Influence of the Prosthetic Index on Fracture Resistance of Morse Taper Dental Implants

Purpose: Manufacturers have inserted a prosthetic index, an internal hexagon to guide prosthetic components inside Morse taper implants. However, it is still unclear if this mechanism could decrease the mechanical strength of Morse taper implants. The aim of this study was to evaluate the influence of the prosthetic index inside Morse taper implants on fracture resistance compared with nonindexed implants. Materials and Methods: Fifty-seven Morse taper implants, with 11.5-degree angulation of the internal conical portion, were divided into three groups: implants without the prosthetic index and solid Morse taper universal post (group 1), implants with the prosthetic index and solid Morse taper universal post (group 2), and implants and abutments with the prosthetic index (group 3). All groups were modeled for finite element stress analysis (FEA), simulating force application of a perpendicular load to the abutments. Fracture resistance (n = 10) was determined under the same condition. Dynamic loading (n = 9) was also performed. The statistical analysis was performed using one-way analysis of variance (ANOVA), and the Tukey test was applied (α = .05). The metallographic analysis was used to identify the fracture distribution and the microstructure of the titanium alloy. Results: There was no statistically significant difference between the values of all tested groups. According to the FEA, the prosthetic index region was out of stress. The mean fracture resistances and loading test were 353.7 N and 200 N for group 1, 397.3 N and 170 N for group 2, and 372.0 N and 160 N for group 3, respectively. Metallographic analysis showed a macroscopic failure pattern just as demonstrated by FEA. Conclusion: The presence of the prosthetic index on Morse taper implants did not decrease its resistance to fracture for the tested implants. Keywords: biomechanics, dental implants, mechanical stress, prosthetic index