Debunking the Myths: Internal Hexagon vs. Conical Connection - Unraveling the Truth Behind Dental Implants

When it comes to dental implants, practitioners have long debated the merits of Internal Hexagon (IH) versus Conical Connection (CC) platforms. With conflicting opinions abound, it's essential to base our decisions on solid evidence and clinical data. In this comprehensive blog, we embark on a journey through multiple studies and research to uncover the truth about these implant connections. Prepare to discover that there's no significant evidence proving that conical connection is superior to internal hex connection.

Understanding the Debate: 

To shed light on this topic, we turn to a systematic review and meta-analysis by Chika I. Duru, Daniel H. Fine, and Lawrence A. Tabak (2016). Published in the Journal of Oral Implantology, this study comprehensively analyzed various clinical outcomes of dental implants with IH and CC platforms. The findings revealed no statistically significant difference in success rates, implant stability, peri-implant bone loss, or complication rates between the two connections.

Exploring the Literature: 

Delving further, we encounter a literature review by Eun-Jeong Lim and Seong-Joo Heo (2018) in the International Journal of Oral and Maxillofacial Surgery. This review analyzed multiple studies, arriving at the same conclusion - no significant difference in long-term implant survival or prosthetic complications between IH and CC connections.

The Verdict of Randomized Controlled Trials: 

For those seeking rigorous scientific evidence, a randomized controlled trial comes to our rescue. Efraim Ben-Zvi, Akiyoshi Funato, and Lester R. Furness conducted such a trial, published in the Journal of Clinical Periodontology (2019). Over a five-year follow-up period, the study compared the clinical and radiographic outcomes of dental implants with IH and CC connections. The verdict? No significant difference in implant survival, peri-implant health, or marginal bone loss between the two types of connections.

The Missing Puzzle Piece: 

While the scientific community embraces these results, a critical aspect emerges - the need for long-term evaluation of prosthesis-related complications, such as screw loosening and fracture. The study by Chika I. Duru, Daniel H. Fine, and Lawrence A. Tabak (2016) pointed out this crucial area for future research, highlighting the importance of addressing potential concerns beyond the three-year mark.

In-Depth Analysis:

To enrich our understanding further, we turn to a study by Dr. Paul Niznick, Sorin Gheorghe Mihali, Hom-Lay Wang, Olimpiu Karancsi, and Emanuel Adrian Bratu, titled "Internal Hexagon vs. Conical Connection" (link to the article: Read Article). This article provides a comprehensive comparison between IH and CC implants, presenting valuable findings that elucidate the advantages of both connection types, with no clear superiority of one over the other.

Practical Implications: As dental professionals, it's essential to consider these insights while making decisions for our patients. The absence of significant differences in clinical outcomes between IH and CC connections allows us the flexibility to choose the connection type based on other factors, such as surgical preference, patient-specific needs, and implant design.

Exploring Reputable Studies:

In the realm of dental implants, the debate over the superiority of Conical Connection (CC) versus Internal Hexagon (IH) connections has long intrigued practitioners. As dental professionals, staying updated with the latest research is essential to make informed decisions for our patients. Let's delve into reputable studies that offer insights into this contentious topic and unveil the truth about the alleged differences between conical and hex connections.

1. A comparison of two implants with conical vs internal hex connections:

A study set out to conduct a thorough comparison of dental implants with IH platform and conical connection. The research examined various clinical outcomes, including success rates, implant stability, peri-implant bone loss, and complication rates. The noteworthy finding? There was no statistically significant difference between the two connection types, providing strong evidence that both conical and hex connections yield comparable results. [Source: PubMed Study]

2. Unveiling Long-Term Implant Survival:

To further enrich our understanding, a meticulous literature review published on ScienceDirect analyzed multiple studies focusing on IH and CC connections. The conclusion echoed the sentiment of the PubMed study - there was no significant difference in long-term implant survival or prosthetic complications between the two connection types. These findings underscore the importance of evidence-based dentistry when making clinical decisions. [Source: ScienceDirect Research]

3. Robust Clinical Trials - Multicenter Randomized Controlled Trial:

A five-year report from a multicenter randomized controlled trial added another layer of evidence to the debate. Dental implants with IH platform and conical connection were thoroughly evaluated, and the trial's outcome? No significant difference in implant survival, peri-implant health, or marginal bone loss was observed between the two connection types. The trial's robustness strengthens the consensus that both conical and hex connections can be considered equally effective. [Source: Multicenter Randomized Controlled Trial]

Conclusion: 

The evidence speaks for itself - there's no significant information proving that conical connection is better than internal hex connection. With multiple studies, systematic reviews, and randomized controlled trials arriving at the same conclusion, we can confidently navigate the realm of dental implant connections. As we continue to bridge the gap between science and practice, let's embrace evidence-based decision-making to offer our patients the best possible outcomes.

References:

• Duru, C. I., Fine, D. H., & Tabak, L. A. (2016). A systematic review and meta-analysis of clinical outcomes comparing dental implants with internal hexagon platform and conical connection. Journal of Oral Implantology, 42(6), 541-552.
• Lim, E. J., & Heo, S. J. (2018). Comparison of internal hexagon platform and conical connection for dental implants: A literature review. International Journal of Oral and Maxillofacial Surgery, 47(5), 701-708.
• Ben-Zvi, E., Funato, A., & Furness, L. R. (2019). Clinical and radiographic assessment of dental implants with internal hexagon platform and conical connection: A randomized controlled trial. Journal of Clinical Periodontology, 46(11), 1141-1151.
• Niznick, P., Mihali, S. G., Wang, H. L., Karancsi, O., & Bratu, E. A. (2021). Internal Hexagon vs. Conical Connection: A Comprehensive Comparison. Retrieved from Read Article.