Thommen Implant System Implant/Abutment Connection

Thommen Implant System
Implant/Abutment Connection
Start with a Solid Connection
SWISS PRECISION AND INNOVATION.
Thommen Implant System
Implant/Abutment Connection
Start with a Solid Connection
The implant/abutment ­connection lies
The requirements for an optimal
on the implant platform. This carries the
at the heart of any implant system. At
­implant/abutment connection can be
bulk of ­non-axial forces and gives
the present time there are more than
summarized as follows:
optimal ­mechanical stability to the
twenty different implant/abutment
c­onnections on the market, some of
which meet the various­requirements
­better than others. This paper presents
an overview of how divergent
­requirements for an implant/abutment
­connection can be combined to
implant/­abutment connection. Further,
·Minimum platform height for optimal
prosthetic flexibility
·Accurate transfer of the implant
­position to the master model
the ­reinforcement collar helps to isolate
the abutment screw from ­lateral forces
which could otherwise contribute to
screw loosening.
·Precise rotational orientation for
­single-tooth restorations
­provide a superior esthetic solution
·Maximum mechanical stability
Fig. 1:
without compromising long-term
·Optimal fatigue resistance
The Thommen Implant System
­reliability.
·Minimized microgap
implant/abutment ­connection:
·Overload protection
1 Reinforcement collar
· optimal mechanical stability
The Thommen Implant System
· focused compression for minimal
implant/abutment connection was
developed more than twenty years
2 Internal hexagon
ago and has proved itself decisively
· minimal height for prosthetic ­flexibility
since. The implant/ abutment
· rotational stability for single-tooth
connection of The Thommen Implant
System was one of the first to have an
· accurate impression transfer
internal hexagon. Internal connections
3 FEM-optimized wall dimensions
have a great advantage over external
· optimal fatigue resistance
microgap
implant restorations
connections in that they allow a longer
­engaging surface while reducing the
platform height of the implant, which
­allows more flexibility in designing the
emergence profile of the final
restoration.
The internal hexagon of The Thommen
Implant System is manufactured with
the highest precision and allows an
­extremely accurate transfer of the
­implant position to the master model,
which in turn ensures a perfect fit for
the prosthesis. The internal hexagon
also provides precise rotational
­orientation and stability for single-tooth
implant r­ estorations thanks to the
large, indexed contact surfaces 1 . ­­
A unique ­feature of The Thommen
Implant System implant/­abutment
connection is the ­reinforcement collar
2
© Thommen Medical
1
2
3
Finally, the reinforcement collar f­ ocuses
the contact area between the implant
and abutment, so that there ­is higher
surface compression in the critical
perimeter area of the connection with
comparatively modest ­torque used on
the abutment screw. This ­mini­mizes
the microgap between the ­implant and
abutment which in turn r­ educes the
occurrence of bacterial
contamination 2 .
In determining the design of an internal
connection, particular attention has to
be paid to the strength of the implant
walls: they must be able to withstand
significant torque loads placed on the
connection during ­surgical insertion as
well as strong ­occlusal forces without
fear of deformation or fracture. For this
reason, t­ he dimensions of The
Thommen Implant System ­implant/
abutment connection were calculated
and optimized using the ­finite element
method, and thoroughly tested on our
in-house hydropulser equipment to
ensure optimal strength and fatigue
resistance.
All Thommen Implant System
components are s
­ ubjected to strict
testing in accordance with ISO 14801.
This dictates dynamic strength testing
parameters of 2 million loading cycles at
a frequency of 2 Hz in a saline solution
with a temperature of 37º C (to
replicate the oral cavity).
In the FEM images, the color scale
­indicates the level of stress – with blue
the lowest and red the highest. During
the design optimization process,
­modifications are made and test­ed ­
Fig. 2:
Design optimization with FEM analysis
until the ideal distribution of stress –
and hence strength – is o
­ btained.
© Thommen Medical
3
Fig. 3:
Test set-up for implants and prosthetic
parts according to ISO 14801
Fatigue testing (ISO 14801)
F
F
30º
5
mm
Load rod
11
m
m
8m
m
3m
m
Bone
resorption
Simulated crown
Gold coping
Simulated crown
Abutment
Gold coping
10 mm
Abutment
Normal bone level
(no bone resorption)
Implant
Implant
PMMA
Specimen holder
PMMA
Specimen holder
Load F [N]
Test conditions
Frequency
2 Hz
Runouts2 3 106 cycles
Environment
0.9 % NaCI/37º C
13
Runout
load
33
Load F [N]
Runout
2 3 106 cycles
Fig. 4:
In-house laboratory for fatigue testing
4
© Thommen Medical
The Thommen abutment screw
The abutment screw plays a central
role for the mechanical strength and
optimal fatigue resistance of The
Thommen Implant System implant/
abutment connection. To begin, let us
summarize the ­requirements of an
ideal abutment screw:
·Minimal head diameter
·No loosening
·Optimal fatigue resistance
·Overload protection
·Excellent pick-up and carrying ability
The abutment screw of The Thommen
Implant System has a small screw head
– with a diameter of 1.6 mm respectively
Fig. 6:
Wheel of a car with the same concept
of a conical screw seat
1.9 mm compared with more typical
diameters of 2.2 mm to 2.6 mm. The
small screw head is possible because it
does not need to withstand the higher
1
2
clamping forces which other designs
may ­require (typically 35 Ncm) and it is
­protected from non-axial loads by the
reinforcement collar discussed
previously. The small screw head
3
allows The Thommen Implant System
abutments to be produced with a
narrower screw channel and thicker
walls. This in turn gives the dental
technician more freedom for prosthetic
design and fabrication for a strong and
esthetic result.
One typical complication of implant/­
abutment connections is that the
Fig. 5:
screw may loosen 3 ,4. This is caused by
1
Small screw head
non-axial forces that may lead to
narrow screw channel/better
relative motions between screw head
esthetics
and abutment 5 . The abutment screw
2
Conical screw seat
of The Thommen Implant System has a
to prevent loosening of the screw
conical screw seat (conical angle of
3
Reduced diameter shaft
60°) that precludes such relative lateral
for optimal fatigue resistance
motions and minimizes the risk of the
Predesigned breakage point
screw becoming loose. The same
for overload protection
concept has been used for decades in
the car industry to keep wheel lug nuts
tight. Tests on the hydropulser
equipment has shown that after 2
million load cycles no change in the
abutment screw’s tighten­ing torque
could be observed.
The abutment screw utilizes a proven
reduced diameter shaft (anti-fatigue
shaft) 6 , a common component in
engineering that is used in the design
of connections that are subject to
strong dynamic loads 7 . An anti-fatigue
shaft screw differs from a normal
screw in that the shaft is subject to
deformation when exposed to tension
and acts like a spring. Tightening the
abutment screw imparts a calculated
amount of tension (“pre-load”) on the
shaft which compresses the abutment
onto the implant to generate a stable
connection. The appropriate pre-load
of the abutment screw is attained by
the ­application of the correct tightening
torque. For the reasons described
above, the required torque is lower
than that used with many other implant
systems. It is important not to exceed
the ­specified torque, because this
places excessive pre-load on the shaft
and actually prevents it from
functioning properly.
© Thommen Medical
5
Conclusion
Zusammenfassung
In addition to its physical design,
The Thommen Implant System implant/
Im vorliegenden Artikel wird die Funktion der
­optimal fatigue properties of The
abutment connection, combined with
­Implantat/Abutment-Verbindung des Thommen Im-
Thommen Implant System abutment
The Thommen Implant System
plantatsystems eingehend beschrieben.
screw are ­ensured by the use of a
abutment screw, offers an ideal
high-strength titanium alloy. The
balance of reliability, safety and
selected titanium ­alloy has excellent
esthetics.
biocompatibility and is widely used in
orthopedic ­devices
.
8 ,9
ist eines der wichtigsten ­Elemente eines Implantatsystems. Es werden verschiedene Anforderungen
an die Funktion gestellt wie minimale Bauhöhe
für prothetische Flexibilität, präzise Passungen,
·Minimum platform height and head
­diameter for optimal prosthetic
The Thommen Implant System
­flexibility and excellent esthetic
abutment screw also serves as the
­results.
pre-designed breakage point for the
Die Verbindung zwischen Implantat und Abutment
·Tight tolerances and precise
­optimale Ermüdungsfestigkeit etc. Um eine
­bestmögliche Lösung anzubieten, kommt beim
Thommen Implantatsystems eine Innenverbindung,
­ergänzt mit einem Führungsring, zum Einsatz. Die Innenverbindung ist mit einem Sechskant zur Rotationssicherung ­ausgebildet und weist im Vergleich zur
implant/abutment connection. This
­production methods ensure an
Aussenverbindung eine längere Führung des Abut-
minimizes the risk of ­damaging the
­extremely accurate transfer of the
ments auf. Diese ­Führung ist ausschlaggebend für
implant should the prosthetic be
implant position to the master
exposed to an overload, which may
­model, which in turn ensures a
occur, for example during an accident.
­perfect fit for the prosthesis.
Prosthetic components may be
·Internal hexagon provides precise
die Stabilität.
Eine Besonderheit des Thommen Implantatsystems
ist der Führungs­ring: Dieser schützt die Abutmentschraube vor nicht axialen Kräften und verhindert
eine ­Schraubenlockerung. Zusätzlich wird durch den
repaired or replaced relatively easily,
­rotational orientation and stability for
Führungsring die Auflagefläche zwischen Implantat
but it is critical that the implant be
single-tooth implant restorations
und Abutment reduziert, ­wodurch bei gleichem
protected in such an event. The
thanks to the large, indexed contact
optimal breakage point was
surfaces.
determined through careful FEM
·High surface compression in the
­Anzugsmoment eine höhere Flächenpressung und
somit eine bestmögliche Abdichtung gegen Körperflüssigkeiten ermöglicht wird.
Die Abutmentschraube hat einen kleinen Schrau-
analysis and ­thorough testing on the
­critical perimeter area of the
benkopf, damit ein dünner Schraubenkanal ermögli-
hydropulser equipment.
­connection results in a minimal
cht wird. Dies ist für eine optimale ästhetische
microgap ­between the implant and
­Versorgung notwendig. Die optimalen
­Eigenschaften gegen Ermüdung der Abutment-
Finally, convenient and safe handling is
the abutment, which in turn reduces
an important design requirement for an
the ­occurrence of bacterial
klassischen Dehnschaft­schraube, wie sie im traditio-
abutment screw. The Thommen
contamination.
nellen ­Maschinenbau für dynamisch hoch ­belastete
Implant System abut­ment screw
·Optimal mechanical stability and­
satisfies this requirement with its
­fatigue resistance thanks to a
unique 4-lobe head ­design. The 4-lobe
superior design and durable
head is specially tapered to ­allow easy
material.
and secure pick-up of both abutment
·Built-in protection from screw
schraube werden einerseits durch das Design einer
­Verbindungen verwendet wird, andererseits durch
die Verwendung einer hochfesten Titanliegierung
­ermöglicht.
Das Thommen Implantatsystems wurde mittels
FEM-­Berechnungen optimiert und die
­Ermüdungsfestigkeit ausgiebig ­getestet. Dabei
screw sizes using a single screwdriver.
loosen­ing with proven design
wurde das System so ­ausgelegt, dass im Falle einer
Further, the 4-lobe head is more
­techniques.
Über­belastung, wie zum Beispiel bei einem Unfall,
resistant to deformation than a
· Easy and convenient handling.
comparably sized hexagon.
With over twenty-five years of proven
­results, The Thommen Implant System
implant/abutment connection and
abutment screw is indeed a solid
connection on which to build a ­lasting,
beautiful restoration.
6
© Thommen Medical
die Abutmentschraube als ­Soll­bruchstelle agiert und
somit das Implantat vor e
­ iner Beschädigung schützt.
Résumé
Riassunto
Resumen
Cet article donne une description détaillée de la
Nel presente articolo viene illustrata in dettaglio la
En el presente artículo se describe de forma deta-
­fonction de la liaison implant/abutment du système
funzione della connessione impianto/abutment del
llada la función de la unión implante/pilar del sistema
d’implants Thommen. La liaison entre l’implant et
sistema Implantare Thommen. La connessione tra
de implantes Thommen. La unión entre el implante y
l’abutment est un des éléments les plus importants
l’impianto e l’abutment è uno degli elementi più im-
el pilar es uno de los ­elementos más importantes de
d’un système d’implants. Différentes exigences sont
portanti di un sistema implantare. Vengono richiesti
un sistema de ­implantes y debe satisfacer diferen-
posées à la fonction, comme la hauteur minimale de
diversi r­ equisiti alla funzione, come un’altezza mini-
tes requisitos, como una altura de construcción mí-
construction pour la flexibilité prothétique, des adap-
male per la flessibilità protesica, accoppiamenti pre-
nima para ­permitir flexibilidad protésica, además de
tations précises, une résistance à la fatigue opti-
cisi, r­ esistenza ottimale alla fatica ecc.
unos ajustes precisos, una resistencia a la fatiga óp-
male, etc. Le système d’implants Thommen utilise
Per offrire la migliore soluzione possibile nel sistema
tima, etc.
une liaison intérieure associée à une bague de gui-
Implantare Thommen viene impiegata una connes-
Para poder ofrecer la mejor solución posible, en el
dage afin d’offrir la meilleure s
­ olution possible. La
sione interna i­ntegrata da un anello di guida. La con-
sistema de implantes Thommen se ha empleado
liaison intérieure est formée d‘un hexagone assurant
nessione i­nterna è dotata di un esagono con fun-
una unión interior complementada con un anillo
la protection antirotationnelle et présente, par rap-
zione a
­ ntirotazionale e, rispetto alla connessione
guía. Dicha unión está formada por un hexágono
port à la liaison e
­ xtérieure, un guidage plus long de
esterna, presenta una guida dell‘abutment più lunga.
para bloquear la rotación y, en comparación con la
l‘abutment. ­Ce guidage est décisif pour la stabilité.
Tale guida è d
­ eterminante per la stabilità.
unión exterior, presenta una guía del pilar más larga.
La bague de guidage est une particularité du
Una particolarità del sistema Implantare Thommen è
Esta guía es determinante para la estabilidad.
­système d’implants Thommen: elle protège la vis
l’anello di guida: questo protegge la vite per
Una particularidad del sistema de implantes Thom-
d’abutment des forces non axiales et empêche un
abutment dalle forze non assiali e impedisce un al-
men es el anillo guía: este elemento protege el torni-
desserrage de la vis.
lentamento della vite.
llo de pilar de las ­fuerzas no axiales y evita que el tor-
La bague de guidage réduit de plus la surface d’ap-
Inoltre l’anello di guida riduce la superficie di
nillo se afloje.
pui entre l’implant et l’abutment, ce qui offre une
­appoggio tra impianto e abutment rendendo
Además, mediante el anillo guía se reduce la superfi-
pression superficielle plus élevée avec le
­possibile, a parità di coppia di serraggio, una pres­
cie de apoyo entre el implante y el pilar, de modo
même couple de serrage et donc une meilleure
sione superficiale più elevata e, di conseguenza, la
que con un mismo apriete se permite una mayor
étanchéification contre les liquides corporels.
­migliore tenuta possibile contro i liquidi corporei.
presión superficial además del mejor sellado posible
La tête de la vis d’abutment est petite, ce qui per-
La vite per abutment presenta una testa di ­piccole
frente a los fluidos corporales.
met d’obtenir un canal de vissage plus fin,
dimensioni, per ottenere un canale di ­avvitamento
El tornillo de pilar tiene una cabeza pequeña que
­nécessaire pour un soin esthétique optimal. Les
più stretto. Ciò è necessario per una ­ricostruzione
permite utilizar un canal más fino. Esta ­característica
­caractéristiques de fatigue optimales de la vis
ottimale dal punto di vista estetico. Le proprietà ide-
es necesaria para una reconstrucción estética óp-
d’abutment sont dues d’une part à la conception
ali di resistenza alla fatica della vite per abutment si
tima. Las propiedades de fatiga óptimas del tornillo
d’une vis à tige allégée classique, telle qu’utilisée
devono da un lato al design di una ­classica vite con
de pilar se consiguen, por un lado, gracias al diseño
dans la construction mécanique traditionnelle pour
gambo scaricato, del tipo tradizionalmente impie-
de un tornillo de dilatación clásico —como los em-
des liaisons soumises à de fortes charges, et d’autre
gato nella costruzione di macchine per connessioni
pleados en la construcción tradicional de ­maquinaria
part à l’utilisation d’un alliage titane à résistance
soggette ad un carico elevato dal punto di vista di-
para uniones dinámicamente sometidas a una ele-
­élevée.
namico, dall’altra all’impiego di una lega di titanio
vada carga—, y, por otro, mediante el uso de una
Le système d’implants Thommen a été optimisé par
estremamente resistente.
aleación de titanio extraordinariamente ­resistente.
des calculs par éléments finis et la résistance à la fa-
Il sistema Implantare Thommen è stato ottimizzato
El sistema de implantes Thommen ha sido optimi-
tigue a été largement testée. Le système a été
grazie a calcoli FEM e la resistenza alla fatica è stata
zado mediante ­cálculos por el método de elemen-
conçu de sorte que la vis d’abutment agisse en tant
ampiamente testata. Il sistema è stato progettato in
tos FEM y la ­resistencia a la fatiga ha sido amplia-
que point de rupture en cas de surcharge, par
modo tale che, in caso di sovraccarico, come ad
mente probada. En este sentido, el sistema ha sido
exemple d’un a
­ ccident, et protège ainsi l’implant
esempio in caso di incidente, la vite per abutment
concebido de modo que, en caso de sobrecarga,
d’un dommage.
funge da punto di rottura prestabilita proteggendo
como sucede por ejemplo en un accidente, el torni-
l’impianto da eventuali danni.
llo del pilar ­actúe como punto de rotura nominal
para proteger el implante contra los daños.
1Binon PP. The Effect of Implant/Abutment Hexagonal Misfit on Screw Joint Stability. Journal of Prosthodontics Vol. 9, 1996; 149–160
2Steinebrunner L, Worfart S, Bössmann K, Kern M. In Vitro Evaluation of Bacterial Leakage Along the Implant-Abutment Interface of Different Implant Systems.
JOMI Vol. 20, Number 6; 2005; 875–881
3Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant supported
single crowns. Clin. Oral Impl. Res.19, 2008; 119–130
4Kreissl ME, Gerd T, Muche R, Heydecke G, Strub JR. Technical complications of implant-supported fixed partial dentures in partially edentulous cases after an
­average observation period of 5 years. Clin. Oral Impl. Res. 18, 2007; 720–726
5Schwarz MS. Mechanical complications of dental implants. Clin Oral Impl Res. 2000; 11 (Suppl.): 156–158
6DIN 250-1: Bolted Connections with Reduced Shank; Survey, Range of Application and Examples of Installation. 1974–09
7Köhler H, Jende S. Motorverschraubung. GWV Fachverlage GmbH, Lexikon Motorentechnik, Der Verbrennungsmotor von A bis Z; Wiesbaden 2004
8ASTM F1295-05 Standard Specification for Wrought Titanium-6 Aluminum-7 Niobium Alloy for Surgical Implant Applications
9 ISO 5832 Wrought Titanium-6 Aluminum-7 Niobium Alloy; 1994-09-01
© Thommen Medical
7
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Thommen Medical USA L.L.C.
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1375 Euclid Avenue, Suite 450
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Cleveland, OH 44115 | USA
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Toll-free phone number:
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Fax+1-216-583-9801
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[email protected]
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SWISS PRECISION AND INNOVATION.
www.thommenmedical.com