CONELOG White Paper: Facts and figures

CONELOG ® implant system - Summary Precision of the conical connection CONELOG implants offer a patented implant- abutment connection with self-locking cone geometry and cams/grooves indexing. Seve- ral in-vitro tests have demonstrated the pre- cision and stability of the implant-abutment connection attributable to geometrical design and high-precision manufacturing (1, 2, 3, 4) . The reduced rotational freedom given by the indexing design and the ability to reposition the abutment without vertical displacement play a major role in the precision of the final prosthetic restoration. Mechanical studies with disassembly and reassembly of the im- plant-abutment complex showed excellent re- sults for the CONELOG connection compared to other systems with conical connections (3, 4) (Fig. 2). Microgaps and its impact, i.e. micro-leakage or bacterial penetration are the reason to aim for small manufacturing tolerances of all the com- ponents in two-piece implant systems. Micro- gaps are impossible to eliminate also in a conical connection (5, 6 , 7 , 8 ) , but it is the good balance of the precision of a deep conical connection and CONELOG specific features which enable to support the clinician in achieving accurate resto- rations and easy workflow (Fig. 3). Excellent bone preservation with platform switching Preservation of the crestal bone is important for the peri-implant long-term stability. Studies with CONELOG implants with integrated plat- form switching showed very stable conditions ( 9 , 10) and even slight bone gain 5-year post- loading (11 , 12) . These data confirm the positi- ve effect of platform switching found in various studies with Camlog implants (13, 14) . Clinically proven success and patient satisfaction The Promote surface has proven to be effec- tive in various preclinical and clinical studies over years ( 15) . For the CONELOG SCREW-LINE implants several clinical studies documented very positive mid- and long-term treatment outcomes in different indications and loading modalities ( 9 , 10, 16, 17, 18) . High survival rate, excellent stability of hard and soft tissues as well as a patients’ satisfaction of 100% could be shown in a multicenter study in daily dental practice with follow-up controls up to 7 years ( 9 ) . The short implants (7mm) are established as reliable and safe treatment option to avoid sinus augmentation procedures in the posteri- or maxilla (10) as well as with splinted and non- splinted fixed dental prostheses in the posteri- or mandible (19 ). Guide system accuracy Template guided implant placement is a me- thod to ensure the ideal implant position for immediate or delayed restoration. The difference between the virtually planned and the clinically achieved implant positions with the CONELOG Guide system was eva- luated in several clinical trials (20, 21, 22) . The accuracy was proven to be high leading to predictable prosthetic results independent of the implant position and the implant dimensi- ons used (20 ). Modern treatment option – PROGRESSIVE-LINE CONELOG implants are available with two dif- ferent outer macro-designs: SCREW-LINE and PROGRESSIVE-LINE. The PROGRESSIVE-LINE implants have a conically shaped apical area and buttress threads to develop high initial sta- bility. In the coronal area, a crestal anchoring th- read gives support for optimal hold with limited bone height, e.g. in sinus lift procedures (Fig. 4). In extraction sockets, these implants showed excellent stability based on insertion torque and ISQ measurements (23) and thus enable modern treatment concepts such as immediate implantation or immediate loading even in soft bone. Conclusion The solid documentation of the CONELOG im- plant system is based on scientific evidence. This is an important contribution to Camlog’s success story. The long-term data of the Pro- mote surface, the use of platform switching, the positioning, and the stability of the implant- abutment connection are key factors contribu- ting to the excellent performance of CONELOG implants in clinical practice. Continuous de- velopments of the system satisfying modern treatment options are going hand in hand with clinical evidence. Fig. 3: “Vertical fit feature”: the impression post is not in contact with the cone during impression taking. The vertical discrepancies – inherent to all conical connections – are reduced by this concept. Fig. 4: PROGRESSIVE-LINE implant placed in posterior maxilla with simultaneous sinus lift (picture courtesy of Dr. R. Polsbroek) Fig. 2: Precision of different conical connections: see White paper X.J7777.09/2020. Semper Hogg et al. (2015) compared the CONELOG implant-abutment connection to other systems with conical connections, i.e. Nobel Active, Ankylos C/X, Astra Tech, Straumann Bone Level, and Straumann Tissue Level. The abutments were torque tigh- tened according to each manufacturer’s re- commendations. CONELOG showed the best results in terms of rotational displacement (Fig. 1) and canting moment range (Fig. 2) and very good results in terms of vertical displace- ment range (Fig. 3). Importance of the results: The precision of the implant-abutment con- nection is of major importance for the fabri- cation and later fit of the prosthetic restora- tions and their accuracy from the model to the patient’s mouth. Stability of the implant- abutment connection is strongly influenced by the precision of fit, the connection design (incl. positional index design) and the manu- facturing precision. The CONELOG implant-abutment connection showed evidences of high-precision manu- facturing and superior positional stability when compared with other conical connec- tions. Fig. 1: Rotational displacement of 6 implant systems. (Graphic depicted from Semper Hogg et al. 2015) 7 6 5 4 3 2 1 0 Rotation in ° CONELOG Nobel Active Ankylos C/X Astra Tech Straumann Straumann Bone Level Tissue Level TAKE HOME MESSAGE: 1. Superior precision of the implant- abutment connection for CAMLOG ® and CONELOG ® Implant Systems 2. Advantages of a good precision: a. Positional stability of supraconstruction b. Better passive fit c. Less abutment screw failure d. Time saving (e.g. less adjustment) 3.Beneficial for the patient, the dentist, and the dental technician Fig. 2: Canting moments of 6 implant systems. (Graphic depicted from Semper Hogg et al. 2015) 5,0 4.5 4,0 3.5 3,0 2.5 2,0 1.5 1,0 0.5 0 Canting moments in ° CONELOG Nobel Active Ankylos C/X Astra Tech Straumann Straumann Bone Level Tissue Level Fig. 3: Vertical displacement of 6 implant systems. (Graphic depicted from Semper Hogg et al. 2015) 160 140 120 100 80 60 40 20 0 Vertical displacement in µm CONELOG Nobel Active Ankylos C/X Astra Tech Straumann Straumann Bone Level Tissue Level High precision of the CONELOG implant-abutment connection As for the CAMLOG ® Implant System, precision testings have confirmed the high precision of the CONELOG ® implant-abutment connection , this to the benefit of the patient, the dentist, and the dental technician. (1,2)