Comparative Analysis of Internal and External-Hex Crown Connection Systems - A Finite Element Study

The abutment connection with the crown is fundamental to the structural stability of the implant system and to the prevention of mechanical exertion that can compromise the success of the implant treatment. The aim of this study is to clarify the difference in the stress distribution patterns between implants with internal and external-hex connections with the crown using the Finite Element Method (FEM). Material and Methods: The internal and external-hex connections of the Neoss and 3i implant systems respectively, are considered. The geometrical properties of the implant systems are modeled using three-dimensional (3D) brick elements. Loading conditions include a masticatory force of 200, 500 and 1000N applied to the occlusal surface of the crown along with an abutment screw torque of 110, 320 and 550Nmm. The von Mises stress distributions in the crown are examined for all loading conditions. Assumptions made in the modeling include: 1. half of the implant system is modeled and symmetrical boundary conditions applied; 2. temperature sensitive elements are used to replicate the torque within the abutment screw. Results: The connection type strongly influences the resulting stress characteristics within the crown. The magnitude of stress produced by the internal-hex implant system is generally lower than that of the external-hex system. The internal-hex system held an advantage by including the use of an abutment between the abutment screw and the crown. Conclusions: The geometrical design of the external-hex system tends to induce stress concentrations in the crown at a distance of 2.89mm from the apex. At this location the torque applied to the abutment screw also affects the stresses, so that the compressive stresses on the right hand side of the crown are increased. The internal-hex system has reduced stress concentrations in the crown. However, because the torque is transferred through the abutment screw to the abutment contact, changing the torque has greater effect on this hex system than the masticatory force. Overall the masticatory force is more influential on the stress within the crown for the external-hex system and the torque is more influential on the internal-hex system.