Influence of vertical misfit in screw fatigue behavior in dental implants: A three-dimensional finite element approach.

Misfit is unavoidable in dental implant-supported prostheses due to machining process or inappropriate assembling, and the definition of an admissible misfit is still a controversial issue. This work aims to understand the behavior of the screws in dental implant-supported prostheses to estimate an admissible vertical misfit value in terms of screw fatigue failure. For that purpose, a finite element model of a dental implant-supported prosthesis was created and analyzed. Vertical misfits were introduced in different positions, the lower and upper screws were tightened to the bolting force values recommended by the manufacturer, and two different occlusal loads were analyzed. In addition, two different prosthesis materials were studied. Screw load variations were reported and a fatigue analysis was performed. As a result, it was observed that the screw tightening sequence closed small vertical misfits (equal to or less than 40 µm), whereas larger misfits (more than 40 µm) remained open. If the vertical misfit is closed by the end of the tightening sequence, it may be considered equivalent to the ideal fit situation in regard to screw fatigue failure. The prosthesis material had no significant influence on the fatigue behavior.