3rd party abutments vs original abutments

[Baobabtree]

Hi all

With the ability nowadays to order customised abutments via Atlantis or through your scanner for example and having it milled through an independent milling centre, do you or your customers have issues if it is not an original component for that particular implant system. I have used Atlantis but they have thus far been only on Astra implants, and they are very good. I have yet to try it on any other platform.

My reason for asking is that I am aware of one multinational arguing the case that they are seeing failures of 3rd party abutments on their implants, due to tolerance levels, the fixture level surfaces being of a slightly different design etc and revoking any guarantees that come with implant. The suggestion is it will be upon our shoulders to find a solution to the situation as it is not an original component. They are clearly trying to discourage the use of other abutments on their platforms. As there are now numerous companies and milling centres offering abutments at a fraction of the price by comparison, I would be interested in what you all think.

 

[Smithwick0208]

The sales reps are doing that around here too. Just trying to pull the business back. It's a sales pitch. We've had maybe one implant fail, ever, that I know of. There are a few doctors that only want manufacturer parts and we give them what they want. I don't have a lot of implant experience, but from what I've heard, it's rarely the abutment that causes failure. Just my 2 cents.

 

[Glassman]

Implant failures are due to occlusion and functional issues. Next to that the leading cause of implant failure is foreign substances left in the sulcus during/after placement i.e. impression material, temporary materials, and adhesives.
I have not seen any peer reviewed information regarding failures due to 3rd party abutments. Not saying they don't exist, just haven't been able to find reliable information on the issue. Certainly it depends on the quality of the abutments you are receiving from a 3rd party milling center.
Have you ever really read the implant companies warranty stipulations? They are not really guaranteeing anything except replacement of the implant if there is a failure within the terms of the warranty. Nothing about replacing the crown or the surgeons or clinicians time and expense to replace the implant. Seems like a scam or scare tactic to me.

 

[ParkwayDental]

Here is the way I look at it. Why should I pay $200 for a abutment that I can mill in house that is identical and just as good? Implant failure does not result in what type of abutment that is placed. If you read the fine print on things all the Implant companies warranty is the implant it self. They do not pay for surgery time, doc time, or anything else they just give the surgeon a new implant. I am willing to eat that cost if a implant fails.

 

[ParkwayDental]

Sorry Glassman didn't mean to be repetitive. We must have posted at the same time.

 

[Glassman]

No worries. I have to agree with you about warrantying the implant yourself.

 

[rkm rdt]

I would argue that some original components are worse.

ie: Nobel 3.0
Nobel ucla plastic ( doesn't burnout very clean )
Straumann all zirconia abutments
Straumann synocta wide platform
Biohorizon closed tray impression copings/stock abutment crap combo

There I said it !!!!!Thefinger

 

[RJS8669]

This is why I offer two levels of abutments - Inclusive if the doc doesn't buy into the "trusted connection" theory, or OEM abutments for most major inplant manufacturers. Around here, the implant reps have done a pretty good job of selling their stuff. I figured it was easier to work with them then against them...

 

[MasterCeramist]

Some milling centers are now offering their own warranty if using their abutments. Here is an example.

 

[JohnWilson]

Implant companies are just looking to take one more variable out of the equation. With that being said I agee I have never seen/heard of ANY 3rd party part that when used appropriately caused a fixture to fail.

As others have stated when I have a dr on the fence about only using tier one components only I am happy to do so and charge for them appropriately. Its not my job to change their minds but when asked about fees I will always offer alternatives. Of course there are advantages at times to steer them one way or another and often times that is to put more money in my pocket but more importantly it can provide a better product for their patients as well. Bottom line is implant warranties equate to scare tactics to maintain restorative sales for the manufacture plain and simple.

The sad truth is fixtures fail due to lack of planning and poor clinical skill not that damn part I use in my lab.

 

[CoolHandLuke]

yeah we match the warranty provided with the manufacturer, for our in-house titanium abutments and we've run into one problem with the Zimmer purple stuff. for one case on this platform the abutment seemed not to seat correctly within the interface (which we did not mill, it was premilled) on two models. it may be that the doc ordered a 3rd party non-NT-Based analog - we just can't be sure. also have not heard back about how seating went, we'll have to call.

of the many implants we've done this year we've had 1 true failure. the screw came loose. going to be tricky to retrieve too, as it is under a cemented pfm.

case was done in april - on all-original-nobel, right down to the scanner (cause this doc wants it that way).

 

[Baobabtree]

Implant failures are due to occlusion and functional issues. Next to that the leading cause of implant failure is foreign substances left in the sulcus during/after placement i.e. impression material, temporary materials, and adhesives.
I have not seen any peer reviewed information regarding failures due to 3rd party abutments. Not saying they don't exist, just haven't been able to find reliable information on the issue. Certainly it depends on the quality of the abutments you are receiving from a 3rd party milling center.
Have you ever really read the implant companies warranty stipulations? They are not really guaranteeing anything except replacement of the implant if there is a failure within the terms of the warranty. Nothing about replacing the crown or the surgeons or clinicians time and expense to replace the implant. Seems like a scam or scare tactic to me.

Thanks Glassman

My understanding was (during a presentation on this subject) for example the screw fracturing and the surgeon calling out their area rep to help retrieve the broken screw, the implant company would feel justified to reject assistance as it wasn't one of theirs and put the ball back in the surgeons/labs park to resolve, and suggesting that we would be leaving ourselves open to litigation etc. I agree that it does seem to be a scare tactic.

 

[Baobabtree]

Some milling centers are now offering their own warranty if using their abutments. Here is an example.

Thanks MasterCeramist

 

[Baobabtree]

Another question on this for you all, I had a flyer today from a milling centre offering CoCr abutments. Is it reasonable to assume that CoCr being harder than Ti could cause issues at the interface? Therefore not recommended. Thanks to all for your responses, much appreciated.

 

[CoolHandLuke]

unless the implant itself is made of cocr you'll have some galvanic reaction in the mouth and that's not good. since the vast majority of implants are titanium, its a better idea to use titanium, titanium bases, and titanium milled implant bars.

cocr is great for pfm copings, as it poses no reaction over endo cores or NP posts.

 

[Glassman]

Thanks Glassman

My understanding was (during a presentation on this subject) for example the screw fracturing and the surgeon calling out their area rep to help retrieve the broken screw, the implant company would feel justified to reject assistance as it wasn't one of theirs and put the ball back in the surgeons/labs park to resolve, and suggesting that we would be leaving ourselves open to litigation etc. I agree that it does seem to be a scare tactic.

If the implant screw breaks 99% of the time it can be backed out easily. Once the torque load on the screw is lost, there is no resistance it can be backed out with the wooden handle of a cotton swab.
If the surgeon/clinician forces the screw into place and cross threads it from the beginning, it won't be covered under warranty by the implant company anyhow. Get the screw extractor and tap kit out and cross your fingers.

 

[Baobabtree]

unless the implant itself is made of cocr you'll have some galvanic reaction in the mouth and that's not good. since the vast majority of implants are titanium, its a better idea to use titanium, titanium bases, and titanium milled implant bars.

cocr is great for pfm copings, as it poses no reaction over endo cores or NP posts.

Thanks CoolHandLuke. Was interested as it would work with the cte of my porcelain, which is probably why these abutments are being offered I imagine.

 

[Doug4DAL]

I don't believe implant companies has their abutments created from the Hand of GOD , if I am not mistaken I think they would mill them from a stock of titanium the same as I and many of you do .

 

[CatamountRob]

I don't believe implant companies has their abutments created from the Hand of GOD , if I am not mistaken I think they would mill them from a stock of titanium the same as I and many of you do .

Yep. The difference, if there is one, is probably in the mill.

 

[Gru]

Why, if CrCo is a poor choice for abutments, do they use it in europe? What am I missing? Or am I misinformed?

Honestly, I think that most docs want all original manufacturer parts so that the lawyers have someone with deeper pockets to go after if the case goes to pieces. No one really cares about the worthless "guaranty" on the parts, only on the backlash if there's a problem. Simple form of insurance, so to speak. They'll spend $300 more for peace of mind.