Fracture resistance after implantoplasty in three implant-abutment connection designs

Background: To assess the effect of implantoplasty and implant-abutment design on the fracture resistance and macroscopic morphology of narrow-diameter (3.5 mm) dental implants. Material and Methods: Screw-shaped titanium dental implants (n = 48) were studied in vitro. Three groups (n = 16) were established, based on implant-abutment connection type: external hexagon, internal hexagon and conical. Eight implants from each group were subjected to an implantoplasty procedure; the remaining 8 implants served as controls. Implant wall thickness was recorded. All samples were subjected to a static strength test. Results: The mean wall thickness reductions varied between 106.46 and 153.75 gm. The mean fracture strengths for the control and test groups were, respectively, 1211.90 +/- 89.95 N and 873.11 +/- 92.37 N in the external hexagon implants; 918.41 +/- 97.19 N and 661.29 +/- 58.03 N in the internal hexagon implants; and 1058.67 +/- 114.05 N and 747.32 +/- 90.05 N in the conical connection implants. Implant wall thickness and fracture resistance (P < 0.001) showed a positive correlation. Fracture strength was influenced by both implantoplasty (P < 0.001) and connection type (P < 0.001). Conclusions: Implantoplasty in diameter-reduced implants decreases implant wall thickness and fracture resistance, and varies depending on the implant-abutment connection. Internal hexagon and conical connection implants seem to be more prone to fracture after implantoplasty.