Bicon is an example of the engineers creating a deep conical internal interface WHITOUT compromising their unique major thread design! This was accomplished by using a shallow 1.5 degree taper thus giving the engineers room to maintain the major thread design all the way to the crestal region of the implant. You are correct about their use in the posterior. Imagine if they had a 6mm tall implant and only 3 threads (or 3mm) of major threads at the implant apex and the crestal region was 3mm of micro threads! That would be a high risk implant solution. Check out the video on THE FIVE THREAD RULE for more information regarding primary stability of dental implants. Thanks for the comment
I like a lot of your work but couple of issue with this.. 1) Many deep conical connections use smaller screws 2) how much strength is actually necessary? i.e. how thin is acceptable for given forces 3) under load how deep does the taper need to be to resist bacterial/fluid intrusion. It is on thing to slide the stack but if the base is fixed in place and then a load placed at the top what happens?
All of your questions are great! These are the questions that the engineers need to answer for each implant being brought to market. If you ask your sales representative for these answers and they don't have them you might want to consider a different manufacture. Remember, an implant designed by a dentist for a dentist is a receipt for disaster! We don't learn about these kinds of mechanical issues in dental school. We need engineers to analysis these implants on behalf of the patients well being.
@@StanleyinstituteYour response just triggered a big “aha” moment for me. Thank you! I’m a 65 y/o consumer with severe dental issues, researching the best solution for me. I’m not an engineer and I’m not a dentist. But I have just enough geek speak in me to follow and understand most of your content. I MUST find a way to generate $65K and get myself to Cary, NC because I know you are the correct provider for me. After hundreds of hours of research, considering providers anywhere in the country, I know to my bones that you’re my guy.
Correct! It is imperative to use non-engaging abutments when dealing with multiple implants that have been splinted together. This means avoiding the use of hex or trilobe abutments. Only non-engaging abutments should be utilized to prevent the occurrence of an over determinate condition. Such a condition goes against sound engineering principles and should be avoided at all costs.
@@Stanleyinstitute "Narrow or Insufficient Bone Volume: If the bone available for implant placement is narrow or insufficient, a conical connection may exert too much pressure on the surrounding bone, potentially leading to bone resorption or implant failure. Severe Bone Loss: In cases where there is severe bone loss or inadequate bone height, other types of connections might be more suitable, as conical connections require a certain amount of bone to provide adequate stability. Complex Prosthetic Rehabilitation: For complex cases requiring significant prosthetic adjustments, a different connection type (like a flat-to-flat connection) may offer easier modifications and adjustments. Soft Bone Quality: In cases of soft bone (D3 or D4 bone density), conical connections may not achieve the same level of initial stability as in denser bone, which could compromise the implant's success." Is that something you would agree with? Thank you in advance.
Hi Doctor Robert, I have been watching you for some time, great content, streight to the point. What exactly is deep Morse, competed to regular one, is it the degree od taper 12°vs 6° for example. Or how do i recognize the implants apart? Also I would love some content on soft tissue menagment. Thanks again.
When looking at internal connections I wouldn’t spend too much time with the angle of the deep taper. I would suggest that as long as there is an internal conical connection that does NOT result in compromised thread design in the crestal region you and your patient will be fine.
What if the implant companies will just roughen the implant T the coronal aspect instead of making shallow threads , would you think that deep Morse taper is beneficial?
I would prefer major threads in the coronal region. Consider the case where you are doing an implant and sinus graft at the same time. The floor of the sinus is 5mm thick and you are going to place a 10mm implant. So 5mm of the crestal region is all that engages the bone. If this region of the implant is just rough or has micro threads what is going to keep it from being avulsed into the sinus? That is my bigger concern
I see your point, and agree with what you said, even if some scientific studies need to come out proving what our empirical knowledge already tells us. But, one of those examples you think is a bad idea was already time-tested. Bicon implants have a deep morse taper at 1,5 degrees and they are primarily used in molar regions. However, it is a nice point of view for companies who are designing new implants 👌 please take this with a grain of salt as it is only my humble opinion
Pretty sure the paper cup And paper plates analogy sticking together has more to do with air pressure like a suction cup rather than friction fit in a morse taper. In a vacuum those papers plates would come apart.
@@Stanleyinstitute there is friction, ofcourse there is. But I don't think it's the main factor in the paper plate analogy. It's like asking me if suction cup's rubber and glass have no friction. Ofcourse. All materials have friction. It's just not the method suction cups stick to glass or paper plates stick together.
Mors taper work via friction. It's a friction fit like you said so yourself. And that friction fit is dependant on surface area in contact with each other and the direction of friction. More parallel, the better like crown preps. Tall and as parallel as possible. A deep mores taper sacrifice implant structure for stability. And vice versa. I'm not saying you're wrong. But I think a study or some evidence of taper vs structural stability of implants long term would be helpful to show you may not "need" a deep mores taper or deeper may not always be better. Just like once upon a time implants needed to be bicortical then 16mm now 8mm. An example (an if my memory serves me correctly) astra implants have a very deep mores taper and they are quite successful. I'm open to having my mind changed though.
@@Stanleyinstitute That's not what i'm saying. I'm saying it's not the main mechanism of how the paper plates are sticking together. like a car coming to a stop, with breaks. Whilst air resistance will slow the car down. It is not the main mechanism for how to car comes to a stop with breaks and tire/road friction. --- My main point is your analogy between paper plates and implant mores taper is slightly flawed as they're completely different mechanism of being stuck together. one is negative air pressure (like trying to pull off a vacuum cup from a glass window) while the other is mechanical friction. I'm not saying your comments on deep mores taper are wrong. I'm simply commenting that the analogy between paper plates and mores taper is flawed. If there are research which says deep mores tapers are not required, could you share them with me please. I'll be grateful to have a read. With the examples of the bins and party cups. simply do the experiment of dropping one into the other. You'll see it slows down, doesn't just drop in. It slows down with air break as it pushes all that air out. Then when you initially try to pull them apart, you're generating negative pressure within, until you break that seal after which it becomes easy. You can simply cut a big hole in the bottom of the cup and you'll drastically see how much easier it is to remove the cusp. If it was the side wall friction which is making the cups so hard to pull apart, then the hole at the bottom of the cup shouldn't make a difference. Again, not saying it's going to slide out like it's been lubricated up. but simply the friction isn't what's mainly really holding the 2 cups / bins together.
Bicon is an example of the engineers creating a deep conical internal interface WHITOUT compromising their unique major thread design! This was accomplished by using a shallow 1.5 degree taper thus giving the engineers room to maintain the major thread design all the way to the crestal region of the implant. You are correct about their use in the posterior. Imagine if they had a 6mm tall implant and only 3 threads (or 3mm) of major threads at the implant apex and the crestal region was 3mm of micro threads! That would be a high risk implant solution. Check out the video on THE FIVE THREAD RULE for more information regarding primary stability of dental implants. Thanks for the comment
I use a solid body implant with an external true Morse taper (1.5 degree) - so there is no wall thickness.
You have my interest. Where can I see a picture or learn more about this implant?
@@Stanleyinstitute KAT Implant
I like a lot of your work but couple of issue with this.. 1) Many deep conical connections use smaller screws 2) how much strength is actually necessary? i.e. how thin is acceptable for given forces 3) under load how deep does the taper need to be to resist bacterial/fluid intrusion. It is on thing to slide the stack but if the base is fixed in place and then a load placed at the top what happens?
All of your questions are great! These are the questions that the engineers need to answer for each implant being brought to market. If you ask your sales representative for these answers and they don't have them you might want to consider a different manufacture. Remember, an implant designed by a dentist for a dentist is a receipt for disaster! We don't learn about these kinds of mechanical issues in dental school. We need engineers to analysis these implants on behalf of the patients well being.
@@StanleyinstituteYour response just triggered a big “aha” moment for me. Thank you! I’m a 65 y/o consumer with severe dental issues, researching the best solution for me. I’m not an engineer and I’m not a dentist. But I have just enough geek speak in me to follow and understand most of your content. I MUST find a way to generate $65K and get myself to Cary, NC because I know you are the correct provider for me. After hundreds of hours of research, considering providers anywhere in the country, I know to my bones that you’re my guy.
In which case(s) a bridge over multiple implants must not use pure conical (or indexed conical) connections? Thank you.
Correct! It is imperative to use non-engaging abutments when dealing with multiple implants that have been splinted together. This means avoiding the use of hex or trilobe abutments. Only non-engaging abutments should be utilized to prevent the occurrence of an over determinate condition. Such a condition goes against sound engineering principles and should be avoided at all costs.
@@Stanleyinstitute
"Narrow or Insufficient Bone Volume: If the bone available for implant placement is narrow or insufficient, a conical connection may exert too much pressure on the surrounding bone, potentially leading to bone resorption or implant failure.
Severe Bone Loss: In cases where there is severe bone loss or inadequate bone height, other types of connections might be more suitable, as conical connections require a certain amount of bone to provide adequate stability.
Complex Prosthetic Rehabilitation: For complex cases requiring significant prosthetic adjustments, a different connection type (like a flat-to-flat connection) may offer easier modifications and adjustments.
Soft Bone Quality: In cases of soft bone (D3 or D4 bone density), conical connections may not achieve the same level of initial stability as in denser bone, which could compromise the implant's success."
Is that something you would agree with?
Thank you in advance.
Hi Doctor Robert, I have been watching you for some time, great content, streight to the point. What exactly is deep Morse, competed to regular one, is it the degree od taper 12°vs 6° for example. Or how do i recognize the implants apart?
Also I would love some content on soft tissue menagment. Thanks again.
When looking at internal connections I wouldn’t spend too much time with the angle of the deep taper. I would suggest that as long as there is an internal conical connection that does NOT result in compromised thread design in the crestal region you and your patient will be fine.
What if the implant companies will just roughen the implant T the coronal aspect instead of making shallow threads , would you think that deep Morse taper is beneficial?
I would prefer major threads in the coronal region. Consider the case where you are doing an implant and sinus graft at the same time. The floor of the sinus is 5mm thick and you are going to place a 10mm implant. So 5mm of the crestal region is all that engages the bone. If this region of the implant is just rough or has micro threads what is going to keep it from being avulsed into the sinus? That is my bigger concern
I see your point, and agree with what you said, even if some scientific studies need to come out proving what our empirical knowledge already tells us. But, one of those examples you think is a bad idea was already time-tested. Bicon implants have a deep morse taper at 1,5 degrees and they are primarily used in molar regions.
However, it is a nice point of view for companies who are designing new implants 👌 please take this with a grain of salt as it is only my humble opinion
Opps. See my reply above. I fat fingered that one 😮
Pretty sure the paper cup And paper plates analogy sticking together has more to do with air pressure like a suction cup rather than friction fit in a morse taper. In a vacuum those papers plates would come apart.
Interesting. So you’re assumption asserts there isn’t any friction between two paper plates or plastic cups?
Just for reference, sand paper has lots of friction and the plastic interproximal finishing strips do too.
@@Stanleyinstitute there is friction, ofcourse there is. But I don't think it's the main factor in the paper plate analogy. It's like asking me if suction cup's rubber and glass have no friction. Ofcourse. All materials have friction. It's just not the method suction cups stick to glass or paper plates stick together.
Mors taper work via friction. It's a friction fit like you said so yourself. And that friction fit is dependant on surface area in contact with each other and the direction of friction. More parallel, the better like crown preps. Tall and as parallel as possible.
A deep mores taper sacrifice implant structure for stability. And vice versa.
I'm not saying you're wrong. But I think a study or some evidence of taper vs structural stability of implants long term would be helpful to show you may not "need" a deep mores taper or deeper may not always be better. Just like once upon a time implants needed to be bicortical then 16mm now 8mm.
An example (an if my memory serves me correctly) astra implants have a very deep mores taper and they are quite successful.
I'm open to having my mind changed though.
@@Stanleyinstitute That's not what i'm saying.
I'm saying it's not the main mechanism of how the paper plates are sticking together.
like a car coming to a stop, with breaks.
Whilst air resistance will slow the car down. It is not the main mechanism for how to car comes to a stop with breaks and tire/road friction.
---
My main point is your analogy between paper plates and implant mores taper is slightly flawed as they're completely different mechanism of being stuck together. one is negative air pressure (like trying to pull off a vacuum cup from a glass window) while the other is mechanical friction.
I'm not saying your comments on deep mores taper are wrong. I'm simply commenting that the analogy between paper plates and mores taper is flawed.
If there are research which says deep mores tapers are not required, could you share them with me please. I'll be grateful to have a read.
With the examples of the bins and party cups. simply do the experiment of dropping one into the other. You'll see it slows down, doesn't just drop in. It slows down with air break as it pushes all that air out. Then when you initially try to pull them apart, you're generating negative pressure within, until you break that seal after which it becomes easy.
You can simply cut a big hole in the bottom of the cup and you'll drastically see how much easier it is to remove the cusp. If it was the side wall friction which is making the cups so hard to pull apart, then the hole at the bottom of the cup shouldn't make a difference. Again, not saying it's going to slide out like it's been lubricated up. but simply the friction isn't what's mainly really holding the 2 cups / bins together.
❤