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Paul P.

Binon, DDS, MSD

Evaluation of Machining
Accuracy and Consistency
of Selected Implants,
Standard Abutments, and
Laboratory Analogs

Private Practice of Prosthadimtics


Rose ville, California;
Research Scientist
Department of Restorative Derttistry
School of Dentistry
University of California, San Francisco
San Francisco, California

Thirteen implants having external hexagonal extensions were evaluated for


machining accuracy and consistency, A composite score was derived to
evaluate overall manufacturing accuracy and consistency of the implants
evaluated in this study. A technique to determine the rotational freedom
hetween implant and abutment is descrihed, and the coronal hexagonal
matings of selected implants and abutments is evaluated and reported.
Crossover use and combinations of products from different manufacturers
was also evaluated fur rotational freedom. Two nonexternal he>:agonal
extension implant configurations were measured for rotational movement as
contrasting and comparative values, Int I Prostbodont 1995;8:162-178.

he introduction and popularity of the


Brnemark implant (Nobelpharma AB,
Gteborg, Sweden) rapidly stimulated the commercial availability of 25 variations o implants having
external hexagonai extensions,' With expanded
implant use for single tooth and partially edentulous applications, the primary purpose of the
hexagonal coronal extension has changed from a
rotational torque transferring mechanism used during the surgical placement of the implant into a
prosthesis indexing and antirotational mechanism,The machined hexagonal extension on the coronal
aspect of the implant and its matching abutment
counterpart comprise the primary docking device
between the implant and the abutment. The impression coping transfers the exact oral relationship of the
implant to the working cast by using the hexagonal
extension as an orientation mechanism.' The hexagonal configuration is also intended to prevent rotation of the abutment on the implant mating surface
and to provide a more stable screw joint assembly,''"^
Clinical requirements often result in the crossover
use of products from different manufacturers.
Considerable variation has been reported in the
accuracy, consistency, and fidelity of some implant
components,'" The amount of freedom between lhe

implant hexagonal extension and its abutment counterpart has also been implicated as a factor in screw
joint instability.'"" The purpose of this study was to
evaluate the machining accuracy and consistency of
thirteen implants having external hexagonal extensions and to determine the rotational freedom
between the patrix implant hexagonal extension and
the matrix hexagonal abutment counterpart.

Materials and Methods


Evaluation of accuracy and consistency of
machining is based on direct measurements
obtained at selected locations, A minimum of five
randomly selected implants were measured with a
digital micrometer (Model 293, Mitutoyo, Tokyo,
japan) and a micrometer microscope (Gertner
Scientific Institute, Chicago, IL), capable of one
micrometer accuracy, A larger sample size was
reported whenever additional components were
available for measurement. Operator error was
evaluated by measuring five replications at the
same location for 11 different samples. Sample
variance for the replications ranged from 0 to 6,4
X 10"' (average variance for all 11 samples was
3,71 X 10') and the standard deviation ranged
from 0 to ,00075, indicating minimal operator
error. Measurements were made at the following
locations: coronal (head) diameter, body diameter
across the threads (width), height and width of the

Reprint requests: Dr Paul P Binon, 1158 Cirby Way, Roseville,


California 95661.

The Imernational lournal of Proslhodontri

162

Accuracy and Coniteilty ol Implants, Abutmenli, and AraloRS

Fig 1 Typical external hexagonal extension implant and


standard abutment oonfiguration. Measurements for the
implant were taken at: C - coronal (head] diameter; D . body
diameter {width); E - hexagonal
extension height, and F hexagonal extension width
from flat to flat for all three
opposing surfaces. Standard
two piece abutments were
measured for: A - collar width
and B - collar length.

Fig 2 Illustration of the calibrated protraotor table base


and pointer handle used to
determine the rotational freecfom between hexagonal oomponenls. The implant was
secured in the table base with
a set screw and the abutment
cylinder was seated on the
implant and secured to the
implant with the abutment
screw. The needle pointer was
attached to the abutment collar
with a set screw. The pointer
handle was then rotated left
and right, and the movement
was recorded in degrees traveled.

<

bntji

imn

mn

Fig 3 Cross sectional view ot the mcunled


implant/abutment unit as it was secured in the
table base with the needle pointer attached to
the abutment cyiinder. Set screws heid each
component in place while allowing tree rotation
of the abutment on the implant face.

hexagonal extension from flat surface to flat surface {Fig 1). All three pairs of flats were measured
and averaged together. The greatest difference
noted between flats on the same hexagonal extension, ihe high and low values within the grouping,
along with the range of the discrepancy, are
reported. The difference between the greatest and
smallest values measured at each location is defined
as the range and is used as an indicator of machining
tolerances, accuracy, and consistency. Two piece
standard abutment collar width and collar length
were also measured (Fig 1 , Three different abutment
lengths were combined in tbe group because of
availability. The variation in like samples, irrespective of designated length, still indicate the overall tolerances that can be expected from the manufacturer
for tbis important measurement. Respective implant

a. [-,'umber 2, I

analogs were also measured for the height and width


(flat to flat) of the hexagonal extension.
Abutment to implant hexagonal extension rotational freedom movement! was measured in
degrees. This was accomplished using a large calibrated protractor table that firmly secured the
implant in the center of a 180 degree circle (Fig 2),
A cross sectional view of the abutment/implant
connection mounting block is illustrated in Fig 3.
The abutments were placed on the implant face
and secured with the abutment screw while still
allowing rotation of the abutment, A needle
attached to the abutment collar was rotated to the
left and to the right until the matrix hexagonal
receptacle would bind with the patrix hexagonal at
each extreme (Fig 4), The difference between the
clockwise and counter clockwise movement was

163

Tlie I me relations I lournal o( Prosthodoriii

Accuracy and Consistency of Implants, Abutments, and An

Action during
abutment rotation

Passive abutment/implant
hsx connection

"j K /
_ Gap G

Rotational
freedom
\ recorded
\ with
\ needie

1/
\ \

'^^"^ t 1

(
mplant hex _y
(external)

/i

Abutment
hex
(internal]

not considered to be from normal distributions, at


the significance level A, and are compared using
the Wilcoxon-Mann-Whitney rank sum test.
Those samples passing the Studcntized range test
for normality were compared using the Hartley test
for equality of variance, in which the ratio of the
largest sample variance to the smallest sample variance among S samples, each of size N, were compared at the significance level A to the critical
value of Fmax{N,S;A). If the test ratio was greater
than this critical value, tbe samples were not considered to be from normal distributions with equal
variance. Clusters of samples passing the
Studentized range test for normality and the
Hartley test for equal variance were compared for
differences of means, using both the Link-Wallace
test and an analysis of variance. The Link-Wallace
statistic is the common sample size N multiplied
by the ratio of the range of 5 sample means to the
sum of 5 sample ranges. If this statistic is greater
than the critical value K{N,S;A), the sample means
are not considered to be equal. The test statistic
used in the analysis of variance is the ratio of variance between means of samples in a cluster to the
sum of variances witbin the samples. This statistic
is compared to tbe theoretical distribution, F, and a
Pvalue is listed.

recordeid as the amount of rotational freedom


within the mating and was reported in degrees.
The closer the machining tolerances, the smaller
the motion.
Hexagonal
extension
implants
from
Nobelpharma USA 3.75 X 15 [NP| (Chicago IL),
Stryker 3.75 X 1 3 STRl (Kalamazoo, Ml), Steri-Oss
4.1 X 8 [SO] (Anaheim, CA), Implant, innovations
Inc. 3.75 X 15 and 4 X 18 |3il (West Palm Beach,
FL), Osseodent 3.75 X 10 [OTC) (Palo Alto, CA],
Implant Support Systems 3.7.') x 13 and 3.75 x ]5
[ISSl (Irvine, CA), IMTEC 3.75 x 8 [IMTEC]
(Ardmore, OK], Dentsply-Core-Vent Div. 3.75 x
10 [SV] (Encino, CA], Impla-Med 3.75 X 15 [IMP]
(Sunrise, FL), Bud Ind. 3.5 X 4 [Bud] (East Aurora,
NY), Crossmark 3.75 X 15 [Xmark] (Belmont, CA),
and Interpore Int. 4 X 1 3 cylinder [IMZ] (Irvine,
CA] were evaluated.
Statistical Analysis

Data were analyzed using a pooled mean and


standard deviation for each data set. The pooled
mean and standard deviation are the average of the
means and standard deviations of the individual
samples, weighted by the number of items in each
sample. The minimum of a sample subtracted from
the maximum of that sample is the "range" of the
sample, and is represented by the symbol w. The
range of a sample divided by the standard deviation
(s), yields the "Studentized range", (w/s). The maximum critical value Cand minimum critical value i.
of this statistic, for a sample of size N and significance level A, are indicated by "L<Q(N,^-A)<U."
Samples with values of w/s outside these limits are

The International tournai of Prosthodont i (

Fig 4 Scherratic olose up of


passive abutment (internal
hexagonal reoess) connection
to Implant faoe (external
hexagonal extension). Gap G
IS the space between the
respective patri and matrix
hexagonal surfaces. The drawing on the right stiows action
during abutment rotation to one
side wiih the internal hexagonal binding against the hexagonal extension. The resultant
angle A represents ttie rotational freedom encountered
during one half of the rotational
movement. Movement to the
opposite of this abutmentimplant contact represents the
complete motion between the
two components and is
reported in degrees in Table 8.

Results

Tbe average diameter at the coronal table (head]


for each of the series varied from 4.092 mm (STD
.0059) [SVI to 3.991 mm (STD ,0041) [IMZ] (Table
1 ). The largest diameter of 60 standard implants measured was 4.099 mm (SV] and the smallest was

164

Binon

Table 1

Accura cy a n d C o sistenty o tn,lon i, Atiiiirne ts, ami Analogs

Implant Diameter Width

Siie

175'15

3 75x13

375x15

4v18

375\ia

375^10

.75x13

3.75^6

3?5<IO

375VI5

MFS

NP

STflK

3iS

3il

SO

XURK

OTC

ISS

IMTFC

SV

Mf

IMZ

SUO

4074

4.065

4 043

4 055

4 076

4 036

4.W0

4.09!

404?

4.033

4.054

3.995

4.50!

3.933

4.664

41"S

413

4.036

4.054

4.055

4.053

4.0B3

4.03B

4.091

4.087

4.046

4.095

4,062

4.0?6

4.064

4051

4.046

4.076

4.0B2

4.095

4.08!

4.043

4.099

4.056

3.995

4,061

4.060

4047

J,050

4.083

4 034

4.089

4.091

4043

4.09?

4.05

3.90

36X4

46!5

4.074

4 060

4053

4.016

4.079

4.039

4.085

4.09!

4.043

4.093

4053

3 386

4 555

msan

4.074

4.063

4.052

4.050

4.079

4.066

4.090

4.083

4.044

409!

4 055

3991

4 594

4105

stddE

0010

5002

0.005

0.004

0.D04

0003

0 003

0D04

0002

0.006

0005

0004

0 076

OOIO pMltdstddei-jS)

tjnje

D027

0005

0.011

0.009

0.00?

0007

0 009

0O10

0004

0.016

0 01!

0009

0.16!

*'s

2 326

2.075

!361

2.408

1.396

2 445

2.751

.312

2.052

!712

2.570

2 202

poolB niE3n

13
2.09iO[5,.9S|<!.78Z
15403 HartIey f max
(5,13;.051-54.B

mean
stddev

4 052

4.050

4.006

4 090

4.039

4 032

4.055

4 074

00S5

0.004

0.003

0003

0004

0O05

0.005

0 004

range

0.011

0.009

0.O7

0009

0010

0.015

0012

pooled mean
pooled std dev (S)

7
42

(Hailnfniax(5.7;
.051=33.6

!.B

>link-Wallaci fq5,7;
051=0.51

f=

10S.5 ^-.000

mean
stddev

4.0B6

4.090

4.009

4 092

4.069 pooled m tan

0,003

0.003

0.004

0006

0.004

langc

0.007

0.009

0 010

0016

pooled s[d ilev [Si

4.2

Hartley fini(5,4;

08

<Un^-Wailace

.05)=20.6
i(5,4;.051-096
211

P139

mean

4.05!

4 05D

4.055

4.053 pooled mean

slddev

0005

D0O4

O.O05

0.004 pooled std de'j (5)

unje

0011

.009

0.012

3
1.5

<iM\ti

f^mu(5,3:

.051=15i
0.6

<Link-Wallaoe

t75

P=!14

Tlie mean. 3.991, ot the sample (rom IMZ is 20 pooled standard deviations lower than the pooled mean, 4.071, of tlie resi of the samples; and the
mean. 4.594 of the sample from BUD is 130 pooled standard deviations greater. These data do not appear on the table. The standard deviation ol the
sample trom BUD is not significantly different from the standard deviations of the cluster ot samples from XMRK, OTC, ISS, anfl SV at the .05 level:
Hartley Fmax ^ 4 a < Fmax(5,5;.O5) = 25.2

3.986 mm (IMZ). IMTEC and STR had 5 micrometers


or less difference between the respective implants
tested, and Xmark, SO, 3i, OTC, and iSS had 10
micrometers or less difference in coronal diameter.
Data analysis shown in Table 1 indicates a significant difference P < .05) bePA-een all manufacturers
except for two cluster groupings: (V 3is, 3il, IMP,
and (2j Xmark, OTC, ISS ,SV Fig 5). Average implant
body diameter measurements varied from 3.655 mm
(STD .0095) [OTCI to 3.726 mm (STD .0270)
IIMTEC] for the 3.75 mm implants and from 4.030
mm (STD ,0131) [IM2| to 3.974 mm (STD .0059)
[SO] for 4.00 mm implants. The least variation
between implants was recorded for ISS, 3i, Xmark
and IMP with less than 10 [jm, and the greatest for
SO with 84 ^m (STD ,0279) (Table 2).
Comparing two piece abutment collar width, all
collars measured differences of less than 10 (Jm
except the Bud and ISS sample with 11 pm and NP

2, 1995

165

with 14 [jm. Data analysis presented in Table 3


indicates a significant different at P < .05 level
between all manufacturers except for one cluster
group composed of ISS and IMP (Fig 6). The difference in abutment collar length was measured and
ranged between 4 fim (STD .0016) for ISS and 143
|jm (STD .0609) for OTC (Table 4),
The average height of the hexagonal extension varied from .455 mm (STD .0604) for SO to .722 mm
(STD ,0152) for OTC. The greatest variation in height
was noted for SO and Bud with 147 pm (STD .0604)
and 105 |jm (STD .0421), respectively (Table 5). Data
analysis in Table 5 shows significant differences at the
P < .05 level. Three cluster groups comprised of (1
IMP, IMZ; (2j 3is, Stryk; and (3) Xmark, 3il, Bud, NP
and SV were identified (Fig 7). No significant difference was noted for samples within the same cluster.
Analog hexagonal extension height varied from .525
mm (STD ,0496) for IMTEC to .688 mm (STD -0097)

The I Hiemal i or a I lournal o Prasthodonlics

Accuracy .ind Consistency of implants. Abutments, and Analogs

Ffg 5 Implant diameter widtti


(fiead) summary plot ot standard deviation versus sample
mean.

0.01

.fiation mm)

NP

0.007
SV

Sample standan

A3iS A IMP

ISS

0.OO4
A3il

SO
STRYK

OTC
XMRK

IMTEC
4.04

Table 2

4.06

Implant Diameter Width (Body)

Mig

Itnplant

NP
STRYK
31

375x15
3.75x13
3.75x15
4X18
4.1X8
3.75X18
3.75X10
3.75x13
3.75x8
3.75x10
3.75x15
4x13
3.5x4

3i

SO
XMARK
OTC
ISS
IMTEC
SV

IMP
IMZ
BUD

4.1

4.08
Sample mean (mm)

Mean

Range mm

SD

3.711
3.726
3.715
3.976
3.853
3.696
3.640
3.669
3.698
3.481
3.688
4.034
3.147

3.715
3.729
3.715
3.978
3.806
3.704
3.663
3.665
3.713
3.502
3.693
4.034
3.134

3.688
3.728
3.706
3.982
3.859
3.695
3.663
3.667
3.716
3.498
3.690
4.037
3.118

3.709
3.708
3.706
3.971
3.871
3.695
3.648
3.668
3.777
3.508
3.686
4.004
3.120

3.708
3.735
3.712
3.965
3.890
3.700
3.662
3.663
3.724
3.521
3.683
4.040
3.122

3.7062
3.7232
3.7108
3.9744
3.8558
3.6980
3.6552
3.6664
3.7256
3.5020
3.6880
4.0298
3.1282

0.027
0.021
0.009
0.017
0.084
0.009
0.023
0.006
0.079
0.040
0.010
0.036
0.029

0.0094
0.0077
0.0041
0.0059
0.0279
0.0035
0.0095
0.0022
0.0270
0.0131
0.0034
0.0131
0.0109

Largest ^ 4.04; Smallesl ^ 3.118; Difference = 0.922.

for the NP sample. The greatest range itn analog


hexagonal extension heights was recorded for ISS
with 154 pm (STD .0627) and IMTEC with 132 \)m
(STD .496). Data analysis shown in Table 6 indicates significant differences at the P < .05 level
between three cluster groups composed of (1) IMTEC,
ISS, IMP; f^J 3i; and f i j STR, NP (Fig 8).
Implant flat to flat hexagonal extension width
was measured for fifteen manufacturers (Table 7).
Average flat to flat tneasurements varied from
2.677 mm (STD .0046) for STR lo 2.707 mm for 3i
(STD .0015), NP (STD .0031), and SwedeVent
ISTD .0264] implants. The greatest and smallest
flat to flat measurement for all implants evaluated
was 2.790 mm for SwedeVent and 2.6S7 mm for
IMTEC, respectively. The data analysis shown in
Table 8 indicates significant differences at the
P< .05 level between cluster groups composed of
(H STRYK, IMTEC, ISS, OTC, SO; (2) Xmark;

The Internatroral lournai of Frostliodontics

(3) IMP, IMZ; (4 3is; and (5} Bud, NP, 3il. The statistical plot is shown in Fig 9.
The least average variation between hexagonal
flat surface to flat surface measurements for the
entire sampling was recorded for 3i 3.75 mm and
4 mm implants at 1 (jm, and the greatest for
SwedeVent with 27 pm. The greatest difference
between flat to flat measurements on the same
hexagonal extension was recorded for SwedeVent
with 61 |jm, and the least for the 3-75 mm and 4
mm 3i samples at 3 pm and 4 |jm, respectively.
Analog flat to flat hexagonal extension width
varied from 2.675 mm (STD .0041) for Stryker to
2.697 mm {STD .0051] for ISS (Table 9). The average difference between analog flat to flat measurement within a given manufacturer's sample varied
from a low of 2 pm for 3i to a high of 29 |jm for
ISS. The greatest difference between flat to flat
measurements on the same hexagonal extension

166

non

Fig 6 Standard abutment collar width summary plot ol


standard deviation versus
sample mean.

Accuracy ard Consistency f Implants, Abutmenli, and Analogs

0.006 .
A ISS
E.

NP

BUD

devia

g 0.004 +
A IMP

OTC

5 0.002
XMRK

S
01
CL

E
M

Table 3

0
4.455

4,465

4,475
Sample mean (mm)

NP

3i

XMRK

OTC

ISS

IMP

BUD

4,494
4,501
4,493
4.489
4.487
4.493
0.005
0.014
2.591

4.479
4.474
4.481
4.483
4.478
4.479
0.003
0.009
2.654

4.468
4.465
4.465
4.466
4,467
4,466
0,001
0.003
2.301

4.485
4.491
4.485
4.483
4.484
4.486
0.003
0.008
2.556

4.474
4.473
4.464
4.474
4.463
4.470
0.006
0.011
1.966

4,468
4,467
A74
4.469
4.474
4.470
0.003
0.007
2.082

4.457
4.460
4.459
4.457
4.468
4.460
0.005
0.011
2.418

4.475
0.004

4.493
0.005
0.014

4.479
0.003
0.009

4.466
0.001
0.003

4.460
0.005
0.011

4.486
0.003
0.008

4.477
0.004

3.6

F=
4.460
0.005
0.011

4.466
0 001
0.003

62.3
4.463
0.003

F=
4.493
0.005
0,014

8.0

4,489
0,004
2
3,0

4,486
0,003
0,008

1.6
F=

Wilooxon-Mann-Whitney rank sum tes! of difterenoe


rank
1
2
3
4
5
6
9
9
9
9

between means of sample from ISS and IMP:


ISS
IMP
0
1
4,463
ISS
0
2
4,464
ISS
0
4,467
3
IMP
0
4,468
4
IMP
0
4,469
5
IMP
6
0
4,473
ISS
4,474
9
0
ISS
4,474
9
0
ISS
0
4,474
9
IMP
4.474
0
9
IMP
26
29
sum

167

pooled mean
pooled std dev (S)
<Hartley Fmax
(5,5;.05)=25.2
>Unk-Wallace
(5,5;.05)=0,81
P=5E-11
pooled mean
pooled std dev (S)

12.2
2.1

mean
std dev
range

2.09<Q(5;.95)<2/782
<Harlley Fmax (5,

17.2

mean
std dev
range

pooled mean
pooled std dev (S)

18,4
mean
std dev
range

4.495

Standard AbutmGnt Width

MFG
2
3
4
5
mean
std dev
range
w/s

4.485

6.6

^Hartley Fmax
5,2;,O5)=9,6
>Unk-Wallace
i((5,2;.05)=i.53
F=,022
pooled mean
pooled std dev (S)
<Hartiey Fmax
(5,2;.05)=9,6
>Link-Wallace
5,2;.05)=l,53
P=.O33

Neither rank sum is less than


Itie critical value R(5,5;.05)=19;
The conclusion is that there is
no difference between means.

The International Jojinal of Prosthodontic

Accuracy and Consistency of Implants, Abulments, and Analogs

Table 4 Standard Abutment


MFG

Width

NP
3i
XMARK
OTC
ISS
IMP
BUD

Mean

Range mm

4,494
4,479
4,468
4,485
4,474
4.468
4.457

4,501
4.474
4.465
4.491
4 473
4 467
4 46

4,493
4,48t
4,465
4,485
4,'J64
4,474
4,459

4,489
4,483
4,466
4,483
4,474
4,469
4,457

4.487
4.478
4,467
4.484
4,463
4.474
4,468

4,4928
4,4790
4,4662
4.4856
4.4696
4.4704
4 4602

0.014
0,009
0,003
0,008
0,011
0,007
0,011

0,0054
0,0034
0,0013
0,0031
0,0056
0,0034
0,0045

5.541
5,478
5,593
5,5t5
2,509
7,032
7,000

5.517
5.476
5.593
5.446
2.512
7,018
6,996

5,507
5,454
5,58t
5,376
2,511
6,974
7,003

5,512
5,474
5,596
5,519
2,508
6,979
7,020

5,537
5,479
5,580
5,426
2,510
7,011
7,006

5.5228
5.4722
5.5886
5,4564
2,5100
7,0008
7,0050

0.034
0.025
0.016
0.143
0.004
0.048
0.024

0,0153
0,0104
0,0075
0,0609
0,0016
0,0226
0,0092

Length
3i**XMABK*
OTC

iss-

IMP"
BUD"
"2.S mm abutment
"7,0 rnm abutment
' " 5 . 5 mm abutment

Table 5 Implant Hexagonal Extension Height


Size
MFG

37515 3,?6x13 3,75!<16


NP STRVK
3is

41X8
SO

3,75x10
XMRK

3,76x10
OTC

375x13
lES

3.75>;a
iMTEO

375/10
SU

375x15
M?

4x13
IMZ

1
2
3
4
5

0.670
0 672
0,6BO
0,704
0,582

0.617
0.640
0.640
0645
0633

0.622
0.616
0.630
0,622
0.560

0.650
0694
0.644
0.698
0.636

0.493
0.428
0.476
0.510
0.353

0663
0690
0.626
0.633
0.645

0.740
0738
0.712
0.712
0.710

0.596
0626
0 534
0590
0594

0546
0557
0 553
0564
0,554

0 762
0,670
0 718
0,662
0,690

0,493
0,558
l],526
0,561
0,524

0541
0517
0.565
0.537
0.550

0,656
0,754
0,671
0680
0.649

mean
std dav
langE
n/s

0,682
0,014
0,034
2.515

0635
0011
0 028
2 561

0,530
0,018
0,045
2 543

0,652
0,027
0,052
2 293

0.455
0.050
0147
2 434

0.651
0.026
0,004
2,487

0.722
0.015
0,030
I.B75

0.590
0.024
0.066
2 750

0,555
0,007
0,019
2,755

0,700
0,041
0100
2460

0,532
0,028
0,058
2,428

0.542
0.019
0.049
2?22

0,692
0,042
0,105
2 497

mian
sId ii"
range

0.682
0.014
0.034

066!
0037
0.062

0.651
0026
0.054

0.700
0.041
0.100

0.682
0,042
0105

f=
rtiean
stddev
tangi

0.635
0,011
0,028

0.630
0,018
0,045

h
0,532
0,028
0068

stdiev
rartge

0,542
0,018
0 048

0,618 pooled mean


0,0!5 poolid std div ()
13
2.09;Q|5:,95)<2,782
85.4 Wartley f mai
(5,13: 5|=54 8
0,676 pooled mean
0,030 pooiiastddev(S)
5
9.7 <Haitiey fmt
(5.5;,05|=25,2
0 <Liiik-iiVanaci
(5,5,.05)=081
15 P=.I654
0,632 ponied mean
0,014 pooled std dev(S)
2
2,5 <Hattiey Fmn
(5,2,.05)=9.6
0.4 <Link-Waliace
i((5,2;05H53
0,3 P-.5915
0.537 pooied mean
0023 pnoiefl std div {S\
2
2,5

f^

04

! Hartley ftnai
(5,2;05)=96
dink-Wallace

0.4

P-- 5348

The mean, 0 455, o l the sample Irom S O is over 8 pooled standard deviations tower than the pooled mean, 0.632, o l the rest of the samples so it
does not appear o n the graph; and Ihe standard deviation of that sample is signiticantly greater than the standard deviations ot the rest of the sarnples
at the ,05 leuei: Hartley F m a x - 85,4 > FmaK(5,13;,05) - 54,S, whereas withdut the sample from SO, Hartley Fman - 41,4 < Fma){(5 12- 05)=51 4

The International lournal of Proslhodontii

168

Afc.Jracy and Coniitency ol Implants, Abuimenis, and Ana

Fig 7 Implant hexagonal


extension height summary plot
of standard deviation versus
sample mean.

0.045

A BUD

A SV

dard deviation

E.
0.03

IMP

XMRK
ISS

S
m0.015

IMZ

3is
OTC

ANP

STRYK

m
en

IMTEC
0
0.575

0.525

Fig 8 Analog hexagonal


extension height summary plot
of standard deviation versus
sample mean.

0.625
Sample mean (mm)

0.675

0.725

A ISS

(mm)

0.06

A IMTEC

1 0.04
A IMP

"D

"
3i

Samr

Z 0.02

STRYK
,
0
0 515

0.575

0.635

NP

0.695

Mean ot sample (mm)

0.0t5-

0.01

OTC
SO

IMTEC
ISS

iat ion

JUJ]

rdd

0)

0.005

IMP IMZ

STRYK

ABUO

A NP

"

5 ampl Star

Fig 9 Implant hexagonal


extension width (flat to flat)
stimmary plot ot standard deviation versus sample mean.

XMRK

A 3il

3is

2,675

2.685

2.695
Sample mean (mm)

Jiimher2, t995

169

Tile International ojrnal of PrasthodoiKics

2.705

Acturcy a d Consiste (-y of 1 ill |) i an5, Abulments, andAiulu,.

Tablee

3i on

Analog Hexagonal Extension Height

MFG

NP

STRYK

3i

SO

ISS

IMTEC

IMP

1
2
3
4
5

0,687
0 698
0.674
0.684
0.696

0.669
0.679
0.681
0.690
0.674

0.632
0.666
0.611
0.633
0.651

1.289
1.331
1.342
1,257
1.304

0.605
0.526
0.634
0.480
0.590

0.545
0.501
0.465
0.597
0.517

0.637
0.547
0.578
0.568
0.567

mean
std dev
range
w/a

0.688
0.010
0.024
2.473

0.679
0.008
0.021
2.661

0.639
0.021
0.055
2,636

1.305
0.034
0.085
2.505

0.567
0.063
0.154
2.457

0,525
0,050
0.132
2.664

0.579
0.034
0.090
2.639

0.712
0.031
7
63.0

mean
std dev
range

mean
std dev
range

0.688
0.010
0 024

0.688
0.010
0.024

0.679
0,008
0.021

0.679
0.008
0.021

0.525
0.050
0.132

0.639
0.021
0.055

0.639
0,021
0,055

0.579
0.034
0.090

0.622
0.024
5
39.4

0.579
0.034
0.090

0.646
0.018
4
18.7
2.9

Pi
mean
std dev
range

0.688
0.010
0.024

0.679
0.008
0.021

0 639
0 021
0.055

27.7
0.668
0.013
3
7.0
2.5

fmean
std dav
range

0,688
0,010
0,024

0 679
0.008
0.021

173
0.683
0.009
2
1.5
1.0

0.567
0.063
0.154

mean
std dev
range

0.525
0.050
0.132

F=
0.579
0.034
0.090

2.7
0.557
0.049
3
3.4
0.7

F=

1.6

pooled mean
pooled std dev (S)
2.09<:Q(5;.95)<2.782
>Hartley Fmax
(5.7:.05)=33.6
pooled mean
pooled std dev (S)
^Hartley Fmax
(5,5;.05)=25.2
pooled mean
pooled std dev (S)
Hartiey F m a x
sLink-Wailace
K(5,4;.05)=0.96
P=1E-06
pooied mean
pooled std dev (S
Hartley Fmax
(5,3;.05)=1S.5
>Link-Waliace
X|5,3;.05)=1.19
P = 0003
pooled mean
pooied std dev (S)
Hartiey F m a x
(5,2;.05)=9.6
Link-Wailace
/15,2;.O5)=1.53
P=.1387
pooled mean
pooled std dev (S)
<Hartley F m a x
(5,3;.05)=15.5
Link-Wailace
<(5,3;.05)=1.19
P =0.2392

The mean, 1.305, of tiie satroie from SO is over 22 pooied standard deviaBons greater than ttie pooled mean, 0.613, ot the rest of ttie sampies, so it
does nol appear on ttie graph; but the standard deviation of that sampie is not signfticantly different from liie standard deviations of the ciuster of sampies from iSS, IMTEC, and IMP. at Ihe 05 !evei : Hartley Fman = 3.4 Fniax(5,4; 05) = 20.6

was recorded for the IMTEC sample with 23 |jm


{STD .0021), Statistical analysis presented in Table
9 shows significant differences at Ehe P< .05 level
between four cluster group consisting of {1) STR;
(2) IMP, NP, ISS1; 3) IMTEC, 3i; and (4) ISS2,
Cluster group distribution is shown in Fig 10,
Rotational freedom between matching hexagonal components was measured for five manufacturers with their respective abutments and for mixed
combinations of implant bodies and two piece
standard abutments from competing manufacturers

The Inieinaiional lournal of Prosthodont i

(Table 10). Considering component combinations


from the same manufacturer, the least amount of
rotational freedom was recorded for Xmark and 3i
with A and 4.6' of rotation, and the most for 3i
and NP with 6-7 of rotation. In the mixed component group, the least amount of rotational
movement was recorded for the combination of
Nobelpharma implants and IMP abutment at 3.5
of rotation. The next three closest component
combinations were the ISS implants/IMP abutments with 4.2 of rotation, 3i implants/IMP abut-

170

Binan

Table 7

MFG

Implant Hexagonal Extension Width

Implant

Flail

Flat 2

Flat 3

Mean

3.75x15

2.699
2.698
2.696
2.696
2 698
2 708
2.705
2.709
2.708
2.706
2.702
2.711
2.710
2.704
2.707
2.688
2.696
2.701
2,688
2.696
2.687
2.690
2.675
2,699
2.661
2.693
2.688
2.687
2.695
2.693
2 685
2.691
2.665
2.678
2.683
2 680
2.676
2.676
2.686
2.683
2.705
2.697
2.691
2.705
2.703
2.678
2.687
3.721
3.685
3.684
2,694
2.700
3.693
3.692
2.681
2.682
2.728
2.702
2.694
2,790
2.682
2.683
2.680
2,672
3.677
2.684
2.683
2.678
2.679
2.658
2,693
2.699
2.706
2 703
2,688

3,698
2,698
2.697
2.696
2.698
3.707
3.706
3,709
2,708
2,708
2.704
2.715
2.708
3,705
2,709
2,694
2.687
2.702
2.689
2.692
2.668
2 678
2 677
2.697
2.661
2.688
2.689
2 702
2.695
2.694
2.684
2.697
2.667
2 675
2.677
2.685
2.686
2,685
2.680
2.678
2.703
2.702
2,699
2,710
2.710
2.676
3.683
2,701
2,683
2.684
2.700
3.699
2,694
2.693
2.691
2.687
2,701
2.690
2.682
2.729
2.682
2.678
2.670
2.678
2.670
2.685
2.687
3.684
3,685
2.657
2.693
2.695
2,694
2.699
2.687

2,696
2 697
2.696
3.697
3.699
2.709
2.705
2 708
2 708
2.707
3.705
3.708
2,706
2,703
2,712
2.695
2.693
2.703
2.689
2.697
2.676
2.676
2.699
2.698
2.660
2 691
2.689
2.689
2.696
2.691
2.678
2.695
2.661
2.673
2.677
2,686
2.682
2.683
2.688
3,687
2.701
2.696
2.700
2.730
2,699
2.674
2.686
2.702
2,686
2,681
2.699
2.695
2.694
2,692
2.688
2.696
2.692
2,696
2,695
2.736
2.680
2.686
2,675
2.664
2.679
2.678
2,690
2.685
2.677
2.657
2,692
2.700
3.698
3.708
2,691

2.698
3.698
3,696
2,696
2 698
2.708
2.705
3.709
3,708
2,707
2,704
2.711
2.708
2.704
2,709
2.692
2.692
3.702
3.688
3.695
3,677
2.685
2.683
3.699
3.660
2,691
2.689
2.693
2.695
2.693
2 682
2.694
2.664
2.675
2,679
2,684
2.681
3.681
2,685
2.683
2.703
2.698
2.697
2,712
2.704
3.676
3.685
2.708
2 685
2.683
2.698
2.698
2 694
2,692
2.687
2.688
2.707
2,696
2,690
2.752
2.681
2.682
2.675
2.671
3.675
3.683
2,687
2.682
2.680
2.657
2,693
2.698
2.699
2.703
2.689

3tl

4x18

NP

3.75x15

NP

3.75 ^ 10

OTC

3.75X10

ISS

4x15

ISS

3.75x13

XMARK

3.75X18

BUD

3.5X4

SO

4.1x8

IMP

3.75x15

SV

3.75X10

STRVK

3.75X13

IMTEC

3.75x8

IMZ

Accuracy and Consisrency of nplanr^, Abul lents, and Analogs

4x13

i^?B, Number 2, 1995

171

Sample
mean

2,697

2 707

2,707

2.694

2,680

2 692

2.679

2.683

2.703

2.687

2.694

2.707

3,677

2,678

2.696

Range
0.003
0,001
0 001
0.001
0.001
0.002
0,001
0.001
0
0,002
0.003
0.007
0.004
0,003
0.005
0.007
0.009
0,001
0,001
0.005
0.019
0,014
0,024
0.002
0.001
0.005
0.001
0 015
0 001
0.003
0.007
0.006
0,006
0.006
0.006
0.006
0010
0.009
0.008
0.009
0.004
0.006
0.009
0.015
0.011
0,004
0.004
0.020
0.003
0.003
0,006
0.005
0.001
0.001
0.010
0,014
0.036
0.013
0.013
0.061
0.002
0.008
0.010
0.014
0.009
0,007
0.007
0.007
0.008
0.001
0,001
0,005
0.012
0.C09
0.004

Mean
sample
range

Greatest
tiat/llat

aift

SD

0.001

0.003

0.0011

0.001

0,004

0.0015

0.004

0.013

0.0031

0.005

0.015

0.0052

0.012

0.039

0.0141

0.005

0.015

0.0023

0.006

0.036

0.0109

0.008

0.012

0.0018

0.009

0 029

0.OG6

0,007

0 047

0.0121

0.005

0,019

0.0046

0.027

0.108

0.0264

0.009

0.022

0.0046

0,006

0,033

0,0118

0.006

0.021

0.0055

Tlie iniernational Jojtnal of Prosthodontii

Accuracy and tonsisiency ol Implanis, Abiitmentj, ard AnaloE

Table 8

Implant Hexagonal Extension Width Hat to Flat Average of 3 Flats


OTC

1
2
3
4

3711
3.708
3704
2.709

2.691
2.69!
2.6?6
2.61
2.66

2699
2699
2.696
2.696
2.699

2 70B
2 705

IM
!.m
%w

2.615
?.?08
2.6SS
2.6B3

mean
std dev
range
w/s

2.707
0.003
0.007
3.2

2.677
0.005
0.011
2.3e9

2697
0001
000!
1826

2.707
0.0O2
0 004
2 63S

2687
001?
003!
2646

mean
stddw
tanoe

im

nit

ISS

IMTEC

S\l

IMP

3.684
3.691
3.6S
3.995
2.962

2.677
2.635
2.693
2.699
3.690

2.6S!
3.6H
3.694
2 675
2 679

3.6B2
3.967
2.962
2,980
2.957

2.089
2.707
2.6%
2.690
2.753

2.696
2.999
2.694
2,692
2,967

2.993
2.998
2 639
2 71)3
2.SB9

3.703
3.699
2697
2713
2704

2.963
0002

3.691
2 679
0.014 0.011

0m

0.039

0.030

2 303

3 756

!.754

!.67B
0.012
am
2 542

2 707
0O26
0.064
2.21

! 694
0005
0 011
2.399

3.696
0005
0.014
3.695

2.703
0 006
0.015
2.510

2703
0.006
0.015

2.07
0.OD2

0003
0.07

f=
mean
stdde
range

2 6B7
001!
0.032

2 677
0005
0,011

2631
0014
Q3S

2.979
0.011
D030

2.679
0.013
0.30

3.692 pooled mean


0.00B pooled slddeii(S) 13
13
2.09<O(5;.951<3.733
592 3 iHartley Fniax
(5.13.05)=54.8
2.706 pooled mean
0.004 pooled std dev (5)
3
15.5 Haiiey fms*
(5.3.05)=15.5
09 <tink-Wallace
(5,3^^051=113
2.1
2.980 pooled mean
0.011 pociled;tddev(61
94

<Hartley Fma*

0.4

f.
2.694
0.005
0.011

2696
0.005
0.014

dink-Wanace
ftl5,5..05)=0.81
0.7 P^.666
2.995 pooled mean
0.005 coaled std dev (S)

2
1.4 (Hartiey f ma*
0.6 <Link-Wallace
(5.2:.05|=1.53

07 P-- 4392

ISS2
IMP

rd devilalion (mm)

0.004

STRYK

NP

0.002

tSS1

A IMTEC

SamIe Star

3i
0
2.67

2,68

2.69
Sample mean mm)

Tiie Iriiernatior.il Journal o Prosthodonlk

172

2.7

2.71

Fig 10 Analog hexagonal


extension widtti (flat to flat)
summary plot of standard deviation versus sample mean.

ncy and Conistency ol Implanls, Abutment;, and Analogs

Table 9 Analog Hexagonal Extension Width Flat to Flat


NP

mean
std dev
range
w/s

SO

STRYK

2,694
2,691
2.688
2.689
2,691

2,697
2,672
2,674
2,696
2,673
2,695
2,678
2,696
2,682
2,697
ISS1 AND ISS2

2,691
0,002
0.006
2,606

2,676
0.004
0.010
2,411

2 696
0.001
0,002
2,390

ISS2

ISS1

2,349
2.690
2,348
2.685
2,347
2,686
2,345
2,687
2,347
2,685
REPRESENT TWO
2,347
0,001
0,004
2,697

2,687
0.002
0.005
2,411

IMTEC

IMP

2,708
2,698
2,686
2,712
2,693
2,687
2,699
2,694
2,684
2,710
2,697
2,696
2,710
2,695
2,689
DIFFEBENT SAMPLE BATCHES
2.708
0.005
0.013
2,540

2,695
0,002
0,005
2,411

2,688
0,005
0,012
2,600

2,649
0,003
8
42,2

mean
std dev
range

2,696
0,001
0,002

2,691
0,002
0,006

2,887
0,002
0,005

2,695
0,002
0,005

2.688
0.005
0.012

2.691
0.002
5
30.4
1.6

mean
std dev
range

2.687
0.002
0.005

2,691
0,002
0.006

2,695
0,002
0,005

2,688
0,005
0,012

12,48
2 690
0,003
4
5.0
1.6

mean
std dev
range

F=
2,688
0,005
0,012

2,687
0,002
0,005

2,691
0,002
0,006

8 22
2,689
0,003
3
5,0
09
1.95
2,696
0,001
2
6,1

2.695
0.002
0.005

2,696
0 001
0.002

mean
std dev
range

0,6

mean
std dev
range

0,64
2,689
0,002
2
1,2

2,687
0,002
0,005

2.691
0,002
0,006

1,8

mean
std dev
range

2,676
0,004
0.010

F=

2.688
0,005
0,012

2,682
0,004
2
1,2
2,9

F=

pies from IMTEC and 3i at the .05 ievel Hartiey

21

pooled mean
pooled std dev (S)
2,09<O(5:,95
<2.782
>Hartley Fmax(5,8;
.051=37,5
pooled mean
pooled std dev (S)
>Hanley Fmax|5,5;
,051=25,2
sLink-Wailace
K[5,5;,05)=0.81
P=.000
pooled mean
pooled std dev (S}
<Hartley Fmax(5,d;
.051=20,6
>Link'Wallace
[5,4;.05|=0,96
P=,002
pooled mean
pooled std dev (S|
<Hartley Fmax(5,3;
,051=15,5
<nk-Wallace
<(5,3;,05)=1,19
P= 165
pooled mean
pooled std dev (S)
<Hartley Fmax(5,2;
051=9.6
<Link-Wallace
K(5,2:.05=1 53
pooled mean
pooled std dev (S)
<Hartiey Fmax(5,2;
,05|=9.6
>Link-Wallace
pooled mean
pooled std dev (S)
<Hartley Fmax(5,2;
,05)=9,6
>Link-Wallace
i<(5,2;,051=l,53
P=,002

nctard devraiions iower than the pooled mear, 2,692, ol the rest ot ttie samp[es, so it
sampie is not signilicarlly diflerert from the standard deviations ol the cluster ol sammaxl5,3;,05) ^ 15.5,

, Niiirber2,1995

173

The tnteinatioral lournal ol Prosthcdontlcs

ty and Consistency ot Implants, Aijulmenb, and Ar.il

Table 10 Hexagonal Play Degrees of Rotation With Standard Abutment


Implant/abutment
combination

Type

ext-hex
XRK/XRK
ext-hex
3i/3i
IMtyiML
ext-hex
ext-hex
ISS/ISS
ISS
ext-hex
NP/NP
Nobelpharma
Stryker, Steri-Oss. IMTEC, SwedeVent do not have two piece standard tiat top aDutments.
Sample Mixed Combinations
10
NP/IMP
ext-hex
NP/IMP
ext-hex
NP/3
NP/31
10
ext-hex
NP/ISS
10
NP/ISS
ext-hex
NP/OTC
10
NP/OTC
ext-hex
3/IMPL
31/IMP
10
3/ISS
ext-tiex
10
3/ISS
ext-hex
3/NP
10
3/NP
exi-hex
3/0TC
3/0TC
10
ext-hex
ISS/IMP
10
ISS/IMP
ext-hex
ISS/NP
ISS/NP
10
ext-hex
ISS/31
10
ISS/3
ext-hex
ISS/OTC
10
ISS/OTC
ext-hex
IMP/NP
IMP/NP
10
ext-hex
IMP/31
10
1MP/3
ext-hex
IMP/ISS
IMPyiSS
10
ext-hex
IMP/OTC
IMP/OTC
10
ext-hex
SO/IMP
SO/IMP
10
ext-hex
S0/3
10
SO/31
ext-hex
SO/ISS
SO/ISS
10
ext-hex
SO/OTC
SO/OTC
10
10
ext-hex
SO/NP
SO/NP
ext-hex
STR/NP
STR/NP
10
ext-hex
STR/3
10
STF1/3
ext-tiex
STR/ISS
STR/ISS
10
ext-hex
STR/OTC
10
STR/OTC
Non External Hexagonal Implants
10
SoremVent*
int-hex
SV/SV
int-octogon
CALC/CALC
Omniloc
5
XMARK
3i

Impla-Med

10
10
10
10
25

Degrees
rotation
4.0
4.8
5.0
6.7
6.7

.000
.450
.630
1.450
1.190

3.5
4.9
64
7.9
4.3
6.3
6.9
7.4
4.2
7.5
7.5
8.9
7.9
87
8.7
9.5

5.7
7.3
8.3
8.6
9.3
8.8
9.0
9.3

10.1
1.4
7.5

.960
2.93

'Excellent nonrotation. In these samples, however, the abutment patrix hexagonal extension did not seal down fully, and significant interlace deiects
can rasult between ttie abutment and implant

ments with 4.3% and the NP implant5/3i abutments with 4.9. All other combinations exceeded
5, with the most rotational freedom recorded for
the STR mplant/OTC abutment combination at
10.1 ot rotation. Two nonexternal hexagonal
combinations were also evaluated for
irtiplant/abutment freedom. The internal hexagonal ScrewVent (Encino, CA) sample measured
1.4 of movement and the internal octagonal
Omniloc (Carlsbad, CA) sample measured 7,5' of
rotational movement.

tion and the magnitude of the variation. The diameter at the head of tbe implant, for example,
requires a predictable and consistent size with
minimal variation to match with tbe abutment
counterpart in a crisp and even interface.
Inconsistencies at this interface that result in a step,
a gap, or a crevice that accumulates bacterial
plaque can result in adverse tissue responses.^"-"
Minimal variation of abutment collar length is a
mandatory prerequisite in the event that an abutment requires replacement under an existing
restoration during long term maintenance. A
replacement abutment that does not passively and
intimately contact the existing prostheses results
not only in a poor interface fit, but more shear
stress on the gold prosthetic screw, leading to
screw loosening, screw failure, or occlusal overload of the remaining implants."

Discussion
Considerable variation in machining accuracy
and consistency was noted in the samples evaluated. The clinical implications of the machining
inconsistencies are directly dependent on the loca-

The Internationtil Jojrnal of Prosthodonlics

174

Atcuracv and Coniistenry ol impiants. Abutments, and Anaiogs

STR

IMT

ISS

OTC

XMK

30

iSS

iMP

t>JP

Manutacturer

Fig 11

Graphic comparison ot tine mean hexagonai extension width ot 15 implants evaluated.

tional movement within the implant/abutment coupling once the effective screw preload has been
dissipated by vibrations and micromovement
within the screw joint as a consequence of functional loading.'^
It is the author's contention that reduction or
elimination of patrix/matrix discrepancy and its
potential for rotational movement will result in a
more stable and predictable screw joint. This is
supported by the results of dynamic tests conducted on the ITI implanl/abutment connection as
well as other typos of interfaces."' These data indicate that screw retained connections progressively
loosen and that given an intimate high precision
connection, the effects of loading can be buffered
to prevent screw loosening and abutment movement. However, the exact parameters have yet to
be determined for external and internal hexagonal
extension components. The hexagonal rotational
freedom data presented in Table 10 does provide
additional insight into the degree of component
coupling and precision currently available,
implant hexagonals greater than 2.692 mm with a
range of less than .015 mm of variation recorded
the least amount of rotational freedom when

Hexagonal extension height has been implicated


as a significant factor in screw joint anti-rotational
stability,'- To attain optimal anti-rotational effect,
the extension theoretically requires a minimal height
of 1.2 mm.' Cloned and retrofitted coronal hexagonal configurations complying with the original
Nobelpharma design have hexagonal extension
heights that approximate .680 mm. [n this study, 75
implants were measured and extension heights varied from .762 mm to .363 mm. Only four of the thirteen implant groups measured had a mean hexagonal extension height of .680 mm or more (Table 5).
In the groups tested, variation In extension heights
ranged from .018 mm to -147 mm, indicating that
the manufacturers do not consider this design factor
critical in attaining a stable screw joint assembly.
Intimate matching of the patrix and matrix
hexagonal width is of greater consequence to antirotational stability.'"'" Average hexagonal flat to
flat measurements for the implants tested (Fig 11)
varied from 2.677 mm (STR) to 2.707 mm 13i, NP,
SV) with sample ranges (Fig 12) of 1 micron (3i) to
61 microns ISV). Corresponding variations in size
also exist within the abutment matrix hexagonal.
The resulting misfit creates the potential for addi-

Njniber2, 1995

1 75

Tiie Internaticnai Journal ol Prosthodoiilies

Acciifacv und Consistency of Implants, Abutnienls, .inri Anaiog


Fig 12 Graphic comparison of the greatest
flat to Hat difterences
measured in each
manjtacturers sample
set evaluated.

0.12

0.1

0,08

;
1 reate St fi;

0.06

0.04

0.02

Table 11

3.75

"0

3i

3i

lili
.
ll l l llllilllillll

XMK r^P NP

ISS IMP IMZ STR BUD IMT ISS OTC SO


Manutacturer

SV

ScrewVent Implant/Abutment Measurements

Component

Location

Mean mm

High

Low

Range mm

SD

Implant
Abutment

Head-Width
Base-Width
Hex-End
Hex-Length

5
5
15
10

3.894
4.494
3.413
1.583

3.709
4.496
2.418
1.663

3.679
4.490
2.404
1.529

.003
.006
.014
.134

,011
.002
.005
.061

-45 microns ISTD 13,441; Ran

Table 12

Implant Machining Composite Index


MFG

Locatioh of
Measurement'
mm

3i
4
X18

3i
3.75
X15

XMARK
3.75
X18

iMP
3.75
x15

IMZ
4.00
x13

STRY
3-75
x13

IMTC
3,75
x8

NP
3.75
X15

BUD
3.5
X4

ISS
3.75

OTC

3.75

SO
4.00

SV
3.75

x13

xiO

x8

xiO

Impiant Diameter H e a d '


Mean Hexagonai
Flat/Fiat Difference
Greatest Difterence
Between Flats on a
Single Implant
Composite Vaiue
Hex Play/Rotation

.009

,011

,007

,012

.009

.005

.004

.037

,011

.010

.009

.007

,016

.001
.004

.001
.003

008
012

005
,019

.006
.021

.009
.022

,006
,033

.004
.013

,009
.039

OOfi

.012
.039

.007
,047

n?7

.014

,015

.027
4.6"

,036
4,0"

,036
5.0'

.036

.043

,044

.049

.052

,060
6.7"

.061

151

6.r

am

IOR

'Vaiues retiect the diffeience between the iiigh and the ioi [range] recorded at each location [or each grojp measured. The smaiier the difference
between tiie samples, tiie Lighter the machining laierances

tested with their own components and those of


other manufacturers. Based on clinical experience
and the preliminary data presented, it is the
author's opinion that hexagonal rotation of less
than S' is desirable for optimal joint stability. In
general, most manufacturers of external hexagonal
components have selected machining tolerances

Tlie International journal ol Prostliodontics

that permit a wide range of compatibility and


interchange with competing products. This
approach results in components having a broader
universal application. In contrast, proprietary
implant to abutment components with precisely
matched hexagonal tolerances to achieve optimal
screw joint stability are presently unavailable. This

176

Accuracy drei Consis[e;i(y ol tmflianl;, Aljulments, and AnaloK

Fig 13a Cross sectional SEM view (X20) of a SorewVent


abutment/implant interfaoe demonstrating incomplete seating
of the internal hexagonal extension into the hexagonal recess
of the implant body. The interface discrepancy is seen at the
top of the cross seotion view.

Fig 13b Higiier magnification (X100) of the interface discrepancy shown In Fig 13a.

Fig 13c X200 magnification of the internal interference on


the left lateral wall within the implant hexagonai recess that
prevented the hexagonal extension of the abutment from
seating completely.

Fig 13d External view (X200) of a ScrewVent abutment


implant interface that demonstrates the open interface experienced in the samples examined.

is especially important in single tooth restorations


where exact seating is critical to attaining repeatable interproximal contacts and optimal anti-rotational characteristics. A recentiy introduced press fit
internally hexagonal system (ScrewVent) is an effort
to overcome the deficiencies identified with the
available external hexagonal implants. This system
demonstrated the least amount of rotational freedom (1,4) of all the components and combinations
evaluated in the study. Although impressive from
an anti-ratational standpoint, this system exhibited
difficulty in sealing the abutment hexagonal fully
within the implant body Fig 13). As a conse-

quence, interface defects between the abutment


and the implant averaging 45 [im (STD 13.44)
(Table 11 ) were noted.
The overall machining accuracy and consistency
of selected hexagonal implants is reported in Table
12, The three parameters listed reflect characteristics of tine implant body that influence coupling
with abutments. The difference between the greatest and least values recorded for each parameter
(range) are listed and are totaled to derive a composite value. The resulting composite values
ranged from .014 (3i) to .151 (SwedeVent), The
smaller the composite value, the greater the accu-

b^jT^-ji; 3, Number 2, 1995

177

The Inlernational (ournal of Proslhodontk

Accuracy and Consisrenc;y of lirykinls, Ahiitments, and Analogs

racy and consistency of the components, and the


closer the machining tolerances.
When clinical requiretnents necessitatti the use
of components (rotri different manufacturers, careful scrutiny and attention should be directed to the
dimensions of the respective matching surfaces,
hexagonal compatibility, and rotational freedom.
The data presented can be used as a general guide
(o component compatibility. It is prudent to
remember, however, that small variations can exist
from one batch to the next and that some manufacturers are continually upgrading their products.
Conclusions
Machining specifications can vary significantly
between manufacturers. However, systems are
available that exhibit close tolerances, excellent
accuracy, and consistency. From the data presented it may be concluded that:

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1, Based on the composite index, the closest tolerances were observed for Implant Innovations
(,014 and ,015) and Crossmark (,0271,
2, The closest hexagonal width (flat to flat) tolerances were observed for Implant Innovations
(1 |jm), Nobelpharma (4 pm|, and Impla-Med
(5 |jml. The greatest tolerance was recorded for
SwedeVent (27 [jml,
3, The closest hexagonal height tolerances were
observed for IMTEC (18 fjm) and Stryker (28
^m). The greatest tolerance was recorded for
Steri-O5s(147^iml,
4, The least amount of hexagonal rotation was
observed for Crossmark (4,0), Implant
Innovations (4,6}, and Impla-Med (5,0),
5, The least amount of hexagonal rotation for mixed
components was observed for NP/Imp (3,S1,
ISS/IMP (4,21, 3/IMP (4,3"), and NP/3i (4.9},

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15,

16,

Acknowledgtnents
The author expresses appreciation for assistance from
Implant Innovations Inc., Crosmark, Implant Support Systems,
IMTEC Inc., Coie-Vent, Bud Ind,, and Interpore Int, for providing some of the components and materials used in the study.
Statistical analysis was provided by Cornell Ormsby,

The International iournal of Prosthodontics

178

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