The influence of stiffness of implant-abutment connection on load-deflection ratios of a screw-retained stiff cantilever beam. 3-D measurements in vitro

Abstract

The purpose of this in vitro study was to investigate the influence of degree of stiffness of implant-abutment connection of a Brånemark implant system on load- deflection ratios in three dimensions of the beam-end of a screw-retained stiff cantilever beam when subjected to vertically directed loads. Two different implant-abutment connections were tested; welded and screw-retained. One of the abutments (EsthetiCone 2.0; Nobel Biocare AB) was screwed with a torque force of 20 N cm and then laser welded around its entire periphery to one of two Brånemark implants (welded unit). This unit and the other implant were tightly screwed into each of two pre-threaded holes in a steel plate so that the implants became submerged in the plate. The remaining abutment was thereafter screwed to its implant with a torque force of 20 N cm (screw-retained unit). A cantilevered gold beam of 6 mm height and width comprising a gold cylinder (Nobel Biocare AB) was attached to each abutment with a slotted, flat headed, prosthetic gold screw (torque force 10 N cm). A force transducer, synchronized with a 3-D motion analysis system, was glued on the upper surface of each beam-end 19.4 mm from the implant, to register the loads transferred from a specially built loading device. The beam-ends were stepwise subjected to vertically directed loads from 14.9 to 40.3 N and the vertical and horizontal deflections of the beam-ends were registered with the 3-D motion analysis system. For load 14.9-40.3 N the vertical (z-axis) deflections of the beam-end were for the welded implant-abutment connection reduced with 18-46% compared with the screw-retained unit. After maximal loading (40.3 N) the horizontal counter-clockwise rotation of the beam around the screw joints (y-axis rotations) was reduced with 61% for the welded connection. The horizontal movements of the beam-end along the x-axis (x-axis deflections) were reduced with 49% at maximal loading. It was concluded that increased implant-abutment stiffness will substantially reduce both vertical and horizontal deflections of a screw-retained stiff cantilever beam subjected to vertically directed loads.