The Conometric Connection for the Implant-Supported Fixed Prosthesis: A Narrative Review

Abstract

Aim: The conometric concept was proposed as a possible connection between the abutment and the prosthetic coping. This research aimed to review the features and possible clinical uses of this connection in an implant-supported fixed prosthesis. Methods: An electronic search was conducted on an online database for the topic in object; articles published in international literature were considered and the research gave 17 results, and 6 parameters were analyzed. Results: This connection eliminated the possibility of cement residues in the subgingival region, reducing the risk of inflammation of peri-implant soft and hard tissues; not having to remove the cement residues, it is possible to place the margins in more apical portions, improving the aesthetics outcomes of the rehabilitations. It is also known that the retention by means of a screw causes a weakening of the restoration. The retentive force is adequate for fixed rehabilitation even after a high number of insertion–disengagement cycles; in vitro studies have also shown a high bacterial sealing. Implant rehabilitation using preformed components, such as conometric hoods, is helpful for CAD/CAM, so a digital workflow is possible. Several types of prosthesis were presented, all of which demonstrated adequate clinical performance in the follow-up observation. Conclusions: This type of connection seems to be suitable to support fixed implant rehabilitations, but long-term clinical studies are needed to validate this system.

Case Report of a Dental Implant with Conometric Abutment–Prosthetic Cap Connection: Advanced High-Resolution Imaging and Peri-Implant Connective Tissue Performance

“…A conometric prosthetic restoration system has been reported by some authors as a means to fix the prosthetic restoration to the abutment, obviating the use of retention through the use of screws or cement. The use of this technique offers very good clinical results; however, while we were able to find relevant histomorphometric evidence of the good performance of peri-implant crestal bone [29], no definitive evidence of the 3D structure of peri-implant connective tissues around conometric prosthetic restorations has been documented.…”

“…Moreover, by not having to remove cement residues, it is possible to set the margins in more apical portions, improving the aesthetics of the restorations. It has also been proven that retentive force is adequate for fixed rehabilitation even after a high number of insertiondisengagement cycles [29].…”

“…Several studies report successful follow-up evaluations of conometric systems [29]; some of these studies are accompanied by histological investigations mainly referring to the study of the peri-implant bone. Consequently, for full acceptance and recognition of the conometric abutment-prosthetic cap connection, it is necessary to further study the peri-implant soft tissues which constitute the actual barrier to the migration of any bacteria and inflammatory cells towards the apical bone areas.…”

Lower Jaw Full-Arch Restoration: A Completely Digital Approach to Immediate Load

“…In addition to the clinical benefits, the efficiency of laser sintering and laser melting in the production of prosthetic elements promises to reduce time and costs [33,34]. This is a win-win situation, as it improves the convenience and accessibility of these advanced techniques for practitioners and translates into more convenient solutions for patients [35]. Digital tools and computerized planning of implant-prosthetic rehabilitation represent the fundamental pillars of modern dentistry.…”

Finite‐Element Analysis Study Comparing Titanium and Polyetheretherketone Caps in a Conometric Connection between Implant and Prosthesis

“…[24,25] In vitro analyses have demonstrated that in a conometric connection, there is no presence of bacteria on the interface between the cap and abutment, [26,27] and in vivo studies have evaluated the success rate of the conometric connection, showing a rate of 97.77% or 100% over a follow-up period of more than 2 years. [23,28,29] Other numerical studies have indicated that the retention force is inversely proportional to the taper angle of the cap. [30,31] Specifically, they have established that the conometric connection is activated with an impulsive force of 40/36 N for a taper angle of 6°and 235 N for a taper angle of 1°.…”