Stress Assessment of Abutment-Free and Three Implant–Abutment Connections Utilizing Various Abutment Materials: A 3D Finite Element Study of Static and Cyclic Static Loading Conditions

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Abstract
Background: The implant–abutment interface has been thoroughly examined due to its impact on the success of implant healing and longevity. Removing the abutment is advantageous, but it changes the biomechanics of the implant fixture and restoration. This in vitro three-dimensional finite element analytical (FEA) study aims to evaluate the distribution of von Mises stress (VMS) in abutment-free and three additional implant abutment connections composed of various titanium alloys. Materials and methods: A three-dimensional implant-supported single-crown prosthesis model was digitally generated on the mandibular section using a combination of microcomputed tomography imaging (microCT), a computer-assisted designing (CAD) program (SolidWorks), Analysis of Systems (ANSYS), and a 3D digital scan (Visual Computing Lab). Four digital models [A (BioHorizons), B (Straumann AG), C abutment-free (Matrix), and D (TRI)] representing three different functional biomaterials [wrought Ti-6Al-4Va ELI, Roxolid (85% Ti, 15% Zr), and Ti-6Al-4V ELI] were subjected to simulated static/cyclic static loading in axial/oblique directions after being restored with highly translucent monolithic zirconia restoration. The stresses generated on the implant fixture, abutment, crown, screw, cortical, and cancellous bones were measured. Results: The highest VMSs were generated by the abutment-free (Model C, Matrix) implant system on the implant fixture [static (32.36 Mpa), cyclic static (83.34 Mpa)], screw [static (16.85 Mpa), cyclic static (30.33 Mpa), oblique (57.46 Mpa)], and cortical bone [static (26.55), cyclic static (108.99 Mpa), oblique (47.8 Mpa)]. The lowest VMSs in the implant fixture, abutment, screw, and crown were associated with the binary alloy Roxolid [83–87% Ti and 13–17% Zr]. Conclusions: Abutment-free implant systems generate twice the stress on cortical bone than other abutment implant systems while producing the highest stresses on the fixture and screw, therefore demanding further clinical investigations. Roxolid, a binary alloy of titanium and zirconia, showed the least overall stresses in different loadings and directions.

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