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de Oliveira Rigotti RL, Tardelli JDC, Dos Reis AC, da Valente MLC. Influence of dental implant/mini-implant design on stress distribution in overdentures: a systematic review. Oral Maxillofac Surg 2024; 28:515-527. [PMID: 37665393 DOI: 10.1007/s10006-023-01177-z] [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: 05/13/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic overdentures according to finite element analysis?". METHODS This systematic review was registered in the Open Science Framework (osf.io/2bquj) and followed the PRISMA protocols. The custom search strategy was applied to 4 databases. In vitro experimental studies that evaluated the influence of dental implant/mini-implant design on stress distribution in overdentures by FEM, without time and language restrictions, were included. The selection process was carried out in two stages by two reviewers independently. Risk of bias analysis was performed by a checklist of important parameters. RESULTS Sixty articles were evaluated by their title and abstract, four were selected for full reading, three were relevant, and nine were included by additional search. The 12 studies have a low risk of bias. The meta-analysis could not be performed due to the heterogeneity of the data (implant type, design variation, load intensity, and direction). CONCLUSION It can be inferred from the evaluated literature that design modifications influence the stress distribution, but as the FEM presents limitations inherent to the in vitro study, clinical trials are necessary to infer the effectiveness of the modifications. It should be noted that there is no consensus on which is the best thread design and that implants with a very narrow diameter are subject to the highest stress concentration.
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Affiliation(s)
- Renan Leonardi de Oliveira Rigotti
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Juliana Dias Corpa Tardelli
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Mariana Lima Costa da Valente
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil.
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Qiu P, Cao R, Li Z, Fan Z. A comprehensive biomechanical evaluation of length and diameter of dental implants using finite element analyses: A systematic review. Heliyon 2024; 10:e26876. [PMID: 38434362 PMCID: PMC10907775 DOI: 10.1016/j.heliyon.2024.e26876] [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: 07/07/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Background With a wide range of dental implants currently used in clinical scenarios, evidence is limited on selecting the type of dental implant best suited to endure the biting force of missing teeth. Finite Element Analysis (FEA) is a reliable technology which has been applied in dental implantology to study the distribution of biomechanical stress within the bone and dental implants. Purpose This study aimed to perform a systematic review to evaluate the biomechanical properties of dental implants regarding their length and diameter using FEA. Material and methods A comprehensive search was performed in PubMed/MEDLINE, Scopus, Embase, and Web of Science for peer-reviewed studies published in English from October 2003 to October 2023. Data were organized based on the following topics: area, bone layers, type of bone, design of implant, implant material, diameter of implant, length of implant, stress units, type of loading, experimental validation, convergence analysis, boundary conditions, parts of Finite Element Model, stability factor, study variables, and main findings. The present study is registered in PROSPERO under number CRD42022382211. Results The query yielded 852 results, of which 40 studies met the inclusion criteria and were selected in this study. The diameter and length of the dental implants were found to significantly influence the stress distribution in cortical and cancellous bone, respectively. Implant diameter was identified as a key factor in minimizing peri-implant stress concentrations and avoiding crestal overloading. In terms of stress reduction, implant length becomes increasingly important as bone density decreases. Conclusions The diameter of dental implants is more important than implant length in reducing bone stress distribution and improving implant stability under both static and immediate loading conditions. Short implants with a larger diameter were found to generate lower stresses than longer implants with a smaller diameter. Other potential influential design factors including implant system, cantilever length, thread features, and abutment collar height should also be considered in future implant design as they may also have an impact on implant performance.
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Affiliation(s)
- Piaopiao Qiu
- Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Rongkai Cao
- Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Zhaoyang Li
- Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Zhen Fan
- Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
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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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Kuroshima S, Sasaki M, Al-Omari FA, Uto Y, Ohta Y, Uchida Y, Sawase T. Implant-assisted removable partial dentures: Part II. a systematic review of the effects of implant position on the biomechanical behavior. J Prosthodont Res 2024; 68:40-49. [PMID: 37211409 DOI: 10.2186/jpr.jpr_d_23_00032] [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] [Indexed: 05/23/2023]
Abstract
PURPOSE This systematic review aimed to evaluate the effects of implant placement sites on the biomechanical behavior of implant-assisted removable partial dentures (IARPDs) using finite element analysis (FEA). STUDY SELECTION Two reviewers independently conducted manual searches of the PubMed, Scopus, and ProQuest databases for articles investigating implant location in IARPDs using FEA, according to the 2020 Systematic Reviews and Meta-analyses statement. Studies published in English up to August 1, 2022, were included in the analysis based on the critical question. RESULTS Seven articles meeting the inclusion criteria were systematically reviewed. Six studies investigated mandibular Kennedy Class I and one study investigated mandibular Kennedy Class II. Implant placement reduced the displacement and stress distribution of the IARPD components, including dental implants and abutment teeth, regardless of the Kennedy Class type and dental implant placement site. Most of the included studies showed that, based on the biomechanical behavior, the molar region, rather than the premolar region, is the preferred implant placement site. None of the selected studies investigated the maxillary Kennedy Class I and II. CONCLUSIONS Based on the FEA regarding mandibular IARPDs, we concluded that implant placement in both the premolar and molar regions improves the biomechanical behaviors of IARPD components, regardless of the Kennedy Class. Implant placement in the molar region results in more suitable biomechanical behaviors compared with implant placement in the premolar region in Kennedy Class I. No conclusion was reached for Kennedy Class II due to the lack of relevant studies.
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Affiliation(s)
- Shinichiro Kuroshima
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Muneteru Sasaki
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Farah A Al-Omari
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Uto
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshikazu Ohta
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Uchida
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takashi Sawase
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Mathur VP, Duggal I, Atif M, Tewari N, Rahul M, Duggal R, Chawla A. Development and validation of risk of bias tool for the use of finite element analysis in dentistry (ROBFEAD). Comput Methods Biomech Biomed Engin 2023; 26:1822-1833. [PMID: 36475384 DOI: 10.1080/10255842.2022.2148465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 11/13/2022] [Indexed: 12/12/2022]
Abstract
There has been a systematic review of studies that used FEA in dental sciences, but no adequate risk of bias (RoB) analysis technique has been developed. Therefore, the development and validation process of RoB in studies using the finite element analysis in dentistry (ROBFEAD) tool is described. In the first phase of development, the scope of the tool and possible modifications were covered, and validation was done in the second phase. The developed tool comprised 6 domains and a total of 22 guiding questions in these domains. This article proposes the development and validation of ROBFEAD, a tool for measuring RoB in finite element research in dentistry.
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Affiliation(s)
- Vijay Prakash Mathur
- Pediatrics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Isha Duggal
- Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Mohammad Atif
- Pediatrics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Pediatrics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Morankar Rahul
- Pediatrics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Anoop Chawla
- Department of Mechanical Engineering, Indian Institute of Technology, New Delhi
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Qin S, Gao Z. Comparative evaluation of short or standard implants with different prosthetic designs in the posterior mandibular region: a three-dimensional finite element analysis study. Comput Methods Biomech Biomed Engin 2023; 26:1499-1509. [PMID: 36125258 DOI: 10.1080/10255842.2022.2124859] [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: 06/05/2022] [Revised: 08/29/2022] [Accepted: 09/11/2022] [Indexed: 11/03/2022]
Abstract
The purpose of this study is to evaluate the stress distribution of splinted or nonsplinted restorations supported by 2 short or 2 standard dental implants in the mandibular molar region using three-dimensional finite element analysis. Two standard implants (4.8 × 10mm) were placed in the mandibular molar area. Two short implants (4.8 × 6 mm) were located in the mandibular molar atrophied area. Implant-supported prostheses were simulated with splinted or nonsplinted crowns design. Vertical load of 200 N and oblique load of 100 N were applied on the central fossa and the buccal cusps. Evaluation of stress distribution in implants and peri-implant cortical bone using the finite element analysis software (Ansys, Version 2020, R2), a multipurpose computer design program. The maximum principal stress of cortical bone around the implants was higher in nonsplinted crowns when compared to splinted crowns. The stress concentration of cortical bone surrounding implants increased as the implant length decreased either splinted crowns or nonsplinted crowns. The short implants with nonsplinted crowns showed lower stresses when compared to standard implants with nonsplinted crowns. The results suggest that the nonsplinted prostheses supported by short dental implants might be considered in the molar area of the atrophic mandible.
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Affiliation(s)
- Siqi Qin
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhi Gao
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Anitua E, Larrazabal Saez de Ibarra N, Saracho Rotaeche L. Implant-Supported Prostheses in the Edentulous Mandible: Biomechanical Analysis of Different Implant Configurations via Finite Element Analysis. Dent J (Basel) 2022; 11:dj11010004. [PMID: 36661541 PMCID: PMC9858073 DOI: 10.3390/dj11010004] [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: 11/25/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
This study explores the implant-supported prosthetic treatment alternatives of the edentulous mandible from a biomechanical point of view by means of a Finite Element Analysis (FEA). Finite element (FE) models were used to simulate cases treated with six, five, and four, implants and a fixed prosthesis with a cantilever. In the four implant treatments, three cases were analyzed; the posterior implants were placed in axial positions, angled at 30° and 45°. Cases with six and four axially placed implants were also analyzed by placing the posterior implants distally to the foramen, thus eliminating the cantilever in the prostheses. In the cases with implants between foramina, the highest values for the principal strains and von Mises stresses were observed in the case with four implants where the posterior implants were angled at 45°. Cases with implants placed distally to the foramen and without a cantilever showed much lower bone stress and strain levels compared to cases with implants between foramina. From a biomechanical point of view, it seems to be a better option to use implants positioned distally to the foramen, eliminating cantilevers.
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Ahn S, Kim J, Jeong SC, Kim M, Kim C, Park D. Stress Distribution Analysis of Threaded Implants for Digital Dentistry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12674. [PMID: 36231974 PMCID: PMC9565012 DOI: 10.3390/ijerph191912674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
In this study, stability evaluation is performed through structural analysis based on digital dental implant design variables. The design variables include the implant length and thickness, cortical bone thickness, and elastic modulus of the cancellous bone. Subsequently, the stress in the external cortical bone, in which numerous nerves exist, is analyzed. Results show that stress increases as the implant length decreases. However, when the implant length is 10 mm, the stress decreases, owing to stress dispersion at the lower section of the implant. Moreover, as the implant thickness increases, the stress decreases. As the elastic modulus of the cancellous bone decreases, the stress exerted on the cancellous bone decreases; consequently, the stress exerted on the cortical bone increases. Finally, as the thickness of the cortical bone increases, the stress decreases when a vertical load is applied. However, when a load is applied in the oblique direction, the stress increases. Based on data obtained via digital radiography, which is a digital dental technology, a more precise implantation plan will be established by substituting the data via structural analysis.
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Affiliation(s)
- Seokho Ahn
- Department of Digital Manufacturing, Hanbat National University, 125 Dongseo-daero, Yuseong-gu, Daejeon 34158, Korea
| | - Jaesung Kim
- Department of Industry-Academic Convergence, Hanbat National University, 125 Dongseo-daero, Yuseong-gu, Daejeon 34158, Korea
| | - Seok Chan Jeong
- Department of e-Business, Dong-Eui University, Busanjin-gu, Busan 47340, Korea
| | - Myungil Kim
- Div. of National Supercomputing Intelligent Simulation Center, Korea Institute of Science and Technology Information 245, Daehak-ro, Yuseong-gu, Daejeon 34141, Korea
| | - Cheolyoung Kim
- Implant Research Laboratory, Cybermed 6-26, Yuseong-daro 1205 beon-gil, Yuseong-gu, Daejeon 34104, Korea
| | - Dongki Park
- Implant Research Laboratory, Cybermed 6-26, Yuseong-daro 1205 beon-gil, Yuseong-gu, Daejeon 34104, Korea
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Armentia M, Abasolo M, Coria I, Sainitier N. Effect of the geometry of butt-joint implant-supported restorations on the fatigue life of prosthetic screws. J Prosthet Dent 2022; 127:477.e1-477.e9. [DOI: 10.1016/j.prosdent.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
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Posterior jaws rehabilitation with < 7mm-short implants. A review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e45-e56. [PMID: 34563727 DOI: 10.1016/j.jormas.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/23/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The results with shorter and shorter implants have been revolutionizing the implantology scenario and are worthy of being well-analyzed and understood. This review aims to add further knowledge about the last 10-years observation period on < 7mm-short implants in the posterior atrophic jaws, better defining the indication of their use. METHODS From a Medline database research, systematic reviews, controlled and no- controlled trials (CT, n-CT) with ≥ 3years-follow-ups on <7 mm / ≥ 5mm-short implants (group A), and clinical studies with ≥ 1year-follow-up on 4mm-short implants (group B) were considered. The outcomes, in terms of implant survival rate (SR), marginal bone loss (MBL), and complications were analyzed according to the duration of follow-ups, implant site (maxilla and mandible), type of prosthesis (single crown or splinted units), vertically impaired or normal sites. RESULTS Thirty-four trials (28 for group A and six for group B) were selected. Group A: a mean follow up of 5,8 (3-10) years came out; pre-and post-loading SR range was 94.4- 100% and 89.6-100%, respectively; the range of MBL was 0.12-1.49; 50% of CT found less statistically significant surgical complications in comparison with standard implants (ST) in reconstructed sites, while major prosthetic problems were recorded with short -implants (SH) in 37.5% of CT; in no atrophied sites, a mean SR range of 86.7-100 % vs. 88-100 % and a total bone loss of 2 vs.1.6 for SH vs.ST emerged. Group B: the overall mean follow-up period was 2,3 years, and the pre-and post- SR ranges were 93-100 % and 87.5-100 %, respectively. The MBL range was 0.02- 0.63 mm. All RCT reported significantly fewer surgical complications with SH than with ST in reconstructed mandibles within one year. No prosthetic complications were reported for up to 5 years using no pontics or cantilevers fixed bridges. CONCLUSIONS Similar or even better results for SH than ST in terms of post-loading SR and MBL came out for < 7mm/ ≥ 5mm-short implants in atrophic bone regardless of the prosthetic solutions, with less surgical complications but a few more prosthetic problems; the good results up to 5 years for 4mm-short implants in mandibles are associated with splinted and no-risk prosthetic solutions.
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Consequences of Peri-Implant Bone Loss in the Occlusal Load Transfer to the Supporting Bone in terms of Magnitude of Stress, Strain, and Stress Distribution: A Finite Element Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:3087071. [PMID: 34513989 PMCID: PMC8429018 DOI: 10.1155/2021/3087071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/21/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022]
Abstract
Methods Three models of a single internal connection bone level-type implant inserted into a posterior mandible bone section were constructed using a 3D finite element software: one control model without marginal bone loss and two test models, both with a circumferential peri-implant bone defect, one with a 3 mm high defect and the other one 6 mm high. A 150 N static load was tested on the central fossa at 6° relative to the axial axis of the implant. Results The results showed differences in the magnitude of strain and stress transferred to the bone between models, being the higher strain found in the trabecular bone around the implant with greater marginal bone loss. Stress distribution differed between models, being concentrated at the cortical bone in the control model and at the trabecular bone in the test models. Conclusion Marginal bone loss around dental implants under occlusal loading influences the magnitude and distribution of the stress transferred and the deformation of peri-implant bone, being higher as the bone loss increases.
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Kosugi Y, Hirota M, Tamai N, Takasu H, Iwai T, Mitsudo K. A three-dimensional finite element analysis of resected mandibular bone to determine the most stable implant positions for a fixed prosthesis. J ORAL IMPLANTOL 2021; 48:84-91. [PMID: 33760031 DOI: 10.1563/aaid-joi-d-20-00180] [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
This study was conducted to determine the most secure implant positioning on the marginally resected mandible to support a fixed complete denture through finite element analysis. Three or four implants were placed at near, middle, or far positions from the resected margin in a simulation model with a symmetrical marginal defect in the mandibular symphysis. The height of the residual bone was 5, 10, or 15 mm. The four possible implant patterns for 3 or 4 implants were defined as: (1) asymmetrically isolated position one to position two, (2) asymmetrically isolated position one to position three, (3) asymmetrically isolated with greater length position one to position two, and (4) two implants symmetrically positioned on each side of the defect. The von Mises stress in the resected and peri-implant bone with respect to the occlusal force was calculated. Initially, as the peri-implant bone stress around isolated implant at the near position was greater than at the middle and far positions regardless of the residual bone height, the near position was excluded. Second, the von Mises stress in the resected bone region was > 10 MPa when the isolated implant was at the far position, and it increased inversely depending on the bone height. However, the stress was < 10 MPa when the isolated implant was placed at the middle position regardless of the bone height, and it was significantly lower compared to the far position, and equivalent to the symmetrically positioned implants. Furthermore, the use of greater length implant reduced the peri-implant bone stress, which was even lower than that of the symmetrically positioned implants. These results suggest that the asymmetrically positioned three-implant-supported fixed denture, using a greater length isolated implant, placed neither too close to nor too far from the resected margin, can be an effective alternative to the symmetrically positioned four-implant-supported fixed denture.
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Affiliation(s)
- Yasufumi Kosugi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan. Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, 4-5
| | - Makoto Hirota
- Yokohama City University Associate professor Oral and Maxillofacial Surgery 3-9 Fuku-ura Kanazawa-ku JAPAN Yokohama Kanagawa 236-0004 Yokohama City University
| | - Naohito Tamai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Hikaru Takasu
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan
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Moraschini V, Mourão CFDAB, Montemezzi P, Kischinhevsky ICC, de Almeida DCF, Javid K, Shibli JA, Granjeiro JM, Calasans-Maia MD. Clinical Comparation of Extra-Short (4 mm) and Long (>8 mm) Dental Implants Placed in Mandibular Bone: A Systematic Review and Metanalysis. Healthcare (Basel) 2021; 9:healthcare9030315. [PMID: 33809203 PMCID: PMC7998998 DOI: 10.3390/healthcare9030315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 01/05/2023] Open
Abstract
This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration’s tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate (p = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly (p = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future.
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Affiliation(s)
- Vittorio Moraschini
- Periodontology Department, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro 20271-020, Brazil;
| | | | | | | | - Daniel Costa Ferreira de Almeida
- Graduate Program, Dentistry School, Universidade Federal Fluminense, Niteroi 24020-140, Brazil; (I.C.C.K.); (D.C.F.d.A.); (K.J.)
| | - Kayvon Javid
- Graduate Program, Dentistry School, Universidade Federal Fluminense, Niteroi 24020-140, Brazil; (I.C.C.K.); (D.C.F.d.A.); (K.J.)
| | - Jamil Awad Shibli
- Periodontology and Oral Implantology Department, University of Guarulhos, Guarulhos 07023-070, Brazil;
| | - José Mauro Granjeiro
- Bioengineering Laboratory, National Institute of Metrology, Quality and Technology (INMETRO), Duque de Caxias 25250-020, Brazil;
- Dental School, Fluminense Federal University, Niterói 24020-140, Brazil
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Effect of different design of abutment and implant on stress distribution in 2 implants and peripheral bone: A finite element analysis study. J Prosthet Dent 2021; 126:664.e1-664.e9. [PMID: 33573834 DOI: 10.1016/j.prosdent.2020.09.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM How adjacent dental implants with different sizes, designs, and abutment connection shapes affect stress on the prosthetic structure is unclear. PURPOSE The purpose of this finite element analysis (FEA) study was to analyze stress distribution around bone and around 2 implants with different sizes, diameters, shapes, and loading directions placed next to each other in splinted and unsplinted prostheses. MATERIAL AND METHODS On 3D FEA models representing the posterior right lateral segment of the mandible, 1 implant (Ø3.5×12 mm) and 1 implant (Ø5.5×8 mm) were placed adjacent. Three different contemporary implant models were created with different teeth, pitch, spiral numbers, and self-taping features, and different abutments for them were modeled in 3D. The implant-abutment connection was internal hexagonal (MIH), stepped conical (MSC), and internal conical (MIC). Vertical and oblique loads of 365 N for molar teeth and of 200 N for premolar teeth were applied as boundary conditions to the cusp ridges and grooves in a nonlinear FEA. RESULTS The MIH implants resulted in improved stress conditions. According to the von Mises stresses occurring on the screw, abutment, and implant, especially under oblique loads, MIH was exposed to less stress than MSC, and MSC was exposed to less stress than MIC. CONCLUSIONS When a standard implant and a short implant were placed adjacent and splinted by crowns, the implants, abutments, and screws had unfavorable stress levels; therefore, adjacent splinted implants should be of similar size. The form of the implant-abutment junction is also an important factor affecting stress.
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Watanabe K, Mutsuzaki H, Fukaya T, Aoyama T, Nakajima S, Sekine N, Mori K. Development of a Knee Joint CT-FEM Model in Load Response of the Stance Phase During Walking Using Muscle Exertion, Motion Analysis, and Ground Reaction Force Data. ACTA ACUST UNITED AC 2020; 56:medicina56020056. [PMID: 32013100 PMCID: PMC7074273 DOI: 10.3390/medicina56020056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/16/2020] [Accepted: 01/26/2020] [Indexed: 02/04/2023]
Abstract
Background and objectives: There are no reports on articular stress distribution during walking based on any computed tomography (CT)-finite element model (CT-FEM). This study aimed to develop a calculation model of the load response (LR) phase, the most burdensome phase on the knee, during walking using the finite element method of quantitative CT images. Materials and Methods: The right knee of a 43-year-old man who had no history of osteoarthritis or surgeries of the knee was examined. An image of the knee was obtained using CT and the extension position image was converted to the flexion angle image in the LR phase. The bone was composed of heterogeneous materials. The ligaments were made of truss elements; therefore, they do not generate strain during expansion or contraction and do not affect the reaction force or pressure. The construction of the knee joint included material properties of the ligament, cartilage, and meniscus. The extensor and flexor muscles were calculated and set as the muscle exercise tension around the knee joint. Ground reaction force was vertically applied to suppress the rotation of the knee, and the thigh was restrained. Results: An FEM was constructed using a motion analyzer, floor reaction force meter, and muscle tractive force calculation. In a normal knee, the equivalent stress and joint contact reaction force in the LR phase were distributed over a wide area on the inner upper surface of the femur and tibia. Conclusions: We developed a calculation model in the LR phase of the knee joint during walking using a CT-FEM. Methods to evaluate the heteromorphic risk, mechanisms of transformation, prevention of knee osteoarthritis, and treatment may be developed using this model.
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Affiliation(s)
- Kunihiro Watanabe
- Department of Radiology, Saitama Prefecture Saiseikai Kurihashi Hospital, Kuki, Saitama 349-1105, Japan;
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo 116-8551, Japan;
| | - Hirotaka Mutsuzaki
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
- Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Ibaraki 300-0331, Japan
| | - Takashi Fukaya
- Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Tsuchiura, Ibaraki 300-0051, Japan;
| | - Toshiyuki Aoyama
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
| | - Syuichi Nakajima
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
| | - Norio Sekine
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo 116-8551, Japan;
| | - Koichi Mori
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan;
- Correspondence: ; Tel.: +81-29-888-4000
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The Effect of the Length and Distribution of Implants for Fixed Prosthetic Reconstructions in the Atrophic Posterior Maxilla: A Finite Element Analysis. MATERIALS 2019; 12:ma12162556. [PMID: 31405201 PMCID: PMC6720585 DOI: 10.3390/ma12162556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
Abstract
In this study, different prosthetic designs that could be applied instead of advanced surgical techniques in atrophic maxilla were evaluated with finite element analysis. Atrophic posterior maxilla was modeled using computer tomography images and four models were prepared as follows: Model 1 (M1), two implants supporting a three-unit distal cantilever prosthesis; Model 2 (M2), two implants supporting a three-unit conventional fixed partial denture; Model 3 (M3), three implants supporting three connected crowns; and Model 4 (M4), two implants supporting two connected crowns. Implants 4 mm in width and 8 mm or 13 mm in length were used. A linear three-dimensional finite element programme was used for analysis. The maximum principle stress (tensile) and minimum principle stress (compressive) were used to display stress in cortical and cancellous bones. The von Mises criteria were used to evaluate the stress on the implants. M1 was found to be the most risky model. The short dental arch case (M4) revealed the lowest stresses among the models but is not recommended when one more implant can be placed because of the bending forces that could occur at the mesial implant. In M2 and M3, the distal implants were placed bicortically between the crestal and sinus cortical plates, causing a fall of the stresses because of the bicortical stability of these implants.
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