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Shoulder Design

Machined versus microstructured implant shoulder – Which is better?

Dr Tim Fienitz, Clinic for Oral, Maxillary and Facial Plastic Surgery, University Hospital Cologne


The majority of the implants currently available on the dental market have good and comparable implant survival rates. In light of this, the aesthetic outcomes when using different implant systems is becoming increasingly important. The aesthetic outcomes are essentially determined by the surrounding soft tissue which is in turn directly dependent on the crestal bone level. The crestal bone level can be affected by the macroarchitecture of the implant body as well as the microarchitecture of the implant surface. This review article examines the importance of the implant shoulder with special consideration of the surface properties in this area using a recent literature review.

A microstructured implant shoulder appears to have a positive effect on the crestal bone resorption, whereas a machined implant shoulder is associated with a reduced risk of infection if the implant is exposed to the oral cavity because there is less plaque accumulation. On the basis of the current body of trial data, no clear statement can be made about the superiority of one particular type of implant shoulder and the choice of one of the two options should be made taking the patient’s individual situation into consideration.

Key words: Implant shoulder, machined, microstructured, platform switching