Introduction to Connections
 
       
  CONTROVERSIES
Implant Connections and Surfaces
 
 

Part 1: Introduction to Connections

Part 2: Comparison of Implant Connections

Part 3: Merger of Nobel Biocare & Steri-Oss

Part 4: Questionable Marketing Claims About Implant Connections

Part 5: Paragon's Advantages

Part 6: Comparison of Implant Surfaces

Part 7: Questionable Marketing Claims About Implant Surfaces

Part 8: BioHorizon's Maestro System

Part 9: Controversies in Early Loading

Part 10: References
TRADEMARKS: Core-Vent, SwissPlus, Screw-Vent, Advent, Bio-Vent, Micro-Vent, Friction-Fit, Dual Transition Selective Surface are now Implant Trademarks of Zimmer Dental Implant Company 1900 Aston Avenue, Carlsbad, CA 92008
Factors to Consider in Selecting an Implant System

urgical specialists and restorative dentists agree that they need an implant system capable of achieving and maintaining osseointegration on a highly consistent basis. In addition, the system must provide simple procedures with few or no long-term complications. Selecting an implant system is not an easy task, however.
     Some implant companies and their professional advocates intentionally generate misinformation to enhance the qualities of their product lines. Amid the resulting confusion created by false advertising and paid company spokespersons, dentists must decipher fact from fiction and determine which implant system will best meet the needs of their patients.
     At the clinical level, failure to understand the prosthetic limitations of a given system by surgical specialists may inadvertently add to the problems of restorative dentists. For example, repeated screw loosening and component fracture may be the legacy of those who select an external hex implant made from grades 1–3 CP Ti [Fig. 1]. Others may experience complicated impression procedures [Figs. 3, 5–6] or the inability to make transfers by selecting an implant without an antirotational connection [Figs. 5–6].


Fig. 1: Standard External Hex
Fig. 2: Tapered External Hex

Fig. 3: External Spline
Fig. 4: Internal Hex

Fig. 5: Conical, No Hex
Fig. 6: Bicon® No Hex
     Implant dentistry is a discipline driven by prosthodontics, and the implant/abutment connection is the point of contact between the surgical and restorative phases. It is here that the implant team must reach a consensus in questions of design, precision and strength requirements. Restorative dentists are highly motivated to work with a system that simplifies procedures, minimizes costs and provides complication-free clinical results. The inability of restorative dentists to accomplish these goals will negatively affect their future interest in referring patients for implant surgery. With restorative dentists assuming the long-term responsibility for the implant case, it is incumbent upon them to understand the limitations of the system used in their patients.
     In light of new research and product developments, soaring costs and competition for referrals, it is time for surgical specialists to take a hard look at the implant system they are currently using and ask the following questions:
  • What implant system optimizes surgical success?
  • What implant system reduces chair time?
  • What implant system encourages more restorative dentists to become members of my implant team?
     The surgical specialist who understands the prosthetic differences dictated by implant/abutment connections– and who selects an implant system that will meet the goals of the restorative dentist– will ultimately win professional confidence and increase referrals.
     This technology report will present an overview of various implant systems and their respective implant/abutment connections. A comprehensive evaluation of the inherent differences between them will show that the Paragon System™ provides the distinct advantages of simplicity, versatility, economy and
reliability [Fig. 4].