In a recent live session of EAO’s "Just Ask," prosthodontist Dr. Stefano Gracis discussed the complex and vital topic of the implant-abutment interface. Hosted by Gerard Heikkop, the session delved into the biomechanical considerations and practical implications of designing stable and long-lasting dental prostheses.
Dr. Gracis, with a wealth of experience in both private practice and education, highlighted the importance of achieving a stable implant-abutment-prosthesis system to prevent complications such as screw loosening, abutment fractures, and implant failures. He emphasized that understanding the intricate details of implant connection designs—whether external or internal—is crucial to success. External connections, despite their historical reputation for instability, can still perform well if the correct preload and torque are applied. Dr. Gracis strongly advised clinicians to calibrate their tools and follow the manufacturer's torque recommendations to ensure stability.
The session also focused on the evolution of implant materials and designs. Dr. Gracis pointed out that while zirconia abutments have gained popularity, they should not be used in internal connections without a metal base. He also explored the role of screw materials, recommending that clinicians use high-quality components for optimal results.
Ultimately, Dr. Gracis stressed that the key to avoiding screw loosening and implant failures lies not in the choice of implant system alone, but in precise and careful application of torque and preload, as well as using the right tools and components. The takeaway? “Read the manual” was Dr. Gracis’s simple yet essential advice to all clinicians. By following manufacturer guidelines and ensuring correct mechanical principles are applied, long-term success in implantology can be achieved.