Mechanical Resistance of Different Implant Suprastructures: A Laboratory Study

Abstract

Background: Appropriate abutment selection according to the individual specificities of each patient is a leading factor in achieving high aesthetic results. Standardized titanium abutments are the most widely used due to their easy use and low cost. It is considered that customized abutments can eliminate many of the complications seen with factory abutments in prosthetic treatment. The purpose of this study is to evaluate whether customized abutments have better mechanical behavior in laboratory settings than standard ones. The null hypothesis is that customized abutments have better resistance to cyclic load and compression than factory abutments. Methods: The study model includes thirty implant suprastructure samples, fabricated digitally, divided into three groups according to the type of implant abutment and the used material: Group A (control group) comprised monolithic implant crowns made of zirconium dioxide and a titanium base; Group B (test group) comprised monolithic implant crowns made of zirconia implant crowns and a customized titanium alloy abutment; and Group C (test group) comprised monolithic implant crowns made of lithium disilicate and a customized titanium alloy abutment. The samples were subjected to dynamic load in a computer-controlled 2-axis machine that simulated masticatory movements, Chewing Simulator CS-4 (SD-Mechatronik, Westerham, Germany), for 250,000 cycles at a frequency of 2 Hz. The samples were then subjected to compressive strength testing in an Instron M 1185 universal testing machine. A metal steel disc was used as an antagonist, exerting pressure at a rate of 2 mm/min at room temperature on each sample. After conducting the laboratory tests, the samples were examined by an experienced expert under a Carl Zeiss microscope (Carl Zeiss Microscopy GmbH, Jena, Germany). Results: All samples were found to have passed the fatigue test in the masticatory simulator without any of the listed complications. The average value of the compressive strength at which the structures in each group fracture is as follows: Group A, 5669.2; Group B, 3126.5; and Group C, 1850.6. Based on the average values, it can be concluded that the combination of materials used in Group A has the greatest resistance. Conclusion: The weak link in the prosthetic complex consisting of a crown and abutment seems to be the crown. No abutment failure was found regardless of the type. However, monolithic zirconia crowns over standard titanium abutments withstand higher mechanical forces compared with zirconia and lithium disilicate crowns over customized ones. Detailed studies in clinical settings may provide more in-depth information on this issue.