Comparison of the Morse Cone Connection with the Internal Hexagon and External Hexagon Connections Based on Microleakage - Review.

Ana Beatriz Bueno Carlini Bittencourt,Eduardo Piza Pellizzer,Clóvis Lamartine De Moraes Melo Neto,Daniela Micheline Dos Santos,Marcelo Coelho Goiato,Paulo Augusto Penitente

doi:10.14712/23362936.2021.15

Ana Beatriz Bueno Carlini Bittencourt, Eduardo Piza Pellizzer + Show 4 more

Open Access

https://doi.org/10.14712/23362936.2021.15

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Abstract

The gap formed at the abutment-implant interface brings about a bacterial colonization. In addition, a bacterial reservoir can be established within the implant. The build-up of microorganisms around the implant can cause soft tissue infections and bone loss around the implant, which can lead to implant failure. Our literature review aimed to evaluate the infiltration at the implant-abutment interface, comparing the Morse cone connection with the external hexagon and internal hexagon connections. A literature search using the PubMed database was performed on March 24, 2021. The search terms were combinations of "Morse cone" or "Morse taper" with each of the following terms (individually): "microleakage", "leakage", "infiltration", and "penetration". The inclusion criterion was in vitro studies comparing the Morse cone with the external hexagon and/or internal hexagon, based on infiltration at the implant-abutment interface. The exclusion criterion was the evaluation of microleakage at the implant-abutment interface after applying a sealant over this region. The search was expanded as needed. There was no limit on the year of publication, and only articles written in English were included. In addition, references cited in included articles were also included in this review when they were appropriate. This literature review concluded that, in most cases, the microleakage in the Morse cone connection was lower when compared with the external hexagon and internal hexagon connections.

Highlights

In implantology, implant-abutment connections have been used clinically for many decades (Scarano et al, 2016a)
The external connection usually has an external hexagon on the implant platform, and the internal connection can be divided into internal hexagon, internal octagon, and Morse cone, which has been currently widely used (Goiato et al, 2015)
De Sousa et al (2019) found that there was no significant difference in the bacterial growth of Enterococcus faecalis or Candida albicans or Enterococcus faecalis + Candida albicans between the Morse cone and external hexagon groups

Summary

Introduction

Implant-abutment connections have been used clinically for many decades (Scarano et al, 2016a). Even when the implant and abutment are connected correctly, a microgap is formed (Pereira et al, 2016); so, there is no implant connection that can provide a complete seal at the implant-abutment interface (Schmitt et al, 2014). This microgap can increase in size over time due to masticatory loads that can cause micromovements of the prosthesis components (Scarano et al, 2015; Pereira et al, 2016). Regardless of the type of connection, the implantabutment interface (with a microgap) is present and may be located at different depths of the bone crest (subcrestal, equicrestal or supracrestal), depending on the connection used (Dibart et al, 2005; Ricomini Filho et al, 2010; Verdugo et al, 2014)

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