Strain analysis of 9 different abutments for cement-retained crowns on an internal hexagonal implant.

STATEMENT OF PROBLEM: Many aftermarket abutments for cement-retained crowns are available for the tapered screw-vent implant. Aftermarket abutments vary widely, from stock to custom abutments and in materials such as zirconia, titanium, or a combination of the two. How these aftermarket abutments perform under occlusal loads with regard to strain distribution is not clear.

PURPOSE: The purpose of this in vitro study was to measure and compare the different strains placed upon the bone around implants by 9 different abutments for cement-retained crowns on an implant with an internal hexagonal platform.

MATERIAL AND METHODS: Nine 4.1×11.5-mm tapered screw-vent implants were placed into a 305×51×8-mm resin block for strain measurements. Five abutment specimens of each of the 9 different abutments (N=45) were evaluated with 1 of the 9 implants. Monolithic zirconia crowns were then fabricated for each of the 9 different abutments, the crowns were cyclically loaded (maximum force 225 N) at 30 degrees, twice at a frequency of 2 Hz, and the strain was measured and recorded. The strain to the resin block was determined using a 3-dimensional digital image correlation (3D DIC) technique. Commercial image correlation software was used to analyze the strain around the implants. Data for maximal and minimal principal strains were compared using analysis of variance with a Tukey-Kramer post hoc test (α=.05).

RESULTS: Strain measurements showed no significant differences among any of the abutments for minimal (compression) principal strains (P>.05). For maximal (tensile) principal strains, the zirconia abutment showed the highest, and the patient-specific abutment showed the second-highest strain around the implant, with the zirconia being significantly greater than all abutments, with the exception of the patient-specific abutment, and the patient-specific abutment being significantly greater than the straight contoured abutment in titanium and also zirconia (P<.05).

CONCLUSIONS: The name brand patient specific titanium and Atlantis zirconia abutments conferred the most tensile strain to the implants. When selecting an abutment for a cement-retained crown on a tapered screw-vent implant, practitioners should consider the abutment material and the manufacturer of the abutment because not all abutments that fit in an individual implant transmit the strains in the same way.