Fracture and Fatigue of Titanium Narrow Dental Implants: New Trends in Order to Improve the Mechanical Response

Sixty-four fractured commercially pure titanium (cp-Ti) narrow dental implants (NDIs) with similar macrogeometry and connection designs were studied after different implantation times in humans in order to determine their reliability and to evaluate the causes of the fracture. These NDIs were compared with other similar implants, made with alloyed titanium with 15% Zr and with 12% strained titanium. Original implants were tested under static and fatigue conditions, simulating the tri-axial loads in the mouth by means of a Bionix hydraulic test machine. Fractography was studied using field-emission scanning electron microscopy (FSEM). The results showed that cp-Ti NDI exhibits low strength for mechanical cycling, and the alloyed Ti and strained titanium increase the mechanical strength, guaranteeing long term mechanical behavior. NDIs fractured due to fatigue, and, in some cases, the presence of cracks in the original NDIs quickly led to fracture. These cracks were attributed to plastic deformation during machining were found to be exacerbated due to acid etching in the passivation process. All cases of fracture were cp-Ti dental implants due to the low fatigue limit. The results show that, when titanium is alloyed or cold-worked, the fatigue limit is higher than cp-Ti. This in vitro research will help clinicians to select a better NDI system for safer treatment.