Influence of Different Implantoplasty Designs on the Fatigue Resistance of Dental Implants: A Systematic Review

Objectives: To analyze the impact of implantoplasty on the mechanical resistance of dental implants, considering different implantoplasty designs and implant types. Methods: A systematic review was conducted in accordance with PRISMA guidelines. A search was performed in four databases: PubMed, Scopus, Web of Science, and Embase, along with a manual search for additional relevant studies. In vitro studies assessing the mechanical resistance of dental implants subjected to implantoplasty were included. A total of 136 studies were identified; after duplicate removal using Rayyan, and screening by title and abstract, 17 studies were ultimately selected after full-text assessment. Results: In vitro studies on external hexagon implants showed that fracture resistance in control groups ranged from 773.1 N to 1660 N for implants with a 4 mm diameter, and from 478.1 N to 1650 N after implantoplasty. For 3.5 mm diameter implants, values ranged from 548.8 N to 1276.1 N in control groups, and from 465.9 N to 1211.7 N after implantoplasty. In internal hexagon connections, fracture resistance after implantoplasty ranged between 321.7 N and 739 N. Conical connections exhibited a broader range of resistance values after implantoplasty, from 315.9 N to 2395.3 N. Conclusions: Implantoplasty reduces the mechanical strength of dental implants. Increased implantoplasty length correlates with decreased resistance, particularly affecting narrow implants. The prosthetic connection most affected by this procedure is the external hexagon, followed by the internal hexagon, with the conical connection being the most resistant.