Steinebrunner Lars, Wolfart Stefan, Ludwig Klaus, Kern Matthias
Department of Prosthodontics, RWTH Aachen University, Aachen, Germany.
Clin Oral Implants Res. 2008 Dec;19(12):1276-84. doi: 10.1111/j.1600-0501.2008.01581.x.
Failures of implant-abutment connections are relatively frequent clinical problems. The aim of this study was to evaluate the influence of long-term dynamic loading on the fracture strength of different implant-abutment connections.
Six implant systems were tested: two systems with external connections (Brånemark, Compress) and four systems with internal connections (Frialit-2, Replace-Select, Camlog, Screw-Vent). Fracture strength was tested in two subgroups for each system: one subgroup with (dyn) and the other without prior dynamic loading (contr). Each subgroup consisted of eight specimens with standard implant-abutment combinations for single molar crowns. Dynamic loading was performed in a two-axis chewing simulator with 1,200,000 load cycles at 120 N.
Median fracture strengths in Newton (N) and 25th and 75th percentiles [in brackets] were: Brånemark: dyn=729 [0;802]/contr=782 [771;811], Frialit-2: dyn=0 [0;611]/contr=887 [798;941], Replace-Select: dyn=1439 [1403;1465]/contr=1542 [1466;1623], Camlog: dyn=1482 [1394;1544]/contr=1467 [1394;1598], Screw-Vent: dyn=0 [0;526]/contr=780 [762;847] and Compress: dyn=818[0;917]/contr=1008 [983;1028]. In some dyn subgroups, failures of the implant-abutment connection occurred already during dynamic loading: three specimens of the Brånemark and Compress groups and six specimens of the Screw-Vent and the Frialit-2 groups failed during dynamic loading. Statistically significant differences (P< or =0.05) in fracture strength could be found between groups with different connection designs.
Implant systems with long internal tube-in-tube connections and cam-slot fixation showed advantages with regard to longevity and fracture strength compared with systems with shorter internal or external connection designs.
种植体-基台连接失败是较为常见的临床问题。本研究旨在评估长期动态加载对不同种植体-基台连接断裂强度的影响。
测试了六种种植系统：两种外部连接系统（Brånemark、Compress）和四种内部连接系统（Frialit-2、Replace-Select、Camlog、Screw-Vent）。对每个系统在两个亚组中测试断裂强度：一个亚组进行（dyn）先前的动态加载，另一个亚组不进行（contr）。每个亚组由八个具有单颗磨牙冠标准种植体-基台组合的标本组成。在两轴咀嚼模拟器中以120 N的力进行1,200,000次加载循环的动态加载。
以牛顿（N）为单位的断裂强度中位数及第25和第75百分位数[方括号内]为：Brånemark：dyn = 729 [0;802]/contr = 782 [771;811]，Frialit-2：dyn = 0 [0;611]/contr = 887 [798;941]，Replace-Select：dyn = 1439 [1403;1465]/contr = 1542 [1466;1623]，Camlog：dyn = 1482 [1394;1544]/contr = 1467 [1394;1598]，Screw-Vent：dyn = 0 [0;526]/contr = 780 [762;847]，Compress：dyn = 818[0;917]/contr = 1008 [983;1028]。在一些dyn亚组中，种植体-基台连接的失败在动态加载过程中就已发生：Brånemark组和Compress组有三个标本，Screw-Vent组和Frialit-2组有六个标本在动态加载过程中失败。不同连接设计的组之间在断裂强度上存在统计学显著差异（P≤0.05）。
与内部或外部连接设计较短的系统相比，具有长内管-管连接和凸轮槽固定的种植系统在寿命和断裂强度方面具有优势。
