Console abutment loading in craniofacial osseointegration

Retention of implant-supported facial prostheses presents challenges in design that may lead to use of freestanding abutments. This is particularly so in the midface and orbit. Individual implant success rates are lower in these regions, and bone remodeling capacity may be compromised by combined modality cancer therapy. The present study was undertaken to determine the variations in load delivery so as to compare the use of long cantilevers and offset abutments with freestanding axially loaded abutments. The study revealed not only that the loads delivered are not trivial, but also that the highest loads generated are frequently delivered at the cervix of the implant. The long cantilevers produced the highest laterally acting cervical loads, whereas the 30-degree and 60-degree Console abutments delivered the highest laterally acting cervical loads of all the Console abutments. The potential of long cantilevers and offset abutments to deliver significant loads should be considered when designing retention for a facial prosthesis.