Influence of a new abutment design concept on the biomechanics of peri-implant bone, implant components, and microgap formation: a finite element analysis

BACKGROUND

A new two-piece abutment design consisting of an upper prosthetic component and tissue-level base has been introduced; however, the biomechanical behavior of such a design has not been documented. This study aimed to investigate the effect of a two-piece abutment design on the stress in the implant components and surrounding bone, as well as its influence on microgap formation.

METHODS

To simulate the implant models in the mandibular left first molar area, we established nine experimental groups that included three bone qualities (type II, III, and IV) and three implant-abutment designs (internal bone level, tissue level, and a two-piece design). After the screw was preloaded, the maximum occlusal (600 N) and masticatory (225 N) forces were established. Finite element analysis was performed to analyze the maximum and minimum principal stresses on the peri-implant bone; the von Mises stresses in the implants, abutments, bases, and screws, and the microgaps at the implant-abutment, implant-base, and base-abutment interfaces.

RESULTS

For all three loading methods, the two-piece abutment design and bone-level connection exhibited similarities in the maximum and minimum principal stresses in the peri-implant bone. The von Mises stresses in both screws and bases were greater for the two-piece design than for the other connection types. The smallest microgap was detected in the tissue-level connection; the largest was observed at the implant-base interface in the two-piece design.

CONCLUSIONS

The present study found no evidence that the abutment design exerts a significant effect on peri-implant bone stress. However, the mechanical effects associated with the base and screws should be noted when using a two-piece abutment design. The two-piece abutment design also had no advantage in eliminating the microgap.

A new design of a multifunctional abutment to morse taper implant connection: Experimental mechanical analysis

The objective of this study was to evaluate a new design of multifunctional abutment for Morse taper implant connections, relative to the retentive stability after the application of cyclic loads in cemented and screwed crowns. Multifunctional abutments with two different angulations in the seating portion of the crown were tested, forming 2 groups (n = 30 samples per group): Group Abut11, where Smart abutments with an angle of 11.42° were used; Group Abut5, where Ideale abutments with an angle of 5° were used. Fifteen samples from each group received cemented crowns (CC) and another fifteen screwed crowns (SC). All crown samples were subjected to the mechanical cycling test at 360,000 cycles at a frequency of 4 Hz and 150 N of the load. The samples with CC were subjected to the tensile test to remove the crowns, while in the samples with SC, the detorque value of the fastening crown screws was measured. The mean tensile strength value of CC in the Abut11 group was 131.9 ± 13.5 N and, in the Abut5 group was 230.9 ± 11.3 N; while the detorque mean value in samples with SC 5.8 ± 1.8 N for the Abut11 group and, 7.6 ± 1.1 N for Abut5 group. Significant statistical differences were found between the two groups in both situations tested (p < 0.05). The multifunctional abutments, presenting a lesser angulation of the crown-seating portion, showed higher values of retention of the CC and a lesser screw loosening of torque of the fixing screws in the SC after the application of cyclic loads when compared to the abutments with more angulation in the crown-seating portion.

Restoration of converging implants: Restorative complexity to facilitate retrievability

Implant treatment should be restoratively driven, however at times, ideal implant positioning may be sacrificed for surgical convenience at the expense of restorative complexity. A prosthesis incorporating a novel design was constructed to restore two converging implants placed in close proximity utilizing standard implant impression componentry and simple clinical stages. As the use of angulated screw channel technology was not possible, a customized cast “rest” abutment and overlying telescopic crown was fabricated that facilitated access for oral hygiene and retrievability as required. The complexity of the case design was transferred to the laboratory phases of construction. The case presented a satisfactory clinical outcome for an initially challenging implant presentation and reinforced the need to work closely with the laboratory technician.

The Effect of CAD/CAM Crown Material and Cement Type on Retention to Implant Abutments

PURPOSE

To evaluate the pullout resistance of CAD/CAM implant-supported crowns cemented with provisional and definitive cements on Ti-base implant abutments.

MATERIALS AND METHODS

Sixty crowns were milled for use in Ti-base implant abutments and divided (n = 15/group) according to material, as follows: (a) [Pr] Temporary acrylic resin; (b) [Co-Cr] Cobalt-Chromium alloy; (c) [Zr] polycrystalline zirconia; and (d) [Ti] titanium. The cementation was performed with RelyX Temp NE (RxT) cement or RelyX U200 self-etching resin cement, under a 50 N (5 kg) load for 10 minutes. Twenty-four hours after cementation, the crowns were subjected to the pullout test in a universal test machine, at a 1.0 mm/min crosshead speed. The tests were performed first without cement to evaluate frictional resistance (Baseline), then with provisional cement (RelyX Temp NE without cement again (Baseline After RxT), and finally with resin cement (U200). The results were analyzed by ANOVA and Tukey test (p < 0.05).

RESULTS

Data evaluation as a function of cement type demonstrated the superiority of resin-based cements relative to provisional and baseline groups (p < 0.01). While Co-Cr crowns presented the highest pullout strength values, Pr showed the lowest values (data collapsed over cement) (p < 0.001). Retentiveness data as a function of both factors demonstrated similar pullout resistance between groups without cement (p < 0.001), except Zr baseline. Also, Co-Cr presented higher pullout strength compared to other materials.

CONCLUSIONS

Self-adhesive resin cement exhibited superior retention compared to temporary cement, regardless of crown material. Co-Cr and titanium presented higher levels of retention to Ti-base abutment after being cemented.