What is a Conical Connection in Dental Implantology?


Grafik Zahnimplantat mit Abutment Konusverbindungbelsky


Abutment Konusverbindung

The conical connection plays an important role in implantology.

A conical connection describes one kind of implant: An abutment connection. For a better understanding, check out the video entitled "Titanium Abutment" to see how a titanium abutment is screwed onto an implant. The implant is held by tweezers. The implant is usually located in the bone and the crown is then attached to the abutment. Therefore, abutments are implant caps that function as a crown base. Normally, the abutments are attached to the implant and screwed on tightly. This means they are plug-in connections. Implant producers implemented conical connections between implant and abutment early on, which created a small difference with significant consequences.

Immediate bone reduction after denture insertion has been observed for a long time with various implant types. This caused the upper implant parts to stick out of the gums frequently, a very bad sign from a medical perspective. The implant surface is rough and this assists with optimal bone healing. It enables the bone to literally intertwine with the implant. However, this rough surface also provides an ideal bacterial hideout and nesting area; as soon as the implant is no longer within the bone, it is lost due to bacterial settlements and associated infections.

Companies reacted to this problem by polishing the upper parts of implants. This was supposed to stop bacterial settlement in cases of bone reduction and worked with partial success. However, bone reduction does not appear to occur with conical connections and the reasons for this could not initially be explained. As a result, producers renounced polished surfaces. Implants with conical connections showed bone development all the way to the abutment; thus, even the implant shoulders are now roughed up.

Dentists observed yet another difference with conical connections that initially could not be explained. When the abutment is unscrewed from the implant for cleaning purposes, the dentist – as well as the patient – often experiences a very foul smell when a common implant system with traditional plug connections is used. This is not the case with conical connections. Nowadays, this phenomenon has been explained; again, the solution lies with the conical connection.

Abutment and implants are linked so tightly with conical connections that not even a scanning electron microscope can reveal any spaces or gaps. With plug-in connections, a clearly visible gap can be found. This gap gets occupied by bacteria and bacterial product because chewing motions cause movement between the implant and abutment. This movement is clearly visible in the special images.  There is absolutely no movement with conical connections. Conventional plug-in connections provide a less than optimal transplant/abutment connection that results in micro movement between the implant and abutment, creating a pumping effect.

Because of this effect, bacteria is transported outside and around the implant and this leads to the foul smell at the dentist’s office; thus, the results of conventional plug-in connections are plate-shaped bone reduction and a foul smell.

Click here to see the video: Tapered Connection

This post is also available in: German

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