Development of Novel Implant Abutments Using the Shape Memory Alloy Nitinol: Preliminary Results

Purpose: The development of gap-free abutments is a challenging problem, because the gap between the implant and the abutment, which is a consequence of current manufacturing limitations, can serve as a reservoir for pathogens. This may lead to peri-implantitis, a major cause of implant failure. Therefore, the aim of this study was to design and fabricate a gap-free abutment using a shape memory alloy with improved ability to prevent microleakage at the implant-abutment gap. Materials and Methods: The abutment was designed using the shape memory alloy nitinol and based on mathematical calculations considering the temperature-related, reversible changes to its crystalline alloy structure. The abutment prototypes were tested for their susceptibility to microbes in vitro, under static and dynamic conditions, by contaminating the abutments before assembly using a bacterial solution. Microbacterial tests were performed after cultivation of the implants for 1 week. The results were tested for statistically significant differences using the chi-square test. Results: The mathematical calculations met the clinical requirements using a contact pressure of 2 x 108 Nm2 with a preload of 1.9 kN on cooled abutments. After recooling, the contact pressure was 1.3 Nm2, allowing for easy disassembly. Microbacterial analysis revealed no penetration of Escherichia coli under static conditions either in the control group or in the prototypes. Under dynamic conditions, however, the prototypes showed significantly reduced bacterial leakage compared to the controls. Conclusions: The data presented here demonstrate that dental implants fabricated with gap-free abutments using a shape memory alloy showed significantly reduced bacterial leakage versus conventional implants. This improvement could minimize clinical problems such as peri-implantitis and consequently enhance the long-term success of dental implants. Keywords: abutment, dental implants, microleakage, nitinol, peri-implantitis, shape memory alloy