Preventing Bacterial Leakage in Implant-Abutment Connection: A Review ^†

1. Introduction

Osseointegration can be affected by oral conditions, in particular the micro gap at the implant-abutment-connection (IAC) represents a site for dental plaque aggregation favoring bacterial leakage that can increase inflammatory cells at the level of the IAC, causing peri-implantitis [1]. This micro gap, once early colonized, may constitute a bacterial reservoir, that could subsequently contaminate fixture’s surroundings and interfere with peri-implant tissues health [2,3].

2. Aim

The aim of this review is to describe, according to the most recent literature, the different kind of implant-abutment connection and their ability to reduce bacterial leakage and thus preventing peri-implantitis.

3. Materials and Methods

The following database were consulted: Pubmed (n = 26), Scopus (n = 90), Research gate (n = 7) and were found a total of 123 articles. Duplicates were excluded and after reading abstract and titles, were excluded those articles that were off topic. The remaining ones (n = 24) were assessed for full-text elegibility: we excluded 5 articles because they were case report, 2 because there was no clear reference to the relationship IAC and bacterial leakage and 2 because was not pertinent with the argument. Fifteen articles were included in the review.

4. Results and Conclusions

From the review, it’s clear that exists a relationship between the IAC and bacterial leakage. All the connection presented an amount of micro-gap and bacterial micro-leakage but conical and mixed connection systems seem to behave better. Moreover, both connections seem to have a better load’s distribution and mixed one has also anti-rotational properties very useful during the positioning of the prosthesis [4].