Strain analysis of maxillary complete denture with three-dimensional finite element method

A Finite Element Analysis Study of Edentulous Model with Complete Denture to Simulate Masticatory Movement

The purposes of this study are to establish and validate a finite element (FE) model using finite element analysis methods and to identify optimal loading conditions to simulate masticatory movement. A three-dimensional FE model of the maxillary and mandibular cortical bone, cancellous bone, and gingiva was constructed based on edentulous cone-beam-computed tomography data. Dental computer-aided design software was used to design the denture base and artificial teeth to produce a complete denture. Mesh convergence was performed to derive the optimal mesh size, and validation was conducted through comparison with mechanical test results. The mandible was rotated step-by-step to induce movements similar to actual mastication. Results showed that there was less than a 6% difference between the mechanical test and the alveolar bone-complete denture. It opened 10° as set in the first stage, confirming that the mouth closed 7° in the second stage. Occlusal contact occurred between the upper and lower artificial teeth as the mouth closed the remaining angle of 3° in the third stage while activating the masseter muscle. These results indicate that the FE model and masticatory loading conditions developed in this study can be applied to analyze biomechanical effects according to the wearing of dentures with various design elements applied.

Development of lightweight and high-strength hollow titanium-plated denture material using three-dimensional printing

Owing to its desirable ability to fabricate complex shapes, three-dimensional printing is preferred over casting for manufacturing dentures. Furthermore, titanium is widely used in dental implants and dentures because of its high corrosion resistance, biocompatibility, strength, and low density. In this study, we aimed to develop a new metal denture material from three-dimensional-printed (3DP) to achieve lighter weight and greater strength than those of PMMA dentures. Hollow (3DP-H) structure and solid (3DP-S) structure titanium plate specimens of 0.5, 1.0, and 3.0 mm in thickness were used. Casted Ti, casted Co-Cr, and PMMA plates were fabricated for comparison. Elastic modulus, density, thermal conductivity, hardness, and proof stress of the specimens were measured and plotted on a radar chart to enable multifaceted evaluation. The results indicated that the density of the 3DP-H plates reduced by 28-36% compared with those of 3DP-S and cast Ti plates. The weight of the metal-denture-equivalent section of the 0.5-mm-thick 3DP-H titanium-plated denture reduced to two-thirds that of the 2.0-mm-thick PMMA denture. The proof stress of the 0.5-mm-thick 3DP-H plate increased to about 3 times that of the 2.0-mm-thick PMMA plate. The total value of the 0.5-mm-thick 3DP-H titanium plates was higher than it of the 1.0-mm-thick PMMA plates. This study suggests that it is possible to produce 3DP-H titanium plate dentures exhibiting not only extremely lightweight compared to conventional PMMA dentures but also sufficient strength.

Effect of thermal cycling on the flexural strength of 3-D printed, CAD/CAM milled and heat-polymerized denture base materials

BACKGROUND

This study compared the impact of thermal cycling on the flexural strength of denture-base materials produced through conventional and digital methods, using both subtractive and additive approaches.

METHODS

In total, 60 rectangular specimens were fabricated with specific dimensions for flexural strength tests. The dimensions were set according to the International Organization for Standardization (ISO) guideline 20795-1:2013 as 64 × 10 × 3.3 ± 0.2 mm. Specimens from each material group were divided into two subgroups (thermal cycled or nonthermal cycled, n = 10/group). We used distinct methods to produce three different denture-base materials: Ivobase (IB), which is a computer-aided-design/computer-aided-manufacturing-type milled pre-polymerized polymethyl methacrylate resin disc; Formlabs (FL), a 3D-printed denture-base resin; and Meliodent (MD), a conventional heat-polymerized acrylic. Flexural strength tests were performed on half of the samples without a thermal-cycle procedure, and the other half were tested after a thermal cycle. The data were analyzed using a two-way analysis of variance and a post hoc Tukey test (α = 0.05).

RESULTS

Based on the results of flexural-strength testing, the ranking was as follows: FL > IB > MD. The effect of thermal aging was statistically significant for the FL and IB bases, but not for the MD base.

CONCLUSIONS

Digitally produced denture bases exhibited superior flexural strength compared with conventionally manufactured bases. Although thermal cycling reduced flexural strength in all groups, the decrease was not statistically significant in the heat-polymerized acrylic group.

Cyclic strain of poly (methyl methacrylate) surfaces triggered the pathogenicity of Candida albicans

Candida albicans is an opportunistic yeast and the primary etiological factor in oral candidiasis and denture stomatitis. The pathogenesis of C. albicans could be triggered by several variables, including environmental, nutritional, and biomaterial surface cues. Specifically, biomaterial interactions are driven by different surface properties, including wettability, stiffness, and roughness. Dental biomaterials experience repetitive (cyclic) stresses from chewing and biomechanical movements. Pathogenic biofilms are formed over these biomaterial surfaces under cyclic strain. This study investigated the effect of the cyclic strain (deformation) of biomaterial surfaces on the virulence of Candida albicans. Candida biofilms were grown over Poly (methyl methacrylate) (PMMA) surfaces subjected to static (no strain) and cyclic strain with different levels (ε˜x=0.1 and 0.2%). To evaluate the biomaterial-biofilm interactions, the biofilm characteristics, yeast-to-hyphae transition, and the expression of virulent genes were measured. Results showed the biofilm biomass and metabolic activity to be significantly higher when Candida adhered to surfaces subjected to cyclic strain compared to static surfaces. Examination of the yeast-to-hyphae transition showed pseudo-hyphae cells (pathogenic) in cyclically strained biomaterial surfaces, whereas static surfaces showed spherical yeast cells (commensal). RNA sequencing was used to determine and compare the transcriptome profiles of cyclically strained and static surfaces. Genes and transcription factors associated with cell adhesion (CSH1, PGA10, and RBT5), biofilm formation (EFG1), and secretion of extracellular matrix (ECM) (CRH1, ADH5, GCA1, and GCA2) were significantly upregulated in the cyclically strained biomaterial surfaces compared to static ones. Genes and transcription factors associated with virulence (UME6 and HGC1) and the secretion of extracellular enzymes (LIP, PLB, and SAP families) were also significantly upregulated in the cyclically strained biomaterial surfaces compared to static. For the first time, this study reveals a biomaterial surface factor triggering the pathogenesis of Candida albicans, which is essential for understanding, controlling, and preventing oral infections. STATEMENT OF SIGNIFICANCE: Fungal infections produced by Candida albicans are a significant contributor to various health conditions. Candida becomes pathogenic when certain environmental conditions change, including temperature, pH, nutrients, and CO2 levels. In addition, surface properties, including wettability, stiffness, and roughness, drive the interactions between Candida and biomaterials. Clinically, Candida adheres to biomaterials that are under repetitive deformation due to body movements. In this work, we revealed that when Candida adhered to biomaterial surfaces subjected to repetitive deformation, the microorganism becomes pathogenic by increasing the formation of biofilms and the expression of virulent factors related to hyphae formation and secretion of enzymes. Findings from this work could aid the development of new strategies for treating fungal infections in medical devices or implanted biomaterials.

The Biomechanical Impact of Loss of an Implant in the Treatment with Mandibular Overdentures on Four Nonsplinted Mini Dental Implants: A Finite Element Analysis

The aim of this study was to evaluate the biomechanical impact, in terms of stress and displacement, at the level of a mandibular overdenture, on four mini dental implants (MDIs) after the loss of an implant. A three-dimensional virtual model was obtained by scanning the overdenture, and a biomechanical analysis was carried out, using the finite element method (FEM). The displacements of the overdenture and the equivalent von Mises stresses were evaluated using logarithmic scales. In the case of a mandibular overdenture on four MDIs inserted in the interforaminal area, the frontal loading generated the lowest values for the von Mises stresses, and the bilateral loading generated the least displacement when two implants were inserted in the canine area and two in the molar area. The highest von Mises stress was observed during frontal loading in the situation of the mandibular overdenture on four MDIs, two of which were inserted in the canine area and two in the molar area, following the loss of an implant in the canine area. The largest displacement was noted in the mandibular overdenture on four interforaminal MDIs during unilateral loading, following the loss of a distally inserted implant. The FEM analysis showed aspects that correlated with clinical observations, with predictive value. The concentration of von Mises stresses, and the occurrence of some displacements of the prosthodontic restoration, can explain the emergence of some complications in the overdenture's biodynamics, and the increased risk of fracture. Complications can be prevented by choosing a certain number of implants and a topographical distribution correlated with biomechanical aspects, and by proposing a correct occlusal scheme with optimal functional loading.

Algorithm for Designing a Removable Complete Denture (RCD) Based on the FEM Analysis of Its Service Life

(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.

Comparison of the Masticatory Force (with 3D Models) of Complete Denture Base Acrylic Resins with Reline and Reinforcing Materials

The reinforcement of acrylic denture base remains problematic. Acrylic prosthesis fractures are commonly observed in prosthodontic practice and have not been reliably resolved. This study compared the resistance to masticatory force of acrylic bases of removable complete conventional prosthesis in 3D upper models. Forty acrylic base test specimens containing two types of reinforcement meshes (20 with glass fiber meshes (FIBER-FORCE^®- Synca, Bio Composants Médicaux^TM, Tullins, France), 20 with metal meshes (DENTAURUM^®-Ispringen, Germany)), 20 with a conventional PMMA acrylic base (LUCITONE 199^®-Dentsply Sirona, York, PA, USA), and 20 using a permanent soft reline material (MOLLOPLAST-B^®-DETAX GmbH & Co. KG, Ettlingen, Germany) were tested—a total of 80 specimens. Half of the specimens were made for a low alveolar ridge and half for a high alveolar ridge. The data were analysed using one-way analysis of variance and Student’s t-test for independent test specimens. In the high-alveolar-ridge group, the prosthesis reinforced with the glass fiber mesh was the most resistant to fracture, while in the low-alveolar-ridge group, the non-reinforced prosthesis showed the highest resistance masticatory force. Prostheses with the permanent soft reline material showed the lowest resistance to fracture in both high and low-alveolar-ridge groups. The results show that the selection of the right reinforcement material for each clinical case, based on the height of the alveolar ridge, may help to prevent prosthesis fractures.

Relationships of Stresses on Alveolar Bone and Abutment of Dental Implant from Various Bite Forces by Three-Dimensional Finite Element Analysis

Occlusal trauma caused by improper bite forces owing to the lack of periodontal membrane may lead to bone resorption, which is still a problem for the success of dental implant. In our study, to avoid occlusal trauma, we put forward a hypothesis that a microelectromechanical system (MEMS) pressure sensor is settled on an implant abutment to track stress on the abutment and predict the stress on alveolar bone for controlling bite forces in real time. Loading forces of different magnitudes (0 N–100 N) and angles (0–90°) were applied to the crown of the dental implant of the left central incisor in a maxillary model. The stress distribution on the abutment and alveolar bone were analyzed using a three-dimensional finite element analysis (3D FEA). Then, the quantitative relation between them was derived using Origin 2017 software. The results show that the relation between the loading forces and the stresses on the alveolar bone and abutment could be described as 3D surface equations associated with the sine function. The appropriate range of stress on the implant abutment is 1.5 MPa–8.66 MPa, and the acceptable loading force range on the dental implant of the left maxillary central incisor is approximately 6 N–86 N. These results could be used as a reference for the layout of MEMS pressure sensors to maintain alveolar bone dynamic remodeling balance.

Efficacy of different designs of mandibular expanders: A 3-dimensional finite element study

INTRODUCTION

Nonsurgical mandibular expansion has been increasingly performed in recent years because it can effectively expand the mandibular dental arch. However, many types of mandibular expanders have been used in previous studies. No relevant studies have compared the biomechanical responses of different designs of mandibular expansion appliances with screws. Therefore, the purpose of this study was to analyze the stress distribution and displacement of the dentoalveolar structures according to different designs of mandibular screw expanders.

METHODS

Cone-beam computed tomography scans were used for 3-dimensional reconstruction of the mandibular finite element model. Four different designs of mandibular expanders, 1 removable expander (type A) and 3 fixed expanders (types B, C, and D), were added to the finite element models. Expanders were activated transversely for 0.2 mm. The initial tooth displacement and von Mises stress distribution were evaluated.

RESULTS

All the expanders enlarged the arch dimensions. In types A and B, the stress was mainly concentrated in the region of the anterior teeth, along with greater tooth displacement, whereas in types C and D, greater stress and displacement occurred in the region of the posterior teeth. Type A showed the greatest amount of transverse displacement. Type D was more efficient in the region of the posterior teeth.

CONCLUSIONS

Types A and B should be used with great caution in the clinic because of their incompatible expansion pattern. Type D is the recommended mandibular expansion appliance because of its appropriate expansion pattern.

Retrospective evaluation of marginal bone loss around implants in a mandibular locator-retained denture using panoramic radiographic images and finite element analysis: A pilot study

BACKGROUND

The follow-up of the peri-implant marginal bone loss is the most important criterion for the determination of implant success.

PURPOSE

The purpose of this study is to measure marginal bone loss using panoramic radiographic images (PRI) of patients treated using a mandibular, two implant-supported, locator-retained denture and to evaluate the compatibility of these findings with those of the finite element analysis (FEA).

MATERIALS AND METHODS

The PRI of patients who had a mandibular, two implant-supported, locator-retained denture were assessed, and the mesial and distal marginal bone loss of both right- and left-sided implants was measured. Mandibular and maxillary models, which have the features of bilateral balanced occlusion, were created. The surfaces of the generated models were converted in a computer-aided design model that could be transferred to the FEA software, and the forces were defined on contacts formed in maximum intercuspation, lateral, and protrusive movement position for bilateral balanced occlusion.

RESULTS

The bone loss in the mesial and distal regions at the right- and left-sided implants was not statistically significant. Higher stresses were formed on the vestibular side under protrusive movement, on the lingual side under maximum intercuspation, on the distolingual side under left unilateral biting, and on the mesiolingual side under right unilateral biting in the FEA.

CONCLUSION

According to FEA, peri-implant bone resorption may be higher in the buccal and palatal regions, implying that panoramic radiographs can be misleading in understanding the amount of peri-implant bone resorption.

Flexural strength of denture base acrylic resins processed by conventional and CAD-CAM methods

STATEMENT OF PROBLEM

High flexural strength is one of the desirable properties for denture base resins, yet only few studies have evaluated the physical properties of newer denture bases such as computer-aided design and computer aided manufacturing (CAD-CAM) milled products.

PURPOSE

The purpose of this in vitro study was to compare the flexural strength of 3 different types of denture base resins: compression molded, injection molded, and CAD-CAM milled.

MATERIAL AND METHODS

Three groups (n=10) of acrylic denture base resins were tested: injection molded, compression molded, and CAD-CAM milled resin. ISO-compliant, rectangular specimens were fabricated (64×10×3.3 mm) (n=30). Specimens were stored in water for 1 week, and flexural strength was measured by using a 3-point bend test until failure. The Student t test was used to evaluate differences in the flexural strength and modulus of elasticity among specimen groups. The Bonferroni formula was used to set significance at α=.017 to account for multiple comparisons among the 3 groups.

RESULTS

The flexural strength of the CAD-CAM milled group was significantly higher than that of the other 2 groups (P<.001), while the strength of the compression molded group was significantly greater than that of the injection molded group (P<.001). The flexural modulus of the CAD-CAM group was significantly higher than that of the other 2 groups (P<.001).

CONCLUSIONS

CAD-CAM milled denture bases may be a useful alternative to conventionally processed denture bases in situations where increased resistance to flexural strength is needed.

A novel computational method to determine subject-specific bite force and occlusal loading during mastication

The evaluation of three-dimensional occlusal loading during biting and chewing may assist in development of new dental materials, in designing effective and long-lasting restorations such as crowns and bridges, and for evaluating functional performance of prosthodontic components such as dental and/or maxillofacial implants. At present, little is known about the dynamic force and pressure distributions at the occlusal surface during mastication, as these quantities cannot be measured directly. The aim of this study was to evaluate subject-specific occlusal loading forces during mastication using accurate jaw motion measurements. Motion data was obtained from experiments in which an individual performed maximal effort dynamic chewing cycles on a rubber sample with known mechanical properties. A finite element model simulation of one recorded chewing cycle was then performed to evaluate the deformation of the rubber. This was achieved by imposing the measured jaw motions on a three-dimensional geometric surface model of the subject's dental impressions. Based on the rubber's deformation and its material behaviour, the simulation was used to compute the resulting stresses within the rubber as well as the contact pressures and forces on the occlusal surfaces. An advantage of this novel modelling approach is that dynamic occlusal pressure maps and biting forces may be predicted with high accuracy and resolution at each time step throughout the chewing cycle. Depending on the motion capture technique and the speed of simulation, the methodology may be automated in such a way that it can be performed chair-side. The present study demonstrates a novel modelling methodology for evaluating dynamic occlusal loading during biting or chewing.

Reinforcing effect of glass-fiber mesh on complete dentures in a test model with a simulated oral mucosa

STATEMENT OF PROBLEM

Studies that evaluated the strength of complete dentures reinforced with glass-fiber mesh or metal mesh on a cast with a simulated oral mucosa are lacking.

PURPOSE

The purpose of this in vitro study was to compare the mechanical properties of maxillary complete dentures reinforced with glass-fiber mesh with those of metal mesh in a new test model, using a simulated oral mucosa.

MATERIAL AND METHODS

Complete dentures reinforced with 2 types of glass-fiber mesh, SES mesh (SES) and glass cloth (GC) and metal mesh (metal) were fabricated. Complete dentures without any reinforcement were prepared as a control (n=10). The complete dentures were located on a cast with a simulated oral mucosa, and a load was applied on the posterior artificial teeth bilaterally. The fracture load, elastic modulus, and toughness of a complete denture were measured using a universal testing machine at a crosshead speed of 5 mm/min. The fracture load and elastic modulus were analyzed using 1-way analysis of variance, and the toughness was analyzed with the Kruskal-Wallis test (α=.05). The Tukey multiple range test was used as a post hoc test.

RESULTS

The fracture load and toughness of the SES group was significantly higher than that of the metal and control groups (P<.05) but not significantly different from that of the GC group. The elastic modulus of the metal group was significantly higher than that of the control group (P<.05), and no significant differences were observed in the SES and GC groups.

CONCLUSIONS

Compared with the control group, the fracture load and toughness of the SES and GC groups were higher, while those of the metal group were not significantly different.

Stress Distribution under Commercial Denture Liners- A Finite Element and Clinical Analysis

INTRODUCTION

Previous studies have shown that 20-30% of denture users have been dissatisfied with their dentures.

AIM

To evaluate the stress pattern under elastic and viscoelastic denture liners using 3-Dimensional Finite Element Analysis (FEA) and its clinical correlation using a questionnaire.

MATERIALS AND METHODS

The study had both in-vitro and in-vivo phases. In in-vitro phase fabrication of a virtual parametric model of edentulous maxilla and dentures with overlying mucosa was made. A virtual load of 166N was analyzed at three points (Point A=anterior ridge, Point B=right posterior ridge and Point C=left posterior ridge). For the in-vivo phase, 20 edentulous patients were provided conventional complete dentures (Group-I). The dentures were lined with silicone (elastic) liners (Group-II) and acrylic resins (viscoelastic) liners (Group-III) at regular (2 months) intervals. After each reline, the patients were evaluated using food eating ability and denture assessment questionnaires. The results were statistically analyzed. The statistical analysis was done using SPSS (Statistical Package for Social Sciences) version 15.0 statistical analysis software. Other than standard statistical test Analysis of Variance (ANOVA) and Post-Hoc tests (Tukey-HSD) were used.

RESULTS

At loading, the in-vitro result for Groups-II and III revealed pressures of 0.074231N and 0.0678364N at Point A, 0.098764N and 0.093642N at Point B, and 0.099876N and 0.093746N at Point C respectively. The in-vivo study revealed that the mean quality of life score for different groups ranged from 23.65±4.00 (Group I) to 33.10±6.15 (Group III). The mean quality of life score for Group II was 29.50±5.08.

CONCLUSION

The viscoelastic liner provided the most uniform stress distribution and performed better than an elastic liner with hard, firm and soft foods.

Biomechanics of oral mucosa

The prevalence of prosthodontic treatment has been well recognized, and the need is continuously increasing with the ageing population. While the oral mucosa plays a critical role in the treatment outcome, the associated biomechanics is not yet fully understood. Using the literature available, this paper provides a critical review on four aspects of mucosal biomechanics, including static, dynamic, volumetric and interactive responses, which are interpreted by its elasticity, viscosity/permeability, apparent Poisson's ratio and friction coefficient, respectively. Both empirical studies and numerical models are analysed and compared to gain anatomical and physiological insights. Furthermore, the clinical applications of such biomechanical knowledge on the mucosa are explored to address some critical concerns, including stimuli for tissue remodelling (interstitial hydrostatic pressure), pressure–pain thresholds, tissue displaceability and residual bone resorption. Through this review, the state of the art in mucosal biomechanics and their clinical implications are discussed for future research interests, including clinical applications, computational modelling, design optimization and prosthetic fabrication.

Influence of three different implant thread designs on stress distribution: A three-dimensional finite element analysis

Purpose:

Clinical success of implant prosthodontics is dependent in part upon the type of implant thread design. The selection of implant thread design plays an important role in the outcome of the treatment. This study was undertaken to evaluate the pattern of stress distribution using a finite element analysis; hence, the area which would be bearing maximum load for a given design would be arrived.

Materials and Methods:

Three implants with different thread designs, namely V-thread, buttress, and reverse buttress thread designs were considered and dimensions were standardized. The site considered was the mandibular molar region with cortical and trabecular bone assuming to be isotropic and homogeneous. The implant modeling was done with the CATIA software. Vertical loads of 100N were applied. The stresses were calculated as Von Mises stress criterion.

Results:

Maximum stresses were seen at the cortical bone and were transferred to the implant. Minimum Von Mises stresses were seen with reverse buttress thread design at the cortical bone. The stresses were observed least at the cancellous bone and maximum at the implant.

Conclusion:

Hence, within the limitations of this study the results obtained can be applied clinically for appropriate selection of implant thread design for a predictable success of implant therapy.

Effects of glass fiber mesh with different fiber content and structures on the compressive properties of complete dentures

STATEMENT OF PROBLEM

No study has yet evaluated the strength of complete dentures reinforced with glass fiber meshes with different content and structures.

PURPOSE

The purpose of this study was to compare the reinforcing effects of glass fiber mesh with different content and structures with that of metal mesh in complete dentures.

MATERIAL AND METHODS

Two types of glass fiber mesh were used: SES mesh (SES) and glass cloth (GC2, GC3, and GC4). A metal mesh was used for comparison. The complete dentures were made by placing the reinforcement 1 mm away from the tissue surface. A control group was prepared without any reinforcement (n=10). The compressive properties were measured by a universal testing machine at a crosshead speed of 5 mm/min. The results were analyzed with the Kruskal-Wallis test and the Duncan multiple range test (α=.05).

RESULTS

The fracture resistance of the SES group was significantly higher than that of the control, GC4, and metal groups (asymptotic P=.004), but not significantly different from the GC2 and GC3 groups. The toughness of the SES and GC3 groups was significantly higher than that of the others (asymptotic P<.001), but not significantly different from that of the GC4 group.

CONCLUSIONS

SES and GC3, which have different structures but similar volume content, were the most effective in reinforcing complete dentures. The content of the glass fiber mesh seemed more important than the structures.

Influence of inner circular sealing area impression method on the retention of complete dentures

The aims of the present study were to describe an impression method of "inner circular sealing area" and to evaluate the effect of the method on retention, aesthetics and comfort of complete dentures, which lack labial base for patients with maxillary protrusions. Three patients were subjected to the experiment, and two sets of complete maxillary dentures were made for each patient; the first set was made without labial base via an inner circular sealing area method (experimental group) and the second had an intact base that was made with conventional methods (control group). Retention force tests were implemented with a tensile strength assessment device to assess the retention and a visual analogue scale (VAS) was used to evaluate the comfort between the two groups. Results showed larger retention force, better aesthetics and more comfort in the experimental group. The improved two-step impression method formed an inner circular sealing area that prevented damage to the peripheral border seal effect of the denture caused by incomplete bases and obtained better denture retention.

Exploring the biomechanics of taurodontism

Taurodontism (i.e. enlarged pulp chamber with concomitant apical displacement of the root bi/trifurcation) is considered a dental anomaly with relatively low incidence in contemporary societies, but it represents a typical trait frequently found in Neandertal teeth. Four hypotheses can be envisioned to explain the high frequency in Neandertals: adaptation to a specific occlusal loading regime (biomechanical advantage), adaptation to a high attrition diet, pleiotropic or genetic drift effects. In this contribution we used finite element analysis (FEA) and advanced loading concepts based on macrowear information to evaluate whether taurodontism supplies some dental biomechanical advantages. Loads were applied to the digital model of the lower right first molar (RM1 ) of the Neandertal specimen Le Moustier 1, as well as to the digital models of both a shortened and a hyper-taurodontic version of Le Moustier RM1 . Moreover, we simulated a scenario where an object is held between teeth and pulled in different directions to investigate whether taurodontism might be useful for para-masticatory activities. Our results do not show any meaningful difference among all the simulations, pointing out that taurodontism does not improve the functional biomechanics of the tooth and does not favour para-masticatory pulling activities. Therefore, taurodontism should be considered either an adaptation to a high attrition diet or most likely the result of pleiotropic or genetic drift effects. Finally, our results have important implications for modern dentistry during endodontic treatments, as we observed that filling the pulp chamber with dentine-like material increases tooth stiffness, and ultimately tensile stresses in the crown, thus favouring tooth failure.

Stress analysis of a complete maxillary denture under various drop impact conditions: a 3D finite element study

Complete maxillary dentures are one of the most economic and easy ways of treatment for edentulous patients and are still widely used. However, their survival rate is slightly above three years. It is presumed that the failure reasons are not only due to normal fatigue but also emerge from damage based on unavoidable improper usage. Failure types other than long-term fatigue, such as over-deforming, also influence the effective life span of dentures. A hypothesis is presumed, stating that the premature/unexpected failures may be initiated by impact on dentures, which can be related to dropping them on the ground or other effects such as biting crispy food. Thus, the behavior of a complete maxillary denture under impact loading due to drop on a rigid surface was investigated using the finite element method utilizing explicit time integration and a rate-sensitive elastoplastic material model of polymethylmethacrylate (PMMA). Local permanent deformations have been observed along with an emphasis on frenulum region of the denture, regardless of the point of impact. Contact stresses at the tooth-denture base were also investigated. The spread of energy within the structure via wave propagation is seen to play a critical role in this fact. Stress-wave propagation is also seen to be an important factor that decreases the denture's fatigue life.

The impact of frenulum height on strains in maxillary denture bases

PURPOSE

The midline fracture of maxillary complete dentures is a frequently encountered complication. The purpose of this study was to assess the effect of frenulum height on midline strains of maxillary complete dentures.

MATERIALS AND METHODS

A removable maxillary complete denture was fabricated and duplicated seven times. Four different labial frenulum heights were tested for stresses occurring on the palatal cameo surface. The strains were measured with strain gauges placed on 5 different locations and the stresses were calculated. To mimic occlusal forces bilaterally 100 N of load was applied from the premolar and molar region.

RESULTS

A statistically significant association between the height of the labial frenulum and the calculated stresses and strains was shown (P<.05) predominantly on the midline and especially on the incisive papilla. The results showed that stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum.

CONCLUSION

Within the limitations of this in vitro study, it can be concluded that the stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. Surgical or mechanical precautions should be taken to prevent short-term failure of maxillary complete dentures due to stress concentration and low cycle fatigue tendency at the labial frenulum region.

Elastic modulus and flexural strength comparisons of high-impact and traditional denture base acrylic resins

BACKGROUND

Fractures of acrylic resin dentures are a common occurrence in clinical dentistry. The denture may be fractured accidentally when dropped or while in service in the mouth due to flexural fatigue.

OBJECTIVES

The aim of this study was to compare the elastic modulus and the flexural strength between two heat-cured acrylic resins used in denture bases: a high-impact resin (Lucitone 199) and a traditional resin (Rodex).

MATERIALS AND METHODS

Rectangular strips of Lucitone 199 and Rodex (10 samples each) were fabricated and stored in artificial saliva at 37 °C for 2 weeks. The specimens were subjected to a three-point flexural test. The data were statistically analysed with Student's t-test (p ⩽ .05).

RESULTS

The high-impact acrylic resin had a lower elastic modulus (p = .000) and higher flexural strength (p = .001) compared to the traditional acrylic resin.

CONCLUSION

Within the limitations of this study, it can be concluded that the high-impact acrylic resin is a suitable denture base material for patients with clinical fracture of the acrylic denture.

Effect of thermal cycling on denture base and autopolymerizing reline resins

Objective:

This study evaluated the fracture toughness (FT) of denture base and autopolymerizing reline resins, with and without thermocycling (T).

Material and Methods:

Specimens of each material (denture base acrylic resin - Lucitone 550 - L; autopolymerizing reline resins - Ufi Gel Hard-UH, Tokuyama Rebase II-TR, New Truliner- NT and Kooliner-K), were produced, notched and divided into two groups (n=10): CG (control group of autopolymerizing reline resins and L): FT tests were performed after polymerization; TG (thermocycled group): FT tests were performed after T (5ºC and 55ºC for 5,000 cycles).

Results:

Results (MPa.m^(1/2)) were analyzed by two-way ANOVA and Tukey's test (p=0.05). L exhibited the highest FT mean values in both groups (CG - 2.33; TG - 2.17). For the CG groups, NT showed the highest FT (1.64) among the autopolymerizing reline resins, and K the lowest (1.04). After T, when the autopolymerizing reline resins were compared, a statistically significant difference in FT was found only between the NT (1.46) and TR (1.00).

Conclusions:

Thermocycling increased the FT of K and did not influence the FT of L, UH, TR and NT.

Patient-specific finite element analysis of viscoelastic masticatory mucosa

The purpose of this study was to analyze the stress and strain inside of the oral mucosa in partially-edentulous patients. The patient-specific finite element models of the mucosa and the bone were constructed using the CT images and in-vivo surface measurement during a continuous load. The mean initial shear modulus of 8.3 × 10^–5 (GPa) and the mean relaxation time of 503 (s) were determined as the viscoelastic properties of the mucosa. The increase of the highest maximum compressive strain during the continuous loading was observed in all the patients, however; the intensity of strain was not in accordance with the thickness of the mucosa. It is suggested that the variations of the morphology and the initial modulus of the mucosa should be considered in the mathematical approaches to detect the mechanical responses of the oral mucosa.

Finite element analysis of different surgical approaches in various occlusal loading locations for zygomatic implant placement for the treatment of atrophic maxillae

The aim of this study was to compare two different types of surgical approaches, intrasinus and extramaxillary, for the placement of zygomatic implants to treat atrophic maxillae. A computational finite element simulation was used to analyze the strength of implant anchorage for both approaches in various occlusal loading locations. Three-dimensional models of the craniofacial structures surrounding a region of interest, soft tissue and framework were developed using computed tomography image datasets. The implants were modelled using computer-aided design software. The bone was assumed to be linear isotropic with a stiffness of 13.4 GPa, and the implants were assumed to be made of titanium with a stiffness of 110 GPa. Masseter forces of 300 N were applied at the zygomatic arch, and occlusal loads of 150 N were applied vertically onto the framework surface at different locations. The intrasinus approach demonstrated more satisfactory results and could be a viable treatment option. The extramaxillary approach could also be recommended as a reasonable treatment option, provided some improvements are made to address the cantilever effects seen with that approach.

The stress state of the fraenal notch region in complete upper dentures

The present study determines the stress field in the region of the labial flange of the complete upper denture (CUD). Using commercial edentulous molds and standardized procedures eight identical CUDs were fabricated with an initial fraenal notch of 5 mm. Three addition notch conditions were produced by deepening the notch two times giving a total depth of the notch of 7 and 9 mm respectively. Finally an incisal diastema of 7 mm was created in every CUD. Three elements rosette strain gauge was cemented onto the midline of each denture specimen near the fraenal notch, for calculating the two principal stresses and the maximum shear stress. It is less possible that a failure crack in a CUD will be initiated from the region of the fraenal notch, due to the compressive nature of the principal stresses (they are varied significantly among the four notch conditions with P=0.035 for σ(1) and P=0.007 for σ(2)) and the low value of the maximum shear stress. The creation of an incisal diastema significantly decreased the values of the principal stresses σ(1) (P=0.012) and σ(2) (P=0.025). Further investigation is needed to detect the region of the CUD where a failure crack may be initiated.

Effects of different implant-abutment connections on micromotion and stress distribution: prediction of microgap formation

OBJECTIVES

The aim of this study was to analyse micromotion and stress distribution at the connections of implants and four types of abutments: internal hexagonal, internal octagonal, internal conical and trilobe.

METHODS

A three dimensional (3D) model of the left posterior mandible was reconstructed from medical datasets. Four dental implant systems were designed and analysed independently in a virtual simulation of a first molar replacement. Material properties, contact properties, physiological loading and boundary conditions were assigned to the 3D model. Statistical analysis was performed using one-way analysis of variance (ANOVA) with a 95% confidence interval and Tukey's Honestly Significant Difference (HSD) multiple comparison test.

RESULTS

The internal hexagonal and octagonal abutments produced similar patterns of micromotion and stress distribution due to their regular polygonal design. The internal conical abutment produced the highest magnitude of micromotion, whereas the trilobe connection showed the lowest magnitude of micromotion due to its polygonal profile.

CONCLUSIONS

Non-cylindrical abutments provided a stable locking mechanism that reduced micromotion, and therefore reduced the occurrence of microgaps. However, stress tends to concentrate at the vertices of abutments, which could lead to microfractures and subsequent microgap formation.

Using occlusal wear information and finite element analysis to investigate stress distributions in human molars

Simulations based on finite element analysis (FEA) have attracted increasing interest in dentistry and dental anthropology for evaluating the stress and strain distribution in teeth under occlusal loading conditions. Nonetheless, FEA is usually applied without considering changes in contacts between antagonistic teeth during the occlusal power stroke. In this contribution we show how occlusal information can be used to investigate the stress distribution with 3D FEA in lower first molars (M(1)). The antagonistic crowns M(1) and P(2)-M(1) of two dried modern human skulls were scanned by μCT in maximum intercuspation (centric occlusion) contact. A virtual analysis of the occlusal power stroke between M(1) and P(2)-M(1) was carried out in the Occlusal Fingerprint Analyser (OFA) software, and the occlusal trajectory path was recorded, while contact areas per time-step were visualized and quantified. Stress distribution of the M(1) in selected occlusal stages were analyzed in strand7, considering occlusal information taken from OFA results for individual loading direction and loading area. Our FEA results show that the stress pattern changes considerably during the power stroke, suggesting that wear facets have a crucial influence on the distribution of stress on the whole tooth. Grooves and fissures on the occlusal surface are seen as critical locations, as tensile stresses are concentrated at these features. Properly accounting for the power stroke kinematics of occluding teeth results in quite different results (less tensile stresses in the crown) than usual loading scenarios based on parallel forces to the long axis of the tooth. This leads to the conclusion that functional studies considering kinematics of teeth are important to understand biomechanics and interpret morphological adaptation of teeth.