To predict the clinical performance of zirconia abutments, it is crucial to examine the mechanical behavior of different dental implant-abutment connection configurations. The international standard protocol for dynamic fatigue tests of dental implants (ISO 14801) allows comparing these configurations using standardized superstructure geometries. However, from a mechanical point of view, the geometry of clinical crowns causes modified boundary conditions. The purpose of this finite element (FE) study was to evaluate the influence of the superstructure geometry on the maximum stress values of zirconia abutments with a conical implant-abutment connection. Geometry models of the experimental setup described in ISO 14801 were generated using CAD software following the reconstruction of computerized tomography scans from all relevant components. These models served as a basis for an FE simulation. To reduce the numerical complexity of the FE model, the interaction between loading stamp and superstructure geometry was taken into account by defining the boundary conditions with regard to the frictional force. The results of the FE simulations performed on standardized superstructure geometry and anatomically shaped crowns showed a strong influence of the superstructure geometry and related surface orientations on the mechanical behavior of the underlying zirconia abutments. In conclusion, ISO testing of zirconia abutments should be accompanied by load-bearing capacity testing under simulated clinical conditions to predict clinical performance.
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