Prosthetic abutment influences bone biomechanical behavior of immediately loaded implants

CAMARGOS, Germana de Villa; SOTTO-MAIOR, Bruno Salles; SILVA, Wander José da; LAZARI, Priscilla Cardoso; DEL BEL CURY, Altair Antoninha

doi:10.1590/1807-3107BOR-2016.vol30.0065

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Implantodontology • Braz. oral. res. 30 (1) • 2016 • https://doi.org/10.1590/1807-3107BOR-2016.vol30.0065 copy

Prosthetic abutment influences bone biomechanical behavior of immediately loaded implants

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to evaluate the influence of the type of prosthetic abutment associated to different implant connection on bone biomechanical behavior of immediately and delayed loaded implants. Computed tomography-based finite element models comprising a mandible with a single molar implant were created with different types of prosthetic abutment (UCLA or conical), implant connection (external hexagon, EH or internal hexagon, IH), and occlusal loading (axial or oblique), for both immediately and delayed loaded implants. Analysis of variance at 95%CI was used to evaluate the peak maximum principal stress and strain in bone after applying a 100 N occlusal load. The results showed that the type of prosthetic abutment influences bone stress/strain in only immediately loaded implants. Attachment of conical abutments to IH implants exhibited the best biomechanical behavior, with optimal distribution and dissipation of the load in peri-implant bone.

Dental Implant-Abutment Design; Finite Element Analysis

Material	Young modulus (MPa)	Poisson ratio
Cortical bone	13,700	0.30
Trabecular bone	1,370	0.30
Titanium alloy	110,000	0.33
Co-Cr alloy	218,000	0.30
TI6AL4V-ELI	105,000	0.36
Feldspatic ceramic	70,000	0.19

Implant Loading	Variables in study		Mean of stress ± Standard Deviation

			Stress (MPa)		Microstrain (με)

			Cortical Bone	Trabecular Bone	Cortical Bone	Trabecular Bone
Immediate loading	Prosthetic abutment	UCLA	222.55 (±112.40)	122.92 (±27.51)	19.03 (±2.07)	108.89 (±97.51)
	Prosthetic abutment	Conical	215.67 (±111.58)	82.83 (±71.02)	18.63 (±1.90)	54.51 (±37.93)
	Implant connection	EH	316.07 (±4.51)	145.52 (±1.44)	20.53 (±0.43)	88.29 (±1.11)
	Implant connection	IH	122.15 (±5.31)	60.22 (±44.95)	17.14 (±0.42)	75.11 (±61.71)
	Occlusal loading	Axial	220.26 (±109.79)	102.62 (±7.91)	19.12 (±1.92)	82.01 (±43.65)
	Occlusal loading	Oblique	217.96 (±114.28)	103.13 (±59.32)	18.54 (±2.02)	81.39 (±44.94)
Delayed loading	Prosthetic abutment	UCLA	13.90 (±6.97)	2.04 (±0.85)	0.96 (±0.44)	1.56 (±0.62)
	Prosthetic abutment	Conical	12.67 (±6.51)	1.96 (±0.85)	0.88 (±0.45)	1.55 (±0.64)
	Implant connection	EH	11.00 (±6.22)	1.97 (±0.60)	0.72 (±0.42)	1.54 (±0.40)
	Implant connection	IH	15.57 (±6.27)	2.04 (±1.04)	1.12 (±0.35)	1.56 (±0.80)
	Occlusal loading	Axial	8.05 (±2.45)	1.30 (±0.19)	0.59 (±0.25)	1.04 (±0.19)
	Occlusal loading	Oblique	18.53 (±3.56)	2.71 (±0.30)	1.24 (±0.25)	2.07 (±0.22)

Implant Loading	Variables in study	Stress				Strain

		Cortical Bone		Trabecular Bone		Cortical Bone		Trabecular Bone

		p	%TSS	p	%TSS	p	%TSS	p	%TSS
Immediate loading	Prosthetic abutment	0.181	0.13%	0.024*	15.60%	0.095	1.34%	0.009*	50.24%
	Implant-abutment connection	0.007*	99.82%	0.011*	70.59%	0.011*	95.55%	0.038*	2.95%
	Occlusal loading	0.458	0.01%	0.790	0%	0.065	2.82%	0.572	0.01%
	Prosthetic abutment × Implant connection	0.798	0	0.025*	13.79%	0.249	0.18%	0.009*	46.78%
	Prosthetic abutment × Occlusal loading	0.302	0%	0.525	0.02%	0.338	0.03%	0.475	0.01%
	Implant connection × Occlusal loading	0.773	0.04%	0.939	0	0.519	0.09%	0.570	0.01%
	Total	-	100%	-	100%	-	100%	-	100%
Delayed loading	Prosthetic abutment	0.604	1.14%	0.608	0.30%	0.622	1.03%	0.829	0.01%
	Implant connection	0.228	15.50%	0.643	0.23%	0.181	26.37%	0.735	0.04%
	Occlusal loading	0.103	81.40%	0.051	91.93%	0.112	70.63%	0.030*	89.71%
	Prosthetic abutment × Implant connection	0.603	1.16%	0.542	0.45%	0.577	1.38%	0.656	0.07%
	Prosthetic abutment × Occlusal loading	0.653	0.80%	0.779	0.08%	0.786	0.28%	0.920	0%
	Implant connection × Occlusal loading	0.868	0	0.180	7.02%	0.771	0.32%	0.088	10.17%
	Total	-	100%	-	100%	-	100%	-	100%

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[1] Corresponding Author: Altair Antoninha Del Bel Cury. E-mail: altair@unicamp.br