Internal Hexagon vs Conical Implant–Abutment Connections: Evaluation of 3-Year Postloading Outcomes

Abstract

Different types of internal implant–abutment connections, namely hexagon and conical, have been used for implant restoration. However, data regarding the benefits of these internal connections in terms of clinical outcomes are scarce. Accordingly, the aim of this study was to compare radiographic marginal bone loss (RMBL) and associated implant complications between implants with internal hexagon (IH) connections and those with internal conical (IC) connections. Forty-nine patients with 98 implants (two per patient) placed in the posterior mandible were recruited. All implants were inserted in pairs in solid D2 bone according to a randomized sequence; the first patient received an IH connection implant on the mesial side while the second patient received an IC connection implant on the mesial side. Each patient received one implant with an IH connection and one with an IC connection, placed side-by-side. Four months after placement, all implants were loaded with single screw-retained ceramic restorations with internal hexagon or conical connections. RMBL and complications, including implant/prosthesis failure, were recorded at the time of implant loading (baseline) and 6, 12, and 36 months after loading. The results revealed no significant between-group differences in RMBL (P = .74), gingival bleeding on probing (P = .29), and complications (P = .32). Thus, the type of internal implant–abutment connection did not affect clinical outcomes, including RMBL and implant/prosthesis failure. Future studies should additionally evaluate long-term prosthesis-related complications such as screw loosening and fracture between the two types of internal connections.

Is the clinical performance of internal conical connection better than internal non‐conical connection for implant‐supported restorations? A systematic review with meta‐analysis of randomized controlled trials

“…After reading the titles and abstracts, 30 articles were considered for full‐text reading, of which 18 were excluded because they did not fulfill the eligibility criteria (Table 2). Thus, 12 RCTs were included 9,13,22–30 . Details of the search are shown in Figure 1.…”

“…Thus, 12 RCTs were included. 9,13,[22][23][24][25][26][27][28][29][30] Details of the search are shown in Figure 1.…”

“…These findings should also be interpreted with caution considering that the mean follow-up period of the included studies was 14 months, with most studies having a follow-up of 1 year. The literature recommends a minimum of 5 years to assess the survival rate of dental implants 40 ; however, these studies were included due to only three studies 10,23,26 comparing this variable with a follow-up period of up to 1 year. Short follow-up period was one of the main limitations of this systematic review, thus highlighting the need for new studies with longer follow-up periods to support the conclusions, especially regarding implant survival rates.…”

Influence Of Conical Versus Trilobe Implant Abutment Connection on Marginal Bone Loss, Soft Tissue Health and Prosthetic Maintenance in Mandibular Implant- Assisted Overdenture: A 3-Year Prospective Split-Mouth Randomized Clinical Trial

“…Few studies evaluated clinically the effect of IAC on either marginal bone loss, periimplant soft tissue or prosthetic maintenance. [46][47][48] .…”

Clinical and Radiographic Evaluation of a Novel Triangular Implant Neck Design: A Case Series

“…New implant designs and protocols are constantly introduced by dental implant manufacturers, and some of them are positively impacting the reliability of implant therapy [ 16 , 17 , 18 ]. Moreover, proper diagnostic case selection, management of hard and soft tissues at the time of surgery, platform-switching or conical implant-abutment connections, three-dimensional implant position at the time of placement, and correct prosthetic management are essential for the success of the final implant restorations [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”