At the Junction: Why Your Connection Choice Is Determining Your Bone Levels

The implant-abutment connection is one of the most consequential decisions in implant treatment planning — and one of the most frequently made on autopilot. Most clinicians use whatever system they trained on and rarely revisit the underlying biology. This issue changes that.

By Dr. Jonathan Misch, DDS, MS · May 26, 2026 · 5 min read

Most discussions about implant-abutment connections focus on the microgap — the interface between implant and abutment where bacteria accumulate. And bacteria do accumulate there; that's been documented since the 1990s. But reducing this to a bacterial contamination problem misses the more important mechanism.