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Structural Engineering and Mechanics
  Volume 74, Number 4, May25 2020 , pages 567-576

Biomechanical stability of internal bone-level implant: Dependency on hex or non-hex structure
Hyeonjong Lee, Si-Myung Park, Kwantae Noh, Su-Jin Ahn, Sangkyun Shin and Gunwoo Noh

    Considerable controversy surrounds the choice of the best abutment type for implant prosthetics. The two most common structures are hex and non-hex abutments. The non-hex abutment typically furnishes a larger contact area between itself and the implant than that provided by a hex structure. However, when a hex abutment is loaded, the position of its contact area may be deeper than that of a non-hex abutment. Hence, the purpose of this study is to determine the different biomechanical behaviors of an internal bone-level implant based on the abutment type—hex or non-hex—and clinical crown length under static and cyclic loadings using finite element analysis (FEA). The hex structure was found to increase the implant and abutment stability more than the non-hex structure among several criteria. The use of the hex structure resulted in a smaller volume of bone tissues being at risk of hypertrophy and fatigue failure. It also reduced micromovement (separation) between the implant components, which is significantly related to the pumping effect and possible inflammation. Both static and fatigue analyses, used to examine short- and long-term stability, demonstrated the advantages of the hex abutment over the non-hex type for the stability of the implant components. Moreover, although its impact was not as significant as that of the abutment type, a large crown-implant ratio (CIR) increased bone strain and stress in the implant components, particularly under oblique loading.
Key Words
    finite element analysis; dental implant; abutment type; fatigue; micromovement
Hyeonjong Lee: Department of Prosthodontics, School of Dentistry, PU.S.A.n National University, 49, BU.S.A.ndaehak-ro,
Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republick of Korea
Si-Myung Park: Center for Medical Robotics, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil,
Seongbuk-gu, Seoul, 02792, Republic of Korea
Kwantae Noh: Department of Prosthodontics, School of Dentistry, Kyung Hee University, 26,
Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
Su-Jin Ahn: Department of Biomaterials & Prosthodontics, Kyung Hee University Hospital at Gangdong,
School of Dentistry, Kyung Hee University, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
Sangkyun Shin and Gunwoo Noh: School of Mechanical Engineering, Kyungpook National University, 80, Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea

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