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Connecting implants to natural teeth and use as pier abutments
The issue of connecting implants and teeth to support a fixed prosthesis is controversial and unresolved. The inherent differences in vertical and lateral movements in response to the occlusal forces and the difference in proprioception, the use of rigid connections is questionable. When an implant is a used as a pier abutment to support a prosthesis with two terminal natural teeth, under occlusal forces stands out due to the difference in mean axial movement of teeth and implants and therefore the chances of prosthesis over the natural teeth getting uncemented is much higher and breakdown of supporting tissue of the implant as it subjected to excessive forces is imminent. The use of non rigid connector is a way of reducing the stress concentration. However, it is best that the connection of natural dentition and implants to support a fixed prosthesis is avoided.
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Using a Tissue Punch The implant heads are located and using a suitable sized tissue punch(depending on the implant diameter), the tissue punch is used and takes a circular pie
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