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ORIGINAL ARTICLE

A study to evaluate the effect of taper on retention of

straight and angled implant abutment
Roseline Meshramkar1,2, Aishwarya Nayak1,2, Abhishek Kavlekar1,2, Ramesh K Nadiger1,2, K Lekha1,2

ABSTRACT

Aim: The purpose of this study was to evaluate the effect of taper on retention of copings in straight
and angled implant abutment.
Materials and Methods: Totally, 10 straight abutments (Adin Israel) of 3° taper and angled
abutment of 15° taper with their analogs were used. Twenty castings were fabricated on the abutment
that incorporated an attachment to allow removal. Castings were cemented to abutments with
provicol (VOCO Germany). A uniaxial tensile force was applied to the crown using an instron machine
until cement failure occurred.
Results: Data were subjected to Shapiro–Wilk test, and it was found that variables have a normal
distribution. Hence, Student’s t‑test was performed, and P value was found to be 0.00 <0.05. Hence
to infer significant statistical difference.
Conclusion: The retention of straight abutments was significantly more when compared to angled
abutment when cemented with provicol. When using angled abutment, permanent luting agent should
be the choice for cementation.

KEY WORDS: Abutment, angled abutment, implant, luting agent, straight abutment, temporary luting agent

INTRODUCTION contours.[3] Factors such as the height and width of

The use of dental implants in the rehabilitation of partially
edentulous patients has become a well‑established and
accepted contemporary clinical method with predictable
long‑term success.[1,2] Ideally, implants should be placed
parallel to each other and to adjacent teeth and be aligned
vertically with axial forces. However, achieving this
may not be possible owing to deficiencies in the ridge’s
anatomy. When dental implants are not placed parallel
to adjacent teeth or contiguous implants, the clinician
can use angled abutments to achieve proper restorative
Department of Prosthodontic, SDM College of Dental Sciences and
1
the prosthetic component, the type of cement and the
cementing may the influence tensile strength of cemented
prosthetic restoration.[4,5] Many of the present‑day implant
systems have abutments onto which superstructures can
be cemented. This design permits the development of the
desired occlusal inter digitation, improved esthetics, and
correct loading characteristics. Abutment preparation
designs and cementation techniques now mimic
conventional fixed prosthodontic procedures for natural
teeth.[6] Most manufacturers machine their abutments to
a standard that approximates a 6° taper. The conclusion
drawn is that machined abutments in implant dentistry 

Hospital, Dharwad, 2RGUHS University, Bengaluru, Karnataka, India (6° of taper) provide ideal retention that is 3–4 times
the retention achieved on natural tooth preparation.[7]
Address for correspondence: Dr. Roseline Meshramkar,
Department of Prosthodontics, SDM College of Dental Sciences and Hospital, Numerous types of prefabricated abutments are available
Dharwad ‑ 580 009, Karnataka, India. at specific angles. Preangled abutments with angulations
E‑mail: roselinemeshramkar@yahoo.co.in
varying from 15° to 35° often are commercially available.
Access this article online A 15° angulation of a prefabricated abutment can create
Quick Response Code: parallelism between adjacent abutments.[3] The success
Website: of cement‑retained designs depends largely on adequate
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retention and resistance.[7] Factors affecting implant
supported restorations are similar to those affecting the
DOI: luting of crown to natural teeth and taper height width of
10.4103/0974-6781.154414 the abutment and type of luting agent. Straight implant
abutment and angled implant abutment retention can

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Meshramkar, et al.: Retention of straight and angled implant abutment

be varied and be affected by type of the cement, taper, after casting it was removed trimmed cleaned. Visual
surface area, texture. The purpose of the study was to inspection was done with magnification lens to assess
evaluate the retention of coping in straight and angled the marginal integrity. All the copings were evaluated for
implant abutment. adaptation and for accuracy of the fit on the abutment. The
coping were accepted when they were seated completely
MATERIALS AND METHODS with no gap along the margins. Ten copings for straight
abutments and ten copings for angled abutments were
This study was conducted to evaluate the effect of cemented by provicol (VOCO, Germany). Provicol was
taper on the retention of straight and angled implant used accordingly to manufacturer instructions. The
abutments. A 10 Adin straight and 10 angled implant copings were filled with cement, and it was seated with
abutments were used in the study. The abutments were finger pressure and 10 kg load was applied for 5 min.
attached to implant analogs and vertically mounted A universal testing machine instron was used to measure
in acrylic resin (self‑cure acrylic resin DPI India) so as the force required to dislodge the copings from the
to apply tensile force to the long axis of the abutment. abutment with a cross head speed of 5 mm/min until
The abutments were connected to implant analogs. cement failure occurred. Difference in mean tensile
The 2 layers of die spacer were applied directly on the strength was analyzed by Shapiro–Wilk test.
abutments 0.5 mm away from the margin. A wax coping
with 1.5 mm for each sample were fabricated with RESULTS
direct wax up technique, a loop was waxed onto the
upper surface of coping so as to facilitate the device of Data were subjected to Shapiro–Wilk test, and it was
instron machine. The 20 wax patterns were invested and found that variables have a normal distribution. Hence,
casted using Nicr Me alloy according to manufacturers’ Student’s t‑test was performed. The mean force required
instructions. The copings were standardized and for tensile failure of straight abutments in Newton was
54.9 (4.14 standard deviation [SD]) and that for angled
Tests of normality abutment was 39.0 (4.10 SD). P value was found to
Kolmogorov- Shapiro-Wilk be 0.00 < 0.05. Hence to infer significant statistical
Smirnova difference.
Statistic df Sig Statistic df Sig
St sbutment 0.126 10 0.200* 0.943 10 0.582 DISCUSSION
Angled abutment 0.133 10 0.200* 0.975 10 0.934
*This is a lower bound of the true significance. aLilliefors significance The use of angled abutments facilitates paralleling
correction, The two variables under consideration have a normal nonaligned implants thereby making prosthesis
distribution as per Shapiro–Wilk test since P>0.05. Hence, we use a
t-test to test the significance difference between two variables
fabrication easier. To achieve prosthetically desired
parallelism between implant and teeth, the clinician
can place an angled abutment, numerous types of
Group statistics
prefabricated abutments are available at specific angle,
Group N Mean Std. Std. error preangled abutments with angulation varying from 15°
deviation mean to 35° often commercially available.[3] Neves et  al., in
Abutment 2013[9] demonstrated that the surface area, the angulation
St sbutment 10 54.9000 4.14863 1.31191 of the axial walls and the characteristics of cements
Angled abutment 10 39.0000 4.10961 1.29957 influence the strength of metal crown cemented on

Independent samples test

Levene's t-test for equality of means
test for
equality of
variances
F Sig. t df Sig. Mean Std. error 95% confidence
(2-tailed) difference difference interval of the
difference
Lower Upper
Abutment
Equal variances assumed 0.086 0.772 8.610 18 0.000 15.9000 1.84662 12.02040 19.77960
Equal variances not assumed 8.610 17.998 0.000 15.9000 1.84662 12.02037 19.77963
There is a significant difference between the two abutments since P=0.000<0.05

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Meshramkar, et al.: Retention of straight and angled implant abutment
customizable abutment. Breeding et al. 1992 suggested
implant supported prosthesis cemented with the
provisional cements are retrievable, and it is the cement
chosen that is the controlling factor in the retention
attained.[8] The proper handling of cement‑retained
implant prosthesis provides for retrievability without
compromising the occlusion, esthetics, and stress
distribution to the prosthetic components and bone
implant interface.[7] Data from this study and a study
by   Neves et  al. provides information regarding the
effect of taper on the retention of the restoration. In our
study, it was found that straight abutment had more
retention compared to angled abutment, which was
similar to Neves et  al.[9] This shows that surface area
and taper of the straight abutments are significant for
the retention.[10,11] In our study, provicol was used for
cementing for both the straight and angled abutments.
When selecting a luting agent, it is important that the
cement be easy to manipulate and remove without
damaging implant components or surrounding soft
tissues.[6] Hence, in our study, provical was used since
it is easy to manipulate and remove; in a study done by
Hebbel and Gajjar, it was found that improve showed
greater resistance to dislodgement than the permanent
zinc phosphate cement. Michalakis et al.,[12] found that
nongenol may be more appropriate for cementation
of implant supported FPDs when retrievability is
important. Based on our findings, we can say when
clinician uses angled abutment for fixed restoration, it
is better to choose zinc phosphate cement or permanent
luting agent than provisional luting agent. It is essential
however that further studies has to be conducted with
different angled abutments using different luting agents
and its effect on the retention. Within the limitations of
the study, it can be concluded that straight abutments
had more bond strength compared to angled abutment.
With straight abutments, provical can be used as luting
agent and for angled abutment permanent luting cement
should be selected.
Journal of Dental Implants | Jan - Jun 2015 | Vol 5 | Issue 1 5
REFERENCES
1. Lekholm U, Gunne J, Henry P, Higuchi K, Lindén U,
Bergström C, et al. Survival of the Brånemark implant in partially
edentulous jaws: A 10‑year prospective multicenter study. Int J
Oral Maxillofac Implants 1999;14:639‑45.
2. Weber HP, Sukotjo C. Does the type of implant prosthesis
affect outcomes in the partially edentulous patient? Int J Oral
Maxillofac Implants 2007;22 Suppl: 140‑72.
3. Cavallaro J Jr, Greenstein G. Angled implant abutments:
A practical application of available knowledge. J Am Dent Assoc
2011;142:150‑8.
4. Covey DA, Kent DK, St Germain HA Jr, Koka S. Effects of abutment
size and luting cement type on the uniaxial retention force of
implant‑supported crowns. J Prosthet Dent 2000;83:344‑8.
5. Kent  DK, Koka  S, Banks  SB, Beatty  MW. Factors influencing
retention of a CeraOne gold cylinder. Implant Dent 1996;5:96‑9.
6. Bernal G, Okamura M, Muñoz CA. The effects of abutment
taper, length and cement type on resistance to dislodgement of
cement‑retained, implant‑supported restorations. J Prosthodont
2003;12:111‑5.
7. Hebel KS, Gajjar RC. Cement‑retained versus screw‑retained
implant restorations: Achieving optimal occlusion and esthetics
in implant dentistry. J Prosthet Dent 1997;77:28‑35.
8. Breeding LC, Dixon DL, Bogacki MT, Tietge JD. Use of
luting agents with an implant system: Part I. J Prosthet Dent
1992;68:737‑41.
9. Neves FD, Dantas TS, Naves LZ, Prado CJ, Muniz LA. Effects of
abutment taper on the uniaxial retention force of cement retained
implant restorations. Rev Odontol Bras Cent 2013;21:110‑3.
10. Taylor TD, Agar JR, Vogiatzi T. Implant prosthodontics: Current
perspective and future directions. Int J Oral Maxillofac Implants
2000;15:66‑75.
11. Naves LZ, Santana FR, Castro CG, Valdivia AD, Da Mota AS,
Estrela C, et al. Surface treatment of glass fiber and carbon fiber
posts: SEM characterization. Microsc Res Tech 2011;74:1088‑92.
12. Michalakis KX, Hirayama H, Garefis PD. Cement‑retained versus
screw‑retained implant restorations: A critical review. Int J Oral
Maxillofac Implants 2003;18:719‑28.
How to cite this article: Meshramkar R, Nayak A, Kavlekar A,
Nadiger RK, Lekha K. A study to evaluate the effect of taper on retention
of straight and angled implant abutment. J Dent Implant 2015;5:3-5.
Source of Support: Nil, Conflict of Interest: None.