Assessment of leakage at the implant-abutment connection using a new gas flow method.

PURPOSE: The aim of this study was to evaluate, with a new gas flow technique, leakage at the implant/abutment junction in systems with four different connections. MATERIALS AND METHODS: Five Branemark System, five One Morse, five Intra-lock System, and five Ankylos Plus implants and abutments were used. A hole was drilled in the apex of each implant to allow gas to flow through the connection from negative to atmospheric pressure. The gas flow was calculated (slope of pressure decrease, in hPa.s-1). Each connection was tested after both manual and key tightening. Statistical analysis was performed on a generalized linear model with repeated measurements. The significance level was set at α=.05. RESULTS: A global significant difference was observed between the various systems (P=.0001). After manual tightening, gas leakage was (Ln[hPa.s-1], means±standard deviations): One Morse: 0.20 (±1.70); Branemark System: -4.56 (±2.61); Intra-lock: -4.31 (±4.17); Ankylos Plus; -7.59 (±0.76). After key tightening, mean values were: One Morse: -2.51 (±2.72); Branemark System: -7.23 (±1.01); Intra-lock: -7.76 (±0.50); Ankylos Plus; -7.73 (±0.62). CONCLUSION: This study confirms that gas flow is an appropriate method to assess connection leakage. Ankylos Plus connection leakage was very low when the assembly was tightened manually. Among conical connection systems, low (Ankylos Plus) and high (One Morse) leakage was observed. This gas flow study suggests, therefore, that connection design is not the most important parameter for implant/abutment connection leakage.

Development of a new quantitative gas permeability method for dental implant-abutment connection tightness assessment.

BACKGROUND: Most dental implant systems are presently made of two pieces: the implant itself and the abutment. The connection tightness between those two pieces is a key point to prevent bacterial proliferation, tissue inflammation and bone loss. The leak has been previously estimated by microbial, color tracer and endotoxin percolation. METHODS: A new nitrogen flow technique was developed for implant-abutment connection leakage measurement, adapted from a recent, sensitive, reproducible and quantitative method used to assess endodontic sealing. RESULTS: The results show very significant differences between various sealing and screwing conditions. The remaining flow was lower after key screwing compared to hand screwing (p = 0.03) and remained different from the negative test (p = 0.0004). The method reproducibility was very good, with a coefficient of variation of 1.29%. CONCLUSIONS: Therefore, the presented new gas flow method appears to be a simple and robust method to compare different implant systems. It allows successive measures without disconnecting the abutment from the implant and should in particular be used to assess the behavior of the connection before and after mechanical stress.