Implant-abutment connections: influence of the design on the microgap and their fatigue and fracture behavior of dental implants.

Microgap between implant and abutment can produce biological and mechanical problems such as peri-implantitis and/or fatigue failures. The aim of this study was to evaluate microgap size and fatigue behavior of external and internal connections. In both systems the torque to tighten the abutment screw of single crown abutments was 45 Ncm. Fifty implants for each connection type were studied. One subgroup (n = 5) was used by the observation and evaluation of the microgap, other (n = 5) was tested for fracture strength and the other (n = 40) was subjected to dynamic loading. The internal connection presents a lower microgap than the external ones. From fatigue results, the external hexagon interface showed superior result compared to the internal hexagon interfaces. The tolerances in the internal connections are better and favour the fatigue behavior but this factor alone is not sufficient to improve the fatigue response in relation to the external connections when the screw is subjected at the same torque. The external system presents a higher value of the area than the internal and it produces a better load distribution. Microgaps and mechanical properties are very important for the long-term behavior of the dental implants and these aspects should be known by the implantologists.