Load Fatigue Performance of a Single-Tooth Implant Abutment System: Effect of Diameter

Purpose: This study investigated the load fatigue performance of narrow-, regular-, and wide-diameter CeraOne (Nobel Biocare) single-tooth implants and abutments. Materials and Methods: Five samples of each implant-abutment combination in 3 different widths were tested at 3 applied screw torque levels (recommended torque, recommended torque +20%, and recommended torque -20%). A rotational load fatigue machine was used to apply a 21-N load, at an angle of 45 degrees to the long axis of the specimens. This loading produced an effective bending moment of 35 Ncm at the abutment-implant interface. An upper cyclic limit was set at 5 3 106 load cycles for all specimens. Results: Two-way analysis of variance revealed a significant difference between narrow-diameter and wide-diameter implant test groups but no significant difference between the 3 torque levels for each implant diameter. In the narrow-diameter group, 6 of the 15 specimens failed (5 abutment screw failures and 1 implant failure). In the regular-diameter group, 3 of the 15 specimens failed (2 implant failures and 1 abutment screw failure). There were no failures in the wide-diameter group. Discussion: The results of this study indicate that the abutment screw is not the only potential failure location. The possibility of implant fracture clinically has been previously reported for prostheses supported by both single- and multiple-implant prostheses. Conclusion: The wide-diameter CeraOne single-tooth implant system demonstrated superior load fatigue performance. For clinical situations with significant functional loading, the narrow-diameter implants would be at a greater risk of fatigue failure. (Basic Science)