J Adv Prosthodont.  2016 Oct;8(5):388-395. 10.4047/jap.2016.8.5.388.

Influence of the connection design and titanium grades of the implant complex on resistance under static loading

Affiliations
  • 1Department of Biomaterials & Prosthodontics, Kyung Hee University Hospital at Gangdong, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea. sbykmw@yahoo.co.kr hswhsh@khu.ac.kr

Abstract

PURPOSE
The purpose of this study was to evaluate the resistance to deformation under static overloading by measuring yield and fracture strength, and to analyze the failure characteristics of implant assemblies made of different titanium grades and connections.
MATERIALS AND METHODS
Six groups of implant assemblies were fabricated according to ISO 14801 (n=10). These consisted of the combinations of 3 platform connections (external, internal, and morse tapered) and 2 materials (titanium grade 2 and titanium grade 4). Yield strength and fracture strength were evaluated with a computer-controlled Universal Testing Machine, and failed implant assemblies were classified and analyzed by optical microscopy. The data were analyzed using the One-way analysis of variance (ANOVA) and Student's t-test with the level of significance at P=.05.
RESULTS
The group IT4S had the significantly highest values and group IT2 the lowest, for both yield strength and fracture strength. Groups IT4N and ET4 had similar yield and fracture strengths despite having different connection designs. Group MT2 and group IT2 had significant differences in yield and fracture strength although they were made by the same material as titanium grade 2. The implant system of the similar fixture-abutment interfaces and the same materials showed the similar characteristics of deformation.
CONCLUSION
A longer internal connection and titanium grade 4 of the implant system is advantageous for static overloading condition. However, it is not only the connection design that affects the stability. The strength of the titanium grade as material is also important since it affects the implant stability. When using the implant system made of titanium grade 2, a larger diameter fixture should be selected in order to provide enough strength to withstand overloading.

Keyword

Dental Implant-Abutment Connection; Titanium grade; Yield strength; Static loading; Implant failure

MeSH Terms

Dental Implant-Abutment Design
Microscopy
Titanium*
Titanium

Figure

  • Fig. 1 (A) Schematic illustration of the design of the testing apparatus following ISO 14801 (2007). The distance from the center of the hemisphere to the top face of the resin cylinder, representing the bone level, was standardized at 11 mm. The specimens were then clamped in a special jig (machine shop, Hannover Medical School, Hannover, Germany) while ensuring a 30° angle between the implant axis and the direction of force transfer. (B) The set up for mechanical testing, with crowns positioned in a 30° off-axis orientation.

  • Fig. 2 Multiple comparisons from the analysis of the mean yield strengths of different types of implants (oneway ANOVA, n = 10). *Significant difference (P < .05). IT4S: Straumann Bone level, IT4D: Dentium superline, IT4N: Neobiotech CMI IS, IT2: Dentsply Xive s, MT2: Ankylos C/X, ET4: Neobiotech CMI EB

  • Fig. 3 Multiple comparisons resulting from the analysis of the mean fracture strength of different types of implants (one-way ANOVA, n = 10). *Significant difference (P < .05) IT4S: Straumann Bone level, IT4D: Dentium superline, IT4N: Neobiotech CMI IS, IT2: Dentsply Xive s, MT2: Ankylos C/X, ET4: Neobiotech CMI EB

  • Fig. 4 Longitudinal section images of failed systems taken with a digital microscope (×20). (A) IT4S (Straumann Bone level), (B) IT4D (Dentium superline), (C) IT4N (Neobiotech CMI IS), (D) IT2 (Dentsply Xive s), (E) MT2 (Ankylos C/X) (F) ET4 (Neobiotech CMI EB).

  • Fig. 5 (A) Bottom view of a failed screw and fixture in group IT2 (×60). Dimples, which are characteristic of ductile failure, can be seen on the surface of the fractured screw. (B) Bottom view of a failed screw and fixture in group IT2 (×60). The black arrow indicates a compression curl, which defines the fracture origin on the opposing tensile side (×100).


Reference

1. Cochran DL, Buser D, ten Bruggenkate CM, Weingart D, Taylor TM, Bernard JP, Peters F, Simpson JP. The use of reduced healing times on ITI implants with a sandblasted and acid-etched (SLA) surface: early results from clinical trials on ITI SLA implants. Clin Oral Implants Res. 2002; 13:144–153.
2. Nelson K, Semper W, Hildebrand D, Ozyuvaci H. A retrospective analysis of sandblasted, acid-etched implants with reduced healing times with an observation period of up to 5 years. Int J Oral Maxillofac Implants. 2008; 23:726–732.
3. Sullivan D, Vincenzi G, Feldman S. Early loading of Osseotite implants 2 months after placement in the maxilla and mandible: a 5-year report. Int J Oral Maxillofac Implants. 2005; 20:905–912.
4. Zarb GA, Zarb FL. Tissue integrated dental prostheses. Quintessence Int. 1985; 16:39–42.
5. Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981; 10:387–416.
6. Jemt T, Lekholm U, Gröndahl K. 3-year followup study of early single implant restorations ad modum Brånemark. Int J Periodontics Restorative Dent. 1990; 10:340–349.
7. Scheller H, Urgell JP, Kultje C, Klineberg I, Goldberg PV, Stevenson-Moore P, Alonso JM, Schaller M, Corria RM, Engquist B, Toreskog S, Kastenbaum F, Smith CR. A 5-year multicenter study on implant-supported single crown restorations. Int J Oral Maxillofac Implants. 1998; 13:212–218.
8. Jemt T, Pettersson P. A 3-year follow-up study on single implant treatment. J Dent. 1993; 21:203–208.
9. Strub JR, Gerds T. Fracture strength and failure mode of five different single-tooth implant-abutment combinations. Int J Prosthodont. 2003; 16:167–171.
10. Brunski JB. Biomaterials and biomechanics in dental implant design. Int J Oral Maxillofac Implants. 1988; 3:85–97.
11. Tagger Green N, Machtei EE, Horwitz J, Peled M. Fracture of dental implants: literature review and report of a case. Implant Dent. 2002; 11:137–143.
12. Binon PP, McHugh MJ. The effect of eliminating implant/abutment rotational misfit on screw joint stability. Int J Prosthodont. 1996; 9:511–519.
13. Truninger TC, Stawarczyk B, Leutert CR, Sailer TR, Hämmerle CH, Sailer I. Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation. Clin Oral Implants Res. 2012; 23:12–18.
14. Sailer I, Sailer T, Stawarczyk B, Jung RE, Hämmerle CH. In vitro study of the influence of the type of connection on the fracture load of zirconia abutments with internal and external implant-abutment connections. Int J Oral Maxillofac Implants. 2009; 24:850–858.
15. Mitsias ME, Silva NR, Pines M, Stappert C, Thompson VP. Reliability and fatigue damage modes of zirconia and titanium abutments. Int J Prosthodont. 2010; 23:56–59.
16. Dixon DL, Breeding LC, Sadler JP, McKay ML. Comparison of screw loosening, rotation, and deflection among three implant designs. J Prosthet Dent. 1995; 74:270–278.
17. Breeding LC, Dixon DL, Nelson EW, Tietge JD. Torque required to loosen single-tooth implant abutment screws before and after simulated function. Int J Prosthodont. 1993; 6:435–439.
18. Standlee JP, Caputo AA. Accuracy of an electric torque-limiting device for implants. Int J Oral Maxillofac Implants. 1999; 14:278–281.
19. Flanagan D. Diet and implant complications. J Oral Implantol. 2016; 42:305–310.
20. Helkimo E, Carlsson GE, Helkimo M. Bite force and state of dentition. Acta Odontol Scand. 1977; 35:297–303.
21. Hagberg C. Assessment of bite force: a review. J Craniomandib Disord. 1987; 1:162–169.
22. Dittmer MP, Dittmer S, Borchers L, Kohorst P, Stiesch M. Influence of the interface design on the yield force of the implant-abutment complex before and after cyclic mechanical loading. J Prosthodont Res. 2012; 56:19–24.
23. Khraisat A. Stability of implant-abutment interface with a hexagon-mediated butt joint: failure mode and bending resistance. Clin Implant Dent Relat Res. 2005; 7:221–228.
24. English CE. Externally hexed implants, abutments, and transfer devices: a comprehensive overview. Implant Dent. 1992; 1:273–282.
25. Semper W, Kraft S, Krüger T, Nelson K. Theoretical considerations: implant positional index design. J Dent Res. 2009; 88:725–730.
26. Semper W, Kraft S, Krüger T, Nelson K. Theoretical optimum of implant positional index design. J Dent Res. 2009; 88:731–735.
27. Möllersten L, Lockowandt P, Lindén LA. Comparison of strength and failure mode of seven implant systems: an in vitro test. J Prosthet Dent. 1997; 78:582–591.
28. McGlumphy EA, Robinson DM, Mendel DA. Implant superstructures: a comparison of ultimate failure force. Int J Oral Maxillofac Implants. 1992; 7:35–39.
29. Merz BR, Hunenbart S, Belser UC. Mechanics of the implant-abutment connection: an 8-degree taper compared to a butt joint connection. Int J Oral Maxillofac Implants. 2000; 15:519–526.
30. Steinebrunner L, Wolfart S, Ludwig K, Kern M. Implant-abutment interface design affects fatigue and fracture strength of implants. Clin Oral Implants Res. 2008; 19:1276–1284.
31. Levine RA, Clem D, Beagle J, Ganeles J, Johnson P, Solnit G, Keller GW. Multicenter retrospective analysis of the solid-screw ITI implant for posterior single-tooth replacements. Int J Oral Maxillofac Implants. 2002; 17:550–556.
32. Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent. 2006; 26:9–17.
33. Semper-Hogg W, Kraft S, Stiller S, Mehrhof J, Nelson K. Analytical and experimental position stability of the abutment in different dental implant systems with a conical implant-abutment connection. Clin Oral Investig. 2013; 17:1017–1023.
34. Freitas Júnior AC, Bonfante EA, Silva NR, Marotta L, Coelho PG. Effect of implant-abutment connection design on reliability of crowns: regular vs. horizontal mismatched platform. Clin Oral Implants Res. 2012; 23:1123–1126.
35. Freitas-Júnior AC, Almeida EO, Bonfante EA, Silva NR, Coelho PG. Reliability and failure modes of internal conical dental implant connections. Clin Oral Implants Res. 2013; 24:197–202.
36. Apicella D, Veltri M, Balleri P, Apicella A, Ferrari M. Influence of abutment material on the fracture strength and failure modes of abutment-fixture assemblies when loaded in a bio-faithful simulation. Clin Oral Implants Res. 2011; 22:182–188.
Full Text Links
  • JAP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr