Forum Implantologicum 14 (2018), No. 1 4. June 2018
The clinician is confronted with the availability of a huge number of dental implants and components today. As a consequence, the choice for the ideal implant and abutment type in each individual situation is quite complex. The goal of implant treatment is to achieve long-term stable implants and restorations which are functionally and esthetically appealing, exhibit healthy peri-implant conditions and create high patient satisfaction. For the survival of implants and prostheses, both the biomechanical stability of the implant components and the biologic response of the surrounding tissues are of relevance. Knowledge of biomechanical and biological principles leads to an understanding of the existing implant types and their range of indications, which facilitates the decision-making process for the clinician. Furthermore, the consequences of implant placement at, below or above the bone crest on the bone reaction are reflected for each implant type. Three levels of significance in implant dentistry are highlighted using basic and recent scientific evidence - the bony part, the interface area between implant and abutment, and the transmucosal part. Key issues such as the formation of a biologic width, the platform switching concept, the influence of microgaps, microleakage and micromovements, and the pros and cons of internal and external implant-abutment connections are discussed. In addition, a short overview on abutments and few condensed clinical recommendations are given.
Keywords: Implant-abutment interface, internal connection, external connection, microgap, bone level