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Forum Category: Implantology

Moderated by:
Bernard Touati

Abutment Loosening

It has been proven that epithelium and connective tissue can effectively adhere to titanium or aluminum oxide transmucosal abutments. Yet, conventional clinical procedures often necessitate one or several disconnections of the initial abutment for impression making, metal framework, and biscuit-bake try-in, and final placement. Unscrewing the abutment mechanically disrupts the mucosal barrier and tears cells from the junctional epithelium and the connective tissue.
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Abutment Loosening

04:34 PM | Mar 20,2012

Abutment Loosening

04:44 PM | Apr 05,2011
do you see the same results with internal connection implants?

Abutment Loosening

04:25 PM | Feb 22,2011
Unintentional loosening of a final or provisional abutment can also occur, and that too will disrupt the soft tissue attachment. As the clinical diagnosis of this type of unscrewing is frequently late, the apical migration of the biologic width often happens, ultimately leading to a marginal bone loss and creating a periodontal pocket in thick biotypes or gingival recession in thin biotypes. Due to the screw loosening, the implant-to-abutment interface turns into a gap that bacteria can invade through the screw hole and the pocket. This further activates the bone loss and the apical migration (~3mm) of the bone level from the interface.

Abutment Loosening

04:24 PM | Feb 22,2011
As an important consequence, clinicians must keep in mind that a removed abutment is covered with a thin layer of living cells: if reinsertion of the same abutment is desired, then either great care must be taken to preserve the vitality of these retrieved cells, or the abutment must be thoroughly cleaned and sterilized before reinsertion. In order to preserve the vitality of the cells, one should avoid using chemical disinfection procedures for the abutment or desiccating the cells. It can rather be advised to thoroughly disinfect the abutment head before unscrewing , to keep the retrieved abutments in sterile saline, and to avoid mixing abutments from several implants within the same arch or patient.

Abutment Loosening

04:24 PM | Feb 22,2011
It has been shown in an animal experiment that repeated disconnection of abutments, together with fixation of the adhering cells in alcohol at each unscrewing, induces bone loss. This bone loss most probably results from an apical migration of the junctional epithelium, the latter being explained by a transmucosal reinsertion of epithelial cells killed by the alcohol dip. A recent human study with the same number of abutment disconnections as in Abrahamsson’s studies induced no bone loss with the abutments were thoroughly cleaned and then autoclaved.