Clinical Guidelines for Hiossen EK Implant System

Guidelines for Clinical Selection, Repair Process, and Solutions of Hiossen EK Implant System

In the field of oral implantation, the connection design of the implant, the universality of the repair components, and the convenience of operation directly affect the clinical treatment effect and long-term stability. The EK Implant System, launched by Hiossen (a brand under the Aoshitai Group), provides a complete solution for clinical practice, from single tooth loss to full mouth edentulous jaw restoration, thanks to its innovative design of "single platform connection, thickened inner wall, 15 ° Mohs taper, and anti rotation locking buckle". However, faced with a wide variety of repair abutments, transfer rods, scanning bodies, and digital processes, doctors and technicians often need a systematic guide from selection to operation.

This article is based on the EK product catalog and combines common clinical scenarios to systematically review the technical characteristics, repair component classification, digital impression process, attachment selection, and key points for replacing old implant systems of EK implant systems. It helps readers quickly establish a knowledge system of EK systems and improve repair efficiency and success rate.

Core technical characteristics of EK implant system

1.1 One Connection

All diameters of implants in the EK system (from Ø 3.5 to Ø 7.0) use identical internal connection structures (including internal hexagon, Mohs taper, and anti rotation groove). This means:

The repair base is completely universal, with simple inventory management and no need to prepare different repair parts for different diameters.

Flexible clinical operation: Even if the diameter of the implant cannot be determined before surgery, the repair abutment can still be selected in advance.

Reducing errors: Avoiding mismatches between the abutment and the implant caused by different connection structures.

1.2 Thickened inner wall and fine diameter screws

The EK system uses small-diameter fixing screws to increase the thickness of the inner wall of the implant. This design brings:

Stronger resistance to mechanical fatigue and reduced risk of screw breakage.

Better stress distribution: Thicker inner walls can absorb some biting force, reducing bone resorption in the neck of the implant.

1.3 Deepened implant abutment connection depth

The connection depth is deeper than traditional designs, effectively dispersing chewing pressure, reducing screw stress, and significantly reducing the probability of screw loosening. Internal testing shows that compared to the traditional 11 ° Mohs taper, a 15 ° taper reduces the risk of screw loosening by 33%.

1.4 15 ° Mohs taper and anti rotation locking buckle

15 ° Mohs taper: Provides strong cold welding effect, even if the screw is slightly loose, the base will not immediately fall off, while reducing the sink down effect.

Three anti rotation locking buckles: Before tightening the screws, the abutment can be firmly locked inside the implant to prevent displacement caused by gum elasticity, making it convenient for mold removal and tooth insertion.

1.5 Surface Treatment

The EK implant adopts a low crystalline nano hydroxyapatite (HA) coating (SA surface) to promote early osseointegration while maintaining long-term stability. Thread design: Small threads on the neck increase the initial stability of cancellous bone; The main body has double threads and cutting blades to improve self tapping ability. It is recommended to implant a torque of ≤ 40 Ncm.

Key points for classification and selection of repair components

The EK system provides a variety of repair components, which can be classified into the following categories based on the type of repair:

2.1 Temporary repair components

Component Model Example Usage Precautions

Healing abutment EKHA403 (H3.0, D4.0) to EKHA709 formed gingival cuff gingival height 0.5mm higher than Ø 3.5 implant, soft tissue thickness should be considered when selecting

Cover the screw and select the buried healing method according to the height H. When sealing the upper end of the implant, manually tighten it with a 1.2 hex wrench

Temporary base EKTA series temporary crown bridge can be used in conjunction with laboratory screws

Selection reference: The gingival height (G/H) ranges from 1.0 to 5.0mm, and the corresponding height of the healing abutment or transfer rod should be selected after measuring the gingival penetration depth.

2.2 Mold taking component (transfer rod)

EK supports two types of impression methods: Open Tray and Closed Tray

Type Component Model Code Characteristics

Open Tray mold transfer body+guide screw (Hex/Non Hex) EKP4011+EKPGP100 is precise and suitable for multiple implants, requiring specialized long guide screws

Closed Tray Transfer Bodies (Hex/Non Hex) EKT4011/EKT4011N are easy to operate and suitable for single or ample gaps

Window type extended mold transfer body L16 EKP4016+EKPGP150 deep implantation or thick gingiva

Hex vs Non Hex: The Hex type has a hexagonal anti rotation structure at the bottom, which can be accurately positioned after stamping; The Non Hex type is a smooth cylinder, often used in situations with large angular deviations. Both need to be tightened with a 1.2 hex wrench.

2.3 Working Model Components (Substitutes)

Type, Model, and Purpose

Transfer Lab Analog EKTA350 (Ø 3.5)/EKTA400 (Ø 4.0-7.0) to cast gypsum models and replicate implant positions

Rigid Lab Analog, as listed in the catalog, is used for bridge repair models and is more stable

Digital Lab Analog is used in conjunction with intraoral scanners in the scanning volume section for 3D printing models

Attention: Alternative parts with a diameter of Ø 3.5 are specialized and Ø 4.0 and above are universal and cannot be mixed.

2.4 Classification of repair base stations

The repair base of EK system can be divided into:

a. Rigid Abutment

Straight, adjustable angle (0 °, 15 °, 25 °, etc.)

Prefabricated with hexagonal anti rotation structure, directly used for screw fixing single crown

Material: Titanium or Gold Alloy

b. Goldcast Abutment/NP Cast Abutment

Used for making metal casting post cores, with personalized adjustment of gingival contour

NP Cast is a plastic castable cap that is easy to embed and cast

c. Pre milled Abutment/Freeform ST Abutment

Pre milling base can perform CAD/CAM personalized carving

Freeform ST is a pure titanium plastic abutment that can directly stack ceramic materials

d. Angled Abutment

Provide angles of 15 °, 25 °, 35 °, etc. to correct the axial deviation of the implant

There are two interfaces: Hex and Non Hex

e. Multi Abutment&Multi Angled Abutment

Used for joint repair of multiple implants (pole clamps, bridge frames)

Multi angle adjustment for easy joint positioning on the track

f. Student Abutment and Locator ®  Legacy Abutment

Used for covering dentures, ball caps or locator attachments to provide ideal retention force

Locator is a universal interface that can replace nylon gaskets of different colors (light, medium, heavy)

g. Temporary Abutment

Plastic or titanium material, used for making temporary crowns

Digital Prosthetics Process

The EK system supports fully digital workflows, including:

3.1 Scan Body

Model applicable characteristics

Universal scanning body (Hex/Non Hex) requires all EK implants to be matched with 1.2 hex screws to provide clear scanning geometry

EK Cerec Scan Post Deep implantation or thick gingiva for Cerec system, with less vertical exposure of the scanning abutment

Operation points:

The scanning body needs to be manually tightened (torque wrenches cannot be used to avoid deformation).

Remove the healing abutment before scanning and clean the internal connections of the implant.

After scanning is completed, the scanning body and screws can be removed and disinfected for reuse.

3.2 Digital Lab Analog

Match the 3D printed model with the scanned volume data.

The material is PEEK or metal, and can be screwed into the model base.

3.3 Pre milled Abutment

The gingival contour and restoration shape can be designed in CAD software and cut using a five axis machine tool.

Save workshop production time and achieve high edge sealing.

Common clinical problems and solutions

4.1 Mismatch between implant abutment connection (abutment cannot be fully seated)

Possible causes and solutions

If there is residual adhesive or blood inside the implant, use a specialized brush or probe to clean the inner hexagon and threads

If the healing abutment or covering screw is not completely removed, check for debris and confirm with X-ray

The base station model is incorrect (such as using Ø 4.0 substitute for Ø 3.5 implant). Check the implant diameter, and the EK system substitute is divided into two categories: 3.5 and 4.0+

4.2 Loose or broken screws

Reason: Insufficient torque, excessive bite, and contaminated connection surface.

Prevention: Use a 1.2 hex torque wrench (recommended 30 Ncm). It is recommended to recheck and tighten the screws every six months.

Solution: If the screw is broken, a specialized removal tool (ET Remover Screws, see catalog page 049) can be used.

4.3 Inaccurate impressions lead to model errors

Problem Countermeasures

Ensure that the transfer rod is not fully secured and tightened with a 1.2 hand wrench, and that the guide nut (if any) is locked in place

Window type impression material dislocation uses rigid impression material, and the guide screw is long enough

The closed window transfer body rotates in the mold. If Non Hex type is used, it can be connected and fixed in the mouth before applying mold glue

4.4 Digital scanning body recognition failure

Reason: Reflectance on the surface of the scanned object, excessive gum coverage, and lack of updated scanner software.

Countermeasure: Use anti spray powder or coated scanning spray; Ensure that the scanned object is fully exposed; Update the scanner database to the latest EK system library file.

4.5 Insufficient locator for the attachment of covered dentures

Selection: The Locator Legacy base has nylon pads in different colors (white - light, pink - medium, blue - heavy, gray - overweight). You can switch tests one by one.

Replacement: Use a special tool to remove the old gasket and press in the new gasket. The gasket has a lifespan of about 6-12 months and needs to be replaced regularly.

Replace old implant systems with EK systems

For cases where other brands (such as Straumann, Nobel Biocare, Osstem TS, etc.) have been implanted but the repair parts have been discontinued or the abutment needs to be replaced, it is generally not possible to directly use the EK abutment due to different internal connections. But there are two situations that can be considered for replacement:

5.1 Complete replacement of implants (revision surgery)

If the original implant has failed, the EK implant should be used for re implantation after removal, and the repair should wait for bone healing before proceeding.

It is recommended to use EK bone level implants and SA surface to promote osseointegration.

5.2 Use compatible base station (third-party)

At present, there are third-party compatible base stations designed for EK connections on the market (such as Medentika, DESS, etc.), but compatibility needs to be confirmed as using original accessories is safer.

5.3 Component Repair Upgrade

If the original system has an external hexagonal structure, can we consider using EK's Hex adaptive base station? No, the internal threads and taper are different. The best solution is to directly select the EK system during the initial diagnosis.

Interpretation of surgical and repair toolkits

The EK system provides a variety of surgical tool boxes, including:

OneGuide Kit: A digital guide tool box that supports guide surgery.

122 Tape Kit: Comes with a 122 cone implant (model HK122TPK).

485 Kit: Surgical tools that come with 485 series implants.

Core tools:

1.2 Hex Hand Driver: A manual wrench used to tighten all repair screws.

1.2 Hex Torque Driver: Torque wrench (recommended 30 Ncm).

Rigid Outer Driver: Used to connect drill bits or abutments.

Preventive maintenance and follow-up recommendations

Regularly take X-rays after surgery to check the bone level and abutment tightness of the implant neck.

Annual review of screw torque: Use a torque wrench to re tighten to 30 Ncm.

Clean the area around the implant: Use a titanium scraper or plastic scraper to avoid scratching the surface of the abutment.

Replace Locator gasket: Replace it every 6-12 months to prevent a decrease in retention force.

Digital data archiving: Save STL files after each mold is taken for easy post production of new restorations.