TissueCare Concept
X-ray image of ANKYLOS implant-abutment connection before starting the test (left) and after 1,000,000 load cycles (x-ray image: Holger Zipprich/Dr. Paul Weigl, Frankfurt am Main)

1-No Micromovement

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.

The only way to form a bacteria-proof keyed and friction-locked connection is for the conical surface to be flush with the mating surface

2-Bacteria-proof Connection

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 combined with a stable, bacteria-proof connection design is an important factor in tissue stability (x-ray: Dr. Nigel Saynor, Stockport, UK).

3-Platform Switching

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.

Deposition of bone tissue on the face of the implant with subcrestal placement. Status three months after uncovery (histology: Dr. Dietmar Weng, Starnberg)

4-Subcrestal Placement

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.

X-rays: Dr. Dietmar Weng, Starnberg

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)

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