Department of Integrated Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Restorative Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Clin Exp Dent Res. 2024 Aug;10(4):e892. doi: 10.1002/cre2.892.
The study aimed to assess the impact on the mechanical strength and failure patterns of implant-abutment complexes of choosing different abutment types, designs and manufacturers, aiding in selecting the optimal restorative solution. Stock and custom abutments from original and aftermarket suppliers were subjected to thermomechanical aging.
Stock and custom abutments from the implant manufacturer (original) and a aftermarket supplier (nonoriginal) were connected to identical implants with internal connection. Custom abutments were designed in a typical molar and premolar design, manufactured using the workflow from the respective suppliers. A total of 90 implants (4 mm diameter, 3.4 mm platform, 13 mm length) equally divided across 6 groups (three designs, two manufacturers) underwent thermo-mechanical aging according to three different regimes, simulating five (n = 30) or 10 years (n = 30) of clinical function, or unaged control (n = 30). Subsequently, all samples were tested to failure.
During aging, no failures occurred. The mean strength at failure was 1009N ± 171, showing significant differences between original and nonoriginal abutments overall (-230N ± 27.1, p < .001), and within each abutment type (p = .000), favoring original abutments. Aging did not significantly affect the failure load, while the type of abutment and manufacturer did, favoring original and custom-designed abutments. The most common failure was implant bending or deformation, significantly differing between original and nonoriginal abutments and screws. All failure tests resulted in clinically unsalvageable implants and abutments.
Within the limitations of this study, original abutments exhibited a higher mechanical strength compared to the nonoriginal alternative, regardless of the amount of simulated clinical use. Similarly, custom abutments showed higher mechanical strength compared to stock abutments. However, mechanical strength in all abutments tested was higher than average chewing forces reported in literature, thus components tested in this study can be expected to perform equally well in clinical situations without excessive force.
本研究旨在评估不同类型、设计和制造商的基台对种植体-基台复合体机械强度和失效模式的影响，以帮助选择最佳修复解决方案。来自原始和售后市场供应商的库存和定制基台均经过热机械老化处理。
将种植体制造商（原始）和售后市场供应商（非原始）的库存和定制基台连接到具有内部连接的相同种植体上。定制基台采用典型的磨牙和前磨牙设计，使用各自供应商的工作流程制造。总共 90 个种植体（直径 4mm，平台 3.4mm，长度 13mm）平均分为 6 组（三种设计，两个制造商），根据三种不同的方案进行热机械老化，模拟 5 年（n=30）或 10 年（n=30）的临床功能，或未经老化的对照组（n=30）。随后，所有样本均进行失效测试。
在老化过程中，没有发生失效。失效时的平均强度为 1009N±171，原始和非原始基台之间存在显著差异（整体差异为-230N±27.1，p<0.001），且在每种基台类型中均存在差异（p=0.000），原始基台更具优势。老化对失效负荷没有显著影响，但基台类型和制造商对其有影响，原始和定制设计的基台更具优势。最常见的失效形式是种植体弯曲或变形，原始和非原始基台及螺丝之间存在显著差异。所有失效测试均导致临床无法修复的种植体和基台。
在本研究的限制范围内，与非原始替代品相比，原始基台无论经过多少模拟临床使用，其机械强度均更高。同样，定制基台的机械强度高于库存基台。然而，所有测试基台的机械强度均高于文献报道的平均咀嚼力，因此，本研究中测试的组件在没有过度用力的临床情况下有望表现同样良好。
