Bicon Abutment Keeps Popping Out: What Do I Do?

Dear Dr. Ac. The essential characteristics of Bicon implant rather than other implants is, you have to place an implant Minimum 2mm infero-boney(2 mm below the creast of the alveolar bone), seal it and place some bone graft on that until you loaded, however, if you don't seal it properly by the time of placing an implant, some up-coming take place same as your problem, so in my view, two possibilty way you need to do to resolve this issue. First, take an B.W X-ray, it's will show you if ABUTMENT is not sitting properly on implant(gap between abutment an implant), the problem would be some osseointegrate on surface of implant(where you didn't seal it by the time of placing an implant), so you should clean it up gentely before placing an abutment. Second,if the first reason not the issue you have to check PROSTHETIC on MARGINAL area( where would be to thick by technical Lab. problem and keep popping out away by some soft tissue. Good luck to you. Dr. Vaziri-..IRAN,Tehran

As per the Bicon, it,s a good implant. Yes, you have to remove enough bone to place the abutment. Another point, the abutments become dislodged in the anterior for single implant restorations. It's a great implant in the posterior maxilla and mand.

On the contrary to above posts.. .. I've been using Bicon for past 4 years and i have to say that if the locking taper connection is engaged properly in the recommended way.. it has never ever loosened for me. May be there is some problem in the seating of the abutment, do check it radiographically, and it should solve the problem. Excellent system with great crestal bone maintainence over the years.

Can the Bicon implant be used for single, free-standing maxillary anterior implants?

Bicons are bad for popping out on anteriors. Posterior recheck to see if well is clean, and use sulcus reamers to assure no bone interference. Check occlusion for parafunctional contacts. You can blast the abutment with 25 micron al oxide to increase retention, but careful, as it's almost impossible to remove if you etch the surface. The 2.0 mm wells are bad for popout.

I used Bicon implants for many years and they were excellent.I no longer use them routinely as I now prefer implants that are torqued into the osteotomy site rather then tapped . As you know the retention of the abutment is dependent on a morse taper.After you check the obvious things as mentioned by the advice given above.It is most important to note that the abutment must be tapped into the implant in the LONG AXIS of the implant.If you tapped it in on an angle and damaged the inside of the well or the abutment shaft it will never stay in because the frictional retention of the morse taper will have been compromised.Try a new abutment. If this does not work call Bicon as I recall they have some suggestions for your situation.

Change the abutment dear..........

But, Doctors...I have already changed the abutment and still it kept popping out. Finally I had to let my teacher do it for me since she is more experienced in this. She said that she felt that the well was not deformed.I am just wondering, I had that placed a few months ago by her and after a month it popped out. Now, I have to see if it happens again.Aren't there reviews that BICON is not really a reliable implant? I have heard from my friends where they used Bicon implants on the upper anterior of their patients and they all popped out. What do you think of that? I am thinking of using another system-Biohorizons for my future patients.

Check the following: 1.Soft tissue interference - Do crestal incision or use sulcus reamer. Be sure to pass a probe around the the abutment to check clearance. Use a round bur to reduce bone if necessary. Take X-rays 2. Check occlusion to the extremes. 3. Check interproximal contacts. Not too tight. 4. If using angled abutments make sure to seat in the long axis. ( Damage to well is rare) Use seating jig to seat if crown already cemented as in you case. 5. Never touch, blast or use cement on abutment shaft. 6. Great system and extremely simple to master. Been using it with fantastic results for many years. 7. 2:5 mm implants with enhanced retention now avaiable.

Dear AC - please listen to Herman Botha. He has ALL the right ways to ensure that this isn't a problem. I have placed well over a thousand Bicon implants and I have NEVER had a molar abutment come loose. All the forces are acting to try and seat the abutment deeper into the implant well. I haven't even tapped a posterior (molar or premolar) permanent abutment into the implant for years - I just get them to bite on a cotton wool roll. It's all you need. I will bet that your problem stems either from contacts that are too tight (tapping wedged the IAC between the adjacent teeth and does not engage the locking taper) or else it's that you haven't sulcus reamed to the same diameter as the abutment being used (so the hemi-sperical base of the implant bottoms-out on the tissue and does not engage into the implant well). Please don't blame the system - any implant system is only as good as the person using it (an obvious point and no disrespect intended). Kind Regards, Bill Schaeffer I have no financial interest in ANY implant make or system and I use multiple implant systems on a daily basis.

ac, I had the same problem years ago with Bicon. I solved it by not using Bicon in the anterior. It's great in the posterior, especially for bruxers. Use an internal hex in the anterior. an external hex is flat out stupid. Before you use Biohorizons, consider MIS-7, AB Dental and Implant Direct. Other than these mentioned you are paying too much money. Also consider Quantum and Tatum Surgical for implants.

But Richard, ACs problem was with a molar implant. Have you ever had or seen a problem with a molar Bicon adutment coming loose? Kind Regards, Bill

Can't agree with you more Bill. Recently battled to retrieve an abutment on a molar Bicon placed more than 5 years ago. They seem to seat better with time. Had to finally take a direct impression to have a new crown made which worked out quite well. I do have a preference for taper lock systems but have to work with them all and have come to realise that you have to gain experience to cope with the different problems of each system. Don't blame the system. Keep working at it!

Bill, I have never had a posterior Bicon abutment come dislidged. I agree with your comments. Sometimes when I place the posterior abutments in areas of thick gingiva, I will make a criss cross incision and reflect, then place the abutment (healing abutment) and give it about two weeks prior to changing out to the abutment and impressing.

AC: Have been using Bicon implants (among other brands) for about 20-25 years and have placed thousands. I would bet that almost everyone will have at least one Bicon abutment dislodge ultimately given enough time/exposure (especially in the maxillary anterior sextant.) Some great previous comments and thought I'd add some additional ideas if your problem has not been solved already by one of the suggestions above. First, as alluded to above by another poster, changing the abutment can solve the problem if there was a machining problem with the 1.5 degree taper in the abutment. Even with great quality control by the manufacturer, it is ridiculous to assume that they are perfect. Obviously, if there is a problem in the tapered well in the implant itself, you will continue to have problems. Resorting to the sand blasting the abutment taper may be your only hope short of removing the implant if this is the case. Please understand that this should be attempted as a "last" resort to save the implant because all the above have been carefully evaluated and nothing else has worked. Never try to cement the abutment in place - it will not work! My second comment is much more common has to do with the long axis of the implant and the path of insertion of the crown (in the mesial-distal aspect.) If these are different by more than 1.5 degrees, it is usually difficult/impossible to re-seat a cemented abutment/crown that has come loose (better to start the case from scratch again.) As a magnified illustration of the problem, assume that you have severely mesially inclined implant in the #30 site relative to the adjacent teeth. Normally, one would use an angled abutment or prep a conventional abutment such that it closely tapers to the parallel of the adjacent teeth to have a path of insertion for the crown. If you don't do this, you have no means to seat the crown (i.e. you would have to remove excessive material from the mesial of the crown to slide it over the abutment and when you seat it that contact would be open.) You have exactly the same problem when a cemented abutment/crown comes loose and there is no common axis. You may be able to fit the post crown into the implant well but, as you seat it, the distal becomes tightly wedged (possibly preventing engagement of the Morse taper) and the mesial becomes looser (in the mesially inclined example above.) This may or may not be your problem but thought it worthwhile to mention. Bicon is a good system with limitations as all systems do. I have had the best luck not using them in the maxillary anterior sextant, trying to place the implant parallel to the path of insertion of the crown (in a mesial-distal orientation) and trying not to use angled abutments. Good luck! Allan

We just introduced a short implant the X6 which is a 6 x 6 with a 3.50 internal hex connection so you can put in an antirotational abutment and not have to tap anything in and can retrieve it as well (ie if you did a one piece screw retained abutment). I find that the Bicon prosthetics are extremely limiting and proprietary and seem quite costly if you have to restore them.....