1
|
Deste Gökay G, Oyar P, Gökçimen G, Durkan R. Static and dynamic stress analysis of different crown materials on a titanium base abutment in an implant-supported single crown: a 3D finite element analysis. BMC Oral Health 2024; 24:545. [PMID: 38730391 PMCID: PMC11088090 DOI: 10.1186/s12903-024-04328-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This Finite Element Analysis was conducted to analyze the biomechanical behaviors of titanium base abutments and several crown materials with respect to fatigue lifetime and stress distribution in implants and prosthetic components. METHODS Five distinct designs of implant-supported single crowns were modeled, including a polyetheretherketone (PEEK), polymer-infiltrated ceramic network, monolithic lithium disilicate, and precrystallized and crystallized zirconia-reinforced lithium silicates supported by a titanium base abutment. For the static load, a 100 N oblique load was applied to the buccal incline of the palatal cusp of the maxillary right first premolar. The dynamic load was applied in the same way as in static loading with a frequency of 1 Hz. The principal stresses in the peripheral bone as well as the von Mises stresses and fatigue strength of the implants, abutments, prosthetic screws, and crowns were assessed. RESULTS All of the models had comparable von Mises stress values from the implants and abutments, as well as comparable maximum and minimum principal stress values from the cortical and trabecular bones. The PEEK crown showed the lowest stress (46.89 MPa) in the cervical region. The prosthetic screws and implants exhibited the highest von Mises stress among the models. The lithium disilicate crown model had approximately 9.5 times more cycles to fatique values for implants and 1.7 times more cycles to fatique values for abutments than for the lowest ones. CONCLUSIONS With the promise of at least ten years of clinical success and favorable stress distributions in implants and prosthetic components, clinicians can suggest using an implant-supported lithium disilicate crown with a titanium base abutment.
Collapse
Affiliation(s)
- Gonca Deste Gökay
- Department of Prosthodontics, Faculty of Dentistry, Bursa Uludag University, Bursa, Türkiye.
| | - Perihan Oyar
- Dental Prosthetics Technology, School of Health Services, Hacettepe University, Ankara, Türkiye
| | - Gülsüm Gökçimen
- Department of Prosthodontics, Ankara 75Th Year Oral and Dental Health Hospital, Ankara, Türkiye
| | - Rukiye Durkan
- Department of Prosthodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Türkiye
| |
Collapse
|
2
|
Aboelfadl A, Keilig L, Ebeid K, Ahmed MAM, Nouh I, Refaie A, Bourauel C. Biomechanical behavior of implant retained prostheses in the posterior maxilla using different materials: a finite element study. BMC Oral Health 2024; 24:455. [PMID: 38622680 PMCID: PMC11020654 DOI: 10.1186/s12903-024-04142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The aim of this study is to evaluate the biomechanical behavior of the mesial and distal off-axial extensions of implant-retained prostheses in the posterior maxilla with different prosthetic materials using finite element analysis (FEA). METHODS Three dimensional (3D) finite element models with three implant configurations and prosthetic designs (fixed-fixed, mesial cantilever, and distal cantilever) were designed and modelled depending upon cone beam computed tomography (CBCT) images of an intact maxilla of an anonymous patient. Implant prostheses with two materials; Monolithic zirconia (Zr) and polyetherketoneketone (PEKK) were also modeled .The 3D modeling software Mimics Innovation Suite (Mimics 14.0 / 3-matic 7.01; Materialise, Leuven, Belgium) was used. All the models were imported into the FE package Marc/Mentat (ver. 2015; MSC Software, Los Angeles, Calif). Then, individual models were subjected to separate axial loads of 300 N. Von mises stress values were computed for the prostheses, implants, and bone under axial loading. RESULTS The highest von Mises stresses in implant (111.6 MPa) and bone (100.0 MPa) were recorded in distal cantilever model with PEKK material, while the lowest values in implant (48.9 MPa) and bone (19.6 MPa) were displayed in fixed fixed model with zirconia material. The distal cantilever model with zirconia material yielded the most elevated levels of von Mises stresses within the prosthesis (105 MPa), while the least stresses in prosthesis (35.4 MPa) were recorded in fixed fixed models with PEKK material. CONCLUSIONS In the light of this study, the combination of fixed fixed implant prosthesis without cantilever using a rigid zirconia material exhibits better biomechanical behavior and stress distribution around bone and implants. As a prosthetic material, low elastic modulus PEKK transmitted more stress to implants and surrounding bone especially with distal cantilever.
Collapse
Affiliation(s)
- Ahmad Aboelfadl
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany.
| | - Ludger Keilig
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Dental Prosthetics, Propaedeutics and Material Science, Dental School, University Hospital Bonn, Bonn, Germany
| | - Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | | | - Ingy Nouh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ashraf Refaie
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Fixed Prosthodontics, Fayoum University, Fayoum, Egypt
| | | |
Collapse
|
3
|
Yuan X, Liu Y, Yang Y, Ren M, Luo L, Zheng L, Liu Y. Effect of short implant crown-to-implant ratio on stress distribution in anisotropic bone with different osseointegration rates. BMC Oral Health 2023; 23:683. [PMID: 37730562 PMCID: PMC10512631 DOI: 10.1186/s12903-023-03379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE This study aimed to provide evidence for the clinical application of single short implants by establishing an anisotropic, three-dimensional (3D) finite element mandible model and simulating the effect of crown-to-implant ratio (CIR) on biomechanics around short implants with different osseointegration rates. METHODS Assuming that the bone is transversely isotropic by finite element method, we created four distinct models of implants for the mandibular first molar. Subsequently, axial and oblique forces were applied to the occlusal surface of these models. Ultimately, the Abaqus 2020 software was employed to compute various mechanical parameters, including the maximum von Mises stress, tensile stress, compressive stress, shear stress, displacement, and strains in the peri-implant bone tissue. RESULTS Upon establishing consistent osseointegration rates, the distribution of stress exhibited similarities across models with varying CIRs when subjected to vertical loads. However, when exposed to inclined loads, the maximum von Mises stress within the cortical bone escalated as the CIR heightened. Among both loading scenarios, notable escalation in the maximum von Mises stress occurred in the model featuring a CIR of 2.5 and an osseointegration rate of 25%. Conversely, other models displayed comparable strength. Notably, stress and strain values uniformly increased with augmented osseointegration across all models. Furthermore, an increase in osseointegration rate correlated with reduced maximum displacement for both cortical bone and implants. CONCLUSIONS After fixing osseointegration rates, the stress around shorter implants increased as the CIR increased under inclined loads. Thus, the effect of lateral forces should be considered when selecting shorter implants. Moreover, an implant failure risk was present in cases with a CIR ≥ 2.5 and low osseointegration rates. Additionally, the higher the osseointegration rate, the more readily the implant can achieve robust stability.
Collapse
Affiliation(s)
- Xi Yuan
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, 712000, China
| | - Yuchen Liu
- Dalian University of Technology, Dalian, 116000, China
| | - Yunhe Yang
- Dalian Stomatological Hospital, Dalian, 116000, China
| | - Mingfa Ren
- Dalian University of Technology, Dalian, 116000, China
| | - Lailong Luo
- Dalian University of Technology, Dalian, 116000, China
| | - Lang Zheng
- Dalian University, Dalian, 116000, China
| | - Yang Liu
- Department of Prosthodontics, Dalian Stomatological Hospital, 935 Changjiang Road, Shahekou District, Dalian, 116000, China.
| |
Collapse
|
4
|
Qin S, Gao Z. Comparative evaluation of short or standard implants with different prosthetic designs in the posterior mandibular region: a three-dimensional finite element analysis study. Comput Methods Biomech Biomed Engin 2023; 26:1499-1509. [PMID: 36125258 DOI: 10.1080/10255842.2022.2124859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/29/2022] [Accepted: 09/11/2022] [Indexed: 11/03/2022]
Abstract
The purpose of this study is to evaluate the stress distribution of splinted or nonsplinted restorations supported by 2 short or 2 standard dental implants in the mandibular molar region using three-dimensional finite element analysis. Two standard implants (4.8 × 10mm) were placed in the mandibular molar area. Two short implants (4.8 × 6 mm) were located in the mandibular molar atrophied area. Implant-supported prostheses were simulated with splinted or nonsplinted crowns design. Vertical load of 200 N and oblique load of 100 N were applied on the central fossa and the buccal cusps. Evaluation of stress distribution in implants and peri-implant cortical bone using the finite element analysis software (Ansys, Version 2020, R2), a multipurpose computer design program. The maximum principal stress of cortical bone around the implants was higher in nonsplinted crowns when compared to splinted crowns. The stress concentration of cortical bone surrounding implants increased as the implant length decreased either splinted crowns or nonsplinted crowns. The short implants with nonsplinted crowns showed lower stresses when compared to standard implants with nonsplinted crowns. The results suggest that the nonsplinted prostheses supported by short dental implants might be considered in the molar area of the atrophic mandible.
Collapse
Affiliation(s)
- Siqi Qin
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhi Gao
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| |
Collapse
|
5
|
Abdul Rahim M, Khan K, Chrcanovic BR. Influence of Crown-Implant Ratio and Implant Inclination on Marginal Bone Loss around Dental Implants Supporting Single Crowns in the Posterior Region: A Retrospective Clinical Study. J Clin Med 2023; 12:jcm12093219. [PMID: 37176659 PMCID: PMC10179148 DOI: 10.3390/jcm12093219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The aim of this present record-based retrospective study was to investigate the influence of the crown-implant ratio (CIR) and implant inclination in relation to the occlusal plane on the marginal bone loss (MBL) around dental implants supporting single crowns in the posterior region of the jaws. All the cases of implant-supported single crowns in the premolar and molar regions were initially considered for inclusion. Only implants not lost, with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow-up, were considered for the analysis of MBL. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built. After the exclusion of 49 cases, a total of 316 implant-supported single crowns in 234 patients were included. The results from the statistical models suggested that implant inclination and anatomical- and clinical CIR (the main related factors investigated in the study) were not statistically significantly related to MBL over time. Age (older people), tooth region (premolar), and bruxism (bruxers) had a statistically significant influence on MBL over time.
Collapse
Affiliation(s)
| | - Kashmala Khan
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
| |
Collapse
|
6
|
Zhang C, Zeng C, Wang Z, Zeng T, Wang Y. Optimization of stress distribution of bone-implant interface (BII). BIOMATERIALS ADVANCES 2023; 147:213342. [PMID: 36841109 DOI: 10.1016/j.bioadv.2023.213342] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
Many studies have found that the threshold of occlusal force tolerated by titanium-based implants is significantly lower than that of natural teeth due to differences in biomechanical mechanisms. Therefore, implants are considered to be susceptible to occlusal trauma. In clinical practice, many implants have shown satisfactory biocompatibility, but the balance between biomechanics and biofunction remains a huge clinical challenge. This paper comprehensively analyzes and summarizes various stress distribution optimization methods to explore strategies for improving the resistance of the implants to adverse stress. Improving stress resistance reduces occlusal trauma and shortens the gap between implants and natural teeth in occlusal function. The study found that: 1) specific implant-abutment connection design can change the force transfer efficiency and force conduction direction of the load at the BII; 2) reasonable implant surface structure and morphological character design can promote osseointegration, maintain alveolar bone height, and reduce the maximum effective stress at the BII; and 3) the elastic modulus of implants matched to surrounding bone tissue can reduce the stress shielding, resulting in a more uniform stress distribution at the BII. This study concluded that the core BII stress distribution optimization lies in increasing the stress distribution area and reducing the local stress peak value at the BII. This improves the biomechanical adaptability of the implants, increasing their long-term survival rate.
Collapse
Affiliation(s)
- Chunyu Zhang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China.
| | - Chunyu Zeng
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Zhefu Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Ting Zeng
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Yuehong Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China.
| |
Collapse
|
7
|
Stress distribution in resin-based CAD-CAM implant-supported crowns. Dent Mater 2023; 39:114-122. [PMID: 36566152 DOI: 10.1016/j.dental.2022.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to evaluate the influence of new resin-based CAD-CAM implant-supported materials on posterior crown restoration stress and strain concentrations. METHODS A previous 3D implant model was edited to receive a cement-retained posterior crown manufactured with different CAD/CAM materials (Estelite P Block, Estelite Block II or Estelite Layered Block). Each solid model was exported to the computer-aided engineering software and submitted to the finite element analysis of stress and strain. Material properties were assigned to each solid with isotropic and homogeneous behavior according to the manufacturer information. A vertical load of 600 N was applied in the occlusal region of the crown, via a simulated food bolus, and stress was calculated in Von Misses (σVM) for the implant, abutment and screw, Maximum (σMAX) Principal Stresses for the crown and microstrain for the bone. RESULTS All simulated materials showed acceptable stresses levels with a similar stress pattern among the models. At the crown intaglio region and cement layer, however, differences were observed: Estelite P Block showed a lower tensile and shear stresses magnitude when compared to other resin-based materials with lower elastic modulus. SIGNIFICANCE The stress effect of different resin-based CAD-CAM implant-supported crowns is predominant in the crown and cement layer, with Estelite P Block showing 7.4 % versus 9.3 % and 9.2 % for Estelite Block II and Estelite Layered Block of crown failure risk.
Collapse
|
8
|
Influence of Different Restoring Materials on Stress Distribution in Prosthesis on Implants: A Review of Finite Element Studies. Eur J Dent 2022; 17:1-6. [PMID: 35728615 PMCID: PMC9949929 DOI: 10.1055/s-0042-1747955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The selection of material used on the occlusal surface of implant-supported prostheses is important, as these materials can transmit destructive forces to the interface between the alveolar bone and the implant. Different prosthetic materials are suggested for implant-supported prostheses. The choice of prosthetic material is a controversial issue, and there is a consensus that implant survival is not affected by the prosthetic material. Three-dimensional finite element studies are often used in dentistry to estimate the stress distribution that occurs in the implant system, peri-implant bone, and prosthetic components. To analyze the influence of the prosthetic restorative material on the stresses in bone tissue and peri-implant through a literature review of three-dimensional finite element studies. The search for articles was performed in the PubMed/Medline database up to November 2021. The selected articles were independently evaluated by two different reviewers. The information collected was author and year of publication, dimensions of implants used, the material used in the prosthetic crown, simulated force and direction, and conclusion and effect. After searching, 14 studies were selected for full reading, and based on the inclusion and exclusion criteria, all could be included in this review. The articles were based on evidence-based laboratory medicine. After analyzing these articles, it was concluded that the prosthetic materials used on the occlusal surface do not interfere with the destruction of stresses to the bone and peri-implant tissue, both in single prostheses and protocol-type prostheses, when three-dimensional finite element method is used.
Collapse
|