In situ microradioscopy and microtomography of fatigue-loaded dental two-piece implants

In vitro assessment of internal implant-abutment connections with different cone angles under static loading using synchrotron-based radiation

BACKGROUND

The stability of implant-abutment connection is crucial to minimize mechanical and biological complications. Therefore, an assessment of the microgap behavior and abutment displacement in different implant-abutment designs was performed.

METHODS

Four implant systems were tested, three with a conical implant-abutment connection based on friction fit and a cone angle < 12 ° (Medentika, Medentis, NobelActive) and a system with an angulated connection (< 40°) (Semados). In different static loading conditions (30 N - 90º, 100 N - 90º, 200 N - 30º) the microgap and abutment displacement was evaluated using synchrotron-based microtomography and phase-contrast radioscopy with numerical forward simulation of the optical Fresnel propagation yielding an accuracy down to 0.1 μm.

RESULTS

Microgaps were present in all implant systems prior to loading (0.15-9 μm). Values increased with mounting force and angle up to 40.5 μm at an off axis loading of 100 N in a 90° angle.

CONCLUSIONS

In contrast to the implant-abutment connection with a large cone angle (45°), the conical connections based on a friction fit (small cone angles with < 12°) demonstrated an abutment displacement which resulted in a deformation of the outer implant wall. The design of the implant-abutment connection seems to be crucial for the force distribution on the implant wall which might influence peri-implant bone stability.

Physical and mechanical changes on titanium base of three different types of hybrid abutment after cyclic loading

PURPOSE

This study investigated the physical and mechanical changes in the titanium base of three different hybrid abutment materials after cyclic loading by estimating the post-load reverse torque value (RTV), compressive side fulcrum wear pattern of titanium base, and surface roughness.

MATERIALS AND METHODS

A total of 24 dental implants were divided into three groups (n = 8 each): Group Z, LD, and P used zirconia, lithium disilicate, and polyetheretherketone, respectively, for hybrid abutment fabrication. RTV was evaluated after cyclic loading with 50 N for 1.2 × 10⁶ chewing cycles. The compressive sides of the titanium bases were analyzed using a scanning electron microscope, and the roughness of the affected areas was measured using an optical profilometer after loading. Datasets were analyzed using Kruskal-Wallis test followed by Mann-Whitney tests with the Bonferroni correction (α = .05).

RESULTS

Twenty-three samples passed the test; one LD sample fractured after 770,474 cycles. Post-load RTV varied significantly depending on the hybrid-abutment material (P = .020). Group P had a significantly higher median of post-load RTVs than group Z (16.5 and 14.3 Ncm, respectively). Groups LD and P showed minor signs of wear, and group Z showed a more pronounced wear pattern. While evaluating compressive side affected area roughness of titanium bases, lower medians were shown in group LD (Ra 0.16 and Rq 0.22 µm) and group P (Ra 0.16 and Rq 0.23 µm) than in group Z (Ra 0.26 and Rq 0.34 µm); significant differences were found only among the unaffected surface and group Z.

CONCLUSION

The hybrid abutment material influences the post-load RTV. Group Z had a more pronounced wear pattern on the compressive side of titanium base; however, the surface roughness was not statistically different among the hybrid-abutment groups.

Original vs compatible stock abutment- implant connection. An in vitro analysis of the internal accuracy and mechanical fatigue behaviour

PURPOSE

To assess the internal accuracy and mechanical behaviour under cyclic loading after artificial aging of implantsupported crowns restored with original stock abutments and two compatible non-original stock abutments.

METHODS

Forty-eight original internal hexagon connection implants were connected to different stock abutments. The samples were divided into three groups depending on the manufacturer of the abutment components (one original, two non-originals).Firstly, samples were cross-sectioned and observed by using Scanning Electron Microscope (SEM) to evaluate the internal accuracy in three different implant-abutment interface locations (platform, internal and screw). Further, cyclic fatigue loading was carried out according to the ISO Norm 14801 using dynamic testing machine under sinusoidal loads for 2,000,000 cycles at test frequencies of 2 Hz in air after thermocycling with 10,000 cycles at 5 °C and 55 °C in artificial saliva for aging simulation.

RESULTS

Original abutment components presented the highest percentage of surface with tight contact with the implant in the three implant-abutment interfaces studied. Additionally, original configuration showed highest fatigue limit value and fatigue strength exponent (280 N and -0.054) than non-original 1 (225 N and -0.109) and non-original 2 (200 N and -0.101).

CONCLUSION

Original abutment components provide better fit and mechanical results under cyclic loading than nonoriginal configurations. The results obtained in this study seem to suggest that the use of the original stock abutments to implants leads to a more homogeneous load distribution between the components that can influence the long-term success of the restorations.

Hydrothermal aging affects the three-dimensional fit and fatigue lifetime of zirconia abutments

OBJECTIVE

Evaluate the effect of aging using two different methods on the three-dimensional fit of zirconia abutments at the implant-abutment connection and estimate the probability of survival of anterior crowns supported by straight and 17-degree angled abutments.

MATERIALS AND METHODS

Two different zirconia abutment designs, straight and 17-degree angled abutments (n = 63/group), were evaluated in the current study. The abutments were randomly allocated into three experimental groups according to laboratory aging condition (134°C, 2.2 bar, 20 h): (i) control, (ii) autoclave aging, and (iii) hydrothermal reactor aging. Crystalline content was determined by X-Ray diffraction (XRD) and Raman spectroscopy, and microstructure was analyzed using field-emission gun scanning electron microscope (FEG-SEM). Implant-abutment volume misfit was determined in the straight abutments by micro-computed tomography using the silicone replica technique. For fatigue testing, abutments were torqued to the implants and connected to standardized maxillary incisor zirconia crowns. The assemblies were subjected to step-stress accelerated life testing (SSALT) in water until fracture or suspension. The use level probability Weibull curves and probability of survival for a mission of 50,000 cycles at 50, 100, 150 and 200 N were calculated and plotted. Fractured samples were analyzed using a stereomicroscope and scanning electron microscope.

RESULTS

The crystalline spectra depicted a zirconia system primarily composed of the tetragonal phase. Laboratory aging yielded a 20%- and 37%-increase in the monoclinic content for abutments aged in autoclave and hydrothermal reactor relative to control, respectively. A fully crystalline matrix with a regular grain size was observed in the FEG-SEM for control abutments, with a considerable presence of intergranular defects. While autoclave aging triggered no significant alteration to the microstructure, defect population was reduced after hydrothermal reactor aging. Control abutments presented a significantly higher volume misfit (2.128 ± 0.54 mm3) relative to aged abutments using autoclave (1.244 ± 0.48 mm3) or hydrothermal reactor (1.441 ± 0.41 mm3). The beta (β) values indicated that failures were predominantly controlled by material strength rather than fatigue damage accumulation for all groups, except for straight control abutments. Irrespective of aging, the probability of survival of straight and angled zirconia abutments was up to 95% (95-100%) at 50 and 100 N. A 50N-increase in the load resulted in wider range of survival estimate, with straight autoclave abutments percentage significantly lower probability of survival (77%) than angled hydrothermal reactor abutments (99%). At 200N, angled hydrothermal reactor (97%) or autoclave (82%) aged abutments demonstrated the highest probability of survival, angled control (71%) and straight hydrothermal reactor (69%) abutments intermediate values, and straight autoclave (23%) and control (7%) abutments the lowest estimate. The failure mode predominantly involved abutment and/or abutment screw fracture for both straight and angled abutments.

CONCLUSIONS

Hydrothermal aging significantly influenced volume misfit, as well as the probability of survival of zirconia abutments at higher loads for both angled and straight abutments.

Three-dimensional misfit between Ti-Base abutments and implants evaluated by replica technique

An important factor affecting the biomechanical behavior of implant-supported reconstructions is the implant-abutment misfit.

Distribution and Chemical Speciation of Exogenous Micro- and Nanoparticles in Inflamed Soft Tissue Adjacent to Titanium and Ceramic Dental Implants

Degradation of the implant surface and particle release/formation as an inflammation catalyst mechanism is an emerging concept in dental medicine that may help explain the pathogenesis of peri-implantitis. The aim of the present study was a synchrotron-based characterization of micro- and nanosized implant-related particles in inflamed human tissues around titanium and ceramic dental implants that exhibited signs of peri-implantitis. Size, distribution, and chemical speciation of the exogenous micro- and nanosized particle content were evaluated using synchrotron μ-X-ray fluorescence spectroscopy (XRF), nano-XRF, and μ-X-ray absorption near-edge structure (XANES). Titanium particles, with variable speciation, were detected in all tissue sections associated with titanium implants. Ceramic particles were found in five out of eight tissue samples associated with ceramic implants. Particles ranged in size from micro- to nanoscale. The local density of both titanium and ceramic particles was calculated to be as high as ∼40 million particles/mm³. μ-XANES identified titanium in predominantly two different chemistries, including metallic and titanium dioxide (TiO₂). The findings highlight the propensity for particle accumulation in the inflamed tissues around dental implants and will help in guiding toxicological studies to determine the biological significance of such exposures.

Implant-abutment fit influences the mechanical performance of single-crown prostheses

OBJECTIVES

To evaluate the three-dimensional fit of abutments fabricated by the industry to those either milled or cast by a commercial laboratory and to correlate the implant-abutment connection fit with stress at fatigue failure of prostheses. Probability of survival (reliability) and fractography to characterize failure modes were also performed for cemented and screw-retained prostheses.

METHODS

One-hundred and twenty-six maxillary central incisor crowns were milled to restore implants and divided in 3 cemented and 3 screwed-retained groups (n = 21/each), as follows: [Digital-Sc]: milled one-piece monolithic abutment/crown; [TiB-Sc]: milled crowns cemented onto Ti-base abutments; [UCLA]: screw-retained crown using UCLA abutments; [Digital-Ce]: milled two-piece assembly comprised by screwed monolithic abutment and a cemented crown; [TiB-Ce]: milled coping cemented onto Ti-base abutments to receive a cemented crown; [UCLA-Ce]: UCLA abutments that received an overcast coping and a cemented crown. Implant-abutment volume misfit was assessed by micro-computed tomography using the silicone replica technique. Implant/crown systems were subjected to step-stress accelerated life testing (SSALT) in water. The use-level probability Weibull curves and reliability for a mission of 50,000 cycles at calculated stress at failure of 2,300, 3300 and 4300 MPa were plotted. Fractographic analysis was performed with scanning electron microscopy. Internal misfit was analyzed through one-way ANOVA following post-hoc comparisons by Tukey test (p < 0.05). Correlation between misfit volume and the stress at fatigue failure was assessed by Pearson test.

RESULTS

Similar misfit volumes were observed for TiB-Sc (0.458 mm³), TiB-Ce (0.461 mm³), UCLA (0.471 mm³) and UCLA-Ce (0.480 mm³), which were significantly lower than Digital-Sc (0.676 mm³) and Digital-Ce (0.633 mm³). The mean β values were: 1.68, 1.39, 1.48, 2.41, 2.27 and 0.71 for Digital-Sc, TiB-Sc, UCLA, Digital-Ce, TiB-Ce and UCLA-Ce, respectively, indicating that fatigue was an accelerating factor for failure of all groups. Higher stress at failure decreased the reliability of all groups, more significantly for screw compared to cement-retained groups, especially for Digital-Sc that demonstrated the lowest reliability. The failure mode was restricted to abutment screw fracture. A negative correlation was observed between misfit values and stress at failure (r = -0.302, p = 0.01).

CONCLUSIONS

Abutments milled by a commercial lab presented higher misfit compared to those provided by the industry and a moderate correlation was observed between higher misfit and lower stress at failure during fatigue. Probability of survival decreased at higher stress, especially for screw compared to cement-retained groups, and failures were confined to abutment screws.

The micromechanical behavior of implant-abutment connections under a dynamic load protocol

BACKGROUND

The implant-abutment connection (IAC) is known to be a key factor for the long-term stability of peri-implant tissue.

PURPOSE

The aim of the present in vitro study was to detect and measure the mechanical behavior of different IACs by X-ray imaging.

MATERIALS AND METHODS

A total of 20 different implant systems with various implant dimensions and IACs (13 conical-, 6 flat-, and 1 gable-like IAC) have been tested using a chewing device simulating dynamic and static loading up to 200 N. Micromovements have been recorded with a high-resolution, high-speed X-ray camera, and gap length and gap width between implant and abutment have been calculated. Furthermore, X-ray video sequences have been recorded to investigate the sealing capacity of different IACs.

RESULTS

Out of the 20 implant systems, eight implant systems with a conical IAC showed no measurable gaps under static and dynamic loading (200 N). By contrast, all investigated implant systems with a flat IAC showed measurable gaps under dynamic and static loading. X-ray video sequences revealed that a representative conical IAC had sufficient sealing capacity.

CONCLUSION

Within the limits of the present in vitro study, X-ray imaging showed reduced formation of microgaps and consecutive micromovements in implants with conical IAC compared to flat IACs.

Validation of finite-element simulations with synchrotron radiography - A descriptive study of micromechanics in two-piece dental implants

State-of-the art, two-piece dental implants made from titanium alloys exhibit a complex micromechanical behavior under dynamical load. Its understanding, especially the formation of microgaps, is of crucial importance in order to predict and improve the long-term performance of such implants. Microgap formation in a loaded dental implant with a conical implant-abutment connection can be studied and quantified by synchrotron radiography with micrometer accuracy. Due to the high costs and limited access to synchrotron radiation sources, alternative approaches are needed in order to depict the microgap formation. Therefore, synchrotron radiography is used in this article to validate a simple finite element model of an experimental conical implant design. Once validated, the model is in turn employed to systematically study the microgap formation developed in a variety of static load scenarios and the influence of the preload of abutment screw on the microgap formation. The size of the microgap in finite element analysis (FEA) simulations is consistent with that found in in-vitro experiments. Furthermore, the FE approach gives access to more information such as the von-Mises stresses. It is found that the influence of the abutment screw preload has only a minor effect on the microgap formation and local stress distribution. The congruence between FE simulations and in-vitro measurements at the micrometer scale underlines the validity and relevance of the simple FE method applied to study the micromovement of the abutment and the abutment screw preload in conical implant-abutment connections under load.