Lack of seal between implant abutment and implant contributing to peri implantitis?

First bicuspid showing some bone loss around top of fixture

I have been wondering about this for the longest time. Ever since I found out that platform switch implant systems may experience less peri implantitis, I wondered whether bacteria from inside the implant leaking out may be contributing to bone loss adjacent to implants. According to implant manufacturers this may be especially true when off brand non implant parts are used in for the screws and abutments, since they may not fit as tightly and allow more micro movement between the fixture and its abutment.

When I do an implant in the esthetic zone, I routinely make a temporary screw retained implant crowns and leave them in place for 3 months or more. When I remove it to take a fixture level impression I invariably notice  a foul smell coming from the inside of the implant fixture. Keep in mind that my temporary crowns use titanium parts manufactured by the implant company itself. This was especially true for Nobel Replace Select fixtures which I used for many years.

Now Nobel Biocare seems to be phasing out their Implant Select design and instead promoting their "Conical connection" designs.

Implant with platform switch 

Clicking on the  following link will allow the reader to watch a Youtube video that  provides an easy to understand explanation for why the conical design combined with a platform switch maybe beneficial:

https://www.youtube.com/watch?v=bP4mvgQuQnc

I have noticed that my implants that have a conical connection and a platform switch experience less bone loss around the head of the implant and have asked my surgeons to place platform switch implants for my patients. So far things look good and these implants have been performing extremely well with no observable bone loss.




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/07/lack-of-seal-between-implant-abutment.html - http://lspindelnycdds.blogspot.com/

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