Dental implant assembly with below gumline abutment

Abstract

A dental implant assembly is for a patient. The dental implant assembly includes an implant to be received by a jaw of the patient. The dental implant assembly also includes a dental prosthesis having a distal abutment prosthesis interface, and an abutment coupled between the implant and the dental prosthesis. The abutment includes a proximal portion to receive the implant, and a distal portion comprising a proximal abutment prosthesis interface to receive the distal abutment prosthesis interface of the dental prosthesis completely below a highest point of a gumline of the patient.

Description

DENTAL IMPLANT ASSEMBLY WITH BELOW GUMLINE ABUTMENTRelated Application

[0001] This application is based upon prior filed copending Application No. 63 / 680,808 filed August 8, 2024, the entire subject matter of which is incorporated herein by reference in its entirety.Technical Field

[0002] The present disclosure relates to the field of dental care, and, more particularly, to dental implant assemblies and related methods.Background

[0003] Dental implant assemblies are devices surgically implanted into the jaw of a patient. The dental implant assembly includes an implant, an abutment, and a prosthetic. The implant is a device used to support dental prosthetics, such as crowns and false teeth, crowns, bridges, or dentures. The abutment provides the mechanical connection between the implant positioned in the jaw of the patient and the dental prosthetic.

[0004] Dental implants are a robust market. In particular, the global dental implants market size is projected to grow from $4.73 billion in 2024 to $8.06 billion by 2032. There are some drawbacks to existing dental implant assemblies, particularly the abutments. In particular, the abutments may tend to degrade mechanically, which requires the patient to return to the dentist for additional work.

[0005] Presently, typical abutments used for removable prostheses are attached to the implant. The implant is usually placed at the bone level in connective tissue, and epithelium line the subepithelial space from the surface of the implant to the surface of the gingiva. In most implant cases, the typical implant is placed 3-4 mm below the gingiva (gums or sub-epithelial). Typical abutments transition from the implant (at bone level) thru the subepithelial space and protrude thru the gingiva and have a male protruding above the gingiva for a minimum of 2-3 mm. The female is usually embedded in the prosthesis. Many systems employ a metal housing in the prothesis to allow easy replacement of the vinyl female coupling or O-ring that eventually wears out. For example, EP4295810A1 to Roshkovan discloses a dental implant attachment system forimplant-supported and implant-retained type removable dentures. The dental attachment system comprises a female component embedded in the body of a denture on a fitting surface for lock up, and a male component usually connected to a dental implant. The male and female components have a semi-elliptical parabolic or dome shape with a tunnel shape or inverted U- shaped lockers and antirotating thorns.Summary

[0006] Generally, a dental implant assembly is for a patient. The dental implant assembly comprises an implant to be received by a jaw of the patient. The dental implant assembly also comprises a dental prosthesis comprising a distal abutment prosthesis interface, and an abutment coupled between the implant and the dental prosthesis. The abutment includes a proximal portion to receive the implant, and a distal portion comprising a proximal abutment prosthesis interface to receive the distal abutment prosthesis interface of the dental prosthesis completely below a highest point of a gumline of the patient.

[0007] In some embodiments, the proximal abutment prosthesis interface and the distal abutment prosthesis interface may cooperate to define a post comprising a peripheral ridge, and an annular body defining an inner annular groove to receive the peripheral ridge. The annular body may be carried by the abutment, and the post may be carried by the dental prosthesis. Alternatively, the annular body may be carried by the dental prosthesis, and the post may be carried by the abutment.

[0008] In other embodiments, one of the proximal abutment prosthesis interface and the distal abutment prosthesis interface may comprise a magnetic device, and the other of the proximal abutment prosthesis interface and the distal abutment prosthesis interface may comprise a companion magnetic device.

[0009] In some embodiments, the implant may be canted at an angle with respect to a vertical axis of the jaw of the patient. The proximal portion of the abutment may be canted at the angle with respect to the vertical axis of the jaw of the patient. A vertical axis of the distal portion of the abutment may be substantial orthogonal to the vertical axis of the jaw of the patient.

[0010] For example, one of the proximal abutment prosthesis interface and the distal abutment prosthesis interface may comprise a vinyl polymer. The dental prosthesis may comprise one of a denture, a crown, and a bridge.

[0011] Another aspect is directed to a method for making a dental implant assembly for a patient including an implant to be received by a jaw of the patient. The dental implant assembly also includes a dental prosthesis comprising a distal abutment prosthesis interface. The method comprises forming an abutment to be coupled between the implant and the dental prosthesis.The abutment comprises a proximal portion to receive the implant, and a distal portion comprising a proximal abutment prosthesis interface to receive the distal abutment prosthesis interface of the dental prosthesis completely below a highest point of a gumline of the patient.Brief Description of the Drawings

[0012] FIG. 1 A is a perspective view of a dental implant assembly, according to the prior art.

[0013] FIG. IB is another perspective view of the dental implant assembly from FIG. 1 A.

[0014] FIG. 2 A is a perspective view of a dental implant assembly, according to a first example embodiment of the present disclosure.

[0015] FIG. 2B is a top perspective view of the dental implant assembly from FIG. 2A without the sacrificial polymer retentive ring.

[0016] FIG. 2C is a top perspective view of the dental implant assembly from FIG. 2A with the sacrificial polymer retentive ring.

[0017] FIG. 3 is a cross-sectional view of the dental implant assembly from FIG. 2A along line 3-3 with the sacrificial polymer retentive ring.

[0018] FIG. 4 is a cross-sectional view of a dental implant assembly along line 3-3, according to a second example embodiment of the present disclosure.

[0019] FIG. 5 is a cross-sectional view of first and second dental implant assemblies, according to a third example embodiment of the present disclosure.

[0020] FIG. 6 is a cross-sectional view of a dental implant assembly, according to a fourth example embodiment of the present disclosure.Detailed Description

[0021] The present disclosure will now be described more fully hereinafter with reference to the accompanying drawings, in which several embodiments of the invention are shown. This present disclosure may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments areprovided so that this disclosure will be thorough and complete, and will fully convey the scope of the present disclosure to those skilled in the art. Like numbers refer to like elements throughout, and base 100 reference numerals are used to indicate similar elements in alternative embodiments.

[0022] Referring initially to FIGS. 1A-1B, an existing approach to a dental implant attachment system 100 is discussed. The dental implant attachment system 100 is for implant-supported and implant-retained type removable dentures. The dental implant attachment system 100 comprises a metal ring housing 101, a vinyl female interface 102 pressed into the metal ring housing, and an implant 103 at bone level 104, protruding through the gingiva. Further, with an abutment 105 attached to the implant, the assembly extends greatly from the gingiva.

[0023] Presently, the majority of attachment mechanisms feature an abutment attached to the implant that traverses through the soft tissues (i.e., sub-gingival) and protrudes through the surface of the gingiva from the gingiva above the surface of the gums with a male-type cylinder that would accommodate a vinyl female or a trailer hitch that would accommodate a female O- ring. A vinyl female or O-ring is embedded in the denture with or without a metal ring housing. If a metal ring housing is used, the undersurface of the denture has to have a sufficient material thickness to embed the metal housing. Embedding the metal housing allows for easier replacement of vinyl females or O-rings becoming less consuming of time. The metal housing will require an additional thickness of material. Eventually, the metal housing loosens and must be replaced causing extensive discomfit time.

[0024] There may be two drawbacks to the existing attachment apparatus. Firstly, the removable denture is substantially weakened by the male protruding out of the gingiva and the dimensions of the metal ring. Presently, 8.5mm is the minimal thickness necessary from the implant platform (i.e., assuming the implant is placed level with the bone) to the outer surface (above the implant) of the removable denture. If 8.5 mm is present, the minimum requirements have been met; however, the structural rigidity of the prosthesis has been compromised. Each additional mm above 8.5 mm will lead to eventual fracture. The present disclosure provides an approach to this drawback of typical designs by materially affecting the fracture resistance of the final prosthesis by allowing more thickness of material above the attachment.

[0025] Secondly, with existing approaches, the present protruding abutment creates a lever arm increasing mechanical forces on the osseously integrated implant, thereby contributing topremature failure. The present disclosure provides an approach to this drawback of typical designs by decreasing the lever arm, thereby keeping the mechanical forces on the implant body within the acceptable range and decreasing overload failure.

[0026] The present disclosure may utilize the part of the abutment that traverses through the gingiva after attachment to the implant at the bone level. The distance from the implant at bone level to the surface of the gingiva is generally accepted to be 4 mm. The present disclosure provides an approach to this drawback of typical designs by strategically saving 3 mm by incorporating the attachment mechanism under the gingival tissue. The 3 mm saved will proportionally increase the fracture resistance of the denture. Implant-retained prostheses are financially expensive and time-consuming procedures. The fracture of prostheses and implant failure substantially contribute to discomfit time. Fractured and failed dentures cause an erosion of patient trust and hinder the dental health and general health of a community.

[0027] Further, by placing the attachment apparatus of the removable prosthesis below the highest point of the gumline (i.e., sub-epithelial) as much as possible, this allows for improved structural integrity of the removable prosthesis. The present disclosure provides an approach to this drawback of typical designs by eliminating the metal housing and making the internal distal part of the abutment a milled receptacle for the vinyl female, O-ring, and or magnet. Of course, in other embodiments, the male could be placed in the abutment (sub-epithelial) with the female in the removable prothesis. The metal housing would still have to be used, which may slightly weaken the removable prosthesis. By placing the male in the removable prosthesis, there would be minimal alteration to the structural integrity of the removable prosthesis (i.e., because the metal housing is eliminated).

[0028] Referring to FIGS. 2A-2C & 3, a dental implant assembly 200 according to the present disclosure is now described. The dental implant assembly 200 is for implantation in a patient. The dental implant assembly 200 comprises an implant 201(e.g., an endosseous implant) to be received by a jaw 202 of the patient below a bone level 216. The implant 201 illustratively includes a doubled threaded screw. For example, the implant 201 may comprise a metallic material (e.g., titanium, stainless steel) or a ceramic material.

[0029] The dental implant assembly 200 illustratively comprises a dental prosthesis 203 comprising a distal abutment prosthesis interface 204 (i.e., being distal to the jaw 202 of the patient). For example, the dental prosthesis 203 may comprise a denture, a crown, a bridge orother dental prosthesis. In the illustrated embodiment, the distal abutment prosthesis interface204 illustratively comprises a post 205 comprising a periphcral / annular ridge 206 (extending completely or substantially around the post) on a proximal end (i.e., being proximal to the jaw 202 of the patient), and a metal mesh 217 on a distal end thereof for attachment to the dental prosthesis 203. In other embodiments, the metal mesh 217 may be omitted, and the post 205 is attached to the dental prosthesis 203 via dental putty, for example. The post 205 is substantially cylinder-shaped, but may take other shapes in other embodiments, for example, rectangle-box shaped.

[0030] The dental implant assembly 200 illustratively comprises an abutment 207 coupled between the implant 201 and the dental prosthesis 203. The abutment 207 illustratively includes a proximal portion 210 to receive the implant 201. Here, the proximal portion 210 comprises a sleeve having a cylinder-shaped body with a cylinder-shaped interior, and an abutment screw 218 received by the cylinder-shaped interior to threadingly engage the threaded portions of the implant. In other embodiments, the proximal portion 210 may comprise a different shape to fit a respective shape of the implant manufacturer, such as a polygonal shape (e.g., octagon, hexagon, etc.) to resist rotation in the jaw 202 of the patient.

[0031] The abutment 207 illustratively includes a distal portion 211 comprising a proximal abutment prosthesis interface 212 to receive the distal abutment prosthesis interface 204, in particular, the peripheral ridge 206 of the post 205, completely below a highest point of a gumline 213 of the patient. Here, the proximal abutment prosthesis interface 212 comprises an annular body 214 defining an inner annular groove 215 to receive the peripheral / annular ridge 206. When the dental prosthesis 203 is implanted, the peripheral / annular ridge 206 of the post205 snaps into the inner annular groove 215 of the abutment 207.

[0032] In some embodiments, the proximal abutment prosthesis interface 212 may comprise an O-ring to be fitted between the post 205 and the annular groove 215. In these embodiments, the post 205 would have a trailer hitch shape to receive the O-ring.

[0033] In some embodiments, the proximal abutment prosthesis interface 212 may comprise a medial retentive post 219 (noted with dashed lines) within the inner annular groove 215, and the post 205 defines a central opening to receive the medial post, providing additional mechanical coupling between the abutment 207 and the dental prosthesis 203. As will be appreciated, thisembodiment of the abutment 207 can only be used when the implant 201 has no more than a threshold amount of cant with respect to the vertical axis 420a-420b (FIG. 5) of the jaw 202.

[0034] Of course, in other embodiments, the arrangement of coupling interfaces for the proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 may be vice versa. In other words, the annular body 214 may be carried by the dental prosthesis 203, and the post 205 may be carried by the abutment 207.

[0035] In some embodiments, the entire distal portion 211 of the abutment 207 is integrally formed, for example, milled from a metallic material. Of course, any material with sufficient mechanical strength may be used, for example, metallic material, ceramic material, or acrylic material, etc. In other embodiments, one, both or parts of the proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 may each comprise a polymer material, for example, vinyl material. Further, in the illustrated embodiment, the distal portion 211 of the abutment 207 is formed to receive a sacrificial polymer retentive ring 225 fitted against adjacent portions of the abutment. Here, the sacrificial polymer retentive ring 225 defines the inner annular groove, and the medial retentive post 219.

[0036] It should be appreciated that one of the proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 may partially comprise a frangible / wearing material that may be periodically replaced (i.e., the illustrated sacrificial polymer retentive ring 225), and the other of the proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 may comprise a metallic material. For example, the proximal abutment prosthesis interface 212 may comprise a plastic material, such as vinyl polymer material, and the distal abutment prosthesis interface 204 may comprise a metallic material. Helpfully, this may eliminate metal housing space in the dental prosthesis 203, and may allow for a tight fit of the post 205 into the distal abutment prosthesis interface 204. Further, this disclosed approach does not require replacing and setting the metal housing in the dental prosthesis 203 or the abutment 207, which is required in typical approaches.

[0037] Of course, in other embodiments, the coupling interface type for the proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 may change to other mechanical interfaces. In yet other embodiments, the coupling interface type for the proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 may comprise a magnetic interface (i.e., companion magnetic devices). For example, the proximal abutmentprosthesis interface 212 may comprise a ferromagnetic material, and the distal abutment prosthesis interface 204 may comprise a magnetic element, such as a permanent magnet. Again, this arrangement of the magnetic interface for the proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 may be vice versa.

[0038] Another aspect is directed to a method for making a dental implant assembly 200 for a patient including an implant 201 to be received by a jaw 202 of the patient, and a dental prosthesis 203 comprising a distal abutment prosthesis interface 204. The method includes forming an abutment 207 to be coupled between the implant 201 and the dental prosthesis 203. The abutment 207 includes a proximal portion 210 to receive the implant 201, and a distal portion 211 comprising a proximal abutment prosthesis interface 212 to receive the distal abutment prosthesis interface 204 of the dental prosthesis 203 below a highest point of a gumline 213 of the patient. The proximal abutment prosthesis interface 212 and the distal abutment prosthesis interface 204 cooperate to define a post 205 comprising a peripheral ridge 206, and an annular body 214 defining an inner annular groove 215 to receive the peripheral ridge.

[0039] Advantageously, the dental implant assembly 200 is more robust and mechanically strong than typical dental implant assemblies. In particular, this strength is provided via the proximal abutment prosthesis interface 212 of the abutment 207 residing below the gumline 213, which reduces the torque forces on the abutment and the dental prosthesis 203. In the illustrated example, the proximal abutment prosthesis interface 212 of the abutment 207 resides completely below any point of the gumline 213. Here, it is assumed the implant 201 was placed medially in the jaw 202 of the patient (i.e., the point of maximum bone thickness, center of the ridge). In other instances, the implant 201 may be placed positionally biased either facially or lingually, and the respective bone and gingiva thickness is reduced. In such applications, the abutment 207 resides below the highest point of the gumline 213.

[0040] Referring now additionally to FIG. 4, another embodiment of the dental implant assembly 300 is now described. In this embodiment of the dental implant assembly 300, those elements already discussed above with respect to FIGS. 2-3 are incremented by 100 and most require no further discussion herein. This embodiment differs from the previous embodiment in that this dental implant assembly 300 illustratively includes a magnetic coupling between the proximal abutment prosthesis interface 312 and the distal abutment prosthesis interface 304.

[0041] In some embodiments, the magnetic coupling of the dental implant assembly 300 may be combined with the mechanical coupling of the dental implant assembly 200 disclosed hereinabove. For example, the annular body 214 may comprise a ferromagnetic material, and the post 206 may comprise a magnetic device, or vice versa.

[0042] Referring now additionally to FIG. 5, another embodiment of the first and second dental implant assemblies 400a-400b is now described. Here, the first and second dental implant assemblies 400a-400b are mitigating a canted second implant 401b via the first and second abutments 407a-407b. For illustrative clarity, only two dental implant assemblies 400a-400b are shown, the first one being substantially aligned with the jaw 402 of the patient, and the second one being canted with respect to the jaw of the patient. In some embodiments, the first and second abutments 407a-407b may be patient specific and formed (e.g., CAD / CAM, additive manufacturing) based upon a scan of the patient.

[0043] In particular, the first and second implants 401a-401b are to be received by the jaw 402 of the patient. The first implant 401a is substantially parallel (i.e., 0°-5° of parallel) with respect to a vertical axis 420a of the jaw of the patient. The second implant 401b is canted at an angle a (e.g., 5°-30°) with respect to a vertical axis 420b of the jaw of the patient. In particular, the vertical axis 421 of implantation is non-parallel to the vertical axis 420b of the jaw 402 of the patient.

[0044] Further, the first and second abutments 407a-407b are respectively coupled between the first and second implants 401a-401b and the first and second dental prostheses 403a-403b. The proximal abutment prosthesis interfaces of the first and second abutments 407a-407b are completely below the highest point of the gumline 413 of the patient. The first and second abutments 407a-407b respectively receive the distal abutment prosthesis interfaces 404a-404b of the first and second dental prostheses 403a-403b completely below the gumline 413 of the patient. Also, the proximal portion 410b of the second abutment 407b is illustratively canted at the angle with respect to the vertical axis 420b of the jaw 402 of the patient while a vertical axis of the distal portion 411b of the second abutment is substantially orthogonal (i.e., 0°-5° of orthogonal) to the vertical axis of the jaw of the patient. Helpfully, regardless of the cant of a given implant 401a-401b, the abutment 407a-407b of the present disclosure is formed to mitigate misalignment and allow for easy implantation of the dental prothesis 403a-403b.Further, since this embodiment of the abutment 407a-407b mitigates cant of the implant 401a-401b respect to the vertical axis 420a-420b of the jaw 402, the embodiment of the abutment with the medial retentive post 219 (FIG. 3) can be used for improved durability and strength.

[0045] Referring now additionally to FIG. 6, another embodiment of the dental implant assembly 500 is now described. In this embodiment of the dental implant assembly 500, those elements already discussed above with respect to FIGS. 2-3 are incremented by 300 and most require no further discussion herein. This embodiment differs from the previous embodiment in that this dental implant assembly 500 illustratively includes the proximal abutment prosthesis interface 512 having a sacrificial vinyl retentive ring 525 with a medial retentive post 519.

[0046] It should be appreciated that features from each of the disclosed embodiments of the dental implant assembly 200, 300, 400a-400b, 500 may be combined with each other. Many modifications and other embodiments of the present disclosure will come to the mind of one skilled in the art having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is understood that the present disclosure is not to be limited to the specific embodiments disclosed, and that modifications and embodiments are intended to be included within the scope of the appended claims.

Claims

CLAIMS:

1. A dental implant assembly for a patient, the dental implant assembly comprising: an implant to be received by a jaw of the patient; a dental prosthesis comprising a distal abutment prosthesis interface; and an abutment coupled between the implant and the dental prosthesis and comprising a proximal portion to receive the implant, and a distal portion comprising a proximal abutment prosthesis interface to receive the distal abutment prosthesis interface of the dental prosthesis completely below a highest point of a gumline of the patient.

2. The dental implant assembly of claim 1 wherein the proximal abutment prosthesis interface and the distal abutment prosthesis interface cooperate to define a post comprising a peripheral ridge, and an annular body defining an inner annular groove to receive the peripheral ridge.

3. The dental implant assembly of claim 2 wherein the annular body is carried by the abutment; and wherein the post is carried by the dental prosthesis.

4. The dental implant assembly of claim 2 wherein the annular body is carried by the dental prosthesis; and wherein the post is carried by the abutment.

5. The dental implant assembly of claim 1 wherein one of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a magnetic device, and the other of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a companion magnetic device.

6. The dental implant assembly of claim 1 wherein the implant is canted at an angle with respect to a vertical axis of the jaw of the patient; and wherein the proximal portion of the abutment is canted at the angle with respect to the vertical axis of the jaw of the patient.

7. The dental implant assembly of claim 1 wherein the implant is canted at an angle with respect to a vertical axis of the jaw of the patient; and wherein a vertical axis of the distal portion of the abutment is substantial orthogonal to the vertical axis of the jaw of the patient.

8. The dental implant assembly of claim 1 wherein one of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a vinyl polymer.

9. The dental implant assembly of claim 1 wherein the dental prosthesis comprises one of a denture, a crown, and a bridge.

10. A dental implant assembly for a patient, the dental implant assembly comprising: an implant to be received by a jaw of the patient, the implant being canted at an angle with respect to a vertical axis of the jaw of the patient; a dental prosthesis comprising a distal abutment prosthesis interface; and an abutment coupled between the implant and the dental prosthesis comprising a proximal portion to receive the implant, the proximal portion being canted at the angle with respect to the vertical axis of the jaw of the patient, and a distal portion comprising a proximal abutment prosthesis interface to receive the distal abutment prosthesis interface of the dental prosthesis completely below a highest point of a gumline of the patient, a vertical axis of the distal portion of the abutment being substantial orthogonal to the vertical axis of the jaw of the patient.

11. The dental implant assembly of claim 10 wherein the proximal abutment prosthesis interface and the distal abutment prosthesis interface cooperate to define a postcomprising a peripheral ridge, and an annular body defining an inner annular groove to receive the peripheral ridge.

12. The dental implant assembly of claim 11 wherein the annular body is carried by the abutment; and wherein the post is carried by the dental prosthesis.

13. The dental implant assembly of claim 11 wherein the annular body is carried by the dental prosthesis; and wherein the post is carried by the abutment.

14. The dental implant assembly of claim 10 wherein one of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a magnetic device, and the other of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a companion magnetic device.

15. The dental implant assembly of claim 10 wherein one of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a vinyl polymer.

16. The dental implant assembly of claim 10 wherein the dental prosthesis comprises one of a denture, a crown, and a bridge.

17. A method for making a dental implant assembly for a patient including an implant to be received by a jaw of the patient, and a dental prosthesis comprising a distal abutment prosthesis interface, the method comprising: forming an abutment to be coupled between the implant and the dental prosthesis, the abutment comprising a proximal portion to receive the implant, and a distal portion comprising a proximal abutment prosthesis interface to receive the distal abutment prosthesis interface of the dental prosthesis completely below a highest point of a gumline of the patient.

18. The method of claim 17 wherein the proximal abutment prosthesis interface and the distal abutment prosthesis interface cooperate to define a post comprising a peripheral ridge, and an annular body defining an inner annular groove to receive the peripheral ridge.

19. The method of claim 17 wherein one of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a magnetic device, and the other of the proximal abutment prosthesis interface and the distal abutment prosthesis interface comprises a companion magnetic device.

20. The method of claim 17 wherein the implant is canted at an angle with respect to a vertical axis of the jaw of the patient; wherein the proximal portion of the abutment is canted at the angle with respect to the vertical axis of the jaw of the patient; and wherein a vertical axis of the distal portion of the abutment is substantial orthogonal to the vertical axis of the jaw of the patient.

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