3

ABUTMENTS FOR SELECTION AND USE WITH

MORSE TAPER IMPLANTS
MORSE TAPER
Ivete Mattias Sartori*
Srgio Rocha Bernardes**
Alexandre Molinari***
Caio Hermann****
Geninho Thom *****
The works initiated by Brnemark enabled the replacement
of lost dental elements by titanium anchorages inserted
into the bone tissue, used as support for prostheses for the
rehabilitation of totally edentulous 1 patients. The technique
has a well documented use and the implant and prostheses
success rate has been 2,3 satisfactory. Partially edentulous
patients can also be rehabilitated with fxed partial prostheses
supported by osseointegrated implants. The success rate
for this procedure is also high, and it is considered a type of
4,5,6,7 viable clinical procedure. However, as reports of clinical
follow-ups have validated the use of implants as an important
treatment option, some data have shown mechanical
problems, such as screw loosening and breakage, and
therefore led to the search of new designs for the prosthetic
interface. Among the developments, implant internal unions
8, 9 can be highlighted. The most used examples are internal
hexagon and Morse taper. Morse taper is a term which has
its origins in the mechanical tools industry, and it designates
a ftting mechanism in which two elements develop an action
resulting in an intimate contact with friction, when a male
conical element is installed in an also conical female (Figure
1). This kind of ftting was invented by Stephen A. Morse
and was widely used to screw a drill or mandrel of cutting
machines, for example, drilling machines. The Morse taper
angle is determined according to the mechanical properties of
each single material, and involves a relation between the angle
values and the friction between the pieces. This is a biconical
ftting mechanism. In which effectiveness is signifcantly
increased due to the preload generated by the contact
surfaces, from the internal cone to the implant and from the
abutment screw, resulting in the control, 10, 11 maintenance
and torque stability. Mechanical tests in an implants laboratory
environment with internal conical union or Morse taper have
produced excellent prosthetical abutment stability 12,13,14,15
,16,17,18,19,20,21,10,22,23,24,25,26. Analytical calculations
about different parameters of implants with Morse taper
internal union show that this kind of interface, in theory, could
result in great retention and 20,10,27,11,24,29,30,31,32,33
prosthesis stability. In order for the biological advantage of
this kind of interface to be expressed, it is necessary that
the implant installation respect some features. Morse taper
implants installation must be at least 1 to 2 mm inside the
bone, especially in aesthetic regions. This maneuver has
the objective of optimizing and facilitating the maintenance
of the tissues which surround the cervical third of the dental
implant. These considerations consequently lead to small
modifcations in the original protocol ad modum Brnemark.
In case of regions where aesthetics are not the main focus
and the available bone height is not enough, the implant
may be installed in the bone crest level. In these cases, if the
quantity of gingival tissue is not enough, the dentist can face
situations of exposure of the retention system metal, which
will demand special components to enable rehabilitations
which do not interfere in aesthetics. An interesting detail which
has been added to the Morse taper implant is the presence of
threads (Figure 1) up to the region next to the implant top.
Studies show that the peri-implant bone loss or saucerization
stabilizes and stops, normally, at the level of the frst threads
of threaded osseointegrated implants 34. Moreover, as this
incorporated modifcation to the design has made the implant
body diameter equal along its whole length, it is not necessary
to use countersink drills to adapt the implant head. The
preparation must only enable adaptation of the cerival portion,
which is 1 mm long. This is performed with a pilot drill (same
diameter as the implant) (Figure 2).
As clinical aspects interfere in the rehabilitation needs,
different abutment ideas have been proposed. In order for the
correct indication to be made, it is necessary that the local
conditions are evaluated and the choice is made exploring
indications. For that reason, the objective of this paper is
4
to present and clarify clinical sequences to the reader, from
the prosthetical point of view, in which Neodent (Curitiba,
Brazil) Morse taper implants are used. The various options
of prosthetic components for this kind of implant will be
shown, drawing attention to important details in relation to
their application and use, in order to facilitate and improve
clinical resolutions. During the idealization of components,
were considered factors which respected the choice between
cemented or screwed, single or multiple prostheses, and
also the features of the surrounding tissues, caring to offer
concepts already used by the company and options which are
easily understood.

GENERAL FEATURES
According to its mechanical project, the Morse taper implant
(Neodent, Curitiba, Brazil) has a special feature: it does not have
a prosthetic platform. The prosthetic component contacts
the implant through its interface, because there is no prosthetic
seating area on the top of the implant cervical region, as shown
in fgure 1. This fact has enabled the idealization of prosthetic
components with the same design for all implant diameters. The
central hole is the same in all implant diameters in the regular
family (Figure 1). WS and zygomatic implants use different
abutments because they have a different internal hole (fgure
3). When using implant with diameters 3.5, 3.75, 4.0, 4.3 or
5.0, the surgeon does not need to worry about identifying the
implant diameter when choosing a prosthetic abutment, since
they are compatible for all Morse taper implants, whatever their
dimensional features, which facilitates the stock management
at the dentists offce. The Morse taper implants abutments do
not have the screw and the component in two separate pieces;
they are always together, but there are two possible versions:
single piece abutment or through-bolt abutment. Nevertheless,
the screw in the through-bolt version is stuck to the component,
there is no possibility of taking off the screw which is housed
through the abutment. Figure 4 shows examples of single piece
and through-bolt components, focusing on the screw/abutment
relation. Neodent Morse taper interface does not have any kind
Detail of the conical male/female ftting
used in an implant with Morse taper
prosthetic interface. Notice that the implant
has threads up to the top of the superior part.
Available diameter and their drill profles
FIGURE 1
FIGURE 2

3

.
0
m
m
17 30
Diagrammatic drawing of WS and
Zygomatic implants.
Internal area measurements.
The abutments are specifc for these
two models.
Diagrammatic drawings of prosthetic components in the single piece
and through-bolt (straight and angled) families, detail of the relation
between screw and abutment. Angled and customizable abutments will
always have a through-bolt.
FIGURE 3:
FIGURE 4:
implantes WS Zigomticos
M
I
N
I

P
I
L
A
R

C

N
I
C
O
M
I
N
I

P
I
L
A
R

C

N
I
C
O

A
N
G
U
L
A
D
O
P
I
L
A
R

C
M
M
U

N

U
N
I
V
E
R
S
A
L
M
U

N

U
N
I
V
E
R
S
A
L

T
O
R
N
I
L
L
O


P
A
S
A
N
T
E
M
U

N

A
N
A
T

M
I
C
O
M
U

N
G
U
L
O

U
N
I
V
E
R
S
A
L
5
of anti-rotational system, which facilitates the surgical installation,
so the surgeon never needs to worry about the place where the
implant must be stabilized, but rather about when the primary
stability will be achieved which is favorable to the long life of
its fxation. From the restorer point of view, this detail enables
the installation of the prosthetic component in 360 different
positions, which facilitates cases of angled implants. Most of the
Morse taper prosthetic components are supplied in two angled
options: 17 or 30, with three options of transmucosal part: 1.5,
2.5 and 3.5 mm. All angled components have a screw which runs
through its structure, as do all customizable components, which
characterizes the through-bolt version.
HEALING SELECTION
TYPES OF ABUTMENTS FOR MORSE
TAPER IMPLANTS
When selecting healing, it is necessary to study the tridimensional
prosthetic space and the mucous thickness. As the healing has the
same design as the abutments in its subgingival portion, it is important
that it is selected according to the height of the gingival tissue and
has the same diameter as the abutment which will be used later. The
available collar heights are: 0.8 to 6.5 mm and the available diameters
are 3.3 and 4.5 mm. The healing shape allows the cicatrization of the
gingival tissue. The concave area will offer conditions for the tissue
growth and the selection of the abutment must respect the outline
formed by the healing (fgure 5). The heights of the straight abutments
vary from 0.8 to 6.5 mm and should be chosen according to the
gingival height found. As the internal shape is the same, if the healing
transmucosal height chosen is too high, the gingival tissue formed will
respect that design. If the abutment collar choice is not compatible (if
it is lower), the abutment will apply a lot of pressure on the tissues and
the patient will report pain generated by compression (Figure 6). In this
case, it is recommended to choose healings of the same diameter
as the abutment and the same height as the gingival tissue. The
choice of the abutment height must be compatible (Figure 7). When
it is chosen at the same height, the fnal height will be 0.9 mm lower.
If the area requires more safety in relation to the subgingival space,
an abutment with a lower collar can be chosen, but in this case the
anesthesia should be used frst, then the abutment can be installed
and the torque can only be applied after tissue accommodation.

Appearance of the design of a healing chosen at the same height as
the gingival tissue and its effect on the tissue structure.
Diagrammatic simulation of the choice of an abutment with a collar
height lower than the healing collar.
The abutment convexity will pressure the soft tissue.
healings with 3.3 and 4.5 mm heights / abutment with 3.3 and 2.5
mm heights
Diagrammatic simulation of a situation in which an abutment was
chosen with the same height as the healing. The fnal height difference
will be 0.9 mm.
healings with 3.3 and 4.5 mm heights / abutment with 3.3 to 4.5 mm
heights
FIGURES 5A AND B:
FIGURAS 6A AND B:
FIGURES 7A AND B:
cicatrizador de 3.3 y 4.5 mm de altura intermediario de 3.3 y 2.5 mm de altura
height difference
0.9 mm
pain and edema
pain and edema
In case of rehabilitations, the frst decision to be taken will be in
relation to the type of prosthesis. They can be cemented or screwed.
This decision must be based on the analysis of advantages and 35
disadvantages that they both represent. As Morse taper implants
have the feature of screws stability, it is possible to choose cemented
prostheses whenever the clinical features point to this option. Screwed
prostheses should be chosen, only in cases in which the reversibility
factor is important (for example, in partial prostheses or total arch),
1. FOR CEMENTED PROSTHESIS
The abutment types for cemented prostheses are: universal post and
universal post with a through-bolt.
6
UNIVERSAL POST
They have two versions: solid and with a through-bolt. The
solid universal post is a single piece component. It should be
indicated in situations of well positioned implants, in which
there will not be the necessity of component adaptations. The
surgeon should choose the collar height, the size and diameter
of the coronary portion and the implant angle. The post with a
through-bolt has the options of preparing in the whole profle,
which enables it to be adapted in cases of inclined implants
or in relation to the cervical contour, when one wishes to
customize the proximal areas. Besides the transmucosal height
options shown previously, this component is also supplied in
two diameter options (3.3 and 4.5 mm) and two options of the
coronary part length (4 or 6 mm). The selection will be based
on the interocclusal space offered and the desired cemented
area. The coronary part end has the shape of chamfer and the
walls are inclined to optimize the cement outfow. In the case
of angled implants, the two options previously cited are also
available (17 and 30).
A B
C
D
Universal post accessories, available for all height and diameter
options.
Intermediate transfers
universal post
code 108.042 to 108.045
Intermediate replicas
code 101.038 to 101.041
Universal post cylinder
Acrylic: provisory prosthesis code
118.186 to 118.189
Calcinable: foundry code 118.181 to
118.184
Alumina: metal-free prosthesis code
118.192 to 118.195
Acrylique Calcinable Alumine
FIGURES 8:
E
F - A F - B
G
H
I
J - A J - B
L -A L - B
M -A M - B
N - A N - B
Universal post clinical sequence
A and B - height choice with the CM height measurer.
C and D - universal posts installed.
E - occlusal view of provisories.
F A and B - interocclusal registers being obtained.
G - Molding components of universal posts in position.
H - Obtained mold: position the universal post replicas on the molding
abutments.
I - obtained plaster mold.
J A and B - Registers which have been obtained inside the mouth (fg. 7)
positioned on the model, enabling mounting on articulator.
L A and B - Crowns obtained by ceramics application on alumina cylinders.
M A and B - Test of the crowns in the mouth.
N A and B - X-rays obtained at the moment of the test.
FIGURE 9:
7
The universal post, as all components which are premade
manufactured abutments, have accessories available.
These are: casting components, replicas, copings for
provisory crowns, calcinable copings or copings in Allumina-
Zirconium (fgure 8). All these accessories are compatible with
the universal posts, whatever their groove height, angle, with
or without a through-bolt. The casting components are made
of plastic and destined for single use. They adapt slightly
below the end of the component by means of claws which
surpass the component cervical design. Therefore, especially
in cases when the abutment collar chosen is more than 1
mm under the gingiva, the tissue should be sculpted with
provisory material, which results in aesthetic and adaptation
of the casting abutment. The casting components should
be used for the technique with the closed guard tray. The
coping for provisory is made of acrylic resin and the surgeon
only needs the premade facets to perform the restoration;
this cylinder can also be used for interocclusal register,
when necessary. The calcinable cylinder is prepared by the
laboratory technician for waxing and ulterior fusion in metal,
preferably for ceramics application. For Alumina-Zirconium
cylinders, the technician just has to apply the same ceramics
which is used on reinforced metal-free copings. Metal-free
copings enable the addition of reinforced restored ceramic
material (aluminized porcelain, Build-up from Allceram,
Dentsply), adapting the clinical case to each special situation,
with no risk of breaking the feldspathic porcelain due to the
lack of ceramic support. In cases in which preparations are
necessary, it would be ideal to use the through-bolt post. This
component enables preparation in a laboratory environment.
However, if small preparations in the active part are necessary,
where the prosthesis is cemented, to solve any problem of
interocclusal space limitation, with no need to modify the end,
these preparations could be made directly inside the mouth.
In this situation, accessories cannot be used by the technician
and the preparation must be made before applying the torque.
In situations in which the soft tissue from the area which will
be rehabilitated has different papillary heights, or in cases in
which the height of gingival tissue in the vestibule face requires
a collar size that does not seem to be a good option of height
in relation to the interproximal bone level (because it results
in infraosseous adaptation), the best option is to indicate the
use of the post with a through-bolt. This component enables
preparation and can offer the control of the end area in the
laboratory.
Initially, the surgeon will transfer the implant position to
the work model, molding the implant surrounding tissue
with the help of a component for closed guard tray, which
adapts directly on the Morse taper implant interface. With
this model ready, the technician will install the universal post
with a through-bolt and prepare it in the laboratory. Notice,
on fgure 4, that the inferior portion of the Universal Post
with a Through-Bolt has a convex shape, different from that
of the straight Universal Post. It is this feature which allows
its preparation, because there is a large quantity of metal,
which accepts a reduction. The prothetist will idealize all the
indicated cervical and coronary preparation on the abutment.
After the preparation, the technician will make a transfer
guide in acrylic resin, adapted in the whole preparation and
in the occlusal faces of the neighbor teeth. The upper part
should be open, enabling the entrance of the driver to remove
and install the abutment. Figure 10G shows an example of a
guide ready to be used. This is an important step, because the
dentist will have a reference which will enable the installation
of the prepared post on the patients implant in the same
position in which it was prepared on the model. In order to
facilitate the technique, it is interesting that, when one uses
this idea, the infrastructure of the defnitive crown is already
prepared for testing and remounting, as well as the provisory
crown which will be installed, since it is not recommended
to remove the abutment after the test. The idealization of
the prosthetic infrastructure in the laboratory also means a
technical facility for the correct adaptation of the abutment,
since it is idealized on top of the prepared abutment itself. It is
important to highlight that this component screw has a union
A
B
C D
E F
G
I
H
Universal post with a through-bolt
clinical sequence
A - initial clinical situation.
B - post choice with selection kit.
C - post x-ray.
D - implant transfer.
E - transfer + replica set (repositioning)
F - post preparation on model.
G - post installation + positioning
guide (15 N.cm).
H - installed post.
I - fnished rehabilitation.
FIGURE 10:
8
area of the screw shaft with the thread, made by welding.
Thus, both the dentist and the prothetist should be careful
when working with it. The recommended torque is from 10
to 15 N.cm. It is enough to offer an excellent interlock and
not offer any risks to the integrity of the welded union. In the
cases in which it is necessary to angle the component but
a cervical preparation is not necessary, the angled universal
post can be chosen and installed directly inside the mouth,
as shown in fgure 11. In this case, the implant was installed
in an inclined position, which required the angled abutment.
However, the use of a selection component with a 2.5 mm
collar showed a good cervical selection with the gingival
tissue and the interproximal bone level. This made the cervical
preparation unnecessary. Thus, the component can be used
directly inside the mouth. As no preparation was made, the
work sequence uses the premade components.
A
B
C - A C - B
D E
Universal post with through-bolt clinical sequence
A - selection component in position (2.5 mm collar 17 angle).
B - x-ray image of selection component. Enables evaluation of collar in
relation to interproximal bone level.
C A and B - 17 angled universal post installation.
D - provisory crown installed.
E - x-ray image of installed provisory crown.
FIGURA 11:
ANATOMIC POST
An abutment in the same family as the universal post with
a through bolt is being created, but with a larger quantity of
metal for the preparation creation. This is a component that
offers a greater titanium mass for preparation. Ideally, it should
be chosen with a collar height which is compatible with the
requirement of the proximal areas to the local in question, and
the collar can be 1 or 2 mm under the gingiva. The exposed
areas in the free faces will then be prepared in the laboratory, in
the same manner described for the posts with a through-bolt.
It is also possible to use this component clinically. The main
feature in relation to the implant position which will lead to its
choice will be in cases in which the vestibularization of the
crown emergence is desired. It works as if it would extend the
cervical area so that the emergence profle can be facilitated.
There are also the advantages of enabling adaptations of the
coronary and cervical portions and the internal profle. Thus, it
can be thoroughly adapted to the indicated place (fgure 12).
Anatomic post use clinical
sequence. This component
is being developed and will
soon be available in the
catalogue.
A - occlusal appearance of
installed implant.
B - selection component in position.
C - x-ray appearance of selection component in position.
E - ceramic crown installed.
F - fnal x-ray appearance.
FIGURE 12:
9
Although the necessity of infra-osseous installation of the
Morse cone implant is already well established, sometimes
that does not happen. The result of a surgery in which the
implant has been installed above the bone crest can be the
exposure of the implant in the oral cavity. The implant top,
when it is above the gingival level, prevents the installation of
any of these cited abutments due to the metallic portion, which
would be apparent. In this case, the indication of abutment
choice would be the customizable Post 0.2. Its use requires
from the surgeon the same steps described for the universal
CUSTOMIZABLE POST
MORSE TAPER ABUTMENT
A B
C D
E F
post with a through-bolt family: the implant should be molded.
After obtaining the mold, a replica should be installed of the
same diameter as the implant which is in place (because,
in more extreme cases, the crown adaptation will involve
the implant cervical portion) and sent to the laboratory. The
prothetist will install the component on the model, make the
preparation needed, create the provisory crowns, the defnitive
crowns infrastructures and the transfer guide which enables
the positioning of the component in the mouth in the same
position as in the model. The crowns may have their ends
positioned in the cervical portion of the implant or, in cases in
which the implants are apparent in the mouth, the waxing can
involve up to the height marked on the replica, fnishing as in
a knife blade. Notice that, although this component offers a
solution for complex cases, these should ideally not happen.
This is the reason for which this component is not in the
catalogue: so that the surgeons do not grow accustomed
to indicating it and its use is not too widespread. It should
be understood as a component which annuls the biological
beneft of the Morse taper concept.
2. FOR SCREWED PROSTHESIS
The abutments for screwed prostheses with Morse taper
interface can be divided in two groups: for unitary or multiple
prostheses
0.2 mm customizable post use clinical sequence.
A - Morse taper implants with positioning problems.
B - molding abutments installed directly on implants.
C - positioned model obtained with prepared abutments and resin transfer
guide.
D - transfer guide positioned enabling abutment transfer.
E - cemented crowns.
F - x-ray appearance.
FIGURE 13
For screwed unitary rehabilitations, the surgeon will use the
Morse taper Abutment (Neodent, Curitiba, Brazil) on the
dental implant, installing it directly in the mouth. It should
be recommended in case of posterior unitary prosthesis in
which, for any reason, a cemented prosthesis is not desired.
It is not recommended for front teeth due to the abutment
volume. Also because in front segments, it is recommended
to use a cemented prosthesis to enable the achievement of an
anatomy which is closer to natural elements which have been
lost. As the Morse taper concept is reliable in relation to screw
stability, there is no reason not to recommend the cemented
prosthesis in an aesthetic area. However, in posterior areas
there can be a low interocclusal height or a large mesiodistal
distance, jeopardizing the cemented unitary prosthesis
stability. Moreover, the Morse taper abutment facilitates the
steps to make the prosthesis. However, this abutment does
not have any angled options available. This component can
be seen in fgure 13. It is like the GT abutment adapted to
the Morse taper implant. As it is an abutment with a wider
diameter, the anti-rotational part is in the cylinder internal
design. The prosthetic screw also has a wider diameter, as is
therefore more resistant.
10
MORSE TAPER MINI-ABUTMENT
FIGURE 14:
Diagrammatic drawing of Morse taper
Abutment
FIGURA 15:
Morse taper Abutment clinical sequence.
A - occlusal appearance of positioned healing.
B - initial x-ray appearance.
C - occlusal view showing the appearance of gingival tissue
conditioned by healing.
D - CM height measurer positioned, enabling evaluation of gingival
tissue height.
E - use of a component from the CM abutment selection kit, enabling
the evaluation of gingival level, relation of height chosen with the
proximal bone and implant axial position.
F - x-ray appearance of 4.5 mm height component in position, notice
the relation between collar and bone level.
G - 4.5 mm Morse taper abutment already installed.
H - application of recommended torque: 32 N.cm.
I - x-ray appearance of installed 4.5 mm Morse taper Abutment.
J - A - B - C - transfer technique: x-ray appearance of installed
molding component, insertion of molding material and obtained mold.
L - metal-ceramic crown on model.
M - metal-ceramic crown - vestibular view.
N - x-ray appearance after crown installation.
For multiple prostheses, the abutment option is well known:
the mini conical abutment (Neodent, Curitiba, Brazil).
It is available according to the collar and angle options
already cited. There was a special care not to modify the
abutment design, so that there was no change either in
the concept which was already used in external or internal
hexagon implants or in the prostheses production options.
After installing the abutment, the sequence to obtain the
prosthesis will be the same already used. In relation to
the abutment collar height choice, it is recommended
to be at gingival level in immediate load cases, and 1 to 2
mm below the gingiva in cases where there are already
osseointegrated implants in aesthetic areas. Even in cases
of lower total arch prostheses, it is better that the choice
is made not to leave the abutments above the gingiva
(fgure 16). Remember that the Morse taper abutment
concave area has the role to enable fbers to fll the area,
and they will maintain the gingival tissue height (Figure 17).
FIGURA 16:
Choice of mini conical abutment height in case of immediate load:
Approximate gingival tissue and calculate the gingival level which will
be obtained after suture.
11
FIGURA 17:
Gingival height maintained after osseointegration period.
In order to help with the abutment selection, there is a Morse
taper height measurer (Figure 18) and the prosthetic selection
kit (fgure 19). The kit offered by the company is made in
titanium, which enables sterilizing and radiological imaging.
The following features should be analyzed:
A. Unitary or multiple prosthesis.
B. Screwed or cemented prosthesis.
C. Interocclusal prosthetic space (height and width).
D. Need for angle correction or parallelism among components.
E. Quantity (height) and quality of transmucosal tissue.
F. Distance from the prosthesis end (cement line) to the bone
crest around the implant.
Feature F is especially relevant in cases where there is an
aesthetic implication. While selecting the prosthetic abutment,
an x-ray should be obtained to evaluate the relation between
the prosthesis end and the bone crest, whose distance should
be at least 1 mm, but values of 2 or 3 mm are preferable when
it is possible to obtain them. This measure has the objective of
maintaining the bone tissue, because it respects the biological
space around the implant. Figure 19 shows a clinical case in
which this selection was used.
The single piece components should be tightened with a
torque of 32 N.cm. The components which have a through-
bolt cannot be tightened with more than 15 N.cm. In case
of screwed prostheses on mini conical abutment, the torque
used is 10 N.cm on the prosthetic retention screw; when
the Morse taper post is used, the torque is 20 N.cm (on the
prosthetic screw).
Morse taper implants offer prosthetic components options for
successful rehabilitation in edentulous spaces, for all clinical
realities, with no difference in relation to any other type of
implant system. However, as always when introducing a new
concept, it is necessary that the surgeons study and get to
know the correct recommendations for each abutment. Thus,
is also useful that the correct positioning of the implant is
obtained, based on correct planning, so that all advantages
offered by this new design can be explored and obtained.
AUXILIARY RESOURCES FOR
ABUTMENT SELECTION
TORQUE APPLICATION
CONCLUSION
FIGURA 18:
Morse taper height measurer.
Enables analysis of gingival tissue
height.
1 a 1,5mm
1 a 2mm
FIGURA 20:
The position of the universal post cementing line should be at least 1.0
mm below the gingiva and 1.5 mm away from bone tissue, respecting
aesthetics and biological space around the implant.
FIGURA 19:
Morse taper prosthetic
selection kit




x
CM Prosthetic Components Selection
T
y
p
e

o
f

p
r
o
s
t
h
e
s
i
s
1. Screwed
Unitary Prosthesis
A. Abutment level
Work manner
B. Implant level
Well positioned
Universal
post
Universal post with
through-bolt
Inclined or requiring
prosthetic abutment
customization
Implant position Unitary Prosthesis
Implants above the gingiva or at
gingival level (with lack of soft
tissue) - Customizable post
(0.2 mm).
Multiple Prosthesis
Multiple Prosthesis
GT Abutment Mini conical abutment
2. Cemented
12
REFERENCES
1. Brnemark P-I; Hansson BO; Adell R; Breine U; Lindatrm J; Halln O. Osseointegrated
implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J
Plast Reconstr Surg Supl 1977; 16:1-132.
2. ADELL,R. et al. A 15-year study of osseointegrated implants in the treatment of the
edentulous jaw. Int J Oral Surg, 1981;10(6): 387-416.
3.ADELL,R., et ai.. A long-term follow-up study of osseointegrated implants in the treatment
of totally edentulus jaws. Int. J. Oral Maxillofac. Implants, v.5, n.4, p.347-59, 1990.
4.VAN STEENBERGHE, D.Bolender,C.et al. The applicability of osseointegrated oral
implants in the rehabilitation of partial edentulism;a prospective multicenter study on 558
fxture. International Journal of oral and Maxillofacial implants, 1990, p. 272-281.
5.ZARB, G.A. & Schimitt. A. The longitudinal clinical effectiveness of osseointegrated dental
implants in anterior partially edentulous patients.International. Journal of prosthodontics,
1993, p.180-188.
6.JENDRESSEN,M.D. et al. Annual review of selected dental literature: Report of the
Committee on Scientifc Investigation of the American Academy of Restorative Dentistry. J.
Prosthet. Dent.1995; 74(1): 60-83.
7.de Deus G, Camanho D, Mendes MCS, Costa E, Souto C, Saliba FM. Avaliao do grau
de sucesso de sucesso de implantes Neodent nos cursos de Implantodontia da Unesa/RJ
um retrospectivo de cinco anos. Revista Implantnews 2007;4:617-20.
8.Binon 2000a;
9.Jokstad A, Braeger U, Brunski JB, Carr AB, Naert I, Wennerbergh A. Quality of dental
implants. Int Dent J 2003;53(suppl 2):409-443.
10. Perriard J, Wiskott WA, Mellal A, Scherrer SS, Botsis J, Belser UC. Fatigue resistence of
ITI implant-abutment connectors - a comparison of the standard cone with a novel internally
keyed design. Clin Oral Implants Res 2002;13:542-549.
11. Bozkaya D, Mft S. Mechanics of the tapered interface ft in dental implants. J
Biomech 2003;36 (11): 1649-1658.
12.Sutter F, Weber HP, Sorensen J, Belser U. The new concept of the ITI dental implant
system: design and engeenering. Int J Periodontics Rest Dent 1993;13:409-431.
13.Binon PP, Sutter F, Beaty K, Brunski J, Gulbransen H, Weiner R. The role of screw in
implant systems. Int J Oral Maxillofac Implants 1994;9(supply 1):48-63.
14. Mllersten, Lockowandt e Lindn 1997;
15.Norton MR. An in vitro evaluation of the strength of an internal conical interface
compared to a butt joint interface in implant design. Clin Oral Impl Res 1997;8:290-298.
16.Norton MR. Assessment of cold wedding properties of the internal conical interface of
two commercially available implant systems. J Prosthet Dent 1999;81:159-66.
17.Norton MR. An in vitro evaluation of the strength of the conical implant-to-abutment joint
in two commercially available implant systems. J Prosthet Dent 2000a;83:567-71.
18.Norton MR. An in vitro evaluation of the strength of a 1-piece and 2-piece conical
abutment joint in implant design. Clin Oral Implants Res. 2000b;11:458-64.
19.Romanos GE, Nentwig GH. Single molar replacement with a progressive thread design
implant system: a retrospective clinical report Int J Oral Maxillofac Implants 2000;15:831
836.
20.Merz B, Hunenbart S, Belser UC. Mechanics of the implant-abutment connection:
an 8-degree taper compared to a butt joint connection. Int J Oral Maxillofac implants
2000;15:519-526.
21.Khraisat A, Stegaroiu R, Nomura S, Miyakawa O. Fatigue resistance of two implant/
abutment joint designs. J Prosthet Dent 2002;88:604-10.
22.ehreli MC, Aka K, Iplikiolu H, Sahin S. Dynamic fatigue resistance of
implantabutment junction in an internally notched morse-taper oral implant: infuence of
abutment design. Clin Oral Implants Res. 2004 Aug;15(4):459-65.
23.Kitagawa T, Tanimoto Y, Odaki M, Nemoto K, Aida M. Infuence of implant/abutment
joint designs on abutment screw loosening in a dental system. J Biomed Mater Res B: Appl
Biomater 2005;75B:457-463.
24.Erneklint C, dman P, rtengren U, Karlsson S. An in vitro load evaluation of a conical
implant system with 2 different designs and 3 different retaining-screw alloys. Int J Oral
Maxillofac Implants 2006;21:733-737.
25.Copped A. 2007.
26. Bernardes SR. Avaliao mecnica da estabilidade de parafusos protticos em
diferentes sistemas de reteno pilar/implante. Tese, FORP/USP,Ribeiro Preto, 120 p.
27.ahin S, Cehreli MC, Yalcin E. The infuence of functional forces on the biomechanics of
implant-supported prostheses - A review. J Dent 2002,30:271-282.
28. Bozkaya D, Mf S. Mechanics of the taper integrated screwed-in (TIS) abutments used
in dental implants. Journal of Biomechanics 2005;38:87-89.
29.Akour SN, Fayyad MA, Nayfeh JF. Finite element analyses of two antirotational designs
of implant fxtures. Implant Dent. 2005 Mar;14(1):77-81.
30.Chun HJ, Shin HS, Han CH, Lee SH. Infuence of implant abutment type on stress
distribution in bone under various loading conditions using fnite element analysis. Int J Oral
Maxillofac Implants. 2006 Mar-Apr;21(2):195-202.
31.Maeda Y, Miura J, Taki I, Sogo M. Biomechanical analysis on platform switching: is there
any biomechanical rationale? Clin Oral Implants Res. 2007;30:1-4.
32.Malevez C, Hermans M, Daelemans P. Marginal bone levels at Brnemark system
implants used for single tooth restoration. The infuence of implant design and anatomical
region. Clin Oral Implants Res. 1996 Jun;7(2):162-9.
33.Chee W, Jivraj S. Screw versus cemented implant supported restaurations. British Dental
Journal 2006;201:501-50