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ePaper created 2017-03-17, 10:24:23 | version 1.38.0
by improving tissue stability. This concept allowed us to understand the relationship between the shape of the abutment and the stabilization of the tissue by the circu- lar fibers of the connective tissue. Q: You have published high-impact literature on platform switching since 2006. A: Yes. We have preferred platform - switched restorations since we began to understand the clinical results due to the biology of the tissue. The same understand- ing led us to the use of straight abutments instead of divergent ones because straight abutments allowed us to increase the thick- ness of the tissue and improve the results in a predictable manner. We thus improved our protocol to an implant with PS, an abut- ment with a straight profile and multiple disconnections. Q: But, of course, the multiple disconnec- tions are also a concern. A: That is true. As we have proved in many articles, every disconnection and recon- ments allows us to avoid the disconnec- tions and reconnections associated with the classical protocol of rehabilitation. No disconnections or reconnections of the abutments means no tissue destabilization. For the first time, the abutments are a guide for the connective tissue and periosteum, which in turn promotes bone growth. That is why we call it a paradigm shift. Q: And what is the function of the micro- threads? A: Ok, here are some things that biology has taught us over the last few years. Fibro- blasts and myofibroblasts are paramount to the production of the collagen fibers that surround the restoration, and science has proved that the presence of micro- threads at the base of the abutment pro- motes the alignment of both fibroblasts and myofibroblasts. This alignment encour- ages the acceleration and increase of the production of collagen, resulting in colla- gen fibers surrounding the restoration with more predictability through the micro- XA abutments and a suitable rehabilitation protocol not only avoids apical migration, but also promotes coronal migration of bone and soft tissue over time. nection of the abutment in a regular pro- tocol compromises the tissue stability, and the body response is further apical migra- tion. To avoid this tissue trauma, we advanced to our latest rehabilitation pro- tocol: an XA abutment with a conical pro- file and microthreads at the base and zero disconnections or reconnections on a platform- switched implant. The use of XA abutments for threaded and cemented prostheses allows us not only to stabilize the tissue, but also to promote its coronal migration over time. Q: So, from divergent to straight and finally to convergent abutments? A: The conicity of these convergent abut- ments promotes the coronal migration of the tissue in the short and long term. The absence of margin on our marginless abut- threads. We are talking about contact guid- ance, a crucial factor in biological sealing. Q: And what about compatibility with other clinical protocols? A: Absolutely. That is something we had been working on for a long time until we finally designed both screw-retained and cemented abutments compatible with var- ious working protocols (screw-retained prosthesis or cemented prosthesis) for all clinical situations (anterior or posterior region, immediate or delayed loading). The apparent extreme simplicity is due to mul- tiple biological criteria in seeking the best possible response of tissue. Its use is simple and facilitates the work of the clinician and laboratory technician. We believe it is a genuine game-changer. Interview Advanced Implant Esthetics issue 2017 — 75