Abstract
Statement of problem
A consensus regarding which implant-abutment connection type would perform best in
the anterior maxilla is lacking.
Purpose
The purpose of this systematic review was to determine the best implant-abutment connection
type for anterior single-tooth implants considering esthetics, success, and survival
rates.
Material and methods
An electronic search was conducted in MEDLINE, Scopus, Embase, and the Cochrane Library
databases to identify clinical studies on single-tooth implants with external and
internal hexagon, and/or Morse taper connections. These studies needed to describe
at least one of the following outcomes: esthetic score, survival/success rate, or
marginal bone loss. The included studies and reports were assessed for bias using
the Cochrane risk of bias tool.
Results
Of the 891 articles identified, 29 were selected and analyzed. The most common technical
complications were abutment screw loosening and crown-cement loosening, while dehiscence
and recession were the most common biological complications. The most frequent complications
were dehiscence for external hexagon, crown-cement loosening for the internal hexagon,
and ceramic fracture for the Morse taper. Esthetics were favorable for all connections,
but the internal hexagon performed better. However, better results for marginal bone
loss, success, and survival were found for the Morse taper. The global annual failure
rate was 0.90% and 0.2% for Morse taper, 0.3% for external hexagon, and 2.2% for internal
hexagon.
Conclusions
This review suggests that Morse taper performs better for survival, success, and marginal
bone loss. Internal hexagon performed better for esthetic parameters. Additional controlled
studies are needed to provide stronger evidence because the evidence generated in
this study was considered low.
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Article info
Publication history
Published online: November 23, 2018
Footnotes
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2018 by the Editorial Council for The Journal of Prosthetic Dentistry.
