The Hiossen ETIII Implant System: A coordinated approach to esthetic restorations

In addition, too labial a positioning can decrease the volume of gingiva, preventing an adequate emergence profile of the final restoration.

In maxillary anterior cases, the implant/abutment interface needs to be at least 2.5 mm apical from final gingival margin of the restoration to give the restoration enough “gingival drape” for an esthetic emergence profile.

Hiossen implants are available in eight diameters from 2.5 mm to 7 mm. This variety allows the clinician to choose an implant that will not compromise esthetics due to encroachment on the facial bone.

Impression and master model

The Hiossen impression copings, whether the pick-up or transfer type, are designed so it is clear where the coping is positioned in the impression. The copings also come in a variety of heights and diameters, which coordinate with the healing abutments. This aids in developing proper emergence profile of the restoration.

In addition, when a soft-tissue simulation material is used as part of the master model, the technician can create a restoration that emerges from the gingiva with a highly esthetic, life-like appearance.

Abutment design

An abutment needs to be kept small in diameter so as to allow good tissue health in the critical subgingival area. An abutment that is too large can compromise the gingival blood supply, which leads to recession and/or an abnormal tissue color.

From a prosthetic standpoint, a smaller abutment allows for a greater amount of porcelain for the restoration, which optimizes esthetics.

The Hiossen ETIII system has a wide range of stock abutments in various gingival and coronal heights and diameters. In cementable restorations, it is crucial to select the proper gingival height to position the crown margin no greater than
2 mm subgingival. This allows access for cement removal and aids in the maintenance of biologic health.

A 17-degree angled abutment is available that is ideally suited for the premaxilla area. This angled abutment is gold in color and very narrow, which preserves gingival health and, as mentioned above, provides ample room for porcelain (Figs. 1, 2). Zirconia stock abutments are also available, which can be customized as needed.

In situations that call for a custom abutment, Hiossen has a “GoldCast” abutment that can be waxed to the desired shape and cast in precious metal. This abutment is also used for one-piece, screw-retained restorations, which use an occlusal access opening.

Another feature of the Hiossen system, which helps simplify abutment selection, is that the five “regular” size implants — from 4 mm to 7 mm in diameter — share the same abutment platform, and all five can use the same abutments interchangeably.

The 3.5 mm diameter “mini” implant has its own group of abutments that are just as extensive as the “regular” sized implants. The “mini” implant is useful in situations with minimal ridge width and is strong enough to be used in posterior areas with confidence.

Hiossen ETIII implants are designed with built-in platform switching — the abutment diameter is slightly smaller than the implant diameter — and a self-sealing 11-degree Morse taper that joins the implant to the abutment.

This hermetic sealing of the implant/abutment interface not only eliminates screw loosening, but also prevents the percolation of saliva and bacteria because there is no micro-movement of the abutment in function and, therefore, no micro-gap to entrap oral fluids (Fig. 3, 4). Studies have shown that bacterial percolation can cause bone loss at the coronal portion of the implant where it meets the abutment.[1-4]

In summary, the Hiossen ETIII Implant System is an organized, systematic approach to esthetic implant dentistry. It is user-friendly, cost-effective and provides the clinician with a broad range of surgical and prosthetic components to meet a wide variety of clinical situations.

Note: This article was published in Implant Tribune U.S. Edition, Vol. 7, No. 11, November 2012 issue. A complete list of references is available from the publisher.