Precision of the Connection Between Implant and Standard or Computer-Aided Design/Computer-Aided Manufacturing Abutments: A Novel Evaluation Method

Diego Lops, DDS, PhD/Roberto Meneghello, PhD, MSME/Luca Sbricoli, DDS/Gianpaolo Savio, DDS, PhD, MSME/Eriberto Bressan, DDS/Edoardo Stellini, DMD: Purpose: The aim of this in vitro study was to verify whether or not stock and computer-aided design/computer-aided manufacturing (CAD/CAM) abutments show similar precision in the connection with the respective implants. Materials and Methods: Ten CAD/CAM titanium abutments were compared with 10 stock titanium abutments. Each abutment fit a regular-platform implant (Institute Straumann). Implants and abutments were measured independently and then connected. During the connection procedure, the torque was measured using a six-axes load cell. Then, outer geometric features of the implant-abutment connection were measured again. Finally, the assembly was sectioned to provide the analysis of inner surfaces in contact. The geometric measurements were performed using a multisensored opto-mechanical coordinate measuring machine. The following parameters were measured and compared for the CAD/CAM and stock titanium abutment groups, respectively: width of interference and interference length between the conical surfaces of the implant and abutment; and volume of material involved in the implant-abutment connection. Results: Interference width mean ± SD values of 18 ± 0.5 and 14 ± 0.5 μm were calculated for the stock and CAD/CAM titanium abutment groups, respectively. The difference was statistically significant (P = .02). Furthermore, the interference length mean ± SD values of 763 ± 10 and 816 ± 43 μm were calculated for stock and CAD/CAM titanium abutment groups, respectively. The difference was also statistically significant (P = .04). Finally, the volume of material involved in the implant-abutment connection was compared between stock and CAD/CAM titanium abutment groups; the mean ± SD values of 0.134 ± 0.014 and 0.108 ± 0.023 mm3 were significantly different (P = .009). Conclusion: Both standard and CAD/CAM abutment groups showed a three-dimensional (3D) seal activation after the screw tightening. Nevertheless, stock titanium abutments showed a significantly higher volume of material involved in the implant-abutment connection compared with that of CAD/CAM titanium abutments.