Micromovement between the implant and abutment irritates the peri-implant bone. It reacts by atrophying in the area of the implant shoulder, referred to as remodeling. In contrast, keyed and friction-locked connections prevent any micromovement. They form a virtual single-component implant, which ensures stable tissue from the start.
Gaps between implant and abutment lead to bacterial colonization. Chewing loads cause a relative movement between the components, which in turn causes a pumping effect. This distributes endotoxins, causing an infectious reaction in the tissue at the implant-abutment interface level. Bone is resorbed below the implant-abutment connection until the biological width is established. Only a bacteria-proof connection prevents bone resorption – and stabilizes the soft tissue.
Platform Switching moves the transition between implant and abutment to a central position. This removes mechanical and microbial irritation from the peri-implant tissue. The biological width is moved from the vertical plane to the horizontal plane. This makes Platform Switching an important factor for tissue stability – but only in combination with a micromovement-free, bacteria-proof connection design. This is referred to as Platform Shifting. The narrower abutment also provides more space for peri-implant soft tissue.
A natural emergence profile is easier with subcrestal placement. Bacteria-proof connections without micromovement prevent bone resorption and are tolerated by the bone even when the implant is inserted at a greater depth. Platform Shifting in combination with subcrestal placement and a microstructured implant shoulder allows bone apposition to the abutment and ensures excellent red esthetics over the long term.
5-Microroughened to the Interface
An implant shoulder with a microstructured surface favors deposition of bone cells. When positioned subcrestally this means that bone can also form on the horizontal shoulder surface. The overlying soft tissue has additional support – favoring successful long-term results.
In a radiographic and histological animal study the implant shoulders were placed in the front tooth region 1 mm below the bone margin in conformity with an esthetic indication to simulate the deep position of the implant-abutment connection point in the region of the bone support of the papillae. Standardized x-ray images were taken at monthly intervals. In addition to other results the peri-implant bone margin around the conical connection remained significantly higher over the six months of the study compared to the position with a blunt abutment connection with an external hexagon (x-rays: Dr. Dietmar Weng, Starnberg)