Evaluation of the clinical effectiveness of the conometric concept-a systematic review

Background: ACone-in-cone Morse taper connection between abutments and crowns has been proposed to retain implantsupported definitive fixed dental prostheses(FDPs). This prosthetic approach, named the“Conometric Concept,” was used to retain both lithium disilicate (LS2) and zirconia restorations.The conometric concept consists of a cone-in-cone connection between an abutment and the respective coping to retain an implant supported restoration without either screws or cement. The fit between abutment and the restoration is achieved with prefabricated components. The conical coupling abutments use the friction between the abutment and the titanium coping to retain a prosthesis without the use of cement. The restoration has no access holes and can be removed easily with a spring fixed partial denture remover. The emergence profile of the restoration can be placed sub-gingivally without the risk of cement remaining at the abutment coping interface. The main objective of this study is to critically review articles that have used conometric concept and to evaluate its clinical effectiveness. Materials And Method: An electronic search was performed in PubMed, Google scholar and Cochrane library till current date. The assessment of articles was done using predetermined selection criteria.Randomized, Non-randomized trials, prospective cohorts, prospective clinical trials and in vitro studies were included. Case series, case reports, conference paper and animalstudies were excluded from this review.The riskof bias was evaluated, and findings were synthesized. Results: Out of the 7 included studies, 8 outcome measures have been identified. A meta-analysis was not feasible as none of the included studies were randomized control studies. 2 studies have analysed cumulative survival rate. Cumulative survival rate was in a range of 97.4%-100%. 4 studies have analysed mean probing depth. The range was 1.3mm-2mm. One study analysed mean crestal bone boss. They gave a result of 0.4mm. 4 studies analysed the rate of framework fracture. The results were in a range of 0%-8.7%. 4 studies analysed the aesthetic satisfaction and overall patient satisfaction and the results were in the range of 82%-91.8% and 79%-91% respectively. 4 studies have analysed mean probing depth. The range was 1.3mm-2mm. Conclusion: Based on the findings of this review, it can be concluded that the conometric concept offers a promising clinical outcome as a prosthetic treatment option. Further long-term studies need to be conducted to evaluate its feasibility as a commercial treatment modality.