Dental implant-abutment fracture resistance and wear induced by single-unit screw-retained CAD components fabricated by four CAM methods after mechanical cycling

Statement of problem. Computer-aided design and computer-aided manufacturing (CAD-CAM) methodologies allow the fabrication of custom dental implant abutments with a variety of materials and techniques. Studies on the mechanical strength of such components and the wear induced at their coupling interface during mechanical cycling are sparse.Purpose. The purpose of this in vitro study was to measure the wear patterns at the hexagonal platform of dental implants induced by the installation and mechanical cycling of custom abutments fabricated by using 4 different CAD-CAM methods and to determine the compressive static resistance of the implant-abutment combinations. Material and methods. A CAD software program was used to design a custom abutment for a single-unit screw-retained external hexagon dental implant crown. The same design file was used to manufacture with 4 CAM methods (N=40): milling and sintering of zirconium dioxide (ZO), cobalt-chromium (Co-Cr) sintered by selective laser melting (SLM), fully sintered machined Co-Cr alloy (MM), and machined and sintered agglutinated Co-Cr alloy powder (AM). Prefabricated titanium abutments were used as a control (TI). Each abutment was installed onto a dental implant (4.1x11 mm), and the specimens were mechanically aged (1 million cycles, 2 Hz, 100N, 37 degrees C). After mechanical cycling, the hexagonal connection of the dental implants was examined with a scanning electron microscope (SEM), and unused dental implants (NI) were examined as a control (n=10). The images were analyzed with a software program to quantify the areas that showed wear. The implant-abutment combinations were reassembled and submitted to a compression test (1mm/min) with a universal testing machine. The data obtained were submitted to 1-way ANOVA (a=.05).Results. The mean +/- standard deviation fracture load (N) of the specimens of each group were 1005 +/- 187 (ZO), 1074 +/- 123 (SLM), 1033 +/- 109 (MM), 1019 +/- 149 (AM), and 923 +/- 129 (TI). These values were statistically similar (P=.213). The mean +/- standard deviation wear of the implants in squared-pixels were 1.1 +/- 0.38x105 (ZO), 2.0 +/- 0.29x105 (SLM), 1.0 +/- 0.38x105 (MM), 1.1 +/- 0.27x105 (AM), 1.1 +/- 0.33x105 (TI), and 0.51 +/- 0.29x105 (NI). The results indicated that, although significantly higher than those in in the control group (NI), the wear values found in the groups TI, ZO, MM, and AM were significantly lower than in the SLM group (P<.001).Conclusions. The CAD-CAM abutments presented the same mechanical fracture load and wear measurements as the TI group, except for the SLM material, which showed increased wear. The failure mode from the load bearing test was the fracture of the abutments for the ZO group. The implants permanently deformed or fractured for the metal abutment groups. (J Prosthet Dent 2022;128:450-7)