Fatigue Resistance of Customized Implant-Supported Restorations.

The design of custom abutments (CA) can affect the mechanical reliability of implant-supported restorations. The purpose of the study was to evaluate the influence of design parameters on the fatigue limit of CA and to compare optimized custom designs with the reference abutment (RA). A morse-tapered dental implant, an anatomical abutment, and a connector screw were digitalized using microcomputed tomography. A cone beam computed tomography scan was obtained from one of the authors to virtually place the implant-abutment assembly in the upper central incisor. Ten design parameters were selected according to the structural geometry of the RA and the implant planning. A reverse-engineered RA model was created in SOLIDWORKS and was modified considering a Taguchi orthogonal array to generate 36 CAs with ±20% dimensional variations. Finite element analysis was conducted in ABAQUS, and fatigue limits were estimated using Fe-safe. ANOVA (α = 0.1) identified the most influential parameters. Von Mises stress values ranged from 229 MPa to 302 MPa, and 94.4% of the CAs had a higher fatigue limit than the RA. Three parameters significantly affected the fatigue performance of the implant system. The design process of custom abutments includes critical design parameters that can be optimized for longer lifetimes of implant-abutment restorations.