Purpose: Finite element analysis and an in vitro experiment were employed to investigate the
loading effects of angled abutments, comparing various customized angled abutments derived
from the average angle of incisors in patients with a commercial 15°∆ angled abutment, on both
the implant and surrounding bone. Methods: Four customized angled abutment models (21.9°∆,
24.15°∆, 20.22°∆, 33°∆) were developed using cone-beam computed tomography (CBCT) images of
incisor inclination from various age groups of patients. 3D maxillary bone models were created
from CBCT images of four individual patients. Finite element analysis and in-vitro strain gauge
experiments were conducted, applying 100N or 50N of axial or oblique force, to assess the
differences in stress/strain between the customized and the commercial 15°∆ angled abutments in
both the implants and surrounding bone. Results: Under axial loading, the stress values in the
dental implant and surrounding bone were elevated due to the relatively higher angles of the
customized angled abutments (21.9°∆, 24.15°∆, 20.22°∆, 33°∆) when compared to the commercial 15°∆
angled abutment; however, under oblique loading the commercial 15°∆angled abutment exhibited
higher stress values in both the implant and surrounding bone. For in vitro experiment, there is
no statically difference in bone strain between the customized (21.9°∆) and the commercial 15°∆
angled abutments in axial loading. Nevertheless, in oblique loading using a commercial 15°∆
angled abutment induced the higher bone strains. Conclusion: Customized angled abutments
offer lower stress/strain under oblique loads but higher stress/strain under axial loads compared
to commercial ones. Therefore, in the design and application of angled abutments, careful
consideration of the occlusal load direction is paramount for achieving biomechanical success of
dental implant.
Keywords: maxillary incisor region; immediate implant placement; customized angled abutments; finite element analysis; in-vitro strain gauge experiment.