Fixed Restoration Combo: Single Zirconia Crown on Titanium Abutment CAD/CAM

A zirconia crown on a custom CAD/CAM titanium abutment for single-tooth implant restorations. The abutment is designed around each implant position and gingival contour, and the zirconia crown is cemented onto it. 3–4.5 working days in the lab, depending on the number of units.

When to choose a custom titanium abutment

A custom titanium abutment is designed and CAD/CAM-milled for each implant, and the zirconia crown is made on top of it. Compared with a stock abutment, it gains three things:

• An emergence profile shaped like the tooth. Stock abutments are round in cross-section; natural cervical sections are not. A custom abutment stays slightly concave next to the implant shoulder to make room for tissue, then flares to the actual cross-section of the tooth being replaced.
• Margins placed where you want them. Shallow lingually and deeper facially; a shallow margin makes excess cement easier to control when the crown is cemented.
• Height kept when interarch space is limited, instead of grinding down a stock abutment.

Titanium is the strongest abutment material, well tolerated by tissue, and the default for posterior teeth and high-load cases. In the anterior zone with thin tissue, where titanium can show grey through the gingiva, consider zirconia bonded on a Ti-base. On posterior implants with a good axis and thick tissue, a stock abutment performs equally well at lower cost. The full reasoning is in custom vs stock implant abutments.

Zirconia crown on a titanium abutment

The crown is cemented onto the abutment. Because a custom abutment margin can sit at or above the gingiva lingually, excess cement is easier to control than with a stock abutment. The crown material follows the site: high-strength zirconia for molars, multilayer zirconia for the esthetic zone; see our dental ceramic materials comparison. For patients who grind, please note it on the prescription.

What to send us

• An intraoral scan with the correct scan body for the implant system (STL, PLY or DCM), the opposing arch and a bite scan; or an implant-level impression with an analog.
• The implant system, line and connection diameter, stated exactly.
• A photo of the emergence profile right after removing the healing abutment, and the depth of the implant shoulder relative to the facial gingival margin.
• Shade, shade photos and a note on bruxism.

Our process and turnaround

1. We check the files in the next working shift; if data is missing, you receive annotated screenshots.
2. We design the abutment around the implant position and gingival contour, then the crown on the abutment.
3. Titanium abutment milling, zirconia crown milling and sintering, shade finishing.
4. A final quality check (fit, contacts, shade) before dispatch.

Implant crowns take 3 working days in the lab for 1–3 units and up to 4.5 days for more than 12 units, from file approval. Shipping comes on top; see turnaround and shipping. Covered by our general warranty (6 months to 15 years depending on the material). Other implant options are on implant bridges and crowns.

To discuss a specific case, contact our team or start through the ordering process.

Written for dentists and technicians. Khai Nguyen Dental Lab manufactures to clinical prescription only and does not sell directly to patients.

Margin depth and excess cement: what the studies show

A custom abutment lets the finish line sit at or slightly below the gingiva for easier cementation and hygiene. Why a shallow margin matters:

A retrospective analysis by Linkevicius et al. (2013) found peri-implant disease at 62 of 73 implants with cement remnants (85%); in patients with a history of periodontitis, every implant with remnants developed peri-implantitis. On the prescription, state the margin depth you want for each surface (for example, equigingival lingually, 0.5 mm subgingival facially).

Cemented or screw-retained on a custom abutment

A systematic review by Wittneben et al. (2014) found no significant difference in 5-year survival between cemented (96.03%) and screw-retained (95.55%) reconstructions, although screw-retained ones showed fewer technical and biological complications overall. For a single crown on a custom abutment there are two routes:

• Intraoral cementation: when the implant axis exits facially or through a cusp, where an access hole would weaken the crown or show.
• Crown with an access hole, bonded to the abutment extraorally: cement is cleaned on the bench before the unit is screwed in, and the restoration stays retrievable. The protocol is in our article on hybrid abutment crowns on a titanium base.

If you want an access hole, note it on the prescription and discuss it with us before design, since its position depends on the implant axis.

Cementing intraorally: limiting residual cement

• Use a copy abutment. In a crossover RCT by Andrijauskas et al. (2021), the median residual cement area was 1.39% with rubber dam and 0.58% with retraction cord plus a copy abutment (excess cement is expressed extraorally before seating).
• Do not rely on radiographs. On zirconia abutments, an in vitro study (Vindasiute-Narbute et al., 2023) could not remove all cement in any specimen, and in 95% of cases the remnants were not detectable radiographically.
• Cement type matters. In the same study, resin-modified glass ionomer left 7.4% more residue than resin cement.

Titanium or zirconia on a Ti-base

We make custom abutments in premium-grade titanium or as zirconia on a titanium base. A systematic review by Linkevicius and Vaitelis (2015) found no clear advantage of either material for recession, probing depth, bleeding on probing or bone level, but mucosal colour was significantly better with zirconia abutments. The 2023 ITI consensus (Derksen et al.) reported similar 1-year performance for single crowns on Ti-bases and other abutment types, and recommended choosing the abutment at the planning stage.

Titanium suits posterior and high-load sites; zirconia on a Ti-base suits thin tissue in the esthetic zone. See zirconia bonded on a Ti-base and the case implant at tooth 11 with a custom hybrid abutment.

Why the implant details must be exact

Mizumoto and Yilmaz (2018) describe intraoral scan bodies as implant-position transfer devices that play an essential role in accurately fitting implant restorations. Design software matches the scan body on the file to the library of the exact implant system, so a wrong line or connection diameter can mean an abutment that does not seat. Besides system, line and connection, tell us the scan body brand and type; with an implant-level impression, include an analog of the same system. File formats are covered in intraoral scanner compatibility.

Sources: Linkevicius et al., Clin Oral Implants Res 2011; Linkevicius et al., Clin Oral Implants Res 2013 (prospective); Linkevicius et al., Clin Oral Implants Res 2013 (retrospective); Wilson, J Periodontol 2009; Wittneben et al., Int J Oral Maxillofac Implants 2014; Andrijauskas et al., Clin Oral Implants Res 2021; Vindasiute-Narbute et al., Int J Prosthodont 2023; Linkevicius and Vaitelis, Clin Oral Implants Res 2015; Derksen et al., ITI Consensus, Clin Oral Implants Res 2023; Mizumoto and Yilmaz, J Prosthet Dent 2018.