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Abstract
Statement of problem
Problems such as loosening and fractures of retained screws and fracture of implant fixture have been frequently reported in implant prosthesis.
Purpose
Implant has weak mechanical properties against lateral loading compared to vertical occlusal loading, and therefore, stress analysis of implant fixture depending on its material and geometric features is needed.
Material and methods
Total 28 of external hexed implants were divided into 7 of 4 groups; Group A (3i, FULL OSSEOTITE®Implant), Group B (Nobelbiocare, Brarnemark System®Mk III Groovy RP), Group C (Neobiotec, SinusQuickTM EB), Group D (Osstem, US-II). The type III gold alloy prostheses were fabricated using adequate UCLA gold abutments. Fixture, abutment screw, and abutment were connected and cross-sectioned vertically. Hardness test was conducted using MXT-α . For fatigue fracture test, with MTS 810, the specimens were loaded to the extent of 60 - 600 N until fracture occurred. The fracture pattern of abutment screw and fixture was observed under scanning electron microscope. A comparative study of stress distribution and fracture area of abutment screw and fixture was carried out through finite element analysis
Results
1. In Vicker's hardness test of abutment screw, the highest value was measured in group A and lowest value was measured in group D. 2. In all implant groups, implant fixture fractures occurred mainly at the 3 - 4th fixture thread valley where tensile stress was concentrated. When the fatigue life was compared, significant difference was found between the group A, B, C and D (P < .05). 3. The fracture patterns of group B and group D showed complex failure type, a fracture behavior including transverse and longitudinal failure patterns in both fixture and abutment screw. In Group A and C, however, the transverse failure of fixture was only observed. 4. The finite element analysis infers that a fatigue crack started at the fixture surface.
Conclusion
The maximum tensile stress was found in the implant fixture at the level of cortical bone. The fatigue fracture occurred when the dead space of implant fixture coincides with jig surface where the maximum tensile stress was generated. To increase implant durability, prevention of surrounding bone resorption is important. However, if the bone resorption progresses to the level of dead space, the frequency of implant fracture would increase. Thus, proper management is needed. (J Korean Acad Prosthodont 2009;47:424-34)
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Table I.
External connection systems used in this study
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