Conical vs external hex implants?

Hello everyone. I ve’been using conical implants over the last 20 years. (Different brands). I was considering swapping to external hex for full arch. What’s you your experience regarding ex hex? Do you use them for single tooth replacement as well? Thanks

drdangober comments:

Can you explain your rationale for making the switch when it comes to full arch cases? Personally, I use Trans-Mucosal (multi-unit) abutments for full arch cases. The advantage of "platform switch" and minimal micro-leakage of internal implants is maintained but you still get the advantage of easier access for impressioning and insertion and perhaps more importantly, the ability to adjust for angulation with a 17 or 30 degree TMA so that you can always restore screw-retained.

timcarter comments:

My understanding is that the external hex would be a wonderful option for full arch and that is precisely the reason that the multi unit abutments so closely resemble that of an ex hex. The issue comes when choosing collar height and angulation which the multi units accommodate. The reason for internal hex/conical etc.., as I understand and have experienced, is that it is a superior connection and seal thus providing better long term success at the implant abutment interface. Ex hex does not perform as well in single tooth cases but is great for multi unit splinted cases precisely because of its "sloppy" interface. In short I think well placed parallel ex hex fixtures would be a great full arch option though I can't imagine a case where it would be practical and given the many shortcomings of the ex hex connection I would recommend limiting your inventory and sticking with your conical of choice and properly utilizing the appropriate multi unit for the best possible outcomes/experience.

jramos comments:

Try using Co-Axis by Southern Implants !****** . It has simplified my work and I have achieved better predictable results .

gregkammeyer comments:

I agree with Tim. Stick with a system and the internal connection has almost eliminated the external because that "slop" allows bacteria to get into the connection and contributes to peri-implantitis and bone loss. It's bad enough that the manufactures change so many things so often. You'll find you have WAY too much out of date inventory as you place implants a long time.