Compatibility of Implants and Abutments from Different Manufacturers?

Purposely interchanging implants and abutments for the sole purpose of cost is absolutely unacceptable. Use the products as the manufacturers intend or it could end up haunting the clinician. I recommend choosing surgical and prosthetic implant components based on merit and their characteristics. Consider attributes like composition, presence of Morse taper, type of connection (ie internal hex), thread type, ability to platform switch, taper vs straight, etc. If stocking both surgical and restorative components is too costly for a practice only provide one of those services for a period of time.

I fear that if you are ever sued by an unhappy patient the fact that parts were mixed with your knowledge will most likely be warrantee issue and you ill be thrown under the bus. That's why I like to use the bigger companies who most likely will be around in the future and have decent track records. A smaller company with a good track record is great too! If you're skimping to save money, re-evaluate our business plan. Interesting since if I had to stock all the abutments instead of good inventory control I would be losing money also. Don't penalize the patient on an inventory issue.

This is not a problem, if they fit. Implant warrantee is usually not the issue in a law suite. I use parts from AB Dental, MIS, Implant Direct and Zimmer, attachments international and they all fit. I also use Blue Sky Bio for Straumman parts. Bule Sky Bio gives great personal service and they really care about helping the doctor. I have had no problems with Blue Sky Bio. AB Dental, MIS, Blue Sky and attachments international do a superlative quality control job.

One of the first things a lawyer will do is read warranties and manuals they don't think like we do. You'd be surprised what they ask it is leaving a loophole that they love. I would not give them the chance just to save a few bucks. The average patient or juror will wonder also. It is different if it is the only available option trust me.

If the parts fit, the parts fit. A warrantee is not going to protest a doc in a law suit. If the doc maintains a strong dr patient relationship, treats the patient right, performs the surgeries correctly, plans the case right, uses a lab that knows what they are doing, does not over complicate the case and yes, carefully select the patient, things rarely happen. You also have to educate the patient on OH. You have to ask yourself and the patient, what caused the loss of the teeth? Are we doing the patient right by restoring with implant prosthesis. You have to ask if the knock offs are such a big issue, then how can these companies legally do this? Some knock off mfg produce a better product than the original mfg. To each their owne. I refuse to use implants from certain big five mfg because of quality control.

Yes you are right Richard, and I only place not restore so I respect your opinion and experience. Also one can always find an expert to testify either way. Thanks for sharing

Implant companies manufacture their implants and abutments to specific tolerances. Then companies reverse engineer their copies of these implants/abutments and have to guess at the exact dimensions and tolerances. Components can be mixed and matched however there is a significant risk that abutment screws will come loose too easily and require frequent visits for the patient's abutment screws to be retightened. This is especially true with regard to single-tooth abutments because the fit has to be very precise so the abutment doesn't have any ability to work itself loose from the implant.

Dr. Richard Hughes, I find your comments very scary. That's like taking my Rolex in for repair and the repairman decides to use knock-off parts. We are dealing with precision connections that are placed under hundreds of thousands of repeated load cycles. Poor fit results in micro-mobility and micro-mobility results in bacterial leakage and screw loosening and bone loss. The screw is the only thing that is "compatible", nothing else. KGH, you hit the nail on the head. Don't mix and match "compatible" parts just because they "fit".

In the early 1990's, implant parts did not fit well. Does anyone remember "Threaded Time Transfer?" As the 1990's progressed, ISO standards entered the picture. Implant companies machine parts to perfections per ISO standards and to specific sizes and types. In a company like Zimmer, BioHorizons, Blue Sky Bio, Implant Direct, American Dental Implants, MIS, etc makes an abutment that does not fit the corresponding size of a different company, it is most likely it will not fit their own implant. I often use and implant I like ( I have surgical kits form 7 companies) for a specific case and then when I restore it I order the abutment that serves my purposes best regardless if it comes from the company that made the implant I have used. Additionally, I do my own lab work for most of my cases and as of yet I have not found parts that did not fit between companies. I do not want to be limited to which implant I use not which abutment I select. I want it to last long and serve my purposes well. Just as a side note, in the early 1990's I ordered some parts from Nobel and they came with metal shavings. That was not unusual for that day. The parts were machined and when 1,000 abutments were made, the first several hundred were good, the last 1-2 hundred were not so good because the burs used in that lot were wearing out. Hence the importance of ISO standards and the wonderful milling machines used by all manufactures today.

I use abutments from different companies often. Ever had an issue? Nope. I've heard this argument before too many times... There are lots who claim that abutments have to be ordered by the same company that made the implant that's in and otherewise there will be chance of lawsuit, unfitting issue, ethical issue... etc.. And most of them in my expereince turned out to be reps from big implant companies or some one who has interest in those companies..

Mike, the key word is"compatible". I only use parts from reputable companies. One cannot use cloned parts for certain implant systems and some you can.

Has anyone of the above dentists who nay-say this been sued before over an implant case and if so, has using different companies parts been a part of the suit?

The original question was about buying dental implants at low cost from independent manufacturers and then buying the abutments from more established implant companies. I don't get why anyone would do that. If I choose Blue Sky Bio (or in my case Hiossen) I will save a few hundred dollars on the implant, healing abutment, etc. Why would I then choose to buy incompatible abutments (or maybe acceptably compatible) from the more expensive companies? If I already used a less expensive implant and it has integrated well and I saved money, wouldn't it make sense to use the compatible parts from the same company that have the best chance of fitting perfectly into my implant?

Mike, I did not mean to scare you! Shame on me. All kidding aside. I have not had problems with MIS, AB dental, CoreVent, Attachments International and Blue Sky Bio. I have had some issues with Astra, Straumann and 3i. You will be surprised who makes what for who. There have been and still are manufacturers (some of the big five) that make bad parts.

Very interesting I myself am unhappy with the customer service of big companies on returns tec. I do pay top dollar for the implant bodies and trust my restoring doctors with their abutment choices. I do think the implant companies are greedy and may go the way of General Motors if they do not change. It is the market place. They make you buy a complete kit when you may only need a few items. And I see by reading the intent of this blog that all posters want to do the right thing for their patients clinical, mechanical and keeping costs reasonable. Anything labeled "dental"seems like there is a big markup. Sometimes I feel like an ATM .

CRS and JS, Both of you hit the nail on the head. I use an internal hex 90% of the time. I buy form AB dental or MIS. They are inexpensive and of high quality. They are are not the big five, but I can call them and buy parts etc without buying a big kit. They are smaller and flexible , so they can give the customer great service. Blue Sky Bio is the same. Yes they sell product but they know they are they are the under dog. They try harder. Bicon also gives great service and a great product. I do not have nor have I found a problem with any of the above companies! Impladent is another company that gives great service and has great products at a reasonable price! All this said, I pass the savings on to my patients.

Just one first hand information...80% implants are produced in just couple of factories located in Israel. Yes, guys even Nobel produce there. This is reason for cross fit of many "different" implants and they are really identical, only difference is box and ofcourse if you insist to buy "Made in Germany" (really placed in box in Germany) you will pay 100-200% more. I placed personally over 1000 implants and produce screw retained restorations for over 10 years without problems. So I do not even use "original" abutments but mill at least 70%. Problems arose if doctor don't work as dr.Richard nicely stated. You need right patient You need correct and optimal planning and execution of surgery and very very precise technical work. And still it is impossible to predict what will happen in longterm but if all steps are done as it should be, risk for complications (patient related and implant related) are inside acceptable area. So the risk is ALWAYS present.

can i ask about comptability with pitt-easy implant

I just want to know if there have been any reports of any screw breaking or loosening or breaks at all when using a 3I abutment with a Zimmer implant