Abutment election and its importance on implant prognosis

5GF73 ePOSTER BASIC RESEARCH

Background: The implant restoration includes different parts which are the implant, the pillar and the crown. This assembly creates a junction that gives a particular dynamic and mechanic. The connector geometry of the pillar plays a role in the harmonious transfer of occlusal forces to the bone, but also in the potential formation of an induced micro gap due to micromovements.

Aim/Hypothesis: This review evaluates the importance of the abutment connection on the implant prognosis.

Materials and Methods: An electronic research was conducted on the following databases : Medline, Web of Science, and Scopus. No language restriction were applied and articles previous to 2014 were not included. A search strategy was developed from Medline and then adapted to Web of Science and Scopus. Initially, the titles and abstracts of the eligible studies were evaluated. The exclusive criteria were : • a sample or a number of implants inferior to 30 • short implant including implant less than 3 mm diameter or less than 6 mm long

Results: The type of connectors, external or internal, may have an impact on the resistance to fracture, the distribution of force, and the marginal bone loss. To limit bone remodeling, platform switching prosthetic pillars were developed. The undersized diameter of the pillar creates a horizontal shift that will allow the soft tissues to adhere to the implant platform, and to move the pillar/implant interface away from the bone. The abutment materials used have an impact on the surrounding soft tissue, the adhesion of the peri-implant tissue, and the amount of plaque. It will allow or not a biological attachment of quality. The restoration can be screwed or cement-retained, presenting both its own advantages and disadvantages. Screwed retentions provide retrievability but may compromise esthetics and present screw fracture. Cement retained prostheses have a tendency to induce peri- implantitis, especially when the margin is subgingival but can compensate for an implant position default.

Conclusions and Clinical Implications: Most of the studies concluded that prognosis of the implant is improved with internal connection, platform switching, screw-retained, and combination of polished zirconia and titanium.

Acknowledgements: I would like to offer my special thanks to Margarita Villota de Jorge for comments that greatly improved the research.

Keywords: Implant prosthodontics, Implant abutment, Implant survival rate