Precisely fitting implant meso- and superstructures place high demands on implants and implant abutments. Hence, it is necessary that the geometries and materials perfectly coordinate with each other. To me, the long-term experience of major international implant manufacturers means an in-depth knowledge about selection of materials and coordination of the geometry of the respective connections. Even after years of prosthodontic restoration, I still want to be able to rely on this quality and, in the event of any clinical complications or a new production of the intermediate implant structure, on the service and guarantee of the implant manufacturer.
We are talking about a two-part medical product which, with a high degree of precision, developmental know-how and several years of interdisciplinary experience of the manufacturers, is to be used in the patient after detailed technical and clinical documentation. Some of the ISO standards test the precise interaction of implant, screw and abutment as early as in the development phase in model trials, which should then be underpinned in the product life cycle. Furthermore, the dental technician craft is subject to master craftsmanship and this seal of approval should also be reflected in the selection of materials.
Long-term implantological treatment can be a success only with the functional interplay of everyday clinical practice, indication-appropriate workmanship and high standards of industrial manufacturing.
If the implant-abutment geometry is not matched precisely, it can cause micro-movement of the abutment, screw loosening or in the worst case, a fracture of the abutment or the implant neck. This must be avoided at all costs!
Screw loosening is a sign that the system implant, abutment and crown do not harmonize properly. Consequences can be a failure of the abutment or in unfavourable cases even an implant loss.
Initial studies on this topic suggest that CAD / CAM abutments of third-party and low-cost suppliers are inferior to industrially produced quality abutment in terms of their bending fracture load and accuracy of fit.
A success is when the system remains resilient and efficient for years to come. In the development of an implant system, the overall concept of implant, abutment and screw is always tested. These simulations are not performed In combination with counterfeit products and the current study on copycats in dental implantology does not allow any assessment of success.