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Manfredini M, Poli PP, Beretta M, Rossi F, Rigoni M, Veronesi V, Maiorana C. Radiographic evaluation of marginal bone levels around implants supporting splinted fixed bridges: A retrospective study on 412 implants. Clin Oral Implants Res 2024; 35:547-559. [PMID: 38372478 DOI: 10.1111/clr.14250] [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: 03/08/2023] [Revised: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES The effect of the implant position within the prosthesis on bone remodeling is scarcely documented so far. Thus, the aim of the present study was to investigate whether central implants may suffer higher peri-implant marginal bone levels (MBL) compared to laterals in case of fixed splinted bridges supported by ≥ three implants. MATERIALS AND METHODS Partially edentulous subjects rehabilitated with at least one fixed bridge supported by ≥ three dental implants were enrolled. MBL was assessed radiographically by means of intraoral radiographs acquired with phosphor plates and imported in a dedicated software. MBL was calculated as the distance between the implant platform level and the most coronal visible bone-to-implant contact. A three-level linear mixed effects model was used for investigating the fixed effect of patient-, prosthesis-, and implant-level variables on the MBL. RESULTS Overall, 90 patients rehabilitated with 130 splinted fixed bridges supported by 412 implants were included. The median follow-up was 136 months. The mean peri-implant MBL resulted statistically significantly higher at central implants if compared to lateral implants (p < .01). The estimated MBL averages for central and external implants were 1.68 and 1.18 mm, respectively. The prosthesis-level variables suggested that a cement-retained bridge was prone to a significant 0.82 mm higher MBL than a screw-retained one. Implant surface showed an association with MBL changes, although less pronounced than implant retention. CONCLUSIONS In case of ≥3 adjacent implants supporting splinted bridges, central implants were more predisposed to MBL compared to laterals. At the prosthesis level, implants supporting cement-retained bridges were statistically more susceptible to MBL compared to screw-retained ones. Surface characteristics can also influence MBL stability at the implant level.
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Affiliation(s)
- Mattia Manfredini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Pier Paolo Poli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Mario Beretta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Federico Rossi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Marta Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Veronesi
- Bicocca Bioinformatics Biostatistics and Bioimaging Center - B4, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carlo Maiorana
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Leandro LNR, Barra Grande MF, Pelegrine AA, Nishioka RS, Teixeira ML, Basting RT. Stress distribution on implant- supported zirconia crown of maxillary first molar: effect of oblique load on natural and antagonist tooth. Comput Methods Biomech Biomed Engin 2024; 27:599-608. [PMID: 37022099 DOI: 10.1080/10255842.2023.2195962] [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: 11/17/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023]
Abstract
This study evaluated the stress distribution on an implant-supported zirconia crown of a mandibular first molar subjected to oblique loading by occlusal contact with the natural maxillary first molar by using the 3D finite element method. Two virtual models were made to simulate the following situations: (1) occlusion between maxillary and mandibular natural first molars; (2) occlusion between zirconia implant-supported ceramic crown on a mandibular first molar and maxillary natural first molar. The models were designed virtually in a modeling program or CAD (Computer Aided Design) (Rhinoceros). An oblique load of 100 N was uniformly applied to the zirconia framework of the crown. The results were obtained by the Von Mises criterion of stress distribution. Replacement of the mandibular tooth by an implant caused a slight increase in stress on portions of the maxillary tooth roots. The crown of the maxillary model in occlusion with natural antagonist tooth showed 12% less stress when compared with the maxillary (model in occlusion with the) implant-supported crown. The mandibular crown of the implant show 35% more stress when compared with the mandibular antagonist crown on the natural tooth. The presence of the implant to replace the mandibular tooth increased the stresses on the maxillary tooth, especially in the region of the mesial and distal buccal roots.
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The Mechanical Behavior of a Screwless Morse Taper Implant-Abutment Connection: An In Vitro Study. MATERIALS 2022; 15:ma15093381. [PMID: 35591715 PMCID: PMC9103680 DOI: 10.3390/ma15093381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/19/2022] [Accepted: 05/04/2022] [Indexed: 12/13/2022]
Abstract
The use of screwless Morse taper implant−abutment connections (IAC) might facilitate the clinician’s work by eliminating the mechanical complications associated with the retention screw. The aim of this study is to evaluate the effect of artificial chewing on the long-term stability of screwless Morse taper IACs. Thirty-two implant abutments restored with an upper central incisor zirconia crown were used and divided into four groups according to the implant−abutment assembling manner (C1,H: screw retained (20 Ncm); C2: tapped; or C3: torqued (20 Ncm; the screws were removed before the dynamic loading)). All specimens were subjected to a cyclic loading (98 N) for 10 million chewing cycles. The survived samples were exposed to a pull-off force until failure/disassembling of the connection. All the samples revealed a 100% survival. Regarding the pull-off test, the screw-retained internal hexagonal IAC revealed significantly higher resistance to failure/disassembling (769.6 N) than screwless conical IACs (171.6 N−246 N) (p < 0.0001). The retention forces in the Morse taper groups were not significantly different (p > 0.05). The screw-retained hexagonal IAC showed the highest retention stability. The screw preload/retention in the conical IAC was lost over time in the group where the screws were kept in place during loading. Nevertheless, the screwless Morse taper IACs were stable for an extended service time and might represent a valid form of treatment for single-tooth replacement.
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Influence of Implant Tilting and Length on the Biomechanics of Single-Tooth Restoration: A Finite Element Analysis in Atrophic Mandible. Dent J (Basel) 2022; 10:dj10050077. [PMID: 35621530 PMCID: PMC9139222 DOI: 10.3390/dj10050077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 12/28/2022] Open
Abstract
The aim of the present study is to assess by means of finite element models the effect on bone stresses of implant length and tilting in single-unit implant restorations. The factors that were analyzed in this study were implant length (4.5, 5.5, and 10 mm), implant titling (0, 17°, 30°, and 45°), bone type (0/I, II, and III), and loading (immediate and delayed). An axial load of 200 N was applied to the occlusal surface of the prosthesis at a height of 11 mm and the Von Mises equivalent stress in the bone was analyzed. Finite element analysis indicated that the most determinant factor was implant tilting. Tilting the implant by 17° doubled the Von Mises stress received by bone. The highest increase was in the case of implant tilting at 45° (by 1300%). The use of extra-short implants did not produce a significant increase in Von Mises stress in bone. Moreover, the length of the implant did not affect the stress value in bone types I and II. Based on the obtained results, an axially placed short implant would be a better option than titling a standard-length implant to support a crown restoration in an atrophic mandible from a biomechanical point of view.
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Lan Y, Yang H, Chang H, Lin L, Wang T. Resolution of Excessive Interocclusal Restoration Space Post‐Mandibulectomy Using A Two‐Layer Retrievable Fixed Implant‐Supported Prosthesis: A Case Report. J Prosthodont 2022; 31:367-373. [DOI: 10.1111/jopr.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 02/05/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yi‐Hao Lan
- Division of Prosthodontics, Department of Dentistry, National Taiwan University Hospital Taipei Taiwan
| | - Hsiao‐Ying Yang
- Department of Dentistry, National Taiwan University Hospital Yun Lin Branch Yun Lin Taiwan
| | - Hao‐Hueng Chang
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, National Taiwan University Hospital Taipei Taiwan
- School of Dentistry, National Taiwan University Taipei Taiwan
| | - Li‐Deh Lin
- Division of Prosthodontics, Department of Dentistry, National Taiwan University Hospital Taipei Taiwan
- School of Dentistry, National Taiwan University Taipei Taiwan
| | - Tong‐Mei Wang
- Division of Prosthodontics, Department of Dentistry, National Taiwan University Hospital Taipei Taiwan
- School of Dentistry, National Taiwan University Taipei Taiwan
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da Rocha Ferreira JJ, Machado LFM, Oliveira JM, Ramos JCT. Effect of crown-to-implant ratio and crown height space on marginal bone stress: a finite element analysis. Int J Implant Dent 2021; 7:81. [PMID: 34467461 PMCID: PMC8408299 DOI: 10.1186/s40729-021-00368-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/16/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Crown-to-implant ratio and crown height space, associated with the use of short implants, have been related with marginal bone loss. However, it is unclear which of the two entities would play the most important role on the bone remodelling process. Using a finite element analysis, the present work aims to help clarifying how those two factors contribute for the stress generation at the marginal bone level. A numerical model (reference model), with a crown-to-implant ratio of 4, was double validated and submitted to a numerical calculation. Then, it was modified in two different ways: (a) by decreasing the prosthetic height obtaining crown-to-implant ratios of 3, 2.5 and 2 and (b) by increasing the implants length obtaining a crown-to-implant ratio of 2.08. The new models were also submitted to numerical calculations. RESULTS The reference model showed a marginal bone stress of 96.9 MPa. The increase in the implants' length did not show statistically significant differences in the marginal bone stress (p-value = 0.2364). The decrease in the prosthetic height was accompanied with a statistically significant decrease in the marginal bone stresses (p-value = 2.2e- 16). CONCLUSIONS The results represent a paradigm change as the crown height space appears to be more responsible for marginal bone stress than the high crown-to-implant ratios or the implants' length. New prosthetic designs should be attempted to decrease the stress generated at the marginal bone level.
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Affiliation(s)
| | | | - José Manuel Oliveira
- Institute of Science and Innovation in Mechanical and Industrial Engineering (INEGI), Oporto, Portugal
| | - João Carlos Tomás Ramos
- Department of Dentistry, Stomatology and Maxillofacial surgery, Faculty of Medicine, University of Coimbra, Av. Bissaya Barreto-Blocos de Celas, 3000-075, Coimbra, Portugal
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Yilmaz B, Gouveia D, Seghi R, Johnston W, Lang LA. Effect of crown height on the screw joint stability of zirconia screw-retained crowns. J Prosthet Dent 2021; 128:1328-1334. [PMID: 33838917 DOI: 10.1016/j.prosdent.2021.02.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Medium- to long-term data for the performance of zirconia crowns with titanium (Ti) bases are sparse, particularly when the crown height space and occlusal loads are high. PURPOSE The purpose of this in vitro study was to assess the effect of the height of zirconia screw-retained implant crowns with a Ti base on the screw joint stability after cyclic loading. A secondary aim was to investigate the survival of zirconia crowns of different heights after cyclic loading. MATERIAL AND METHODS Twenty-one internal connection implants were secured between fiberglass-reinforced epoxy resin sleeves. Mandibular first molar monolithic zirconia crowns with 3 different heights (6 mm, 10 mm, and 14 mm) were milled and bonded to the Ti bases (n=7). The screws were tightened to 30 Ncm, and a 30-degree 120-N cyclic load was applied to the crowns at 2 Hz for 5 million cycles. After 5 million cycles, the crowns were evaluated for stability, and the same protocol was repeated for 275-N and 435-N loads for 5 million cycles each. After loading, the detorque values were recorded. Failure was characterized based on whether the crown, screw, and/or implant fracture was observed. The detorque values were analyzed by using a 1-way-ANOVA with the restricted maximum likelihood estimation. The percentage of torque loss was calculated. The LIFETEST procedure was used to analyze the survival probability of the groups (α=.05). RESULTS The effect of crown height on the detorque values of screws was not found to be statistically significant (P>.05). The mean detorque value for 6-mm crowns was 23.5 Ncm, 24.4 Ncm for 10-mm crowns, and 22.1 Ncm for 14-mm crowns. A significant effect of crown height was found on the survival (P=.006), and the time-to-failure survival of 14-mm crowns was significantly lower than the survival of 6 mm and 10 mm crowns (P=.020), where no failures were observed. Four 14-mm crowns failed between the 1 and 2 million cycles after the loads were increased to 435 N. The failure modes were the same for all the crowns, implants, and screws fractured. CONCLUSIONS When the tested internal connection implant was used, the crown height did not affect the detorque values, and 14-mm crowns performed similarly to the shorter crowns in terms of torque loss after cyclic loading. However, survival of the 14-mm crown-implant complex was lower, resulting in screw and implant fractures.
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Affiliation(s)
- Burak Yilmaz
- Professor, Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Diogo Gouveia
- Assistant Professor, Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio.
| | - Robert Seghi
- Professor Emeritus, Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - William Johnston
- Professor Emeritus, Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Lisa A Lang
- Professor, Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
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Chen J, Wang L, Yang L, Zhang X, Huang B, Li J. The prosthetic screw loosening of two-implant supported screw-retained fixed dental prostheses in the posterior region: A retrospective evaluation and finite element analysis. J Biomech 2021; 122:110423. [PMID: 33895541 DOI: 10.1016/j.jbiomech.2021.110423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 03/21/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
The study was aimed to investigate the prosthetic screw loosening of two splinted implants-supported, screw-retained (2-4-unit) fixed dental prostheses (TIS-FDPs) in posterior region and to explore the underlying mechanism. In the retrospective study, a study group of TIS-FDPs (n = 23) presenting prosthetic screw loosening and a control group of TIS-FDPs (n = 32) absent of prosthetic screw loosening during observation period were included. The prosthesis height (PH), inter-implant distance (ID) and cantilever distance (CD) of TIS-FDPs were measured and compared within two groups. In the finite element analysis (FEA) part, three serials of models presenting different clinical scenarios were constructed based on the abovementioned PH, ID and CD values respectively. In the clinical evaluation, the values of pH and CD in study group were statistically higher than those in control group, whereas the values of ID had no significant difference. In the FEA, the results indicated that there was no linear correlation between the increased ID values and the maximum von Mises stresses and the rotation angles. On the other hand, the increased PH and CD values would result in a strong linear growth of the maximum von Mises stresses and the rotation angles. Besides, it was found that the regression coefficients in PH model were all higher than those in ID and CD models. When TIS-FDPs were delivered in posterior region, the PH and the CD, rather than the ID, seemed to have a significant impact on the stress concentration of the prosthetic screws and the incident of prosthetic screws loosening.
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Affiliation(s)
- Jianyu Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Lin Wang
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
| | - Lijia Yang
- College of Stomatology, Jinan University, Guangzhou, China
| | - Xiao Zhang
- Guangzhou Janus Biotechnology Co. Ltd., Guangzhou, China; Foshan Angels Biotechnology Co. Ltd., Foshan, China
| | - Baoxin Huang
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Jingping Li
- Guanghua School of Stomatology, Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
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Yilmaz B, Batak B, Seghi R, Johnston WM, Lang LA. Effect of Crown Height on the Screw Stability of Titanium Screw-Retained Crowns. J Prosthodont 2021; 30:515-519. [PMID: 33666307 DOI: 10.1111/jopr.13352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this in vitro study was to evaluate the effect of crown height on the screw stability of screw-retained titanium implant crowns subjected to cyclic loading conditions. MATERIALS AND METHODS Twenty-one implants with internal hex connections were placed in epoxy resin holders. Mandibular first molar screw-retained titanium implant crowns with UCLA type, crown-abutment connections were CAD/CAM fabricated. Seven crowns of 3 different heights (6 mm, 10 mm, and 14 mm) were made. The crowns were seated onto the implants and screws were tightened to 30 Ncm. The implants were clamped into holders and stepwise cyclic loads were applied to the occlusal surface at 30-degree angles to the long axes of the crowns. The detorque values were measured after each 5 million cycles. Before increasing the applied load, the crowns were secured with new screws and tightened to 30 Ncm. Failure times, survival estimates and detorque values were then analyzed. (alpha = 0.05). RESULTS Crown height did not significantly affect detorque values. However, five 14-mm crowns failed with varying fractures during the 475 N loading condition. Overall, a significantly lower survival for 14 mm crowns was found compared to 6 mm and 10 mm crowns (p = 0.004). CONCLUSIONS Crown heights of one-piece screw-retained titanium implant crowns did not significantly affect detorque values. Screw fracture, however, was greater for crown height of 14 mm than those of 6 mm and 10 mm.
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Affiliation(s)
- Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Burcu Batak
- Department of Prosthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Robert Seghi
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - William M Johnston
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Lisa A Lang
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
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Murakami H, Igarashi K, Fuse M, Kitagawa T, Igarashi M, Uchibori S, Komine C, Gotouda H, Okada H, Kawai Y. Risk factors for abutment and implant fracture after loading. J Oral Sci 2020; 63:92-97. [PMID: 33311012 DOI: 10.2334/josnusd.20-0443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE Implant component fractures are one of the most serious complications in implant treatment. With a better understanding of the risk factors for fracture in the preoperative, surgery, superstructure, and post-loading phases of implant treatment, low-risk treatment could reduce implant component fractures, leading to a better prognosis. The aim of this study was to clarify the risk factors for abutment and implant fractures that occur after loading, and to perform a retrospective, approximately 10-year follow-up study to explore the risk factors in each treatment phase. METHODS Subjects were fitted with an implant prosthesis between January 2008 and December 2009. In total, 1,126 Ankylos implants in 430 patients were included for analysis. Binary logistic regression analysis was performed to extract factors related to non-fracture and fracture of the abutment or implant as a dependent variable. RESULTS Gender (OR = 3.466, 95% CI 1.296-9.268, P = 0.013), gonial angle (OR = 3.420, 95% CI 1.308-8.945, P = 0.012), and splinting status of the superstructure (OR = 4.456, 95% CI 1.861-10.669, P = 0.001) were identified as significant risk factors. CONCLUSION The risk of fracture is increased in males, especially those with a mandibular angle of less than 120° on panoramic radiographs, and those with a non-splinted superstructure.
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Affiliation(s)
- Hiroshi Murakami
- Department of Fixed Prosthodontics and Oral Implantology, Nihon University School of Dentistry at Matsudo
| | - Kentaro Igarashi
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo
| | - Megumi Fuse
- Liberal Arts (Chemistry), Nihon University School of Dentistry at Matsudo
| | - Tsuyoshi Kitagawa
- Department of Fixed Prosthodontics and Oral Implantology, Nihon University School of Dentistry at Matsudo
| | - Mitsuhiko Igarashi
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Satoshi Uchibori
- Department of Fixed Prosthodontics and Oral Implantology, Nihon University School of Dentistry at Matsudo
| | - Chiaki Komine
- Department of Oral Health Science, Division of Laboratory Medicine for Dentistry, Nihon University School of Dentistry at Matsudo
| | - Hiroya Gotouda
- Department of Community Oral Health, Nihon University School of Dentistry at Matsudo
| | - Hiroyuki Okada
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Yasuhiko Kawai
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo
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Torres-Alemany A, Fernández-Estevan L, Agustín-Panadero R, Montiel-Company JM, Labaig-Rueda C, Mañes-Ferrer JF. Clinical Behavior of Short Dental Implants: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E3271. [PMID: 33053872 PMCID: PMC7599668 DOI: 10.3390/jcm9103271] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 12/19/2022] Open
Abstract
Short implants are an increasingly common alternative to other surgical techniques in areas where bone availability is reduced. Despite the advantages they offer, a variety of biological repercussions have been described in the literature that can even lead to the loss of these. The aim of this systematic review and meta-analysis was to analyze the impact of the use of short implants on their survival and on peri-implant bone loss, evaluating the influence that length, diameter, and crown-to-implant ratio (C/I) have on these parameters. This systematic review was based on guidelines proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). An electronic search was conducted using terms related to the use of short implants in partially or totally edentulous patients. A total of five databases were consulted in the literature search: PubMed, Embase, Cochrane, Scopus, and Web of Science. After eliminating the duplicate articles and assessing which ones met the inclusion criteria, 15 articles were included for the qualitative analysis and 14 for the quantitative study. Through meta-analysis, the percentage of implant loss and peri-implant bone loss was estimated. Relating these parameters to length, diameter, and C/I ratio, no significant differences have been found for implant loss (values of p = 0.06, 0.10, and 0.9, respectively for length, diameter, and C/I ratio), nor for peri-implant bone loss (values of p = 0.71, 0.72, and 0.36, respectively for length, diameter, and C/I ratio). In conclusion, the use of short implants does not seem to have a significant influence on marginal bone loss or the survival rate of implants.
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Affiliation(s)
| | - Lucía Fernández-Estevan
- Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag 1, 46010 Valencia, Spain; (A.T.-A.); (R.A.-P.); (J.M.M.-C.); (C.L.-R.); (J.F.M.-F.)
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Bagegni A, Spies BC, Kern M, Hazard D, Kohal R. The influence of prosthetic crown height and implant-abutment connection design selection on the long-term implant-abutment stability: A laboratory study. J Mech Behav Biomed Mater 2020; 113:104095. [PMID: 33017717 DOI: 10.1016/j.jmbbm.2020.104095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIM Long-term edentulism associated with vertical loss of alveolar bone might lead to increased suprastructure height. This study aimed to evaluate the effect of suprastructure height on the stability of the implant-abutment connection by investigating the stability of two different two-piece titanium implants with internal hexagonal or conical connections under simulated oral loading conditions. MATERIALS AND METHODS A total of 48 specimens were used. The specimens were divided into 2 groups according to their implant-abutment connection (group H: internal hex connection, group C: conical connection). Each group was further divided into 3 groups according to the applied suprastructure height (H1; C1: 10 mm, H2; C2: 14 mm and H3; C3: 18 mm) (n = 8). All specimens were subjected to a cyclic loading force of 98 N for 5 million simulated chewing cycles. Then, all implants that survived the chewing simulation were quasi-statically loaded until failure. The monotonic-failure load and monotonic-bending moment at failure were evaluated. RESULTS After the dynamic chewing loading, the implants showed the following survival rates: group H: 95.8%; group C: 100%. The implant suprastructures revealed survival rates of 100% and 91.5% for groups H and C, respectively. After the artificial chewing simulation of 5 million cycles, some implants in the groups with higher crowns (14 mm and 18 mm) showed crack formation and plastic deformations under the light microscope. Regarding monotonic-failure load, implants with shorter suprastructures (10 mm) revealed higher resistance to failure (C1: 1496 and H1: 1201 N) than longer suprastructures (18 mm) (C3: 465 and H3: 585 N) which was expected. The mean monotonic-bending moment values at failure ranged from 400.7 Ncm to 673.3 Ncm. CONCLUSION Implant-supported restorations with increased crown height are considered stable for an extended time period (5 million cycles which equals approximately 20 years clinical service) and a reliable treatment option in case of increased inter-arch distance. There was no difference in stability of the two internal connections. Nevertheless, the integrity of implant components might be impaired when crowns with increased heights are applied.
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Affiliation(s)
- Aimen Bagegni
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Derek Hazard
- Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine - University of Freiburg, Ernst-Zermelo-Straße 1, 79104, Freiburg, Germany.
| | - Ralf Kohal
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
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Kang DW, Yun PY, Choi YH, Kim YK. Sinus bone graft and simultaneous vertical ridge augmentation: case series study. Maxillofac Plast Reconstr Surg 2019; 41:36. [PMID: 31572698 PMCID: PMC6745305 DOI: 10.1186/s40902-019-0221-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/20/2019] [Indexed: 11/10/2022] Open
Abstract
Background This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of peri-implantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.
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Affiliation(s)
- Dong-Woo Kang
- 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 South Korea
| | - Pil-Young Yun
- 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 South Korea
| | - Yong-Hoon Choi
- 2Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Young-Kyun Kim
- 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 South Korea.,3Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
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14
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Katsavochristou A, Koumoulis D. Incidence of abutment screw failure of single or splinted implant prostheses: A review and update on current clinical status. J Oral Rehabil 2019; 46:776-786. [PMID: 31074882 DOI: 10.1111/joor.12817] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/15/2019] [Accepted: 05/04/2019] [Indexed: 11/28/2022]
Abstract
Osseointegrated implants have been widely used for decades with high survival and success rates. However, mechanical complications continue to be reported in the literature, and their clinical management can be often very challenging for the clinician while there is no consensus on the ideal management. The aim of this manuscript was to review the risk factors of abutment screw complications, to identify the most recent incidence of screw failure in the clinical setting and report on the methodology used and the outcome of intervention. Clinical studies and reports were reviewed that reported on abutment screw looseness and/or fracture. A search of the electronic database PUBMED was conducted in November 2018, including manuscripts published in English from 2004 to 2018. Study selection: animal studies, narrative reviews, expert opinions and communications/letters were excluded. Further exclusion criteria included reports on occlusal prosthetic screws and fracture of abutments, and reports that did not provide adequate data. A total of 12 manuscripts were finally included that reported on single implant crowns or 2-unit implant fixed dental prosthesis. To conclude, the most current abutment screw loosening incidence ranges between 7% and 11%, while the abutment screw fracture incidence was found to be 0.6%. The majority reported on fracture of the screw body. Screw loosening or fracture was often located at the first molar restored area, while the maxillary central incisor area was also reported as an area that presented screw fracture. No single abutment screw failure management can be identified as the ideal treatment approach.
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Affiliation(s)
- Anastasia Katsavochristou
- Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, Buffalo, New York.,Division of Dentistry and Maxillofacial Prosthetics, Roswell Park Cancer Institute, Buffalo, New York
| | - Dimitrios Koumoulis
- Department of Physics, University at Buffalo, Buffalo, New York.,Department of Chemistry and Biochemistry, University of California, Los Angeles, California
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Anitua E. Implantes extracortos en mandíbulas con extrema reabsorción vertical: serie de casos. ACTA ODONTOLÓGICA COLOMBIANA 2019. [DOI: 10.15446/aoc.v9n1.74251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: el uso de los implantes extracortos permite la rehabilitación de extremas reabsorciones. Esto obliga en ocasiones a la utilización de prótesis sobre los mismos con una proporción corona-implante desfavorable llegando a ratios de 2:1 o de 3:1 en los casos más extremos. Materiales y métodos: se realizó un análisis de casos clínicos donde se insertaron implantes extracortos con un reborde residual (menor o igual a 5,5mm) y tiempo de carga mínimo de seis meses. Se realizó una prueba de chi-cuadrado para las variables categóricas y una t de Student para las variables continuas. Posteriormente, se realizaron modelos de regresión lineal ajustados. Resultados: fueron reclutados seis casos a los que se les insertaron implantes extracortos. El 21,2% de los pacientes incluidos en el estudio fueron hombres y el 78,8% mujeres, con una edad media de 57 años. La proporción corona-implante medio fue de 3,19 (+/- 0,24). La media de la pérdida ósea mesial de los implantes estudiados fue de 0,86mm (+/- 0,33) y la media de la pérdida ósea prodistal fue de 0,83mm (+/- 0,47). Cuando se analizó la pérdida ósea mesial y distal en función proporción no se encontraron diferencias estadísticamente significativas (p=0,224). Conclusiones: el uso de implantes extracortos no es un factor de riesgo para la pérdida ósea crestal o para el fracaso de la prótesis o del implante según los datos aportados por este estudio aun cuando la proporción corona-implante sea superior a tres.
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16
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de Souza Batista VE, Verri FR, Almeida DADF, Santiago Junior JF, Lemos CAA, Pellizzer EP. Evaluation of the effect of an offset implant configuration in the posterior maxilla with external hexagon implant platform: A 3-dimensional finite element analysis. J Prosthet Dent 2017; 118:363-371. [DOI: 10.1016/j.prosdent.2016.10.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/21/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
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17
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De Marco G, Di Francesco F, Lanza A. Analysis and management of implant-prosthetic complications: Description of a diagnostic and therapeutic algorithm with a clinical case. J Prosthodont Res 2017; 62:386-390. [PMID: 28844413 DOI: 10.1016/j.jpor.2017.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/03/2017] [Accepted: 08/01/2017] [Indexed: 10/28/2022]
Abstract
PATIENT A 65-year-old non-smoker man with stabilized chronic periodontitis and in good general health conditions presented to our observation. The patient reported crown mobility, gingival inflammation and localized pain, corresponding to the mandibular right first molar rehabilitated with a cement-retained implant crown. This clinical situation suspected a fracture of an implant-prosthetic component. Through the described diagnostic algorithm, an abutment hexagon fracture was revealed. Thus, a minimally invasive treatment was carried out in order to use the residual implant-prosthetic components for a new implant-prosthetic rehabilitation. DISCUSSION Fractures of implant-prosthetic components are clinical occurrences that may result in irreversible failures. The main causes of a possible fracture are dependent on biomechanical considerations and production processes of implant-prosthetic components. The respect of the rigorous planning and the employment of the implant-prosthetic devices of the same manufacturer are recommended. CONCLUSIONS Specific employments and protocols have to be offered in order to manage the fractures of implant-prosthetic components. This work showed that through the described diagnostic and therapeutic algorithm, the clinician can be guided towards a proper diagnosis and a correct management of the cases where a fracture of implant-prosthetic components may occur.
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Affiliation(s)
- Gennaro De Marco
- Prosthodontics Division, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University Luigi Vanvitelli, Naples, Italy
| | - Fabrizio Di Francesco
- Prosthodontics Division, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University Luigi Vanvitelli, Naples, Italy
| | - Alessandro Lanza
- Prosthodontics Division, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University Luigi Vanvitelli, Naples, Italy.
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Lee JB, Kim MY, Kim CS, Kim YT. The prognosis of splinted restoration of the most-distal implants in the posterior region. J Adv Prosthodont 2016; 8:494-503. [PMID: 28018568 PMCID: PMC5179489 DOI: 10.4047/jap.2016.8.6.494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/25/2016] [Accepted: 08/08/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The aim of this study was to compare the efficacies of two-implant splinting (2-IS) and single-implant restoration (1-IR) in the first and second molar regions over a mean functional loading period (FLP) of 40 months, and to propose the appropriate clinical considerations for the splinting technique. MATERIALS AND METHODS The following clinical factors were examined in the 1-IR and 2-IS groups based on the total hospital records of the patients: sex, mean age, implant location, FLP, bone grafting, clinical crown-implant ratio, crown height space, and horizontal distance. The mechanical complications [i.e., screw loosening (SL), screw fracture, crown fracture, and repeated SL] and biological complications [i.e., peri-implant mucositis (PM) and peri-implantitis (PI)] were also evaluated for each patient. In analysis of two groups, the chi-square test and Student's t-test were used to identify the relationship between clinical factors and complication rates. The optimal cutoff value for the FLP based on complications was evaluated using receiver operating characteristics analysis. RESULTS In total, 234 patients with 408 implants that had been placed during 2005 - 2014 were investigated. The incident rates of SL (P<.001), PM (P=.002), and PI (P=.046) differed significantly between the 1-IR and 2-IS groups. The FLP was the only meaningful clinical factor for mechanical and biological complication rates in 2-IS. CONCLUSION The mechanical complication rates were lower for 2-IS than for 1-IR, while the biological complication rates were higher for 2-IS. FLP of 39.80 and 46.57 months were the reference follow-up periods for preventing biological and mechanical complications, respectively.
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Affiliation(s)
- Jong-Bin Lee
- Department of Periodontology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Man-Yong Kim
- Department of Prosthodontics, Ilsan Hospital, National Health Insurance Service, Goyang, Republic of Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Young-Taek Kim
- Department of Periodontology, Ilsan Hospital, National Health Insurance Service, Goyang, Republic of Korea
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19
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Technical and biological complications related to crown to implant ratio: a systematic review. IMPLANT DENT 2016; 23:180-7. [PMID: 24637523 DOI: 10.1097/id.0000000000000026] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To review the occurrence of prosthetic failure and biological complications with respect to the crown to implant (C/I) ratio. METHODS Accurate search was made on the subject C/I ratio with the following criteria: (1) studies on humans with data on prosthetic failure and/or biological complications related to C/I ratio; (2) partial edentulous patients; (3) randomized clinical trials, prospective, longitudinal, retrospective, and multicenter studies with a minimum of 48 months mean follow-up; (4) language: English; (5) radiographic measurements by peri-apical x-ray; (6) implant material: titanium; and (7) no implant type selection was applied. RESULTS Six articles were considered eligible for full-text analysis. Unfavorable C/I ratio can be considered a potential risk factor for single crown and abutment loosening (C/I ratio ≥ 1.46) and abutment fractures in posterior areas (C/I ratio ≥ 2.01). CONCLUSIONS Despite the limited data, high C/I ratio may be related to some prosthetic failures. Unfavorable C/I ratio does not affect biological complications and implant failure.
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21
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Effect of increased crown height on stress distribution in short dental implant components and their surrounding bone: A finite element analysis. J Prosthet Dent 2015; 113:548-57. [DOI: 10.1016/j.prosdent.2014.11.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/04/2014] [Accepted: 11/04/2014] [Indexed: 11/24/2022]
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22
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Anitua E, Alkhraisat MH, Piñas L, Orive G. Efficacy of biologically guided implant site preparation to obtain adequate primary implant stability. Ann Anat 2015; 199:9-15. [DOI: 10.1016/j.aanat.2014.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/25/2014] [Accepted: 02/19/2014] [Indexed: 10/25/2022]
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23
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Naves MM, de Menezes HHM, de Magalhães D, de Araújo CA, Júnior PCS. The Influence of Interproximal Contact on Implant-Supported Fixed Partial Dentures in the Posterior Jaw: A Photoelastic Analysis. J ORAL IMPLANTOL 2015; 41:3-9. [DOI: 10.1563/aaid-joi-d-12-00118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to analyze the effect of the separation of prosthetic crowns from fixed partial dentures by means of stress gradient evaluation. Three photoelastic models were created to examine contiguous implants with varying contact between the crowns (contact point [CP], contact surface [CS], splinted [SP]). The SP group presented the best results, followed by the CS group, indicating that the use of splinted prosthetic crowns and crowns with broad surface contacts is viable when considering the stress values.
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Affiliation(s)
- Marina Melo Naves
- Department of Post-Graduation, Dental School, Federal University of Uberlandia and Periodontology and Implantology Department, HD Postgraduate Dental Education Center, Uberlandia, Brazil
| | | | - Denildo de Magalhães
- Periodontology and Implantology Department, Dental School, Federal University of Uberlandia, Uberlandia, Brazil
| | - Cleudmar Amaral de Araújo
- Mechanical Projects Laboratory Henner A. Gomide, Mechanical School, Federal University of Uberlandia, Uberlandia, Brazil
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Anitua E, Murias-Freijo A, Alkhraisat MH. Conservative Implant Removal for the Analysis of the Cause, Removal Torque, and Surface Treatment of Failed Nonmobile Dental Implants. J ORAL IMPLANTOL 2014; 42:69-77. [PMID: 25436836 DOI: 10.1563/aaid-joi-d-14-00207] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was performed to study the effect of implant surface treatment on the cause and removal torque of failed nonmobile implants. Implant explantation was achieved by the application of countertorque at the implant-bone interface. The explantation socket was examined carefully and curetted to remove any granulation tissue. Immediate implant placement was accomplished when primary stability could be achieved. Eighty-one patients were treated according to the described treatment protocol for the explantation of 158 nonmobile implants in the maxilla and the mandible. The patient's mean age was 62 ± 11 years. The main cause of implant explantation was peri-implantitis (131 implants; 82.9%) followed by malpositioning of the implants (22 implants; 13.9%). The explantation of 139 implants at 146 ± 5 Ncm was performed without the need for trephine bur. However, the use of trephine burs to cut into the first 3 to 4 mm was necessary in 19 explantations, and the removal torque was 161 ± 13 Ncm. All titanium plasma-sprayed implants were removed due to peri-implantitis at a significantly lower torque when compared to acid-etched, particle-blasted, and oxidized implants. The postoperative recovery of the patients was uneventful and the conservation of the available hard and soft tissues was successfully achieved. The protocol followed in this study could constitute a real alternative to other traumatic technique for the removal of failed implants and advanced stages of peri-implantitis. The type of implant surface treatment could influence the value of removal torque and the occurrence of peri-implantitis.
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Affiliation(s)
- Eduardo Anitua
- 1 Private practice in oral implantology, Vitoria, Spain.,2 Eduardo Anitua Foundation, Vitoria, Spain
| | - Alia Murias-Freijo
- 1 Private practice in oral implantology, Vitoria, Spain.,2 Eduardo Anitua Foundation, Vitoria, Spain
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Verri FR, Batista VEDS, Santiago JF, Almeida DADF, Pellizzer EP. Effect of crown-to-implant ratio on peri-implant stress: a finite element analysis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 45:234-40. [PMID: 25491825 DOI: 10.1016/j.msec.2014.09.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 08/04/2014] [Accepted: 09/09/2014] [Indexed: 01/13/2023]
Abstract
The aim of this study was to evaluate stress distribution in the fixation screws and bone tissue around implants in single-implant supported prostheses with crowns of different heights (10, 12.5, 15 mm - crown-to-implant ratio 1:1, 1.25:1, 1.5:1, respectively). It was designed using three 3-D models. Each model was developed with a mandibular segment of bone block including an internal hexagon implant supporting a screw-retained, single metal-ceramic crown. The crown height was set at 10, 12.5, and 15 mm with crown-to-implant ratio of 1:1, 1.25:1, 1.5:1, respectively. The applied forces were 200N (axial) and 100 N (oblique). The increase of crown height showed differences with the oblique load in some situations. By von Mises' criterion, a high stress area was concentrated at the implant/fixation screw and abutment/implant interfaces at crown-to-implant ratio of 1:1, 1.25:1, 1.5:1, respectively. Using the maximum principal criteria, the buccal regions showed higher traction stress intensity, whereas the distal regions showed the largest compressive stress in all models. The increase of C/I ratio must be carefully evaluated by the dentist since the increase of this C/I ratio is proportional to the increase of average stress for both screw fixation (C/I 1:1 to 1:1.25 ratio=30.1% and C/I 1:1 to 1:1.5 ratio=46.3%) and bone tissue (C/I 1:1 to 1:1.25 ratio=30% and C/I 1:1 to 1:1.5 ratio=51.5%).
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Affiliation(s)
- Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, UNESP, Univ Estadual Paulista, 1193 José Bonifácio Street, Araçatuba, São Paulo 16015050, Brazil.
| | - Victor Eduardo de Souza Batista
- Department of Dental Materials and Prosthodontics, UNESP, Univ Estadual Paulista, 1193 José Bonifácio Street, Araçatuba, São Paulo 16015050, Brazil
| | - Joel Ferreira Santiago
- Department of Dental Materials and Prosthodontics, UNESP, Univ Estadual Paulista, 1193 José Bonifácio Street, Araçatuba, São Paulo 16015050, Brazil
| | - Daniel Augusto de Faria Almeida
- Department of Dental Materials and Prosthodontics, UNESP, Univ Estadual Paulista, 1193 José Bonifácio Street, Araçatuba, São Paulo 16015050, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, UNESP, Univ Estadual Paulista, 1193 José Bonifácio Street, Araçatuba, São Paulo 16015050, Brazil
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Tiossi R, de Torres EM, Rodrigues RC, Conrad HJ, de Mattos MDGC, Fok AS, Ribeiro RF. Comparison of the correlation of photoelasticity and digital imaging to characterize the load transfer of implant-supported restorations. J Prosthet Dent 2014; 112:276-84. [DOI: 10.1016/j.prosdent.2013.09.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 09/11/2013] [Accepted: 09/15/2013] [Indexed: 10/25/2022]
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Hof M, Pommer B, Zukic N, Vasak C, Lorenzoni M, Zechner W. Influence of Prosthetic Parameters on Peri-Implant Bone Resorption in the First Year of Loading: A Multi-Factorial Analysis. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e183-91. [DOI: 10.1111/cid.12153] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Markus Hof
- Department of Oral Surgery; Bernhard Gottlieb University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
| | - Bernhard Pommer
- Department of Oral Surgery; Bernhard Gottlieb University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
| | - Nizama Zukic
- Department of Oral Surgery; Bernhard Gottlieb University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
| | - Christoph Vasak
- Department of Oral Surgery; Bernhard Gottlieb University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
| | - Martin Lorenzoni
- Department of Prosthodontics; University Dental Clinic, Medical University Graz; Graz Austria
| | - Werner Zechner
- Department of Oral Surgery; Bernhard Gottlieb University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
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Moraes SLD, Pellizzer EP, Verri FR, Santiago JF, Silva JVL. Three-dimensional finite element analysis of stress distribution in retention screws of different crown-implant ratios. Comput Methods Biomech Biomed Engin 2013; 18:689-96. [PMID: 23947571 DOI: 10.1080/10255842.2013.820719] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The retaining screw of the implant-supported dental prosthesis is the weakest point of the crown/implant system. Furthermore, crown height is another important factor that may increase the lever arm. Therefore, the aim of this study was to assess the stress distribution in implant prosthetic screws with different heights of the clinical crown of the prosthesis using the method of three-dimensional finite element analysis. Three models were created with implants (3.75 mm × 10 mm) and crowns (heights of 10, 12.5 and 15 mm). The results were visualised by means of von Mises stress maps that increased the crown heights. The screw structure exhibited higher levels of stresses in the oblique load. The oblique loading resulted in higher stress concentration when compared with the axial loading. It is concluded that the increase of the crown was damaging to the stress distribution on the screw, mainly in oblique loading.
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Affiliation(s)
- S L D Moraes
- a Department of Prosthodontics , Pernambuco State University , Recife , Brazil
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Okada S, Koretake K, Miyamoto Y, Oue H, Akagawa Y. Increased crown-to-implant ratio may not be a risk factor for dental implant failure under appropriate plaque control. PLoS One 2013; 8:e63992. [PMID: 23737960 PMCID: PMC3667837 DOI: 10.1371/journal.pone.0063992] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 04/08/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate whether increased crown-to-implant (C/I) ratio influences implant stability or not under proper healthy control of peri-implant mucosa. The hypothesis of this study is that implant stability can be maintained despite High C/I, under appropriate plaque control. MATERIALS AND METHODS Five male Beagle-Labrador hybrid dogs (2 years old) were used. Their bilateral mandibular premolar extraction was performed. After allowing 12 weeks for bone healing, 3 types of vertical marginal bone loss were simultaneously prepared randomly. Then, 30 titanium implants were placed in the edentulous areas and defined as High C/I, Mid C/I and Low C/I groups. This time point was designated as the baseline (0 Week). Twelve weeks after implant placement, metal superstructures were cemented to the implants and an occlusal plate was set at the opposite side. At the same time, Calcein green was injected for remodeling evaluation. Implants were loaded by feeding the dogs a hard pellet diet. Tooth brushing was performed 5 days per week during the study to maintain healthy peri-implant mucosa. Twenty-four weeks following implant placement, the interface structure was evaluated clinically, radiologically, and histologically. RESULT Implant stability quotient (ISQ) increased with time in all 3 groups, without any significant correlation with the C/I value (p >0.05). Moreover, mean marginal bone loss adjacent around implants in all 3 groups ranged between 0.11 and 0.19 mm, with no significant difference (p >0.05). Many fluorescence-labeled bones are shown in the High C/I group. It is considered that high remodeling activity prevent marginal bone loss in the High C/I group and this may provide favorable implant stability under proper plaque control. CONCLUSION These findings suggest that increased C/I may not be a risk factor for implant failure if the peri-implant mucosa is kept healthy, as was the case in this animal model.
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Affiliation(s)
- Shinsuke Okada
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
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