Abstract
Background To assess the effect of implantoplasty and implant-abutment design on the fracture resistance and macroscopic morphology of narrow-diameter (3.5 mm) dental implants. Material and Methods Screw-shaped titanium dental implants (n = 48) were studied in vitro. Three groups (n = 16) were established, based on implant-abutment connection type: external hexagon, internal hexagon and conical. Eight implants from each group were subjected to an implantoplasty procedure; the remaining 8 implants served as controls. Implant wall thickness was recorded. All samples were subjected to a static strength test. Results The mean wall thickness reductions varied between 106.46 and 153.75 µm. The mean fracture strengths for the control and test groups were, respectively, 1211.90±89.95 N and 873.11±92.37 N in the external hexagon implants; 918.41±97.19 N and 661.29±58.03 N in the internal hexagon implants; and 1058.67±114.05 N and 747.32±90.05 N in the conical connection implants. Implant wall thickness and fracture resistance (P < 0.001) showed a positive correlation. Fracture strength was influenced by both implantoplasty (P < 0.001) and connection type (P < 0.001). Conclusions Implantoplasty in diameter-reduced implants decreases implant wall thickness and fracture resistance, and varies depending on the implant-abutment connection. Internal hexagon and conical connection implants seem to be more prone to fracture after implantoplasty. Key words:Dental implants, narrow diameter, implant connection, peri-implantitis, implantoplasty, fracture strength.
Highlights
Over recent decades, oral rehabilitation with dental implants has shown highly satisfactory results regarding restoration of the patient’s function and esthetics, with predictable and safe long-term results (1,2)
The aim of the present study was to assess whether IP and implant-abutment design influence the fracture resistance of narrow-diameter, screw-shaped, rough-surfaced titanium dental implants in conjunction with a horizontal peri-implant defect corresponding to half of their length
Three different implant-abutment connection designs were used for a total of 16 fixtures in each group: external hexagonal connection (EC), internal hexagonal connection (IC) and conical connection (CC)
Summary
Oral rehabilitation with dental implants has shown highly satisfactory results regarding restoration of the patient’s function and esthetics, with predictable and safe long-term results (1,2). IP reduces the implant diameter and the thickness of the implant wall and, together with the bone loss from peri-implantitis, may increase the risk of fixture fracture (16-18). Gehrke et al (20) compared three different implant connections and found that the resistance to loading of 4 mm diameter implants decreased significantly after IP but varied among the three implant-abutment designs, the Morse tapered fixtures being the most resistant None of these studies were conducted under the most unfavorable conditions The aim of the present study was to assess whether IP and implant-abutment design influence the fracture resistance of narrow-diameter, screw-shaped, rough-surfaced titanium dental implants in conjunction with a horizontal peri-implant defect corresponding to half of their length. Conclusions: Implantoplasty in diameter-reduced implants decreases implant wall thickness and fracture resistance, and varies depending on the implant-abutment connection. Internal hexagon and conical connection implants seem to be more prone to fracture after implantoplasty
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