A digital image correlation analysis on the influence of crown material in implant-supported prostheses on bone strain distribution

Impact Testing in Implant-Supported Prostheses and Natural Teeth: A Systematic Review of Properties and Performance

Dental implants offer an effective solution for partial and total edentulism, but mechanical and biological complications exist. Furthermore, high occlusal loads challenge implants and lead to potential failures. This review focuses on impact testing in contrast to incremental and static tests, an underexplored aspect of assessing daily loads on implants, bringing to light potential complications. The review examines studies employing impact forces to assess implant-supported prostheses and natural teeth properties, highlighting their significance in dental research. A systematic search following PRISMA guidelines identified 21 relevant articles out of 224, emphasizing studies employing impact forces to evaluate various aspects of dental implant treatments. The diverse applications of impact forces in dental research were categorized into tooth structure, restorative materials, interface evaluation, implant properties, and finite element models. Some studies showed the significance of impact forces in assessing stress distribution, shock absorption, and biomechanical response. Impact testing is a critical tool for understanding the daily forces on implants. Despite diverse experimental approaches, a lack of standardized protocols complicates the systematization of the results and, therefore, the conclusions. This review highlights the need for consistent methodologies in impact testing studies for future research on implant-supported prostheses.

Analysis of implant-supported cantilever fixed partial denture: An in vitro comparative study on vertical misfit, stress distribution, and cantilever fracture strength

PURPOSE

To evaluate the vertical misfit, stress distribution around dental implants, and cantilever fracture strength of 3-unit implant-supported cantilever fixed partial dentures (FPDs) using frameworks made from different materials and manufacturing techniques.

MATERIALS AND METHODS

Forty FPDs were fabricated and divided into 5 groups (n = 8) based on the framework material used: LAS Co-Cr (Conventional casting-laser welding); TIG Co-Cr (Conventional casting -TIG welding); OP Co-Cr (Conventional casting-one-piece); CAD Co-Cr (CAD-CAM); and CAD Zr (CAD-CAM ZrO2). The vertical misfit was evaluated before porcelain application (T1) and before (T2), and after thermomechanical cycling (T3) by stereomicroscopy. Cantilever fracture strength was tested with a 50 kN (5000 kgf) load cell at a crosshead speed of 0.5 mm/min. Qualitative and quantitative photoelastic analysis was performed to evaluate stress distribution at seven specific points in five FPDs (n = 1/group) subjected to occlusal loading.

RESULTS

Only the molar showed interaction among the three factors (G × S × T; F(20.932) = 1.630; p = 0.044). Thermomechanical cycling (T2 vs. T3) had a significant effect on intra-group vertical misfit in molar, especially in LAS Co-Cr (Δ = 5.87; p = 0.018) and OP Co-Cr (Δ = 5.39; p = 0.007), with no significant effect in premolar (p > 0.05). Ceramic application combined with thermomechanical cycling (T1 vs. T3) caused a significant intra-group increase in vertical misfit in all groups, both in the molar and premolar (p < 0.05). OP Co-Cr was associated with greater vertical misfit and stress concentration. Frameworks manufactured by the CAD-CAM system exhibited lower vertical misfit and better stress distribution. FPDs with metal frameworks (>410.83 ± 72.26 N) showed significantly higher fracture strength (p < 0.05) than zirconia (277.47 ± 39.10 N), and the first signs of ceramic veneering fracture were observed around 900 N.

CONCLUSIONS

FPDs with frameworks manufactured using a CAD-CAM system appear to be associated with lower vertical misfit and better stress distribution, although the section of the frameworks followed by welding may be a viable alternative. In addition, metal frameworks exhibit high fracture strength.

Bioengineering Tools Applied to Dentistry: Validation Methods for In Vitro and In Silico Analysis

This study aimed to evaluate the use of bioengineering tools, finite element analysis, strain gauge analysis, photoelastic analysis, and digital image correlation, in computational studies with greater validity and reproducibility. A bibliographic search was performed in the main health databases PUBMED and Scholar Google, in which different studies, among them, laboratory studies, case reports, systematic reviews, and literature reviews, which were developed in living individuals, were included. Therefore, articles that did not deal with the use of finite element analysis, strain gauge analysis, photoelastic analysis, and digital image correlation were excluded, as well as their use in computational studies with greater validity and reproducibility. According to the methodological analysis, it is observed that the average publication of articles in the Pubmed database was 2.03 and with a standard deviation of 1.89. While in Google Scholar, the average was 0.78 and the standard deviation was 0.90. Thus, it is possible to verify that there was a significant variation in the number of articles in the two databases. Modern dentistry finds in finite element analysis, strain gauge, photoelastic and digital image correlation a way to analyze the biomechanical behavior in dental materials to obtain results that assist to obtain rehabilitations with favorable prognosis and patient satisfaction.

Digital image correlation in dental materials and related research: A review

OBJECTIVE

Digital image correlation (DIC) is a non-contact image processing technique for full-field strain measurement. Although DIC has been widely used in engineering and biomechanical fields, it is in the spotlight only recently in dental materials. Therefore, the purpose of this review paper is introducing the working principle of the DIC technique with some modifications and providing further potential applications in various dental materials and related fields.

METHODS

The accuracy of the algorithm depending on the environmental characteristics of the DIC technique, as well as the advantages and disadvantages of strain measurement using optical measurements, have been elaborated in dental materials and related fields. Applications to those researches have been classified into the following categories: shrinkage behavior of light-cured resin composite, resin-tooth interface, mechanical properties of tooth structure, crack extension and elastic properties of dental materials, and deformation of dental restoration and prosthesis. This classification and discussion were performed using literature survey and review based on numerous papers in the international journals published over the past 20 years. The future directions for predicting the precise deformation of dental materials under various environments, as well as limitations of the DIC technique, was presented in this review.

RESULTS

The DIC technique was demonstrated as a more effective tool to measure full-field polymerization shrinkage of composite resin, even in a simulated clinical condition over the existing methods. Moreover, the DIC combined with other technologies can be useful to evaluate the mechanical behavior of material-tooth interface, dentine structure and restorative and prosthetic materials with high accuracy. Three-dimensional DIC using two cameras extended the measurement range in-plane to out-of-plane, enabling measure of the strain directly on the surface of dental restorations or prosthesis.

SIGNIFICANCE

DIC technique is a potential tool for measuring and predicting the full-field deformation/strain of dental materials and actual prostheses in diverse clinical conditions. The versatility of DIC can replace the existing complex sensor devices in those studies.

In vitro digital image correlation analysis of the strain transferred by screw-retained fixed partial dentures supported by short and conventional implants

PURPOSE

This study used digital image correlation (DIC) to evaluate the strain transferred by splinted and non-splinted screw-retained fixed partial dentures (FPDs) supported by short and conventional implants.

MATERIAL AND METHODS

Four polyurethane models were fabricated to simulate half of the mandibular arch with acrylic resin replicas of the first premolar. Short (5 mm) and/or conventional (11 mm) implants replaced the second premolar and the first and second molars. Groups were: G1, two conventional (second premolar and first molar) and one short (second molar) implant; G2, one conventional (second premolar) and two short (first and second molar) implants; G3, three short implants; and G4, three conventional implants. Splinted (S) and non-splinted (NS) FPDs were screwed to the implant abutments. Occlusal load and a single point load on the second premolar, both of 250 N, were applied. Strain in the horizontal direction (Ɛ_xx) was calculated and compared using the DIC software.

RESULTS

Splinted crowns presented the highest strain magnitudes of all tested groups (p < 0.05). The strain was concentrated near the short implants and presented a higher magnitude compared to conventional implants, especially in G2S (-560.13 μS), G3S (-372.97 μS), and G4S (-356.67 μS).

CONCLUSIONS

Splinted crowns presented a higher strain concentration around the implants, particularly near the implant replacing the first molar. A combination of short and conventional implants seems to be a viable alternative for the rehabilitation of the posterior edentulous mandible with reduced bone height.

Does a PEEK Femoral TKA Implant Preserve Intact Femoral Surface Strains Compared With CoCr? A Preliminary Laboratory Study

BACKGROUND

Both the material and geometry of a total knee arthroplasty (TKA) component influence the induced periprosthetic bone strain field. Strain, a measure of the local relative deformation in a structure, corresponds to the mechanical stimulus that governs bone remodeling and is therefore a useful in vitro biomechanical measure for assessing the response of bone to new implant designs and materials. A polyetheretherketone (PEEK) femoral implant has the potential to promote bone strains closer to that of natural bone as a result of its low elastic modulus compared with cobalt-chromium (CoCr).

QUESTIONS/PURPOSES

In the present study, we used a Digital Image Correlation (DIC) technique to answer the following question: Does a PEEK TKA femoral component induce a more physiologically normal bone strain distribution than a CoCr component? To achieve this, a DIC test protocol was developed for periprosthetic bone strain assessment using an analog model; the protocol aimed to minimize errors in strain assessment through the selection of appropriate analysis parameters.

METHODS

Three synthetic bone femurs were used in this experiment. One was implanted with a CoCr femoral component and one with a PEEK femoral component. The third (unimplanted) femur was intact and used as the physiological reference (control) model. All models were subjected to standing loads on the corresponding polyethylene (ultrahigh-molecular-weight polyethylene) tibial component, and speckle image data were acquired for surface strain analysis using DIC in six repeat tests. The strain in 16 regions of interest on the lateral surface of each of the implanted bone models was plotted for comparison with the corresponding strains in the intact case. A Wilcoxon signed-rank test was used to test for difference at the 5% significance level.

RESULTS

Surface analog bone strain after CoCr implantation indicated strain shielding (R² = 0.6178 with slope, β = 0.4314) and was lower than the intact case (p = 0.014). The strain after implantation with the PEEK implant deviated less from the intact case (R² = 0.7972 with slope β = 0.939) with no difference (p = 0.231).

CONCLUSIONS

The strain shielding observed with the contemporary CoCr implant, consistent with clinical bone mineral density change data reported by others, may be reduced by using a PEEK implant.

CLINICAL RELEVANCE

This bone analog in vitro study suggests that a PEEK femoral component could transfer more physiologically normal bone strains with a potentially reduced stress shielding effect, which may improve long-term bone preservation. Additional studies including paired cadaver tests are necessary to test the hypothesis further.