Considerations of Implant-abutment Connections for the Longevity of Dental Implants

There are two types of implant-abutment configurations: one-piece and two-piece. One-piece design lacks interfaces as the implant body and abutment are continuous. On the contrary, two-piece configurations have an implant abutment interface (IAC). This chapter classifies the different IACs designs, compares their sealing capability against microorganisms, and describes strategies for the maintenance of IACs. Microbial contamination of the IAC can be induced by implant insertion, before the restoration is delivered, and during function. The chapter discusses the differences in microgap between IACs designs, the influence of the IAC design on the microbial leakage from and toward the implant connection, and the potential contamination ways of the implant and abutment connections. It summarizes methods to clean and disinfect the implant connection. Finally, the chapter describes a workflow for an ideal maintenance protocol for the IAC.