Reverse coronal taper for implants: your thoughts?

I recently have seen an implant which has reverse coronal taper at the top of implant. These implants have a coronal portion narrower than the middle portion.  This is supposed to decrease bone loss around the coronal portion after placement. With this type of system, how do you manage the space created around the coronal portion?  Also, since this design features a decreased bone-to-implant contact in the coronal portion, will this be a problem? I would like to get your opinions about these implant designs with a reverse coronal taper. 

9 thoughts on: Reverse coronal taper for implants: your thoughts?

  1. Montana says:

    The Nobel Active RP and various clones have a smaller radius at the “micro” level than at the macro thread dimension. Therefore, tapping a large enough hole to fit the implant leaves the coronal portion in a mote or blood. Integration is fine but die back is a pretty common sequelae; predictably more so in the mandible given the cortical plate.

    Reverse coronal taper makes sense, except for that osteotomy problem; tough to place them without a wide enough hole.

  2. Chris W. says:

    Perhaps this is an example of fixing a problem that does not exist? I mean, bone loss in this area may be do to other factors such as tissue thickness etc.
    The worry I have is that we don’t know if this change will be a benefit or not. Lots of experimentation being done in our offices at our expense for their ideas. Who wants to go first?

  3. Bruce A Smoler says:

    Here’s an idea, for softer max bone (D3/D4) the osteotomy is the size of the reduced taper coronal portion while the body of the implant is undersized for higher Initial Implant Stability AND allowing no gapping or space at the coronal portion. I experience this with the NeoDent drive implants where the bone/implant torque value is HIGH due to the slightly undersized body of the implant and the slightly narrower reduce diameter coronal portion seems to fit snuggly without gapping. Follow my explanation? Hope this helps. Bone specific and drilling specific protocols differentiate this from other ‘similar’ systems.

  4. Montana says:

    Back in the 90’s, one of the big players experienced problems with an implant design that produced too much pressure on the bone mid-body. High failure rate due to pressure necrosis. The design disappeared quickly without much response from the company. Clearly we have to be careful tinkering with a very successful standard and we should question the need for another 1/2% improvement. My desire is for a healthy 2 mm of bone thickness around the implant, placed with minimal trauma to the site.

  5. John Stone says:

    I suggest that you check out Sweden and Martina implants, used in Europe for decades and in the US now. Designed using papers by Dr Ignacio Loi, MD DDs

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