Purpose

To ascertain whether the compatibility of non-original abutments (NOAs) with dental implants is influenced by the type of implant connection i.e. internal or external, and whether certain combinations of componentry may be as compatible as the original components.

Methods

A structured literature search was conducted using 3 electronic databases (MEDLINE®, The Cochrane Library, and Web of Science Core Collection) for studies reporting on the use of non-original abutments published between 1995 and 2020. This was supplemented with hand searching in relevant journals and references, as well as searching grey literature. Relevant studies were selected according to specific inclusion criteria. Data was collected for the following parameters: precision of fit, microleakage, micromorphological differences, micromotion, rotational misfit, screw loosening, maximum load capacity, fracture resistance, tensile strength, compressive strength and in-vivo implant and prosthesis outcomes.

Results

The electronic searching and hand search yielded titles and abstracts of 5617 studies following de-duplication; 40 studies were finally selected. Overall, original abutments showed better precision of fit, ability to resist microleakage, prevention of rotational misfit and micromotion, and fatigue strength compared with non-original abutments. Some non-original abutments on external connections were comparable with original abutments in terms of precision of fit and resistance to screw loosening and may be associated with less catastrophic failures than those on internal connections.

Conclusion

Original abutments present more predictable outcomes than non-original abutments with regards to the parameters investigated. However, it seems that external connections can provide some level of compatibility in terms of precision of fit and may also exhibit less catastrophic failures than NOAs on internal connections. This may be due to increased rotational freedom external connections provide. There is a lack of information regarding the influence of connection geometry on many aspects of compatibility and therefore the current clinical recommendation should be to use original abutments. More laboratory studies comparing non-original abutments on different implant connections are required. In addition, there is a need for long-term in vivo studies providing data on the clinical performance of non-original abutments.

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