Abutment rotational displacement of external hexagon implant system under lateral cyclic loading

Purpose This in vitro study investigated the effect of lateral cyclic loading with different load positions and periods on abutment rotational displacement (RD) of external hexagon implant system. Materials and Methods Four groups of five implant assemblies each were used. Each assembly consisted of Brånemark System® Mk IV implant (Nobel Biocare AB, Göteborg, Sweden), CeraOne® abutment (Nobel Biocare AB), and a cement‐retained casting. A cyclic load of 50 N was applied centrally and perpendicular to the long axis of the implant for groups A and B for 0.25 and 0.50 × 10⁶ cycles, respectively, while for groups C and D, the same load was applied at 4‐mm distance eccentrically for 0.25 and 0.50 × 10⁶ cycles, respectively. The displacement was evaluated by hand drawing a longitudinal line across the implant‐abutment interface. Before and after loading, the lateral distance between two reference points on the abutment and implant was measured under high resolution (×200) and the difference formed the RD value. The data were analyzed with one‐way analysis of variance and compared with Tukey test (α=0.05). Results Group D had the highest mean of RD value (55.00 ± 1.871 μm), while group A had the lowest (2.800 ± 0.837 μm). Groups A and B had a high statistically significant difference in RD values, as compared to groups C or D (p < .001). Moreover, group C had statistically significant difference from group D (p=.011). Conversely, no statistical significance was obtained when group A was compared with group B. Conclusion Within the limits of this in vitro study, the RD of the external hexagon joint components occurred significantly under eccentric lateral loading when compared to centric loading. The displacement increased significantly with longer period of eccentric lateral loading.