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Liao X, Cao R, Zhong J, Chen C, Pan S. Influence of implant distribution on the biomechanical behaviors of mandibular implant-retained overdentures: a three-dimensional finite element analysis. BMC Oral Health 2024; 24:405. [PMID: 38555452 PMCID: PMC10981806 DOI: 10.1186/s12903-024-04146-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE To assess stress distribution in peri-implant bone and attachments of mandibular overdentures retained by small diameter implants, and to explore the impact of implant distribution on denture stability. METHODS Through three-dimensional Finite Element Analysis (3D FEA), four models were established: three models of a two mandibular implants retained overdenture (IOD) and one model of a conventional complete denture (CD). The three IOD models consisted of one with two implants in the bilateral canine area, another with implants in the bilateral lateral incisor area, and the third with one implant in the canine area, and another in the lateral incisor area. Three types of loads were applied on the overdenture for each model: a 100 N vertical load and a inclined load on the left first molar, and a100N vertical load on the lower incisors. The stress distribution in the peri-implant bone, attachments, and the biomechanical behaviors of the overdentures were analyzed. RESULTS Despite different distribution of implants, the maximum stress values in peri-implant bone remained within the physiological threshold for all models across three loading conditions. The dispersed implant distribution design (implant in the canine area) exhibited the highest maximum stress in peri-implant bone (822.8 µe) and the attachments (275 MPa) among the three IOD models. The CD model demonstrated highest peak pressure on mucosa under three loading conditions (0.8188 Mpa). The contact area between the denture and mucosa of the CD model was smaller than that in the IOD models under molar loading, yet it was larger in the CD model compared to the IOD model under anterior loading. However, the contact area between the denture and mucosa under anterior loading in all models was significantly smaller than those under molar loading. The IOD in all three models exhibited significantly less rotational movement than the complete denture. Different implant positions had minimal impact on the rotational movement of the IOD. CONCLUSION IOD with implants in canine area exhibited the highest maximum stress in the peri-implant bone and attachments, and demonstrated increased rotational movement. The maximum principal stress was concentrated around the neck of the small diameter one-piece implant, rather than in the abutment. An overdenture retained by two implants showed better stability than a complete denture.
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Affiliation(s)
- Xiaoling Liao
- Department of Prosthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, No. 75, Dagu North Road, Heping District, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Ruitao Cao
- Department of Prosthodontics , Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Juan Zhong
- Hospital of Stomotology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No. 56 Lingyuan West Road, Yuexiu District, Guangzhou, 510055, China
| | - Chunxia Chen
- Department of Prosthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, No. 75, Dagu North Road, Heping District, Tianjin, 300041, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China.
| | - Shaoxia Pan
- Department of Prosthodontics , Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices& Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
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Unal Erzurumlu Z, Sadik E, Gokkurt BN, Ozbey F, Erzurumlu K, Kasko Arici Y. Morphological evaluation of gonial and antegonial regions in bruxers on panoramic radiographic images. BMC Oral Health 2023; 23:457. [PMID: 37420199 PMCID: PMC10327333 DOI: 10.1186/s12903-023-03162-0] [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: 04/26/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND This is the first study to report both cortical and trabecular bone evaluation of mandibles in bruxers, within the knowledge of the authors. The purpose of this study was to evaluate the effects of bruxism on both the cortical and the trabecular bone in antegonial and gonial regions of the mandible, which is the attachment of the masticatory muscles, by using panoramic radiographic images. METHODS In this study, the data of 65 bruxer (31 female, 34 male) and 71 non-bruxer (37 female, 34 male) young adult patients (20-30 years) were evaluated. Antegonial Notch Depth (AND), Antegonial-Index (AI), Gonial-Index, Fractal Dimension (FD) and Bone Peaks (BP) were evaluated on panoramic radiographic images. The effects of the bruxism, gender and side factors were investigated according to these findings. The statistical significance level was set atP ≤ 0.05. RESULTS The mean AND of bruxers (2.03 ± 0.91) was significantly higher than non-bruxers (1.57 ± 0.71; P < 0.001). The mean AND of males was significantly higher than females on both sides (P < 0.05). The mean AI of bruxers (2.95 ± 0.50) was significantly higher than non-bruxers (2.77 ± 0.43; P = 0.019). The mean FD on each side was significantly lower in bruxers than in non-bruxers (P < 0.05). The mean FD of males (1.39 ± 0.06) was significantly higher than females (1.37 ± 0.06; P = 0.049). BP were observed in 72.5% of bruxers and 27.5% of non-bruxers. The probability of existing BP, in bruxers was approximately 3.4 times higher than in non-bruxers (P = 0.003), in males was approximately 5.5 times higher than in females (P < 0.001). CONCLUSION According to the findings of this study, the morphological differences seen in cortical and trabecular bone in the antegonial and gonial regions of the mandible in bruxers can be emphasized as deeper AND, higher AI, increased of existing BPs, and lower FD, respectively. The appearance of these morphological changes on radiographs may be useful for indication and follow-up of bruxism. Gender is an effective factor on AND, existing BP and FD.
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Affiliation(s)
- Zerrin Unal Erzurumlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Elif Sadik
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Busra Nur Gokkurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Furkan Ozbey
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey.
| | - Kerem Erzurumlu
- Computer Science and Engineer, Department of Computer Programming, Vocational School of Technical Sciences, Ordu University, Ordu, Turkey
| | - Yeliz Kasko Arici
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ordu University, Ordu, Turkey
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Schuster AJ, da Rosa Possebon AP, Schinestsck AR, Chagas-Júnior OL, Faot F. Circumferential bone level and bone remodeling in the posterior mandible of edentulous mandibular overdenture wearers: influence of mandibular bone atrophy in a 3-year cohort study. Clin Oral Investig 2021; 26:3119-3130. [PMID: 34854990 DOI: 10.1007/s00784-021-04294-9] [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: 07/02/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Evaluate circumferential bone level and morphological alterations in the posterior mandibular ridge of atrophic (AP) and non-atrophic (NAP) patients using implant-retained mandibular overdentures (MO) over 3 years. MATERIALS AND METHODS Twenty-six edentulous patients categorized according to mandibular atrophy (AP = 13/NAP = 13) received two narrow diameter implants (Facility, 2.9 × 10 mm) in the anterior region of mandible. The vertical and horizontal bone level was measured along with bone remodeling at 4 distances from the mental foramen in the posterior region of the mandible (L1-L4) via CBCT. RESULTS NAP showed significantly higher total height and medullary height in all posterior regions at 1 and 3 years (p ≤ 0.01). Cortical height and width were significantly higher (p ≤ 0.05) in this group at distances L1 and L4, respectively, in year 1. NAP shows a significantly higher % of medullary height at distances L1 (p ≤ 0.05), L2 (p ≤ 0.01), and L3 (p ≤ 0.05) after 1 year, and at all distances (p ≤ 0.05) after 3 years. Bone remodeling in the groups differed significantly (p ≤ 0.05) in terms of cortical width and % medullary width at L3. CONCLUSION AP and NAP showed similar vertical and horizontal bone level. Bone resorption in the posterior ridge was stabilized by MO over 3 years; however, AP are more susceptible to the long-term substitution of medullary bone by cortical bone. CLINICAL RELEVANCE This study is the first to longitudinally evaluate bone dimensions in atrophic and non-atrophic two-implant MO users by CBCT and revealed that MO is a predictable treatment based on the stabilization of the posterior bone resorption.
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Affiliation(s)
- Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Otacílio Luiz Chagas-Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, RS, 96015-560, Brazil.
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Crestal bone loss and implant failure of prefabricated versus customized abutments: a 10-year retrospective radiological study. Clin Oral Investig 2021; 26:2879-2886. [PMID: 34767097 DOI: 10.1007/s00784-021-04269-w] [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: 09/15/2021] [Accepted: 11/06/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES There is no information today about the impact of abutment type on the crestal bone stability. This retrospective study was aimed to evaluate the crestal bone levels (CBL) and failures of implants with prefabricated and customized abutments after the long term. MATERIALS AND METHODS The mesial and distal CBL around dental implants with prefabricated and custom abutments were recorded. Measures were completed at 5- and 10-year endpoints. RESULTS Sixty-three patients with 249 implants were included. One hundred twenty-seven implants (51%) were restored with prefabricated and 122 implants (49%) with customized abutments. All the patients received fixed restorations. The results showed that the CBL was higher in patients with custom abutments than the CBL of patients with prefabricated abutments. The mean bone loss around implants with prefabricated abutments was 0.29 mm mesial/0.45 mm distal after 10 years. Meanwhile, the mean bone loss at implants with custom abutments was 1.19 mm mesial/1.27 mm distal (p < 0.05) after 10 years. None of the implants with prefabricated abutments failed up to 10-year follow-up, whereas 4.1% of implants with customized abutments failed. CONCLUSION Implants with prefabricated abutments present less crestal bone loss compared to customized abutments. CLINICAL RELEVANCE The selection of abutment type is associated with the crestal bone stability or marginal bone loss.
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Evaluation of Implant Survival by Analysing Dental Panoramic Radiographs: 10-Year Retrospective Study. BALKAN JOURNAL OF DENTAL MEDICINE 2021. [DOI: 10.2478/bjdm-2020-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Background/Aim: Panoramic radiographs have been used widely for pre-implant evaluation and the preparation of treatment protocols. Panoramic radiography is often the first choice method for the implant placements because it gives information on the overall shape of the jaws, the position of the maxillary sinus floor and the nasal cavity floor, and vertical position of the mandibular canal and the mental foramen in relation to dental implants. The specific aim of the present study was to evaluate 10-year survival rate of dental implants by analysis of dental panoramic radiographs.
Material and Methods: This retrospective study was conducted on 507 panoramic radiographs of 156 implant patients. Initial oral health status, proceedings of Restorative/Endodontic treatments before implant placement, missing number of teeth and edentulism types, finalization of implant related prosthetic treatments during controls, implant quality scorings at baseline/ controls and implant fails were analyzed.
Results: The study results reveal statistically significant difference between the performed R/E treatment rates, according to the need for R/E treatments (p= 0.008). During the initial radiograph 96.1% of the implants were successful and 3.9% had satisfactory survival. At last control 86% of the implants were successful, 10.3% had satisfactory survival, 1% had impairment in survival and 2.8% were unsuccessful. The change in the last control compared to the initial radiograph is statistically significant (p= 0.000) regarding satisfactory survival.
Conclusions: Long-term implant survival is not significantly affected by gender, age, type of edentulism, the presence of periodontal disease, R/E treatment needs, implant location, prosthesis type, and the presence of multiple implants.
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Yin S, Zhang W, Tang Y, Yang G, Wu X, Lin S, Liu X, Cao H, Jiang X. Preservation of alveolar ridge height through mechanical memory: A novel dental implant design. Bioact Mater 2021; 6:75-83. [PMID: 32817915 PMCID: PMC7419257 DOI: 10.1016/j.bioactmat.2020.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 11/26/2022] Open
Abstract
Irreversible marginal bone loss can hinder recovery around dental implants. Insufficient alveolar osteogenesis and stress concentration during chewing contribute to marginal bone resorption and can result in implant failure. A biomaterial with a micropore-channel structure was developed using 3D printing technology. This design facilitated bony ingrowth and provided similar mechanical stimulation at the implant neck during mastication to a natural tooth. The micropore channels provided a guiding structure for bone mesenchymal stem cell proliferation and differentiation without the need for growth factors. Specifically, this was achieved through mechanical transduction by F-actin remodeling and the activation of Yes-associated protein (YAP). The implants were verified in a canine dental implant surgery model, which demonstrated the promising use of biomaterial-based dental implants in future clinical applications.
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Affiliation(s)
- Shi Yin
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Wenjie Zhang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yanmei Tang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Guangzheng Yang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xiaolin Wu
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Sihan Lin
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xuanyong Liu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Science, Beijing, 100049, China
| | - Huiliang Cao
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Xinquan Jiang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
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Autogenous Chin Block Grafts in the Aesthetic Zone: A 20-Year Follow-Up Case Report. Case Rep Dent 2020; 2020:6525797. [PMID: 32566325 PMCID: PMC7301219 DOI: 10.1155/2020/6525797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/30/2020] [Accepted: 05/29/2020] [Indexed: 11/24/2022] Open
Abstract
The successful use of osseointegrated implants in the treatment of partial or complete edentulism requires a sufficient bone support. Whenever rehabilitation in atrophic edentulous areas is needed, bone augmentation procedures are recommended. The aim is to provide adequate amount of supporting bone to achieve a prosthetically guided implant placement. This in turn leads to functional and aesthetic improvements that can be maintained on the long term. Bone grafting of the atrophic site can be performed either prior to implant placement or at the time of implantation. Irrespective of the timing, bone augmentation by means of autogenous bone grafts is a reliable technique, as confirmed by several studies. On the other hand, long-term evidence on the use of autogenous chin block grafts in preprosthetic implant surgery is still scarce. Thus, the purpose of the present case is to report the 20-year clinical and radiological outcome of autogenous chin block grafts used to augment a bilateral defect due to agenesis of the upper lateral incisors for implant placement purposes.
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