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Esthetic factors influence the decision to use titanium or zirconia abutments in anterior regions. Clinicians may have concerns about the durability and behavior of these zirconia abutments.The purpose of this in vitro study was to evaluate the longitudinal and transverse long axes of the implant-abutment interface before and after the cyclic loading of titanium and zirconia abutments with an external hexagon.Forty dental implants with an external hexagon and 40 corresponding abutments made of titanium (Ti) and zirconia (Zr) were subjected to cyclic load (c1) versus no load (c2). The longitudinal and transverse axes of 4 experimental groups (Tic1, Tic2, Zrc1, and Zrc2) were analyzed (vertical/horizontal adjustment) using a scanning electron microscope at ×1000 magnification. The differences among the groups were determined by 1-way analysis of variance (ANOVA) and post hoc Tukey tests (α=.05). T tests were used to identify the statistically significant differences between each group and each condition (α=.05).Significant differences were found among the groups with respect to the misfits analyzed in the 2 sections (longitudinal and transverse) before and after load application (P<.05). The behaviors of the groups differed particularly with regard to the accommodation of sets (abutment/implant) after the application of cyclic loads (P<.05).The use of zirconia abutments in titanium implants can cause changes to and/or permanent deformation of the implant hexagon.