The Impact of Force Transmission on Narrow-Body Dental Implants Made of Commercially Pure Titanium and Titanium Zirconia Alloy with a Conical Implant-Abutment Connection: An Experimental Pilot Study

Purpose: The purpose of this study was to visualize the mode and impact of force transmission in narrowdiameter implants with different implant-abutment designs and material properties and to quantify the displacement of the abutment. Materials and Methods: Narrow-diameter implants from two manufacturers were examined: Astra 3.0-mm-diameter implants (Astra OsseoSpeed TX; n = 2) and Straumann Bone Level implants with a 3.3-mm diameter made of commercially pure titanium (cpTi) Gr. 4 (n = 2) and 3.3-mm TiZr-alloy (n = 2; Bone Level, Straumann) under incremental force application using synchrotron radiography (absorption and inline x-ray phase-contrast) and tomography. Results: During loading (250 N), Astra 3.0 and Bone Level 3.3- mm implants showed a deformation of the outer implant shoulder of 61.75 to 95 μm independent of the implant body material; the inner implant diameter showed a deformation of 71.25 to 109.25 μm. A deformation of the implant shoulder persisted after the removal of the load (range, 42.75 to 104.5 μm). An angulated intrusion of the abutment (maximum, 140 μm) into the implant body during load application was demonstrated; this spatial displacement persisted after removal of the load. Conclusion: This study demonstrated a deformation of the implant shoulder and displacement of the abutment during load application in narrow-diameter implants. Keywords: abutment intrusion, implant diameter, implant shoulder deformation, narrow diameter, overload, synchrotron radiography and tomography