Elsheikh Shawkat A, El-Anwar Mohamed I, Hong Tao, Bourauel Christoph, Alhotan Abdulaziz, Anany Noha M, Shahin Islam G, Diab Al-Hassan, Elshazly Tarek M
Faculty of Dentistry, Galala University, Suez, Egypt; Implantology Department, Hospital of Stomatology, Xi'an Jiaotong University, Shaanxi, China.
Department of Mechanical Engineering, National Research Centre, Giza, Egypt.
Int Dent J. 2025 Jun 26;75(4):100873. doi: 10.1016/j.identj.2025.100873.
To evaluate the biomechanical behavior of 5 types of commonly used implant/abutment connectors, using Finite Element Methods (FEM).
Five models of implant-abutment connections were designed using computer-aided design (CAD) software: Tri-channel (M1), Conical internal hexagon (M2), Morse taper with an integrated screw (M3), Internal hexagon (M4), and Tube-in-tube (M5). The bone was modeled as coaxial cylinders, with the inner cylinder representing spongy bone and the outer 1 mm-thick cylinder representing cortical bone. A premolar crown geometry was designed onto the abutment with a 40 µm-thick cement layer. Three loading scenarios were applied to each model: (1) a 100 N compressive load, (2) a 50 N oblique load at 45° (relative to the implant axis), and (3) a 50 N lateral load.
All stress and deformation values remain within the tolerable limits for the materials used. Notably, M1, M4, and M5 exhibited optimal biomechanical performance. M1 and M4 recorded the lowest stresses in implant components, 24.4 to 24.8 MPa in the abutment and 27.5 to 27.9 MPa in the screw under compression, along with minimal crown deformation (8.6 µm compared to M3's 11.7 µm). In contrast, M3 experienced the highest implant-component stresses (68.5 MPa in the abutment and 120.2 MPa in the screw) but showed the lowest cortical bone stress at 7.7 MPa, versus 10.2 MPa in M4.
For long-term durability, implants with an internal hexagon (M4) or tri-channel (M1) design are preferable, as they minimize stress and deformation within the implant complex, thereby reducing the risk of prosthetic failure. While the Morse taper (M3) design may benefit patients with compromised bone density, its higher implant-component stresses warrant caution.
This study provides valuable insights to support evidence-based selection of implant-abutment connection designs. Among the 5 evaluated systems, the Tri-channel (M1) and Internal Hexagon (M4) designs demonstrated superior biomechanical performance by minimizing stress concentrations within the implant components and surrounding bone. These configurations are therefore recommended for routine clinical use to enhance prosthetic stability, reduce the likelihood of mechanical complications such as screw loosening or fracture, and prolong implant longevity. Conversely, although the Morse Taper with integrated screw (M3) design showed the lowest stress on cortical bone - suggesting potential benefit for patients with reduced bone quality - it exhibited the highest stress levels within implant components, indicating a higher mechanical failure risk. Clinicians should weigh these biomechanical trade-offs when planning treatment, particularly in patients with high functional loads or compromised bone conditions.
采用有限元方法（FEM）评估5种常用种植体/基台连接体的生物力学行为。
使用计算机辅助设计（CAD）软件设计了5种种植体 - 基台连接模型：三通道（M1）、锥形内六角（M2）、带一体式螺钉的莫氏锥度（M3）、内六角（M4）和管中管（M5）。将骨建模为同轴圆柱体，内圆柱体代表松质骨，外1毫米厚的圆柱体代表皮质骨。在基台上设计了前磨牙冠的几何形状，并带有40微米厚的粘结剂层。对每个模型施加三种加载情况：（1）100 N压缩载荷，（2）相对于种植体长轴成45°的50 N斜向载荷，（3）50 N侧向载荷。
所有应力和变形值均保持在所使用材料的可耐受范围内。值得注意的是，M1、M4和M5表现出最佳的生物力学性能。M1和M4在种植体部件中记录到最低应力，压缩时基台应力为24.4至24.8 MPa，螺钉应力为27.5至27.9 MPa，同时牙冠变形最小（与M3的11.7微米相比为8.6微米）。相比之下，M3经历了最高的种植体部件应力（基台为68.5 MPa，螺钉为120.2 MPa），但皮质骨应力最低，为7.7 MPa，而M4为10.2 MPa。
为实现长期耐用性，采用内六角（M4）或三通道（M1）设计的种植体更可取，因为它们可将种植体复合体内部的应力和变形降至最低，从而降低修复失败的风险。虽然莫氏锥度（M3）设计可能对骨密度受损的患者有益，但其较高的种植体部件应力值得谨慎对待。
本研究提供了有价值的见解，以支持基于证据的种植体 - 基台连接设计选择。在评估的5种系统中，三通道（M1）和内六角（M4）设计通过将种植体部件和周围骨内的应力集中降至最低，展现出卓越的生物力学性能。因此，推荐这些构型用于常规临床，以提高修复稳定性，降低诸如螺钉松动或骨折等机械并发症的可能性，并延长种植体使用寿命。相反，尽管带一体式螺钉的莫氏锥度（M3）设计在皮质骨上显示出最低应力——表明对骨质量降低的患者可能有益——但它在种植体部件内表现出最高应力水平，这表明机械故障风险更高。临床医生在规划治疗时应权衡这些生物力学方面的利弊，尤其是在功能负荷高或骨条件不佳患者中。
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