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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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Cruz RS, Fernandes E Oliveira HF, Lemos CAA, de Souza Batista VE, Capalbo da Silva R, Verri FR. Biomechanical influence of narrow-diameter implants placed at the crestal and subcrestal level in the maxillary anterior region. A 3D finite element analysis. J Prosthodont 2024; 33:180-187. [PMID: 36799260 DOI: 10.1111/jopr.13667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 02/18/2023] Open
Abstract
PURPOSE To evaluate the tendency of movement, stress distribution, and microstrain of single-unit crowns in simulated cortical and trabecular bone, implants, and prosthetic components of narrow-diameter implants with different lengths placed at the crestal and subcrestal levels in the maxillary anterior region using 3D finite element analysis (FEA). MATERIALS AND METHODS Six 3D models were simulated using Invesalius 3.0, Rhinoceros 4.0, and SolidWorks software. Each model simulated the right anterior maxillary region including a Morse taper implant of Ø2.9 mm with different lengths (7, 10, and 13 mm) placed at the crestal and subcrestal level and supporting a cement-retained monolithic single crown in the area of tooth 12. The FEA was performed using ANSYS 19.2. The simulated applied force was 178 N at 0°, 30°, and 60°. The results were analyzed using maps of displacement, von Mises (vM) stress, maximum principal stress, and microstrain. RESULTS Models with implants at the subcrestal level showed greater displacement. vM stress increased in the implant and prosthetic components when implants were placed at the subcrestal level compared with the crestal level; the length of the implants had a low influence on the stress distribution. Higher stress and strain concentrations were observed in the cortical bone of the subcrestal placement, independent of implant length. Non-axial loading influenced the increased stress and strain in all the evaluated structures. CONCLUSIONS Narrow-diameter implants positioned at the crestal level showed a more favorable biomechanical behavior for simulated cortical bone, implants, and prosthetic components. Implant length had a smaller influence on stress or strain distribution than the other variables.
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Affiliation(s)
- Ronaldo S Cruz
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | | | - Cleidiel Aparecido Araújo Lemos
- Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora (UFJF)-Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Victor Eduardo de Souza Batista
- Department Prosthodontics, Presidente Prudente Dental School, The University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - Rodrigo Capalbo da Silva
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Fellippo R Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
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Andrade CS, de Abreu Costa L, Menechelli LG, Lemos CAA, Okamoto R, Verri FR, de Souza Batista VE. Biomechanical effects of different materials for an occlusal device on implant-supported rehabilitation in a tooth clenching situation. A 3D finite element analysis. J Prosthodont 2023. [PMID: 37675950 DOI: 10.1111/jopr.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE The purpose of this 3D finite element analysis was to evaluate the biomechanical effects of different materials used to fabricate occlusal devices to achieve stress distribution in simulated abutment screws, dental implants, and peri-implant bone tissue in individuals who clench their teeth. MATERIALS AND METHODS Eight 3D models simulated a posterior maxillary bone block with three external hexagon implants (Ø4.0 × 7.0 mm) supporting a 3-unit screw-retained metal-ceramic prosthesis with different crown connection (splinting), and the use of an occlusal device (OD). The OD was modeled to be 2-mm thick. ANSYS 19.2 software was used to generate the finite-element models in the pre-and post-processing phases. Simulated abutment screws and dental implants were evaluated by von Mises stress maps, and simulated bone was evaluated by maximum principal stress and microstrain maps by using a finite element software program. RESULTS The highest stress values in the dental implants and screws were observed in single crowns without OD (M1). Furthermore, the highest stress values and bone tissue strain were found in single crowns without OD (M1). The simulated material for the OD did not cause many discrepancies in terms of the stress magnitude in the simulated dental implant and abutment screw for both single and splinted crowns; however, more rigid materials exhibited lower stress values. CONCLUSION The use of OD was effective in reducing stress in the simulated implants and abutment screws and stress and strain in the simulated bone tissue. The material used to simulate the OD influenced the biomechanical behavior of implant-supported fixed prostheses, whereas splints with rigid materials such as PEEK and PMMA exhibited better biomechanical behavior.
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Affiliation(s)
- Carla Souza Andrade
- Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo - UNOESTE, Presidente Prudente, Brazil
| | - Luy de Abreu Costa
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| | - Luana Gonçalves Menechelli
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| | - Cleidiel A A Lemos
- Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora, Campus Avançado Governador Valadares (UFJF/GV), Governador Valadares, Minas Gerais, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Universidade Estadual Paulista Júlio de Mesquita Filho, School of Dentistry at Araçatuba, Araçatuba, Brazil
| | - Fellippo R Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| | - Victor Eduardo de Souza Batista
- Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo - UNOESTE, Presidente Prudente, Brazil
- Postgraduate Program in Dentistry - Implantology concentration area, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
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Cao R, Chen B, Xu H, Fan Z. Clinical outcomes of titanium-zirconium alloy narrow-diameter implants for single-crown restorations: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2023; 61:403-410. [PMID: 37331853 DOI: 10.1016/j.bjoms.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 02/26/2023] [Accepted: 05/07/2023] [Indexed: 06/20/2023]
Abstract
Evidence is limited on whether titanium-zirconium alloy, narrow-diameter implants (Ti-Zr NDIs) have promising clinical outcomes when used to support single crowns. The purpose of this systematic review and meta-analysis was to evaluate clinical evidence, including survival rates, success rates, and marginal bone loss (MBL) on Ti-Zr NDIs that support single crowns. An extensive search was performed in the databases of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library for studies published in English up to April 2022. Only peer-reviewed clinical studies with at least 10 patients and a follow-up time of at least 12 months were included. Risk of bias in each study was assessed and data extraction was carried out independently by two reviewers. The outcome variables were survival rates, success rates, and MBL. The search returned 779 results. Eight studies were identified for qualitative analysis and seven for quantitative synthesis. Overall, a total of 256 Ti-Zr NDIs were included. Cumulative implant survival rates and success rates were 97.5% (95% confidence interval (CI): 94.5% to 98.9%) and 97.2% (95% CI: 94.2% to 98.7%), respectively, over a maximum follow-up period of 36 months, with no difference between Ti-Zr NDIs and commercial pure titanium (cpTi) implants. Cumulative mean (SD) MBL was 0.44 (0.04) mm (95% CI: 0.36 to 0.52) after one year. Meta-analysis of MBL indicated a mean difference of 0.02 mm (95% CI: -0.23 to 0.10), with no differences between Ti-Zr NDIs and cpTi implants. Short-term results of Ti-Zr NDIs for single-crown restorations are quite promising, although the number of published studies and follow-up periods are insufficient to determine the real benefit for single crowns. Long-term, follow-up clinical studies are needed to verify the excellent clinical performance of Ti-Zr NDIs.
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Affiliation(s)
- Rongkai Cao
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Beibei Chen
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Hui Xu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Zhen Fan
- Department of Oral Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China.
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Zhang C, Zeng C, Wang Z, Zeng T, Wang Y. Optimization of stress distribution of bone-implant interface (BII). BIOMATERIALS ADVANCES 2023; 147:213342. [PMID: 36841109 DOI: 10.1016/j.bioadv.2023.213342] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
Many studies have found that the threshold of occlusal force tolerated by titanium-based implants is significantly lower than that of natural teeth due to differences in biomechanical mechanisms. Therefore, implants are considered to be susceptible to occlusal trauma. In clinical practice, many implants have shown satisfactory biocompatibility, but the balance between biomechanics and biofunction remains a huge clinical challenge. This paper comprehensively analyzes and summarizes various stress distribution optimization methods to explore strategies for improving the resistance of the implants to adverse stress. Improving stress resistance reduces occlusal trauma and shortens the gap between implants and natural teeth in occlusal function. The study found that: 1) specific implant-abutment connection design can change the force transfer efficiency and force conduction direction of the load at the BII; 2) reasonable implant surface structure and morphological character design can promote osseointegration, maintain alveolar bone height, and reduce the maximum effective stress at the BII; and 3) the elastic modulus of implants matched to surrounding bone tissue can reduce the stress shielding, resulting in a more uniform stress distribution at the BII. This study concluded that the core BII stress distribution optimization lies in increasing the stress distribution area and reducing the local stress peak value at the BII. This improves the biomechanical adaptability of the implants, increasing their long-term survival rate.
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Affiliation(s)
- Chunyu Zhang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China.
| | - Chunyu Zeng
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Zhefu Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Ting Zeng
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Yuehong Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China.
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Mendez A, Coronado H. [Stress in an implant-supported unitary fixed partial prosthesis with different materials in the first lower premolar through finite elements]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e140. [PMID: 38288318 PMCID: PMC10810070 DOI: 10.21142/2523-2754-1101-2023-140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/09/2023] [Indexed: 01/31/2024] Open
Abstract
AIM To analyze stress in a metal-ceramic, zirconia and lithium disilicate implant-supported unitary fixed partial prosthesis in the first lower premolar through finite element analysis at a 500 N force. MATERIALS AND METHODS Three study models were carried out, metal-ceramic, lithium disilicate and zirconium implant-supported crowns in the first lower premolar. The dental implant was made of titanium grade 5 based on the Bolt® model of UniDentalDirect with internal grooved connection (18 grooves) and the implant had a size of 11,0 x 4,5 mm, preformed abutment and integrated screw. The three designs had vertical and oblique (45°) forces applications at 500 N. The geometric modeling was performed with the SolidWorks® 2017 program and the results were obtained through the Von mises analysis using the CosmoWorks®2017 program. RESULTS The lowest value of maximum stress on crown level, under vertical and oblique forces, was found in the lithium disilicate crown with 21,9 MPa and 33,2 MPa, and with a minimum difference with the zirconium crown with 22,1 MPa and 35,1 MPa; on the abutment level, the zirconium crown had the lowest value of maximum stress with 18,6 MPa and 28,1 MPa; at the screw level, there were no significant differences. CONCLUSION Metal-ceramic, lithium disilicate, and zirconia crowns proved to be materials of good compressive and tensile strength, but it was concluded that the zirconia crown design generated lower overall stress.
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Affiliation(s)
- A Mendez
- Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Carrera de Estomatología Universidad Científica del Sur Lima Peru
| | - H Coronado
- Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Carrera de Estomatología Universidad Científica del Sur Lima Peru
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Grachev DI, Ruzuddinov NS, Arutyunov AS, Akhmedov GD, Dubova LV, Kharakh YN, Panin SV, Arutyunov SD. Algorithm for Designing a Removable Complete Denture (RCD) Based on the FEM Analysis of Its Service Life. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7246. [PMID: 36295314 PMCID: PMC9610509 DOI: 10.3390/ma15207246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The paper addresses the computer simulation and prediction of the service life of the base of removable complete dentures (RCDs) under typical loads caused by biting and chewing food. For this purpose, the finite element method (FEM) was used. It is assumed that various blocks of teeth, such as incisors, canines, premolars and molars, are subjected to cyclic impacts during a human life. (2) Methods: Both symmetric and asymmetric mastication (two- and one-sided loads, respectively) cases were considered. The load level was assumed to be 100 N, which corresponds to the average muscular compression force of typical human jaws. (3) Results: The FEM analysis of the stress-strain state evolution for RCDs under cyclic loads was carried out. Maps of equivalent lines were drawn for the denture base in terms of its durability. A multi-axial criterion was implemented to determine the number of cycles prior to failure by the mechanism of a normal opening mode crack. The FEM-based assessment of the service life of RCDs enabled us to establish the critical stress concentration areas, thereby allowing for further planning for the correction of an occlusal scheme or teeth inclinations. As a result, the service life of RCDs under cyclic loading can be improved. (4) Conclusions: An algorithm for designing RCDs in the case of edentulism based on the FEM simulation using commercial software as part of the procedure is proposed.
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Affiliation(s)
- Dmitry I. Grachev
- Digital Dentistry Department, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | | | - Anatoliy S. Arutyunov
- Propaedeutics of Prosthetics Technologies in Dentistry Department, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | - Gadzhi D. Akhmedov
- Propaedeutics in Surgical Dentistry, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | - Lubov V. Dubova
- Orthopedic Dentistry Department, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | - Yaser N. Kharakh
- Digital Dentistry Department, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | - Sergey V. Panin
- Laboratory of Mechanics of Polymer Composite Materials, Institute of Strength Physics and Materials Science of Siberian Branch of Russian Academy of Sciences, 634055 Tomsk, Russia
| | - Sergey D. Arutyunov
- Digital Dentistry Department, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
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Nimmawitt P, Aliyu AAA, Lohwongwatana B, Arunjaroensuk S, Puncreobutr C, Mattheos N, Pimkhaokham A. Understanding the Stress Distribution on Anatomic Customized Root-Analog Dental Implant at Bone-Implant Interface for Different Bone Densities. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6379. [PMID: 36143689 PMCID: PMC9506153 DOI: 10.3390/ma15186379] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study is to assess the stress distribution on the bone tissue and bone-implant interface of a customized anatomic root-analog dental implant (RAI) by means of finite element analysis (FEA) for different types of bone density. A mandibular right second premolar was selected from the CBCT database. A DICOM file was converted to an STL file to create a CAD model in FEA software. The bone boundary model was created, while bone density types I-IV were determined. Von Mises stress was measured at bone tissues and bone-implant interfaces. To validate the models, the RAI was 3D printed through a laser powder-bed fusion (L-PBF) approach. The results revealed that all RAI designs could not cause plastic deformation or fracture resulting in lower stress than the ultimate tensile stress of natural bone and implant. Compared to a conventional screw-type implant, RAIs possess a more favorable stress distribution pattern around the bone tissue and the bone-implant interface. The presence of a porous structure was found to reduce the stress at cancellous bone in type IV bone density.
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Affiliation(s)
- Pawhat Nimmawitt
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
| | - Abdul Azeez Abdu Aliyu
- Biomedical Engineering Research Center, Chulalongkorn University, Bangkok 10330, Thailand
| | - Boonrat Lohwongwatana
- Biomedical Engineering Research Center, Chulalongkorn University, Bangkok 10330, Thailand
- Department of Metallurgical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chedtha Puncreobutr
- Biomedical Engineering Research Center, Chulalongkorn University, Bangkok 10330, Thailand
- Department of Metallurgical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
- Department of Dental Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
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Moraschini V, Kischinhevsky ICC, Sartoretto SC, de Almeida Barros Mourão CF, Sculean A, Calasans-Maia MD, Shibli JA. Does implant location influence the risk of peri-implantitis? Periodontol 2000 2022; 90:224-235. [PMID: 35913455 DOI: 10.1111/prd.12459] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Peri-implantitis is characterized by nonreversible and progressive loss of supporting bone and is associated with bleeding and/or suppuration on probing. Peri-implant disease is considered as the main etiologic factor related to implant failure. Peri-implant disease has a pathogenesis similar to that of periodontal disease, both being triggered by an inflammatory response to the biofilm accumulation. Although the prevalence of peri-implantitis has been evaluated by several clinical studies with different follow-ups, there are currently little data on the impact of implant location and the prevalence of peri-implantitis. The aim of this review, therefore, was to summarize the evidence concerning the prevalence of peri-implantitis in relation to implant location and associated risk predictors. Even though most studies evaluating the prevalence of peri-implantitis in relation to implant location are cross-sectional or retrospective, they suggest that the occurrence of peri-implantitis is most prevalent in the anterior regions of the maxilla and mandible. Moreover, it seems that there is a higher prevalence of peri-implantitis in the maxilla than in the mandible.
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Affiliation(s)
- Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil.,Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Suelen Cristina Sartoretto
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Monica Diuana Calasans-Maia
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil
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Zupancic Cepic L, Frank M, Reisinger A, Pahr D, Zechner W, Schedle A. Biomechanical finite element analysis of short-implant-supported, 3-unit, fixed CAD/CAM prostheses in the posterior mandible. Int J Implant Dent 2022; 8:8. [PMID: 35147791 PMCID: PMC8837704 DOI: 10.1186/s40729-022-00404-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/17/2022] [Indexed: 11/21/2022] Open
Abstract
Objective To assess the biomechanical effects of different prosthetic/implant configurations and load directions on 3-unit fixed prostheses supported by short dental implants in the posterior mandible using validated 3-D finite element (FE) models.
Methods Models represented an atrophic mandible, missing the 2nd premolar, 1st and 2nd molars, and rehabilitated with either two short implants (implant length-IL = 8 mm and 4 mm) supporting a 3-unit dental bridge or three short implants (IL = 8 mm, 6 mm and 4 mm) supporting zirconia prosthesis in splinted or single crowns design. Load simulations were performed in ABAQUS (Dassault Systèmes, France) under axial and oblique (30°) force of 100 N to assess the global stiffness and forces within the implant prosthesis. Local stresses within implant/prosthesis system and strain energy density (SED) within surrounding bone were determined and compared between configurations. Results The global stiffness was around 1.5 times higher in splinted configurations vs. single crowns, whereby off-axis loading lead to a decrease of 39%. Splinted prostheses exhibited a better stress distribution than single crowns. Local stresses were larger and distributed over a larger area under oblique loads compared to axial load direction. The forces on each implant in the 2-implant-splinted configurations increased by 25% compared to splinted crowns on 3 implants. Loading of un-splinted configurations resulted in increased local SED magnitude. Conclusion Splinting of adjacent short implants in posterior mandible by the prosthetic restoration has a profound effect on the magnitude and distribution of the local stress peaks in peri-implant regions. Replacing each missing tooth with an implant is recommended, whenever bone supply and costs permit.
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Affiliation(s)
- Lana Zupancic Cepic
- Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Martin Frank
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Vienna, Austria
| | - Andreas Reisinger
- Division Biomechanics, Department of Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Dieter Pahr
- Division Biomechanics, Department of Anatomy and Biomechanics, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Werner Zechner
- Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Schedle
- Competence Centre Dental Materials, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
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Zhang X, Li MQ, Guo J, Yang HW, Yu J, Li GJ. An analysis of the optimal intrusion force of the maxillary central incisor with root horizontal resorption using the finite element method and curve fitting. Comput Methods Biomech Biomed Engin 2021; 25:1471-1486. [PMID: 34964691 DOI: 10.1080/10255842.2021.2017904] [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: 10/19/2022]
Abstract
There are no studies on the optimal intrusion force in orthodontic patients with the existing root resorption (RR). The study aimed to analyze the optimal intrusion force for central incisors with existing horizontal root resorption using the finite element method (FEM). We calculated the optimal intrusion force using the finite element method and curve fitting. We found that with the increase of the maxillary central incisor's root horizontal resorption length, the optimal intrusion force interval's median gradually increases. If the resorption length is more significant than 1/2 of the root length, it is not recommended to use intrusion force theoretically.
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Affiliation(s)
- Xin Zhang
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Min-Qi Li
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Jie Guo
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Heng-Wei Yang
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Jian Yu
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Guo-Ju Li
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
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12
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Sun F, Lv LT, Cheng W, Zhang JL, Ba DC, Song GQ, Lin Z. Effect of Loading Angles and Implant Lengths on the Static and Fatigue Fractures of Dental Implants. MATERIALS (BASEL, SWITZERLAND) 2021; 14:5542. [PMID: 34639935 PMCID: PMC8509834 DOI: 10.3390/ma14195542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022]
Abstract
Mechanical properties play a key role in the failure of dental implants. Dental implants require fatigue life testing before clinical application, but this process takes a lot of time. This study investigated the effect of various loading angles and implant lengths on the static fracture and fatigue life of dental implants. Implants with lengths of 9 mm and 11 mm were prepared. Static fracture tests and dynamic fatigue life tests were performed under three loading angles (30°, 40°, and 50°), and the level arm and bending moment were measured. After that, the fracture morphology and fracture mode of the implant were observed. The results showed that 9 mm length implants have a higher static failure load and can withstand greater bending moments, while 11 mm length implants have a longer fatigue life. In addition, as the loading angle increases, the static strength and bending moment decrease linearly, and the fatigue life shows an exponential decrease at a rate of three times. Increasing the loading angle reduces the time of the implant fatigue test, which may be an effective method to improve the efficiency of the experiment.
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Affiliation(s)
| | | | | | | | | | | | - Zeng Lin
- Key Laboratory of Implant Device and Interface Science of Liaoning Province, School of Mechanical Engineering and Automation, Northeastern University, Shenyang 110819, China; (F.S.); (L.-T.L.); (W.C.); (J.-L.Z.); (D.-C.B.); (G.-Q.S.)
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13
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The Impact of Dental Implant Length on Failure Rates: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14143972. [PMID: 34300891 PMCID: PMC8307721 DOI: 10.3390/ma14143972] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/22/2022]
Abstract
The present review aimed to evaluate the impact of implant length on failure rates between short (<10 mm) and long (≥10 mm) dental implants. An electronic search was undertaken in three databases, as well as a manual search of journals. Implant failure was the outcome evaluated. Meta-analysis was performed in addition to a meta-regression in order to verify how the risk ratio (RR) was associated with the follow-up time. The review included 353 publications. Altogether, there were 25,490 short and 159,435 long implants. Pairwise meta-analysis showed that short implants had a higher failure risk than long implants (RR 2.437, p < 0.001). There was a decrease in the probability of implant failure with longer implants when implants of different length groups were compared. A sensitivity analysis, which plotted together only studies with follow-up times of 7 years or less, resulted in an estimated increase of 0.6 in RR for every additional month of follow-up. In conclusion, short implants showed a 2.5 times higher risk of failure than long implants. Implant failure is multifactorial, and the implant length is only one of the many factors contributing to the loss of an implant. A good treatment plan and the patient’s general health should be taken into account when planning for an implant treatment.
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14
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Biomechanical effect of an occlusal device for patients with an implant-supported fixed dental prosthesis under parafunctional loading: A 3D finite element analysis. J Prosthet Dent 2021; 126:223.e1-223.e8. [PMID: 34099274 DOI: 10.1016/j.prosdent.2021.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Whether providing an occlusal device for a patient with bruxism and an implant-supported fixed dental prosthesis leads to improved biomechanics is unclear. PURPOSE The purpose of this 3D finite element analysis (FEA) study was to evaluate the biomechanical behavior of 3-unit implant-supported prostheses under parafunctional forces with and without an occlusal device. MATERIALS AND METHODS Eight 3D models consisting of a posterior (type IV) maxillary bone block with 3 external hexagon implants (Ø4.0×7.0 mm) and 3-unit implant-supported prostheses with different crown connections (splinted or unsplinted) and an occlusal device under functional and parafunctional loading were simulated. The abutment screws were evaluated by von Mises stress maps, and the bone tissue by maximum principal stress and microstrain maps by using a finite element software program. RESULTS An occlusal device improved the biomechanical behavior of the prostheses by reducing stress in the abutment screws and stress and strain in the bone tissue. However, the use of an occlusal device was not sufficiently effective to negate the biomechanical benefit of splinting. CONCLUSIONS The use of splinted crowns in the posterior maxillary region with an occlusal device was the most effective method of reducing stress in the abutment screws and stress and strain in the bone tissue when parafunction was modeled.
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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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Cruz RS, Lemos CAA, de Batista VES, Yogui FC, Oliveira HFF, Verri FR. Narrow-diameter implants versus regular-diameter implants for rehabilitation of the anterior region: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2020; 50:674-682. [PMID: 33158693 DOI: 10.1016/j.ijom.2020.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/16/2020] [Accepted: 10/02/2020] [Indexed: 12/26/2022]
Abstract
The aim of this systematic review and meta-analysis was to evaluate studies comparing implant survival rates, marginal bone loss (MBL), and mechanical and biological complication rates between narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) used for oral rehabilitation in the anterior region. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases for studies published until May 2020. A total of 843 implants (484 NDIs and 359 RDIs) were included. No significant difference in implant survival rate (risk difference (RD) 0.01, 95% confidence interval (CI) -0.01 to 0.03; P=0.34), MBL (standardised mean difference -0.51mm, 95% CI -1.29 to 0.26mm; P=0.19), mechanical complications (RD 0.01, 95% CI -0.02 to 0.04; P=0.40), or biological complications (RD 0.01, 95% CI -0.09 to 0.11; P=0.85) was found between the implant groups. Within the limitations of this study, it is concluded that NDIs are an effective alternative to RDIs due to similar survival rates, MBL, and mechanical and biological complication rates. However, future studies are highly encouraged due to the small number of interventional studies on this topic.
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Affiliation(s)
- R S Cruz
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil.
| | - C A A Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Governador Valadares, Governador Valadares, MG, Brazil
| | - V E S de Batista
- Department of Prosthodontics, Presidente Prudente Dental School, University of the West of São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - F C Yogui
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil
| | - H F F Oliveira
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil
| | - F R Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil
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17
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Biomechanical Design Application on the Effect of Different Occlusion Conditions on Dental Implants with Different Positions—A Finite Element Analysis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10175826] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A dental implant is currently the most commonly used treatment for patients with lost teeth. There is no biomechanical reference available to study the effect of different occlusion conditions on dental implants with different positions. Therefore, the aim of this study was to conduct a biomechanical analysis of the impact of four common occlusion conditions on the different positions of dental implants using the finite element method. We built a finite element model that included the entire mandible and implanted seven dental implant fixtures. We also applied external force to the position of muscles on the mandible of the superficial masseter, deep masseter, medial pterygoid, anterior temporalis, middle temporalis, and posterior temporalis to simulate the four clenching tasks, namely the incisal clench (INC), intercuspal position (ICP), right unilateral molar clench (RMOL), and right group function (RGF). The main indicators measured in this study were the reaction force on the temporomandibular joint (TMJ) and the fixed top end of the abutment in the dental implant system, and the stress on the mandible and dental implant systems. The results of the study showed that under the occlusion conditions of RMOL, the dental implant system (113.99 MPa) and the entire mandible (46.036 MPa) experienced significantly higher stress, and the reaction force on the fixed-top end of the abutment in the dental implant system (261.09 N) were also stronger. Under the occlusion of ICP, there was a greater reaction force (365.8 N) on the temporomandibular joint. In addition, it was found that the reaction force on the posterior region (26.968 N to 261.09 N) was not necessarily greater than that on the anterior region (28.819 N to 70.431 N). This information can help clinicians and dental implant researchers understand the impact of different chewing forces on the dental implant system at different positions after the implantation.
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18
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Zhang X, Mao J, Zhou Y, Ji F, Chen X. Study on statics and fatigue analysis of dental implants in the descending process of alveolar bone level. Proc Inst Mech Eng H 2020; 234:843-853. [PMID: 32423356 DOI: 10.1177/0954411920926080] [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] [Indexed: 11/15/2022]
Abstract
Alveolar bone atrophy can directly cause a decrease in bone level. The effect of this process on the service life of dental implants is unknown. The aim of this study was to determine the failure forms of the two-piece dental implants in the descending process of alveolar bone level, and the specific states of the components during the failure process. The CAD software SolidWorks was used to establish the model of alveolar bone and dental implants in this article. The finite element analysis was used to analyze the statics of the dental implants in the host oral model. The finite element analysis results showed that the stress concentration point of the implant and abutment in the implant system has changed greatly during the descending process of alveolar bone level, and indirectly increased the fatigue life of the same fatigue risk point. At the same time, the dental implants were tested in vitro in the descending process of alveolar bone level. Then, the fracture of the implant system was scanned by scanning electron microscope. The fatigue test results proved the finite element analysis hypothesis the central screw first fractured under fatigue and then caused an overload break of the implant and abutment.
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Affiliation(s)
- Xuetao Zhang
- School of Mechanical Engineering, Shanghai University of Engineering Science, Shanghai, China
| | - Jian Mao
- School of Mechanical Engineering, Shanghai University of Engineering Science, Shanghai, China
| | - Yufeng Zhou
- School of Mechanical Engineering, Shanghai University of Engineering Science, Shanghai, China
| | - Fangqiu Ji
- Guangzhou Janus Biotechnology Co., Ltd, Guangzhou, China
| | - Xianshuai Chen
- Guangzhou Janus Biotechnology Co., Ltd, Guangzhou, China
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19
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Toniollo MB, Sá MDS, Silva FP, Reis GR, Macedo AP, Terada ASSD. Comparison of Conventional and Pontic Fixed Partial Dentures Over Implants Using the Finite Element Method: Three-Dimensional Analysis of Cortical and Medullary Bone Stress. J ORAL IMPLANTOL 2020; 46:175-181. [PMID: 32030425 DOI: 10.1563/aaid-joi-d-19-00115] [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: 11/22/2022]
Abstract
Rehabilitation with implant prostheses in posterior areas requires the maximum number of possible implants due to the greater masticatory load of the region. However, the necessary minimum requirements are not always present in full. This project analyzed the minimum principal stresses (TMiP, representative of the compressive stress) to the friable structures, specifically the vestibular face of the cortical bone and the vestibular and internal/lingual face of the medullary bone. The experimental groups were as follows: the regular splinted group (GR), with a conventional infrastructure on 3 regular-length Morse taper implants (4 × 11 mm); and the regular pontic group (GP), with a pontic infrastructure on 2 regular-length Morse taper implants (4 × 11 mm). The results showed that the TMiP of the cortical and medullary bones were greater for the GP in regions surrounding the implants (especially in the cervical and apical areas of the same region) but they did not reach bone damage levels, at least under the loads applied in this study. It was concluded that greater stress observed in the GP demonstrates greater fragility with this modality of rehabilitation; this should draw the professional's attention to possible biomechanical implications. Whenever possible, professionals should give preference to use of a greater number of implants in the rehabilitation system, with a focus on preserving the supporting tissue with the generation of less intense stresses.
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Affiliation(s)
| | - Mikaelly Dos Santos Sá
- Dental School of Rio Verde, University of Rio Verde (FORV/UniRV), Rio Verde - GO, Brazil
| | - Fernanda Pereira Silva
- Dental School of Rio Verde, University of Rio Verde (FORV/UniRV), Rio Verde - GO, Brazil
| | - Giselle Rodrigues Reis
- Dental School of Rio Verde, University of Rio Verde (FORV/UniRV), Rio Verde - GO, Brazil
| | - Ana Paula Macedo
- Dental School of Ribeirão Preto, University of São Paulo, Department of Dental Materials and Prosthodontics, Ribeirão Preto - SP, Brazil
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20
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Pirmoradian M, Naeeni HA, Firouzbakht M, Toghraie D, Khabaz MK, Darabi R. Finite element analysis and experimental evaluation on stress distribution and sensitivity of dental implants to assess optimum length and thread pitch. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 187:105258. [PMID: 31830699 DOI: 10.1016/j.cmpb.2019.105258] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/29/2019] [Accepted: 12/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE The dental implant is one of the long term proper remedies to recover a missed tooth as a different prosthetic rehabilitation way. The finite element (FE) method and photoelasticity test are employed to achieve stress distribution and sensitivity in dental implants in order to obtain optimum length and thread pitch. METHODS The finite element method and experimental test are developed to evaluate stress distribution and sensitivity around dental implants. Three dimensional FE models of implant-abutment, cortical bone and cancellous bone are created by considering a variation of 0.6 to -1 mm on threads pitch while the implant lengths range from 8.5 mm to 13 mm. Then, axial and oblique forces are applied to the models to obtain the resultant stress contours. RESULTS The results indicate that the resultant von Mises stresses in the implant-abutment, cortical bones, and cancellous bones are different. The optimized setting for length and pitch is suggested according to maximum von Mises stress and sensitivity analysis. CONCLUSIONS It is concluded that the present FE model accurately predicts stress distribution pattern in dental implants. The results indicate that sensitivity of length play a more significant role in comparison with thread pitch. The accuracy of FEM results in comparison with those of the photoelasticity test recommends applying computation methods in medical practice as great potential in terms of future studies.
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Affiliation(s)
- Mostafa Pirmoradian
- Department of Mechanical Engineering, Khomeinishahr branch, Islamic Azad University, Khomeinishahr, Iran.
| | - Hamed Ajabi Naeeni
- Department of Mechanical Engineering, Khomeinishahr branch, Islamic Azad University, Khomeinishahr, Iran
| | - Masih Firouzbakht
- Department of Mechanical Engineering, Khomeinishahr branch, Islamic Azad University, Khomeinishahr, Iran
| | - Davood Toghraie
- Department of Mechanical Engineering, Khomeinishahr branch, Islamic Azad University, Khomeinishahr, Iran
| | - Mohamad Khaje Khabaz
- Young Researchers and Elite Club, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Iran
| | - Reza Darabi
- Department of Prosthodontics, Faculty of Dentistry, Isfahan (Khorasgan) branch, Islamic Azad University, Isfahan, Iran
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21
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Manea A, Bran S, Dinu C, Rotaru H, Barbur I, Crisan B, Armencea G, Onisor F, Lazar M, Ostas D, Baciut M, Vacaras S, Mitre I, Crisan L, Muresan O, Roman R, Baciut G. Principles of biomechanics in oral implantology. Med Pharm Rep 2019; 92:S14-S19. [PMID: 31989104 PMCID: PMC6978931 DOI: 10.15386/mpr-1512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/02/2019] [Indexed: 01/04/2023] Open
Abstract
Background and aims The principles of biomechanics comprise all the interactions between the body (tissues) and the forces acting upon it (directly or via different medical devices). Besides the mechanical aspects, the tissues response is also studied. Understanding and applying these principles is vital for the researchers in the field of oral implantology, but they must be equally known by the practitioners. From the planning stages to the final prosthetic restoration, they are involved in each and every aspect. Ignoring them inevitably leads to failure. Methods The first part of this paper includes a review of our current research in oral implantology (mechanical, digital and biological testing), while the second part includes a review of the available literature on certain biomechanical aspects and their implications in everyday practice. Results Our research opens new study directions and provides increased chances of success for dental implant therapy. The practical aspects of our findings, combined with the available literature (from the basic principles described more than 40 years ago to the most recent studies and technologies) can serve as a guide to practitioners for increasing their success rate. Conclusion While no therapy is without failure risk, a good understanding of the biomechanics involved in oral implantology can lead to higher success rates in implant supported prosthetic restorations.
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Affiliation(s)
- Avram Manea
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotaru
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Barbur
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Bogdan Crisan
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florin Onisor
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Madalina Lazar
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel Ostas
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sergiu Vacaras
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ileana Mitre
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Liana Crisan
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ovidiu Muresan
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rares Roman
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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22
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Yan Q, Wu X, Su M, Hua F, Shi B. Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis. BMJ Open 2019; 9:e029826. [PMID: 31662363 PMCID: PMC6830603 DOI: 10.1136/bmjopen-2019-029826] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/06/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To compare the use of short implants (≤6 mm) in atrophic posterior maxilla versus longer implants (≥10 mm) with sinus floor elevation. DESIGN A systematic review and meta-analysis based on randomised controlled trials (RCTs). DATA SOURCES Electronic searches were conducted in PubMed, Embase and the Cochrane CENTRAL. Retrospective and prospective hand searches were also performed. ELIGIBILITY CRITERIA RCTs comparing short implants (≤6 mm) and longer implants (≥10 mm) with sinus floor elevation were included. Outcome measures included implant survival (primary outcome), marginal bone loss (MBL), complications and patient satisfaction. DATA EXTRACTION AND SYNTHESIS Risks of bias in and across studies were evaluated. Meta-analysis, subgroup analysis and sensitivity analysis were undertaken. Quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation. RESULTS A total of seven RCTs involving 310 participants were included. No significant difference in survival rate was found for 1-3 years follow-up (RR 1.01, 95% CI 0.97 to 1.04, p=0.74, I²=0%, moderate-quality evidence) or for 3 years or longer follow-up (RR 1.00, 95% CI 0.97 to 1.04, p=0.79, I²=0%, moderate-quality evidence). However, short implants (≤6 mm) showed significantly less MBL in 1-3 years follow-up (MD=-0.13 mm, 95% CI -0.21 to 0.05; p=0.001, I²=87%, low-quality evidence) and in 3 years or longer follow-up (MD=-0.25 mm, 95% CI -0.40 to 0.10; p=0.001, I²=0%, moderate-quality evidence). In addition, short implant (≤6 mm) resulted in fewer postsurgery reaction (RR 0.11, 95% CI 0.14 to 0.31, p<0.001, I²=40%, moderate-quality evidence) and sinus perforation or infection (RR 0.11, 95% CI 0.02 to 0.63, p=0.01, I²=0%, moderate-quality evidence). CONCLUSIONS For atrophic posterior maxilla, short implants (≤6 mm) are a promising alternative to sinus floor elevation, with comparable survival rate, less MBL and postsurgery reactions. Additional high-quality studies are needed to evaluate the long-term effectiveness of short implants (≤6 mm). TRIAL REGISTERATION NUMBER The protocol has been registered at PROSPERO (CRD42018103531).
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Affiliation(s)
- Qi Yan
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xinyu Wu
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Meiying Su
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Cochrane Oral Health, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Bin Shi
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Micromotion of implant-abutment interfaces (IAI) after loading: correlation of finite element analysis with in vitro performances. Med Biol Eng Comput 2019; 57:1133-1144. [PMID: 30656596 DOI: 10.1007/s11517-018-1937-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 12/04/2018] [Indexed: 02/05/2023]
Abstract
Micromotion between IAI affects long-term survival rate of dental implants. The use of practical implants for mechanical test is costly. Finite element analysis (FEA) could test the micron level deformation changes, but whether it reflects the in vitro mechanical performances remains unknown. This study aims to investigate the correlation between IAI micromotion of FEA and in vitro performances. The two-step-two-component FEA method was used to test the relative deformation between IAI for three implant designs (M1, M2, and M3) during torque loading and cyclic oblique loading. The micromotion was divided into directions that perpendicular to (x-axis) and parallel to (y-axis) IAI. In vitro experiments on the micromotion relevant performance of IAI microleakage (tested by toluidine blue releasing with a spectrometer) and IAI locked condition (tested by abutment removal force tests after detaching the central screws) were also conducted for the identical implant systems (G1, G2, and G3). One-way ANOVA and Pearson's correlation tests were performed for data analysis. FEA illustrated that the three implant systems performed different micromotion patterns. Significant differences were found in the IAI microleakage and removal force among the groups. Positive correlations were found between FEA and in vitro outcomes. Therefore, the two-step-two-component FEA method is an appropriate method to evaluate the IAI micromotion after loading. Graphical abstract The correspondence of IAI micromotion between FEA analysis and in vitro performances.
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Cruz RS, Lemos CADA, Batista VEDS, Oliveira HFFE, Gomes JMDL, Pellizzer EP, Verri FR. Short implants versus longer implants with maxillary sinus lift. A systematic review and meta-analysis. Braz Oral Res 2018; 32:e86. [PMID: 30231176 DOI: 10.1590/1807-3107bor-2018.vol32.0086] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 07/17/2018] [Indexed: 11/22/2022] Open
Abstract
This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46-2.52] or in the amount of marginal bone loss (p = 0.08; RR: -0.05; 95%CI: -0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10-0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32-7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered.
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Affiliation(s)
- Ronaldo Silva Cruz
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
| | | | - Victor Eduardo de Souza Batista
- Department Prosthodontics, Presidente Prudente Dental School, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | | | - Jéssica Marcela de Luna Gomes
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
| | - Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
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de Souza Batista VE, Verri FR, Lemos CAA, Cruz RS, Oliveira HFF, Gomes JML, Pellizzer EP. Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis. J Prosthet Dent 2018; 121:41-51. [PMID: 29961632 DOI: 10.1016/j.prosdent.2018.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 10/28/2022]
Abstract
STATEMENT OF PROBLEM The decision to splint or to restore independently generally occurs during the planning stage, when the advantages and disadvantages of each clinical situation are considered based on the proposed treatment. However, clinical evidence to help clinicians make this decision is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the marginal bone loss, implant survival rate, and prosthetic complications of splinted and nonsplinted implant restorations. MATERIAL AND METHODS This study was designed according to the Cochrane criteria for elaborating a systematic review and meta-analysis and adopted the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Also, this review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017080162). An electronic search in the PubMed/MEDLINE, Cochrane Library, and Scopus databases was conducted up to November 2017. A specific clinical question was structured according to the population, intervention, comparison, outcome (PICO) approach. The addressed focused question was "Should the restoration of adjacent implants be splinted or nonsplinted?" The meta-analysis was based on the Mantel-Haenszel and inverse variance methods to assess the marginal bone loss, implant survival, and prosthetic complications of splinted and nonsplinted implant restorations. RESULTS Nineteen studies were selected for qualitative and quantitative analyses. A total of 4215 implants were placed in 2185 patients (splinted, 2768; nonsplinted, 1447); the mean follow-up was 87.8 months (range=12-264 months). Quantitative analysis found no significant differences between splinted and nonsplinted restorations for marginal bone loss. The assessed studies reported that 75 implants failed (3.4%), of which 24 were splinted (99.1% of survival rate) and 51 were nonsplinted (96.5% of survival rate). Quantitative analysis of all studies showed statistically significant higher survival rates for splinted restorations than for nonsplinted restorations. Ceramic chipping, screw loosening, abutment screw breakage, and soft tissue inflammation were reported in the selected studies. The quantitative analysis found no statistically significant difference in the prosthetic complications of splinted and nonsplinted restorations. CONCLUSIONS Within the limitations of this systematic review and meta-analysis, it was concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations; this is especially true for restorations in the posterior region. However, splinted restorations were associated with decreased implant failure.
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Affiliation(s)
- Victor E de Souza Batista
- Associate Professor, Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil.
| | - Fellippo R Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Cleidiel A A Lemos
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ronaldo S Cruz
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Hiskell F F Oliveira
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Jéssica M L Gomes
- Graduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Eduardo P Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
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Peixoto HE, Camati PR, Faot F, Sotto-Maior BS, Martinez EF, Peruzzo DC. Rehabilitation of the atrophic mandible with short implants in different positions: A finite elements study. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 80:122-128. [PMID: 28866146 DOI: 10.1016/j.msec.2017.03.310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 03/07/2017] [Accepted: 03/12/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to analyze whether the use of inclined short implants without lower transcortical involvement (test model - SI), thus preserving the mandibular lower cortical bone, could optimize stress distribution. MATERIALS AND METHODS Six identical atrophic mandible models were created featuring 8mm of height at the symphysis. Two study factors were evaluated: implant length and angulation. Implant length was represented either by short implants (7mm) with preservation of the mandibular lower cortical bone or standard implants (9mm) with a bicortical approach and 3 possible implant positioning configurations: 4 distally-inclined implants at 45° (experimental model), all-on-four, 4 vertical implants. All tridimensional (3D) models were analyzed using the Finite Element Method (FEM) and the Ansys Workbench software. RESULTS The maximum stress on the bone at the cervical region of the implants in the experimental model was 132MPa and transcortical involvement with implant inclination yielded higher values (171MPa). Regarding von Mises stress on the retaining screw of the prosthesis, 61MPa was recorded for the experimental model while upright implants had the highest values (223MPa). At the acrylic base, 4MPa was recorded for the experimental model whereas models with upright implants showed the highest stress values (11MPa). CONCLUSION Rehabilitation of severely resorbed mandibles with 4 short implants placed distally at 45°, without lower transcortical involvement, were biomechanically more favorable, generating lower stress peaks, than the models with short implants on an all-on-four, or on an upright configuration, with or without lower transcortical involvement.
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Affiliation(s)
- Hugo E Peixoto
- São Leopoldo Mandic Dental Institute and Research Center, Campinas, SP, Brazil
| | | | - Fernanda Faot
- Federal University of Pelotas, Department of Restorative Dentistry, Pelotas, RS, Brazil
| | - Bruno S Sotto-Maior
- Federal University of Juiz de Fora, Department of Restorative Dentistry, Juiz de Fora, MG, Brazil; Brazil and São Leopoldo Mandic Dental Institute and Research Center, Campinas, SP, Brazil
| | | | - Daiane C Peruzzo
- São Leopoldo Mandic Dental Institute and Research Center, Campinas, SP, Brazil.
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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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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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A Digital Image Correlation Analysis of Strain Generated by 3-Unit Implant-Supported Fixed Dental Prosthesis. IMPLANT DENT 2017; 26:567-573. [DOI: 10.1097/id.0000000000000588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Didier P, Piotrowski B, Fischer M, Laheurte P. Mechanical stability of custom-made implants: Numerical study of anatomical device and low elastic Young's modulus alloy. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 74:399-409. [DOI: 10.1016/j.msec.2016.12.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/21/2016] [Accepted: 12/07/2016] [Indexed: 11/24/2022]
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de Souza Batista VE, Verri FR, Almeida DADF, Santiago Junior JF, Lemos CAA, Pellizzer EP. Finite element analysis of implant-supported prosthesis with pontic and cantilever in the posterior maxilla. Comput Methods Biomech Biomed Engin 2017; 20:663-670. [DOI: 10.1080/10255842.2017.1287905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Victor Eduardo de Souza Batista
- Graduate Program in Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP – Univ Estadual Paulista, Araçatuba, Brazil
| | - Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP – Univ Estadual Paulista, Araçatuba, Brazil
| | | | | | - Cleidiel Aparecido Araújo Lemos
- Graduate Program in Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP – Univ Estadual Paulista, Araçatuba, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP – Univ Estadual Paulista, Araçatuba, Brazil
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Minatel L, Verri FR, Kudo GAH, de Faria Almeida DA, de Souza Batista VE, Lemos CAA, Pellizzer EP, Santiago JF. Effect of different types of prosthetic platforms on stress-distribution in dental implant-supported prostheses. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 71:35-42. [DOI: 10.1016/j.msec.2016.09.062] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 09/17/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
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Verri FR, Cruz RS, Lemos CAA, de Souza Batista VE, Almeida DAF, Verri ACG, Pellizzer EP. Influence of bicortical techniques in internal connection placed in premaxillary area by 3D finite element analysis. Comput Methods Biomech Biomed Engin 2016; 20:193-200. [PMID: 27409042 DOI: 10.1080/10255842.2016.1209188] [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] [Indexed: 10/21/2022]
Abstract
The aim of study was to evaluate the stress distribution in implant-supported prostheses and peri-implant bone using internal hexagon (IH) implants in the premaxillary area, varying surgical techniques (conventional, bicortical and bicortical in association with nasal floor elevation), and loading directions (0°, 30° and 60°) by three-dimensional (3D) finite element analysis. Three models were designed with Invesalius, Rhinoceros 3D and Solidworks software. Each model contained a bone block of the premaxillary area including an implant (IH, Ø4 × 10 mm) supporting a metal-ceramic crown. 178 N was applied in different inclinations (0°, 30°, 60°). The results were analyzed by von Mises, maximum principal stress, microstrain and displacement maps including ANOVA statistical test for some situations. Von Mises maps of implant, screws and abutment showed increase of stress concentration as increased loading inclination. Bicortical techniques showed reduction in implant apical area and in the head of fixation screws. Bicortical techniques showed slight increase stress in cortical bone in the maximum principal stress and microstrain maps under 60° loading. No differences in bone tissue regarding surgical techniques were observed. As conclusion, non-axial loads increased stress concentration in all maps. Bicortical techniques showed lower stress for implant and screw; however, there was slightly higher stress on cortical bone only under loads of higher inclinations (60°).
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Affiliation(s)
- Fellippo Ramos Verri
- a Department of Dental Materials and Prosthodontics, Aracatuba Dental School , UNESP - Univ Estadual Paulista , Aracatuba , Brazil
| | - Ronaldo Silva Cruz
- a Department of Dental Materials and Prosthodontics, Aracatuba Dental School , UNESP - Univ Estadual Paulista , Aracatuba , Brazil
| | - Cleidiel Aparecido Araújo Lemos
- a Department of Dental Materials and Prosthodontics, Aracatuba Dental School , UNESP - Univ Estadual Paulista , Aracatuba , Brazil
| | - Victor Eduardo de Souza Batista
- a Department of Dental Materials and Prosthodontics, Aracatuba Dental School , UNESP - Univ Estadual Paulista , Aracatuba , Brazil
| | - Daniel Augusto Faria Almeida
- c Department of Operative Dentistry, School of Dentistry , Federal University of Alfenas - UNIFAL-MG , Alfenas , Brazil
| | - Ana Caroline Gonçales Verri
- b Department of Pediatric and Community Dentistry, Aracatuba Dental School , UNESP - Univ Estadual Paulista , Aracatuba , Brazil
| | - Eduardo Piza Pellizzer
- a Department of Dental Materials and Prosthodontics, Aracatuba Dental School , UNESP - Univ Estadual Paulista , Aracatuba , Brazil
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Santiago JF, Verri FR, Almeida DADF, de Souza Batista VE, Lemos CAA, Pellizzer EP. Finite element analysis on influence of implant surface treatments, connection and bone types. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 63:292-300. [DOI: 10.1016/j.msec.2016.02.061] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/02/2016] [Accepted: 02/19/2016] [Indexed: 11/27/2022]
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Three-Dimensional Finite Element Analysis Surface Stress Distribution on Regular and Short Morse Taper Implants Generated by Splinted and Nonsplinted Prostheses in the Rehabilitation of Various Bony Ridges. J Craniofac Surg 2016; 27:e276-80. [DOI: 10.1097/scs.0000000000002520] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lu YJ, Chang SH, Ye JT, Ye YS, Yu YS. Finite Element Analysis of Bone Stress around Micro-Implants of Different Diameters and Lengths with Application of a Single or Composite Torque Force. PLoS One 2015; 10:e0144744. [PMID: 26659581 PMCID: PMC4682797 DOI: 10.1371/journal.pone.0144744] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 11/22/2015] [Indexed: 11/19/2022] Open
Abstract
Background Stress on the bone surrounding dental micro-implants affects implant success. Purpose To compare the stress on the bone surrounding a micro-implant after application of a single force (SF) of 200 g or a composite force (CF) of 200 g and 6 N.mm torque. Materials and Methods Finite element models were developed for micro-implant diameters of 1.2, 1.6, and 2.0 mm, and lengths of 6, 8, 10, and 12 mm and either a SF or CF was applied. The maximum equivalent stress (Max EQS) of the bone surrounding the micro-implant was determined, and the relationships among type of force, diameter, and length were evaluated. Results The Max EQS of the CF exceeded that of the SF (P< 0.05). The effect of force on stress was related to implant diameter, but not to implant length. The larger CF led to greater instability of the micro-implant and the effect was most pronounced at an implant diameter of 1.2 mm. The use of implant diameters of 1.6 mm and 2.0 mm produced no significant difference in implant stability when either a CF or SF was applied. Conclusion When considering the use of an implant to perform three-dimensional control on the teeth, the implant diameter chosen should be > 1.2 mm.
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Affiliation(s)
- Ying-juan Lu
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
| | - Shao-hai Chang
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
- * E-mail:
| | - Jian-tao Ye
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
| | - Yu-shan Ye
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
| | - Yan-song Yu
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
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Analysis of the biomechanical behavior of short implants: The photo-elasticity method. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 55:187-92. [DOI: 10.1016/j.msec.2015.05.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 04/02/2015] [Accepted: 05/07/2015] [Indexed: 11/22/2022]
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Ghariani L, Segaan L, Rayyan MM, Galli S, Jimbo R, Ibrahim A. Does crown/implant ratio influence the survival and marginal bone level of short single implants in the mandibular molar? A preliminary investigation consisting of 12 patients. J Oral Rehabil 2015; 43:127-35. [PMID: 26333185 DOI: 10.1111/joor.12342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2015] [Indexed: 11/28/2022]
Abstract
Crown/implant (C/I) ratio has been proven to not affect the survival of the implants; however, it is also a fact that no evidence exists with regard to the use of single short implants in the mandibular molar. The aim of this study was to determine whether the crown/implant ratios of single implant-supported fixed restorations on implants of 6-8 mm in the mandibular molar have an impact on the implant survival and marginal bone maintenance. Twelve short dental implants (6-8 mm) were installed and restored with single crowns, loaded after 3 months of healing. The restorations were divided according to crown-to-implant ratio into two groups: Group 1: C/I < 2.0 and Group 2: C/I ≧ 2.0. Alveolar bone loss was measured using CBCT scan, taken at the implant placement and after 12 months follow-up from loading. Reduced implant/crown ratio shown no statistic significant differences on implant survival and the alveolar bone level compared with recommended implant/crown ratio. Within the limitation of this study, it can be concluded that reduced C/I ratio could be used as a substitute for recommended C/I ratio in severely mandibular atrophic residual alveolar ridges.
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Affiliation(s)
- L Ghariani
- Department of Oral Surgical Sciences, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - L Segaan
- Department of Oral Rehabilitation Sciences, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - M M Rayyan
- Department of Oral Surgical Sciences, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon.,Department of Fixed Prosthodontics, Faculty of dentistry, Misr University for Science and Technology, Giza Governorate, Giza, Egypt
| | - S Galli
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - R Jimbo
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - A Ibrahim
- Public Health Service (Folktandvården), Gefle, Sweden
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Three-Dimensional Finite Element Analysis of Anterior Single Implant-Supported Prostheses with Different Bone Anchorages. ScientificWorldJournal 2015; 2015:321528. [PMID: 26351654 PMCID: PMC4550744 DOI: 10.1155/2015/321528] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/09/2015] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to evaluate the stress distribution of monocortical and bicortical implant placement of external hexagon connection in the anterior region of the maxilla by 3D finite element analysis (FEA). 3D models were simulated to represent a bone block of anterior region of the maxilla containing an implant (4.0 × 10.0 mm) and an implant-supported cemented metalloceramic crown of the central incisor. Different techniques were tested (monocortical, bicortical, and bicortical associated with nasal floor elevation). FEA was performed in FEMAP/NeiNastran software using loads of 178 N at 0°, 30°, and 60° in relation to implant long axis. The von Mises, maximum principal stress, and displacement maps were plotted for evaluation. Similar stress patterns were observed for all models. Oblique loads increased the stress concentration on fixation screws and in the cervical area of the implants and bone around them. Bicortical technique showed less movement tendency in the implant and its components. Cortical bone of apical region showed increase of stress concentration for bicortical techniques. Within the limitations of this study, oblique loading increased the stress concentrations for all techniques. Moreover, bicortical techniques showed the best biomechanical behavior compared with monocortical technique in the anterior maxillary area.
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Trivedi S. Finite element analysis: A boon to dentistry. J Oral Biol Craniofac Res 2014; 4:200-3. [PMID: 25737944 PMCID: PMC4306993 DOI: 10.1016/j.jobcr.2014.11.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 11/20/2014] [Indexed: 11/30/2022] Open
Abstract
The finite element analysis (FEA) is an upcoming and significant research tool for biomechanical analyses in biological research. It is an ultimate method for modeling complex structures and analyzing their mechanical properties. In Implantology, FEA has been used to study the stress patterns in various implant components and also in the peri-implant bone. It is also useful for studying the biomechanical properties of implants as well as for predicting the success of implants in clinical condition. FEA of simulated traumatic loads can be used to understand the biomechanics of fracture. FEA has various advantages compared with studies on real models. The experiments are repeatable, there are no ethical considerations and the study designs may be modified and changed as per the requirement. There are certain limitations of FEA too. It is a computerized in vitro study in which clinical condition may not be completely replicated. So, further FEA research should be supplemented with clinical evaluation.
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