Improvement in Fatigue Behavior of Dental Implant Fixtures by Changing Internal Connection Design: An In Vitro Pilot Study

(1) Background: The stability of the dental implant–abutment complex is necessary to minimize mechanical complications. The purpose of this study was to compare the behaviors of two internal connection type fixtures, manufactured by the same company, with different connection designs. (2) Methods: 15 implant–abutment complexes were prepared for each group of Osseospeed(®) TX (TX) and Osseospeed(®) EV (EV): 3 for single-load fracture tests and 12 for cyclic-loaded fatigue tests (nominal peak values as 80%, 60%, 50%, and 40% of the maximum breaking load) according to international standards (UNI EN ISO 14801:2013). They were assessed with micro-computed tomography (CT), and failure modes were analyzed by scanning electron microscope (SEM) images. (3) Results: The maximum breaking load [TX: 711 ± 36 N (95% CI; 670–752), EV: 791 ± 58 N (95% CI; 725–857)] and fatigue limit (TX: 285 N, EV: 316 N) were higher in EV than those in TX. There was no statistical difference in the fracture areas (P > 0.99). All specimens with 40% nominal peak value survived 5 × 10(6) cycles, while 50% specimens failed before 10(5) cycles. (4) Conclusions: EV has improved mechanical properties compared with TX. A loading regimen with a nominal peak value between 40% and 50% is ideal for future tests of implant cyclic loading.