Retention of Implant Prosthesis: Alternate Emerging Concepts

Hari Parkash*
Department of Dental Education & Research, All India Institute of Medical Sciences, India

*Corresponding author: Hari Parkash, Department of Dental Education & Research, All India Institute of Medical Sciences, P-1, LGF, Green Park Extension, New Delhi - 110016, India

Published: 18 Jan, 2018
Cite this article as: Parkash H. Retention of Implant Prosthesis: Alternate Emerging Concepts. J Dent Oral Biol. 2018; 3(2): 1126.


Oral Implantology has established itself as a predictable modality in rehabilitation of missing teeth in the past two decades. The success of implant bone anchorage has been phenomenal and lot is attributed to the greater understanding of implant macro design and micro design. With the increase in implant numbers being used worldwide, a lot of literature regarding peri implantistis is available. It is well documented that the prevalence of peri implantitis is 10% of implants and 20% of patients, 5 to 10 years after implant placement [1]. Besides systemic factors, habits of the patient (Smoking and hygiene measures) another contributing factor to peri implantitis can be excessive cement around the implant prosthesis. To counter this iatrogenic cause of peri implantitis an option of screw retained prosthesis is always there. However, the screw retained prosthesis with castable abutments can have a complete castable abutment where marginal gap would exist between the implant abutment interfaces. The other option where a castable prosthesis is luted over milled base has inherent problems of debonding. The alternate modalities on the rise are milled metal abutments which are only possible for implant systems that have shared their implant digital library. The other promising option has been the emergence of Conometry Concept. This concept focuses on Morse tapered conical connection that would provide an excellent retention between the implant cone connection and cone prosthesis connection. With proper insertion forces this connection can provide a fixed connection between dental implants and prosthesis without the need of cement [2]. With the Conometry concept in place Dr Degidi combined it with intraoral welding and presented to the world a novel concept of immediate rehabilitation of maxilla and mandible wherein implants with weldable sleeves could be splinted intraorally and the prosthesis could be placed with conometric retention [3]. This intraoral weld connection has been subjected to various studies and tests like UTM analysis, EDAX analysis etc to evaluate the strength and quality of the welding.
Such a technique helps to splint implants and provide full arch solutions and yet is retrievable and avoids use of any cement thus surely caring for the peri implant health of implants. Definitely such alternate modalities have to pass the test of time and Meta analysis and long term data is awaited for the same. A clinician should be aware that a lot of changes are happening in the world of Oral Implantology and in future many options would definitely be available for the patients.


  1. Heitz-Mayfield LJ, Needleman I, Salvi GE, Pietursson BE. Consensus Statements and Clinical Recommendations for Prevention and Management of Biologic and Technical Implant Complications. J Oral Maxillofac Implants. 2014;29(s):325-45.
  2. Bressan E, Lops D, Tomassi C, Ricci S. Stocchero M. Carniel EL. Experimental and computational investigation of morse taper conometric connection between dental implants and prosthesis. Proceedings of the Institution of Mechanical Engineers, Part H, Journal of Enginerring in Medicine. 2014;228(7):674-81.
  3. Degidi M, Nardi D, Piattelli A. Immediate loading of the edentulous maxilla with a final restoration supported by an intraoral welded titanium bar: a case series of 20 consecutive cases. J Periodontol. 2008;79(11):2207-13.