Fatigue resistance analysis of implant abutments made with different materials and manufacturing methods

Aim: This in vitro study evaluated the fatigue resistance of zirconia and metal abutments connected to externalhexagon dental implants. Methods: Forty 3.75-mm implant-body diameter and 4.1-mm platform diameter external connection implants were divided into 4 groups (n = 10), according to the abutment type: completely cast group (CC); overcast group (OC); zirkonzahn group (Z); neodent group (N). The abutments were screwed to the implants according to the manufacturer’s recommendation. Fatigue resistance analysis was performed in sequence using the stepwise test. All the specimens were fatigued until failure. The fatigue failure load (FFL) and number of cycles for failure (CFF) data were analyzed using the survival analysis function, Kaplan–Meier survival analysis and the Mantel–Cox (log-rank) test (p < 0.05). Results: The CC group had the lowest values for both FFL and CFF, followed by the OC, Z, and N groups, respectively. For FFL and CFF, statistically significant differences were found between all groups (p ≤ 0.05), except for the CFF between Z and N. Conclusions: Zirconia abutments manufactured by Neodent demonstrated superior mechanical performance compared to other zirconia and metal abutments, suggesting a favorable option for clinical situations requiring both strength and esthetics.