Effect of the geometry of butt-joint implant-supported restorations on the fatigue life of prosthetic screws

Abstract

Statement of problem: Dental implant geometry affects the mechanical performance and fatigue behavior of butt-joint implant-supported restorations. However, failure of the implant component has been generally studied by ignoring the prosthetic screw, which is frequently the critical restoration component.

Purpose: The purpose of this in vitro study was to evaluate the effect of 3 main implant geometric parameters: the implant body diameter, the platform diameter, and the implant-abutment connection type (external versus internal butt-joint) on the fatigue life of the prosthetic screw. The experimental values were further compared with the theoretical ones obtained by using a previously published methodology.

Material and methods: Four different designs of direct-to-implant dental restorations from the manufacturer BTI were tested. Forty-eight fatigue tests were performed in an axial fatigue testing machine according to the International Organization for Standardization (ISO) 14801. Linear regression models, 95% interval confidence bands for the linear regression, and 95% prediction intervals of the fatigue load-life (F-N) results were obtained and compared through an analysis of covariance (ANCOVA) to determine the influence of the 3 parameters under study on the fatigue behavior (α=.05).

Results: Linear regression models showed a statistical difference (P<.001) when the implant body diameter was increased by 1 mm; an average 3.5-fold increase in fatigue life was observed. Increasing the implant abutment connection diameter by 1.4 mm also showed a significant difference (P<.001), leading to 7-fold longer fatigue life on average. No significant statistical evidence was found to demonstrate a difference in fatigue life between internal and external implant-abutment connection types.

Conclusions: Increasing the implant platform and body diameter significantly improved (P<.001) the fatigue life of the prosthetic screw, whereas external and internal connections provided similar results. In addition, experimental results proved the accuracy of the fatigue life prediction methodology.