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Sun X, Tang X, Cheng K, Xia Z, Liu Y, Yang F, Wang L. Comparative biomechanics of all-on-4 and vertical implant placement in asymmetrical mandibular: a finite element study. BMC Oral Health 2024; 24:425. [PMID: 38582842 PMCID: PMC10998417 DOI: 10.1186/s12903-024-04186-w] [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: 01/10/2024] [Accepted: 03/26/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Clinical scenarios frequently present challenges when patients exhibit asymmetrical mandibular atrophy. The dilemma arises: should we adhere to the conventional All-on-4 technique, or should we contemplate placing vertically oriented implants on the side with sufficient bone mass? This study aims to employ three-dimensional finite element analysis to simulate and explore the biomechanical advantages of each approach. METHODS A finite element model, derived from computed tomography (CT) data, was utilized to simulate the nonhomogeneous features of the mandible. Three configurations-All-on-4, All-on-5-v and All-on-5-o were studied. Vertical and oblique forces of 200 N were applied unilaterally, and vertical force of 100 N was applied anteriorly to simulate different masticatory mechanisms. The maximum von Mises stresses on the implant and framework were recorded, as well as the maximum equivalent strain in the peri-implant bone. RESULTS The maximum stress values for all designs were located at the neck of the distal implant, and the maximum strains in the bone tissue were located around the distal implant. The All-on-5-o and All-on-5-v models exhibited reduced stresses and strains compared to All-on-4, highlighting the potential benefits of the additional implant. There were no considerable differences in stresses and strains between the All-on-5-o and All-on-5-v groups. CONCLUSIONS With the presence of adequate bone volume on one side and severe atrophy of the contralateral bone, while the "All-on-4 concept" is a viable approach, vertical implant placement optimizes the transfer of forces between components and tissues.
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Affiliation(s)
- Xin Sun
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Department of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiaodong Tang
- Department of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Tiantai County Hospital of Traditional Chinese Medicine, Taizhou, Zhejiang, China
| | - Kangjie Cheng
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Zhuoheng Xia
- Department of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yunfeng Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Fan Yang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
| | - Linhong Wang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Tezerişener HA, Özalp Ö, Altay MA, Sindel A. Comparison of stress distribution around all-on-four implants of different angulations and zygoma implants: a 7-model finite element analysis. BMC Oral Health 2024; 24:176. [PMID: 38310260 PMCID: PMC10837953 DOI: 10.1186/s12903-023-03761-x] [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: 08/17/2023] [Accepted: 12/12/2023] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND In recent years, zygomatic implants and the all-on-four treatment concept have been increasingly preferred for rehabilitation of atrophic maxillae. However, debate continues regarding the optimal configuration and angulation of the implants. The aim of this study was to analyze the biomechanical stress in implants and peri-implant bone in an edentulous maxilla with zygomatic implants and the all-on-four concept, using multiple implant configurations. METHODS A total of 7 models consisting different combinations of 4-tilted dental implants and zygomatic implants were included in the study. In each model, a total of 200 N perpendicular to the posterior teeth and 50 N with 45° to the lateral tooth were applied. A finite element analysis was performed for determination of stress distribution on implants and peri-implant bone for each model. RESULTS Higher stress values were observed in both cortical and trabecular bone around the 45°-tilted posterior implants in all-on-four models when compared to zygomatic implants. In cortical bone, the highest stress was established in an all-on-four model including 45°-tilted posterior implant with 4,346 megapascal (MPa), while the lowest stress was determined in the model including anterior dental implant combined with zygomatic implants with 0.817 MPa. In trabecular bone, the highest stress was determined in an all-on-four model including 30°-tilted posterior implant with 0.872 MPa while the lowest stress was observed in quad-zygoma model with 0.119 MPa. Regarding von Mises values, the highest stress among anterior implants was observed in an all-on-four model including 17° buccally tilted anterior implant with 38.141 MPa, while the lowest was in the including anterior dental implant combined with zygomatic implants with 20,446 MPa. Among posterior implants, the highest von Mises value was observed in the all-on-four model including 30°-tilted posterior implant with 97.002 MPa and the lowest stress was in quad zygoma model with 35.802 MPa. CONCLUSIONS Within the limits of the present study, the use of zygoma implants may provide benefit in decreasing biomechanical stress around both dental and zygoma implants. Regarding the all-on-four concept, a 17° buccal angulation of anterior implants may not cause a significant stress increase while tilting the posterior implant from 30° to 45° may cause an increase in the stress around these implants.
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Affiliation(s)
| | - Öznur Özalp
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Campus, Dumlupinar Boulevard, Antalya, 07058, Turkey
| | - Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Campus, Dumlupinar Boulevard, Antalya, 07058, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Campus, Dumlupinar Boulevard, Antalya, 07058, Turkey.
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Mishra D, Basu B. Biomechanical analysis of peri-prosthetic bone response to hybrid threaded zirconia dental implants: An in silico model. J Mech Behav Biomed Mater 2024; 150:106310. [PMID: 38128471 DOI: 10.1016/j.jmbbm.2023.106310] [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: 10/19/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
The biomechanical response of mandibular bone determines primary stability and concomitant osseointegration of dental implants. This study explores the impact of nature of loading and bone conditions on biomechanical response of hybrid threaded single-piece zirconia dental implants. To develop such understanding, three implants (SQ_V, V_BUT, and V_V), with different combinations of threads, square (SQ), buttress (BUT), and triangular (V), have been investigated. Finite Element Analysis (FEA) was carried out to simulate implantation at the molar position of mandible of varying densities under axial (≤500 N) and oblique (118.2 N) loadings. Patient-specific bone conditions (for a wider population) were considered by scaling the density and the elastic modulus of mandible to represent, 'weak', 'healthy', and 'strong' bone conditions. FEA results revealed that SQ_V and V_BUT implants exhibited a better biomechanical response without significant variation (<0.5%) in von Mises stress, regardless of bone density and axial loadings. These implants are predicted to perform with clinically acceptable factor of safety under investigated implantation scenarios, whereas V_BUT implant showed a larger variation (∼±12%). FEA simulation with oblique loading further validated such results. The 'weak' bone conditions resulted in maximum peri-implant microstrain, whereas 'strong and healthy' bone exhibited values close to the permissible range of physiological remodeling. The maximum micromotion (∼12.3 ± 6.2 μm for 'weak' bone) at bone-implant interface suggested that implant loosening and impaired osseointegration will not occur in any of selected virtual implantation cases. Both SQ_V and V_BUT implants will be considered further in implant development, involving manufacturing and product prototype validation. Taken together, the critical analysis of FEA results indicates a significant impact of bone density and distinct combinations of external threads on the biomechanical responses, in both the implant and the surrounding bone.
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Affiliation(s)
- Deepa Mishra
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bengaluru, 560012, India
| | - Bikramjit Basu
- Laboratory for Biomaterials, Materials Research Centre, Indian Institute of Science, Bengaluru, 560012, India; Centre for Biosystems Science and Engineering, Indian Institute of Science, Bangalore, 560012, India.
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Ekinci F, Asuroglu T, Acici K. Monte Carlo Simulation of TRIM Algorithm in Ceramic Biomaterial in Proton Therapy. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4833. [PMID: 37445147 DOI: 10.3390/ma16134833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
Biomaterials play a crucial role in enhancing human health and quality of life. They are employed in applications such as tissue substitution, diagnostic tools, medical supplies, therapeutic treatments, regenerative medicine, and radiation dosimetric studies. However, their predisposition to proton therapy, which is a trending treatment in the world, has not been adequately studied. Ceramic biomaterials, known for their hardness and durability, offer versatile uses, especially in bone tissue replacements. The wide range of physical, mechanical, and chemical properties exhibited by ceramics has spurred extensive research, development, and application in this field. This study focuses on investigating and analyzing the ionization, recoils, phonon release, collision events, and lateral scattering properties of ceramic biomaterials that closely resemble bone tissue in proton therapy applications. Monte Carlo (MC) Transport of Ions in Matter (TRIM) simulation tools were utilized for this analysis. The results showed that Silicon dioxide exhibited the Bragg peak position closest to bone tissue, with a deviation of 10.6%. The average recoils differed by 1.7%, and the lateral scattering differed by 3.6%. The main innovation of this study lies in considering interactions such as recoil, collision events, phonon production, and lateral scattering when selecting biomaterials, despite their limited digitization and understanding. By evaluating all these interactions, the study aimed to identify the most suitable ceramic biomaterial to replace bone tissue in proton therapy.
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Affiliation(s)
- Fatih Ekinci
- Institute of Nuclear Sciences, Ankara University, 06830 Ankara, Turkey
| | - Tunc Asuroglu
- Faculty of Medicine and Health Technology, Tampere University, 33720 Tampere, Finland
| | - Koray Acici
- Artifical Intelligence and Data Engineerig, Ankara University, 06830 Ankara, Turkey
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Assoratgoon I, Yoda N, Iwamoto M, Sato T, Kawata T, Egusa H, Sasaki K. In vivo measurement of three-dimensional load exerted on dental implants: a literature review. Int J Implant Dent 2022; 8:52. [DOI: 10.1186/s40729-022-00454-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/17/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
For biomechanical consideration of dental implants, an understanding of the three-dimensional (3D) load exerted on the implant is essential, but little information is available on the in vivo load, including the measuring devices.
Purpose
This review aimed to evaluate studies that used specific load-measuring devices that could be mounted on an implant to measure the functional load in vivo.
Materials and methods
An electronic search utilizing the internet research databases PubMed, Google Scholar, and Scopus was performed. The articles were chosen by two authors based on the inclusion and exclusion criteria.
Results
In all, 132 studies were selected from the database search, and 16 were selected from a manual search. Twenty-three studies were finally included in this review after a complete full-text evaluation. Eleven studies were related to the force measurements using the strain gauges, and 12 were related to the piezoelectric force transducer. The principles of the two types of devices were completely different, but the devices produced comparable outcomes. The dynamics of the load magnitude and direction on the implant during function were clarified, although the number of participants in each study was small.
Conclusions
The load exerted on the implant during function was precisely measured in vivo using specific measuring devices, such as strain gauges or piezoelectric force transducers. The in vivo load data enable us to determine the actual biomechanical status in more detail, which might be useful for optimization of the implant prosthetic design and development of related materials. Due to the limited data and difficulty of in vivo measurements, the development of a new, simpler force measurement device and method might be necessary.
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Ouldyerou A, Mehboob H, Merdji A, Aminallah L, Mehboob A, Mukdadi OM. Biomechanical analysis of printable functionally graded material (FGM) dental implants for different bone densities. Comput Biol Med 2022; 150:106111. [PMID: 36195043 DOI: 10.1016/j.compbiomed.2022.106111] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/18/2022] [Accepted: 09/17/2022] [Indexed: 11/24/2022]
Abstract
The long-term success of a dental implant is related to the material and design of the implant, and bone density. Conventional implants cause stress-shielding due to a mismatch between the implant and bone stiffness. Functionally graded porous materials and designs are a great choice for the design of implants to control the local stiffness at a certain location to meet the biomechanical requirements. The purpose of this study is to analyze five designs of axial and radial functionally graded materials (FGM) implants besides the conventional implant and conical and cylindrical shapes that were simulated with five different bone densities. The results showed that strain in bone increased with a decrease in cancellous bone density. The shape of the implant did not play an important role in strain/stress distribution. Conventional implants showed optimal strain (1000-2240 με) in low-density (0.7-0.8 g/cm3) bone, however, FGM implants produced optimal strain (990-1280 με) in the high-density bone (0.9-1 g/cm3) as compared to conventional implants. The proposed designs of FGM implants have the potential to address the complications of conventional implants in high-density bone.
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Affiliation(s)
- Abdelhak Ouldyerou
- Department of Mechanical Engineering, Faculty of Science and Technology, University of Mascara, Mascara, Algeria.
| | - Hassan Mehboob
- Department of Engineering Management, College of Engineering, Prince Sultan University, Riyadh, 11586, Saudi Arabia.
| | - Ali Merdji
- Department of Mechanical Engineering, Faculty of Science and Technology, University of Mascara, Mascara, Algeria; Laboratory of Mechanics Physics of Materials (LMPM), Faculty of Technology, Djillali Liabes University, Sidi Bel-Abbes, 22000, Algeria.
| | - Laid Aminallah
- Department of Mechanical Engineering, Faculty of Science and Technology, University of Mascara, Mascara, Algeria.
| | - Ali Mehboob
- Department of Textile Engineering, School of Engineering and Technology, National Textile University, Faisalabad, Pakistan.
| | - Osama M Mukdadi
- Department of Mechanical and Aerospace Engineering, West Virginia University, Morgantown, WV, 26506, USA.
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Chakraborty A, Datta P, Kumar CS, Majumder S, Roychowdhury A. Probing combinational influence of design variables on bone biomechanical response around dental implant-supported fixed prosthesis. J Biomed Mater Res B Appl Biomater 2022; 110:2338-2352. [PMID: 35567493 DOI: 10.1002/jbm.b.35081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/03/2022] [Accepted: 04/18/2022] [Indexed: 11/08/2022]
Abstract
This study aimed to understand the effect of physiological and dental implant-related parameter variations on the osseointegration for an implant-supported fixed prosthesis. Eight design factors were considered (implant shape, diameter, and length; thread pitch, depth, and profile; cantilever [CL] length and implant-loading protocol). Total 36 implantation scenarios were simulated using finite element method based on Taguchi L36 orthogonal array. Three patient-specific bone conditions were also simulated by scaling the density and Young's modulus of a mandible sample to mimic weak, normal, and strong bones. Taguchi method was employed to determine the significance of each design factor in controlling the peri-implant cortical bone microstrain. For normal bone condition, CL length had the maximum contribution (28%) followed by implant diameter (18%), thread pitch (14%), implant length (8%), and thread profile (5%). For strong bone condition, CL and implant diameter had equal contribution (32%) followed by thread pitch (7%) and implant length (5%). For weak bone condition, implant diameter had the highest contribution (31%) followed by CL length (30%), thread pitch (11%) and implant length (8%). The presence of distal CL in dental framework was found to be the most influential design factor, which can cause high strain in the cervical cortical bone. It was seen that implant diameter had more effect compared to implant length toward peri-implant bone biomechanical response. Implant-loading time had no significant effect towards peri-implant bone biomechanical response, signifying immediate loading is possible with sufficient mechanical retention.
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Affiliation(s)
- Arindam Chakraborty
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Howrah, West Bengal, India
| | - Pallab Datta
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Kolkata, West Bengal, India
| | - Cheruvu Siva Kumar
- Department of Mechanical Engineering, Indian Institute of Technology, Kharagpur, West Bengal, India
| | - Santanu Majumder
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Howrah, West Bengal, India
| | - Amit Roychowdhury
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Howrah, West Bengal, India
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Akyol O, Olgar T, Toklu T, Eren H, Dirican B. Dose distrubution evaluation of different dental implants on a real human dry-skull model for head and neck cancer radiotherapy. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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