portion of the impression transfer device;

[0038] Fig. 11 is a schematic assembly view of the impression transfer device and the abutment replica of Fig. 7, the first portion of the impression transfer device shown joined to the abutment replica and the second portion of the impression transfer device shown embedded in the impression material;

[0039] Fig. 12 is a schematic assembly view of the abutment replica of Fig. 7 and of a retention device of the set of attachment devices of Fig. 4, the abutment replica shown embedded in a cast and coupled to the dental prosthesis via the retention device.

[0040] Fig. 13 is a schematic assembly view of an abutment installation device of the abutment system according to embodiments of the present technology; and

[0041] Fig. 14 is schematic assembly view of a first portion of the abutment installation device of Fig. 13 shown detached from a second portion thereof and with a healing cap of the abutment system according to embodiments of the present technology being secured thereto.

DESCRIPTION OF THE EXEMPLARY EMBODIMENTS

[0042] In the forthcoming description, terminology based on anatomical landmarks of a natural tooth may be used to describe positions and directions with respect to structures in context of an oral cavity. For example, "apically" and "coronally" may be used to refer to opposite directions with respect to a tooth, i.e., respectively toward an apex of a root of the tooth and toward a crown of the tooth. Further, "mesially" and "distally" may be used to refer to opposite directions with respect to the crown, i.e., respectively toward a midline separating left and right sides of a dental arch having the tooth and toward a rear of the dental arch. Furthermore, "buccally" and "orally" may be used to refer to opposite directions with respect to the crown, i.e., respectively outward of the oral cavity toward the lips or the mouth and inward of the oral cavity toward the tongue or the palate. The foregoing terminology may also be used with reference to a dental implant instead of the root and with reference to a dental prosthesis instead of the crown.

[ 0043 ] According to the present technology and with reference to the Figures, there is provided a custom abutment 10 for coupling a dental prosthesis 2 to a dental implant 4 by passing through a gingival recess 6 coronal to the implant 4. The custom abutment 10 may be used in conjunction with the prosthesis 2 and the implant 4 in context of a dental treatment devised to restore masticatory function to a subject ailed with compromised dentition or even an edentulous dental arch. Indeed, securing the implant 4 to a bone of a dental arch and securing the prosthesis 2 to the implant 4 may desirably assist in transmitting masticatory loads from the prosthesis 2 to the bone via the implant 4. The prosthesis 2 may thus be constructed so as to withstand such loads and may be shaped complementarily to an opposite dentition (in this case being a dentition of a mandibular arch) so as to allow adequate occlusion dynamics as the arches oppose one another during mastication. The opposite dentition may consist in another dental prosthesis or may include one or more natural teeth.

[ 0044 ] As the arches are lined by a mucosal membrane, such as a gingiva overlaying the bone in which the implant 4 is embedded, securing the prosthesis 2 to the implant 4 may require a transgingival interface. Indeed, the implant 4 may be placed subgingivally (i.e., beneath an outer surface 6a of the gingiva) and the prosthesis 2 may be placed supragingivally. The recess 6 and the prosthesis 2 may thus be said to be successively disposed coronally with respect to the implant 4. In some cases, the implant 4 may be placed subcrestally (i.e., beneath an outer surface 6b of the bone beneath the gingiva). The transgingival interface may preferably be configured to fit with respect to the gingiva akin to how a cervical portion of a healthy tooth espouses a healthy gingival sulcus, i.e., a portion of the gingiva recessed inward its outer surface 6a and following a periphery of the tooth toward its junction with the underlying bone. The recess 6 may for instance represent the gingival sulcus being generally unaltered upon extracting the tooth from the bone and securing the implant 4 to the bone via the gingival sulcus. The recess 6 may otherwise be formed by gingiva having been compromised, at least in part, and having then healed around a healing abutment (not shown) secured to the implant 4 and extending coronally and transgingivally therefrom. Although the recess 6 typically constricts as it extends from the outer surface 6a of the gingiva toward the implant 4, it will be understood that the recess 6 may have a shape that is uniquely characterized, and generally specific to a sole recess 6 of a sole subject. As will be described hereinbelow, the custom abutment 10 is configurable to espouse the recess 6 upon being coupled to the implant 4 and the prosthesis 2.

[0045] Referring to Fig. 1, the custom abutment 10 may for example be configured based on a dataset pertaining to intraoral structures of the subject such as the bone and the gingiva of the arch, the prosthesis 2, the implant 4, the recess 6 and the opposite arch. The dataset may include a 3D map 8 (a.k.a., a 3D model) indicative of geometries of the intraoral structures as well as their positions one with respect to the other. The 3D map 8 may also be indicative of volumetric properties of the intraoral structures such as their respective densities, porosities, hardness, etc. Imaging techniques may be used to produce the 3D map 8, at least in part. Among possibilities, the 3D map 8 may include surfacic data that may be obtainable intraorally via exposure of the intraoral structures to a field of view of an optical imaging scanning device (i.e., an intraoral scanner). The surfacic data may be obtained so as to include one or more of a variety of surfaces exposed inside the oral cavity, such as the outer surface of the gingiva 6, the recesses 6, teeth and prostheses emerging coronally from the arch and mucosa membranes lining the oral cavity buccal to and lingual to the arch. Among the possibilities, the 3D map 8 may include volumetric data that may be obtainable extraorally via exposure of the intraoral structures to a field of view of a cone beam computed tomography (i.e., CBCT) scanner, a computed tomography (i.e., CT) scanner or a magnetic resonance imaging

(MRI) scanner. The volumetric data may be selectively obtained so as to include (or exclude, as the case may be), select intraoral structures based on their respective volumetric properties, for example based on their radiodensity in the case of data obtained via CT scanners. The radiodensity may be quantified in Houndsfield units (HU), and the volumetric data may thus be parsed, or segmented, based on HU ranges typical to some such structures, such as cortical bone. Some such structures having a substantially lesser radiodensity in comparison to cortical bone, such as resorbing bone typical of edentulous arches or such as the gingiva, may be rendered efficiently via other imaging modalities, such as MRI.

[0046] Alternatively, as possibilities among others, direct impression techniques may be used to make a physical copy of some such intraoral structures by applying an impression material thereto so as to make a mold thereof. Such mold may then be scanned extraorally to produce the 3D map 8, or used to cast a physical model that may be in turn scanned to produce the 3D map 8. Some of the above techniques may be used in conjunction so as to produce a compound 3D map 8 that may include as an example a 3D volume of the bone obtained via CBCT scanning, a 3D surface of the arch including the recess 6 obtained via intraoral scanning and aligned to the bone, and a 3D model of the implant 4 aligned with the recess 6. The 3D map 8 may include 3D landmark indicative of a position of other structures, such as the prosthesis 2 and the implant 4. As such, 3D models of the prosthesis 2 and the implant 4, being one or more of volumetric, surfacic and wireframe), may be aligned to the 3D map 8 based on the 3D landmark. The prosthesis 2 and the implant 4 may, in some cases, be included in datasets obtained via one of the above-mentioned techniques.

[0047] Still referring to Fig. 1, a first portion 8a of the 3D map 8 may represent an outer gingival surface of an edentulous maxillary arch of the subject including the recess 6. In this case, the 3D map 8 represents a plurality of recesses 6 and a plurality of implants 4 consistent with those of the subject. A second portion 8b of the 3D map 8 may represent a plurality of surfaces including one or more of buccal, occlusal, oral, mesial and distal surfaces of the prosthesis 2 depending on whether the prosthesis 2 replaces one or more teeth. The plurality of surfaces forms an occlusal side of the prosthesis 2 generally opposite to an intaglio side of the prosthesis 2. The second portion 8b may for example represent an existing prosthesis (i.e., a prosthesis worn by the subject prior to the onset of the dental treatment), or be indicative of a prosthetic plan (i.e., a prosthesis shape determined during the planning stage of the dental treatment, also known as a prosthetic setup or waxup). In this case, the second portion 8b represents a prosthetic plan indicative of the prosthesis 2 being intended to replace the entire dentition of the arch, i.e., a full-arch prosthesis. The 3D map 8 also includes a plurality of custom abutments 10 respectively coupled to one of the plurality of dental implants 4.

[0048] Under certain circumstances, the production of the 3D map 8 may benefit from handling of subgingival or transgingival structures and may thus involve surgical intervention. For example, it may be desirable to secure a component (such as a scan body or an impression transfer) to the implant 4 such that it extends coronally therefrom and transgingivally to outside the recess 6. As the component may have a geometry indicative of a position and an orientation of the implant 4 secured thereto, a portion of the 3D map 8 representing the component may thus be representative of its corresponding implant 4. On the other hand, the presence of a component inward of the recess 6 may undesirably hinder application of impression material onto the gingiva and inward the recess 6, or may hinder exposure of the recess 6 to the intraoral scanning device. Removal of the component may thus be desirable in order to integrally represent the recess 6 in the 3D map 8.

[0049] Further, securing the prosthesis 2 to implants 4 placed subgingivally via a conventional abutment may involve several additional surgical interventions. For example, under certain circumstances, the conventional abutment may undesirably exert pressure on the gingiva inward of the recess 6 upon being secured to the implant 4, resulting in inflammation. This may cause for example additional treatment, such as surgical removal of the conventional abutment for the gingiva to heal. Also, securing the prosthesis 2 to such conventional abutment may cause discomfort to the subject, render the prosthesis 2 undesirably difficult to remove or to clean. In some such cases, it may be desirable to surgically replace the conventional abutment, for instance with another conventional abutment in an attempt to solve such problems. As will become apparent from the forthcoming, the present technology can desirably assist in securing the prosthesis 2 to the implant 4 without exerting undesirable pressure inward the recess 6. Moreover, the present technology can desirably assist in adjusting coupling characteristics of the prosthesis 2 such as the force required to remove it from the implant 4 and its spacing relative to the outer surface 6a of the gingiva, without surgical intervention.

[0050] For brevity, the forthcoming description will focus on a sole custom abutment 10. However, it should be noted that the description applies, mutatis mutandis , to the other custom abutments 10. Also, description of like elements having like reference numerals may not be repeated. Hence, the custom abutment 10 will now be described in detail, and first with reference to Figs. 1 to 3.

[ 0051 ] The custom abutment 10 has an implant-side end 12 disposed about an implant-coupling axis 12a. The implant-side end 12 is configured to be fastenable to the implant 4. Upon fastening the implant-side end 12 to the implant 4, the implant coupling axis 12a may be collinear with a longitudinal implant axis 4a about which the implant 4 is disposed, though the collinearity may not always be present. The custom abutment 10 also has a prosthesis-side end 14 disposed opposite to the implant-side end 12 about a prosthesis-coupling axis 14a. The prosthesis-coupling axis 14a may be collinear with the implant coupling axis 12a. The prosthesis-coupling axis 14a may otherwise be at a correction angle relative to the implant coupling axis 12a, and may or may not intersect one another. The correction angle may for example be within a range of 0 to 35 degrees. The custom abutment 10 may be orientable about the implant axis 4a such that upon fastening the implant-side end 12 to the implant 4, the prosthesis-coupling axis 14a being at the correction angle may be collinear with an axis normal to an occlusal plane (not shown) of the subject. The implant-side end 12 may have an anti-rotational feature 12b complementary to a shape of the implant 4 such that rotation of the custom abutment 10 about the implant axis 4b may be hindered upon orienting and fastening the custom abutment 10 with respect to the implant 4. The custom abutment 10 also has a custom contour 16 disposed between the implant-side and prosthesis-side ends 12, 14. The custom contour 16 has a shape complementary to that of the recess 6. Upon fastening the custom abutment 10 to the implant 4, the custom contour may espouse the recess 6, for example at a junction between the recess 6 and the outer surface 6a of the gingiva. Stated differently, the custom contour 16 has a 3D shape that may be a negative of the 3D shape of the surrounding recess 6. As the recess 6 is specific to the subject, the custom contour 16 may be said to be customized to the subject, i.e., unique. The 3D shape of the custom contour 16 may therefore be based on the 3D map 8, the impression, or the like to be contoured as a negative of the recess 6. The custom contour 16 may include a coronal-most edge that emulates or espouses a margin of the outer surface 6a, i.e., the surrounding periphery of the outer surface 6a of the gingiva.

[ 0052 ] Also, the custom abutment 10 has an abutment socket 18 extending inwardly from the prosthesis-side end 14 along the prosthesis-coupling axis 14a. The abutment socket 18 is configured to be fastenable to any one of a plurality of attachment devices 20, for example a retention device 20 fastened to the abutment socket 18 so as to be disposed along the prosthesis-coupling axis 14a. As best seen in Fig. 2, the retention device 20 has a root 22 having a shape complementary to that of the abutment socket 18 so as to be receivable thereby. As one possible embodiment, the abutment socket 18 and the root 22 have complementary threads. The retention device 20 may have a base 24 defining an annular flange disposed on or above the root 22. Moreover, the retention device has an implement 26 disposed opposite to the root 22. The implement 26 has a shape complementary to that of a housing 2b (Fig. 12) of the prosthesis 2 so as to be fastenable to the housing 2b. The custom abutment 10 may thus be fastened to the prosthesis 2 via the retention device 20 upon being fastened thereto. The base 24 may act as a stop to delimit the penetration of the retention device 20 in the custom abutment 10. As another possibility, the retention device 20 may have its root 22 come into contact with the bottom of the abutment socket 18 to delimit the depth of insertion.

[ 0053 ] As seen in Fig. 3, the custom abutment 10 may define a first peripheral surface 10a extending between the custom contour 16 and the prosthesis-side end 14. The first peripheral surface 10a may constrict or taper toward the prosthesis coupling axis 14a as it extends away from the custom contour 16. Upon inspection of the custom abutment 10 from a generally coronal perspective along the prosthesis-coupling axis 14a, the first peripheral surface 10a may be said to be located inward of the custom contour 16, and the prosthesis-side end 14 may be said to be located inward of the first peripheral surface 10a. The custom abutment 10 may also define a second peripheral surface 10b extending from the custom contour 16 opposite the first peripheral surface 10a. The second peripheral surface 10b may constrict toward the implant-coupling axis 12a as it extends away from the custom contour 16. In an embodiment, the second peripheral surface 10b is part of the custom contour 16. The second peripheral surface 10b may have a shape complementary to that of the recess 6 such that upon the custom abutment 10 being fastened to the implant 4, the second peripheral surface 10b espouses the recess 6. Upon inspection of the custom abutment 10 from a generally apical perspective along the implant-coupling axis 12a, the second peripheral surface 10b may be said to be located inward of the custom contour 16, and the implant-side end 12 may be said to be located inward of the second peripheral surface 10b. Further, the custom contour 16 may overhang an apical contour of the custom abutment 10 circumscribing the implant-side end 12 with respect to the implant-coupling axis 12a. The apical contour may generally correspond to a coronal contour of the implant 4 circumscribing a coronal end of the implant 4. Thus, upon fastening the custom abutment 10 to the implant 4, the second peripheral surface 10b may represent a generally continuous emergence profile diverging relative to the implant-coupling axis 12a as it extends from the coronal end of the implant 4 to the custom contour 16 of the custom abutment 10. It shall be noted that this emergence arrangement may desirable for transgingival probing of the recess 6. For example, a stem-like probe may follow the custom contour 16 around the implant-coupling axis 12a unhindered. Also, the second peripheral surface 10b may be probed from the custom contour 16 to the implant 4 substantially unhindered. The custom abutment 10 may also have a third peripheral surface 10c disposed apically relative to the second peripheral surface 10b about the implant-coupling axis 12a. The third peripheral surface 10c may be part of the implant-side end 12 and be configured to penetrate the implant 4 via its coronal end upon the implant-side end 12 being fastened thereto. This male- female arrangement is a possibility among others.

[0054] Still referring to Fig. 3, the abutment socket 18 may extend to a bottom 18a spaced from the prosthesis-side end 14 along the prosthesis-coupling axis 14a. The bottom 18a may be disposed coronally relative to the custom contour 16. An implant fastener channel 18b may extend along the implant-coupling axis 12a inwardly from the bottom 18a of the abutment socket 18 to outward the implant-side end 12. The channel 18b may be sized to receive the fastener 4b such that upon a shank of the fastener 4b extending apically of the implant-side end 12 and being threadedly engaged with the implant 4, a head of the fastener 4b may engage a portion 18c of the custom abutment 10 inward to the channel 18b to hinder movement of the custom abutment 10 relative to the implant 4. As shown, a countersink arrangement is shown, but a counterbore arrangement is an alternative among others.

[0055] Turning now to Fig. 4, the plurality of attachment devices 20 may include a plurality of retention devices 20a, 20b, 20c, 20d having different shapes and being respectively retainable by a corresponding one of a plurality of housings 2b in the prostheses via one of several retention types. The retention types may include cementing (20a), fastening (20b) or interlocking, i.e., "snap fit" (20c, 20d). The plurality of attachment features 20 may also include a healing device 20e and a scanning device 20f. The healing device 20e may be arranged to seal the abutment socket 18 upon its root 22e being fastened to the abutment socket 18. The scanning device 20f may feature a 3D landmark 28 arranged so as to be indicative of an orientation of the custom abutment 10 upon its root 22f being fastened to the abutment socket 18.

[0056] With reference to Fig. 5, an abutment installation tool 30 being one of the plurality of attachment devices 20 is shown with an implant fastener driver 40. The implant fastener driver 40 has a working portion 42 adapted to drive the fastener 4b upon engaging the fastener 4b at a drive angle b. The drive angle b may generally correspond to the correction angle a, or may vary from the correction angle by a range of about 5 degrees. For instance, the implant fastener driver 40 may be of a ball-end type. The working portion 42 may have a generally spherical shape having an arrangement of bevels complementary to a shape of the fastener 4b. The working portion 42 may have any other geometry complementary to that of the fastener 4b allowing the working portion 42 to drive the fastener 4b at the drive angle b. This drive arrangement is akin to a universal joint that is formed as the working portion 42 interfaces the fastener 4b. The working portion 42 may be inclined relative to the fastener 4b as the working portion 42 exerts a torque to the fastener 4b to induce rotary motion thereto. The working portion 42 may be arranged to exert a rated torque to fasten the custom abutment 10 to the implant 4 via the fastener 4b at the drive angle b relative to the implant-coupling axis 12a. The rated torque may be for example be between 10 N-cm and 30 N-cm. Further, the working portion 42 may be arranged to retain the fastener 42, for example to displace the fastener 4b to or from the abutment socket 18 of the custom abutment 10. Also, the implant fastener driver 40 may be adapted to be securable to a handling attachment such as a thumb driver, a torque wrench or a motorized hand piece via which the working portion 42 may be driven. The implant fastener driver 40 has a holding portion 46 spaced away from the working portion 42, and may be securable to the holding attachment via the holding portion 46. The holding portion 46 may feature a retentive shape arranged to be releasably retainable by a latch type mechanism of the holding attachment. The working portion 42 may be spaced from the holding portion 46 by a shank 44 shaped so as to facilitate penetration of the working portion 42 into narrow spaces. Moreover, the abutment installation tool 30 has a root 32 arranged to be fastenable to the abutment socket 18 so as to place the abutment installation tool 30 in an attached position with respect to the custom abutment 10. In the attached position, the abutment installation tool 30 may be disposed along the prosthesis-coupling axis 14a and be held at a certain depth inward of the abutment socket 18. For example, the abutment installation tool 30 may have a base disposed on the root 32 and forming an annular flange laying against the prosthesis-side end 14 in the attached position. Among alternatives, the root 32 may otherwise be arranged to engage the bottom 18a of the abutment socket 18 in the attached position .

[ 0057 ] The abutment installation tool 30 has a holding portion 36 spaced away from the root 32, and may be securable to the holding attachment via the holding portion 36. The holding portion 36 may feature a retentive shape arranged to be releasably retainable by the latch type mechanism of the holding attachment. The abutment installation tool 30 defines a passage 38 extending inwardly through a bottom surface of the root 32 to a peripheral surface of the abutment installation tool 30 spaced away from the root 32. The passage 38 may have a corner-like shape. The abutment installation tool 40 is adapted such that upon its root being fastened to the abutment socket 38, the passage 38 is in communication with the abutment channel 18b and sized such that the fastener 4b may pass through the passage 38 to be received inside the abutment channel 18b. The passage 38 may be sized relative to the abutment socket 18, the abutment channel 18b and the shank 44 of the implant fastener driver 40 such that the working portion 42 being received inward the abutment channel 18 via the passage 38, the implant fastener driver 40 may be positioned at the drive angle b with respect to the prosthesis-coupling axis 14a. Also, the abutment installation tool 30 may be adapted to be connected to the thumb driver, the torque wrench or to the hand piece via the shank 36.

[0058] In Fig. 7, an impression transfer device 50 including one of the plurality of attachment devices 20 is shown with an attachment driver 60 and an abutment replica 70. The impression transfer device 80 has a root 52, a base 54 disposed on the root 52 and a shank 56 extending from the base 54 opposite the root 52. The impression transfer device 50 has a first portion 50a, which may be one of the retention devices 20 of Fig. 4, and a second portion 50b detachable from the first portion 50a. The first portion 50a has the root 52 and the base 84, and also has a head 56 sized to be received by a cavity of the second portion 50b. The second portion 50b may have a channel 50c in communication with the cavity and arranged to receive a transfer fastener (not shown) to fasten the second portion 50b to the head 56 of the first portion 50a. Also, the second portion 50b may have a retentive shape 58. As non-limiting examples, the retentive shape 58 may be a discontinuity defined in a peripheral surface of the second portion 50b, such as a groove concentric with the peripheral surface or a protrusion projecting from the peripheral surface, in which impression material may be entrapped or wrapped around, as the case may be. For instance, the impression transfer device 50 may be arranged such that upon the first portion 50a being secured to the custom abutment 10 via the root 52 and impression material 6c being molded therearound, the second portion 50b being secured to impression material 6c via the retentive shape 58, the second portion 50b may be detached from the first portion 50a to be removed from the custom abutment 10 with the impression material 6c. The attachment driver 60 has a first end 62 configured to be securable to a retention device 20a, 20b, 20c, 20d, to the healing device 20e, or to the scanning device 20f via their respective implement 26a, 26b, 26c, 26d, 26e, 26f such that they may be driven by the attachment driver 60 to be fastened to the custom abutment 10. The attachment driver 60 may have a second end 64 opposite the first end 62, and may be adapted to be connected to the thumb driver, the torque wrench or the hand piece via the second end 64.

[0059] The abutment replica 70 has a first end 72 and a second end 74 opposite the first end 72. The abutment replica 70 may have a retentive shape 76 disposed between the first and second ends 72, 74. A replica socket 78 extends inwardly of the prosthesis-side end 14. The replica socket 78 is arranged to generally correspond to the abutment socket 18 so as to be fastenable to any one of the plurality of attachment devices 20. The second end 74 may have a shape corresponding to the prosthesis-side end 14 of the custom abutment 10.

[0060] With reference to Figs. 8 to 12, the impression transfer device 50 and the abutment replica 70 are shown in use. In Fig. 8, the first portion 50a of the impression transfer device is fastened to the custom abutment 10. The second portion 50b is attached to the first portion 50a, its retentive shape 58 being embedded in the impression material 6c. In Fig. 9, the transfer fastener is removed from the second portion 50b such that the second portion 50b is removable from the first portion 50a unhindered and together with the impression material 6c. In Fig. 10, the second portion 50b is shown removed with the impression material 6c. The impression material 6c may include a surface 6d complementary to the outer surface of the gingiva 6a and a surface 6e complementary to the first abutment portion 10a. In Fig. 11, the first portion 50a of the impression transfer device 50 is fastened to the second portion 50b via the transfer fastener and to the replica socket 78 via the root 52, such that the abutment replica 70 is secured with respect to the impression material 6c. A casting material may be applied onto the impression material 6c so as to surround the abutment replica 70 to create a cast 7 embedded with the abutment replica 70. The cast 7 may include a surface 7a representative of the outer surface of the gingiva 6a and a surface 7b representative of the first abutment portion 10a. As shown in Fig. 12, the cast 7 may be representative of the dental arch and may thus be used to configure the prosthesis 2 extraorally. For instance, the retention device 20 may be fastened to the abutment replica 70 so as to position it relative to the surface 7b as it would be positioned relative to the first abutment portion 10a upon being fastened to the custom abutment 10. The prosthesis housing 2b may be fastened to the retention device 20 so as to be secured to the cast 7. A gingiva-facing surface 2c (i.e., an underside) of the prosthesis 2 opposite an occlusal surface 2d thereof may be embedded with the prosthesis housing 2b and may be shaped with respect to the prosthesis housing 2b and to the cast 7.

[0061] With reference to Figs. 13 and 14, an abutment installation device 80 being one of the plurality of attachment devices 20 is shown. The abutment installation device 80 has a root 82, a hollow base 84 disposed on the root 82 and a shank 86 extending from the base 84 opposite the root 82. A passage 88 adapted to receive the driver 40 with the fastener 4b is defined inwardly from the shank 86 and extends through the base 84 to outward the root 82. The abutment installation device 80 has a first portion 80a and a second portion 80b detachable from the first portion 80a. The first portion 80a has the root 82 and the base 84. The first portion 80a may also have a portion of the shank 88 defining a first portion 88a of the passage 88. The second portion 80b may have a remainder 88b of the passage 88. Also, the second portion 80b may have a retentive shape 86a. For instance, the abutment installation device 80 may be arranged such that upon the first portion 80a being secured to the custom abutment 10 via the root 82 and impression material being molded therearound, the second portion 80b being secured to impression material via the retentive shape 86a, the second portion 80b may be detached from the first portion 80a to be removed from the custom abutment 10 with the impression material. The abutment installation device 80 may include a sealing cap 90 arranged with respect to the first portion 80a such that upon the second portion 80b being removed therefrom, the sealing cap 90 may be secured onto the first portion 80a so as to seal the passage 88. The sealing cap 90 may for instance be arranged so as to form a seal with respect to the base 84 upon being secured to the first portion 80a. The sealing cap 90 may have a 3D landmark (not shown) and be arranged with respect to the first portion 80a such that the 3D landmark is indicative of an orientation of the custom abutment 10 upon the sealing cap being secured to the first portion 80a and the first portion 80a being fastened to the custom abutment 10. The abutment installation device 80 may thus be described as a multi-functional abutment installation tool.

[0062] It shall be noted that under certain circumstances, upon using the custom abutment 10 in the course of a dental treatment, any one of the attachment devices 20 may be interchangeably fastened to the custom abutment 10 without involving any subgingival intervention.

[0063] According to another aspect of the present technology, there is provided a custom abutment system comprising the custom abutment 10 and at least one of the retention devices 20a, 20b, 20c, 20d. In some embodiments, the custom abutment system may further comprise any one of the prosthesis housings 2b, the healing device 20e, the scanning device 20f, the installation tool 30, the implant fastener 4b, the implant fastener driver 40, the impression transfer device 50, the attachment device driver 60, the abutment replica 70, the abutment installation device 80 and the sealing cap 90.

[0064] According to another aspect of the present technology, there is also provided a method to configure the custom abutment 10 including obtaining a 3D map 8 indicative of the recess 6 and the implant 4. [0065] According to another aspect of the present technology, there is also provided a method of making a dental prosthesis configured to be coupled to the custom abutment 10.