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Gao J, Li X, He J, Jiang L, Zhao B. The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis. Front Bioeng Biotechnol 2022; 10:928656. [PMID: 36105608 PMCID: PMC9465293 DOI: 10.3389/fbioe.2022.928656] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: Investigating the biomechanical effects of mandibular flexure (MF) on the design of implant-supported fixed restorations in edentulous jaws of different facial types. Methods: Three-dimensional finite element models were established to analyze mandibular displacement and stress distribution of implant-supported fixed restorations (four or six implants, different implant numbers and sites, and the design of the superstructure across the dental arch in one or two or three pieces, under the loading conditions of maximum opening or right unilateral molar occlusion) in mandibular edentulous patients of three different facial types (brachyfacial, mesofacial, and dolichofacial types). Results: The brachyfacial type presented higher mandibular flexure and stress in the overall restorative system, followed by the mesofacial and dolichofacial types. During jaw opening and occlusal movements, the one-piece framework showed the lowest bone stress values surrounding the anterior implants and gradually increased to the distal position, and the three-piece framework showed the highest stress values for peri-implant bones. Also, the split framework could greatly increase the stress on abutments and frameworks. Moreover, fixed implant prostheses with cantilevers can generate high amounts of biomechanical stress and strain on implants and surrounding bones. The bone surrounding the anterior implant increased in stress values as the most distal implants were more distally located regardless of frameworks. The zirconia framework demonstrated higher stresses than the titanium framework. Conclusion: The design of edentulous fixed implant-supported restorations can be optimized for facial types. For patients of the brachyfacial type or with high masticatory muscle strength, the non-segmented framework without a cantilever provides an optimal biomechanical environment.
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Affiliation(s)
- Jing Gao
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
| | - Xuejing Li
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, School and Hospital of Stomatology, Tongji University, Shanghai, China
| | - Jing He
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
| | - Lulu Jiang
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
- *Correspondence: Lulu Jiang, ; Baohong Zhao,
| | - Baohong Zhao
- Center of Implantology School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
- *Correspondence: Lulu Jiang, ; Baohong Zhao,
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In Vitro Study of Preload Loss in Different Implant Abutment Connection Designs. MATERIALS 2022; 15:ma15041392. [PMID: 35207933 PMCID: PMC8879145 DOI: 10.3390/ma15041392] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/02/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
The stability and integrity of the abutment-implant connection, by means of a screw, is fallible from the moment the prosthetic elements are joined and is dependent on the applied preload, wear of the components and function. One of the main causes of screw loosening is the loss of preload. The loosening of the screw-abutment can cause complications such as screw fracture, marginal gap, peri-implantitis, bacterial microleakage, loosening of the crown and discomfort of the patient. It is also reported that loosening of the screw/abutment may lead to a failure of osseointegration. It is necessary to evaluate and quantify, with in vitro studies, the torque loss before and after loading in the different connections. Aim: evaluate the influence of implant- abutment connection design in torque maintenance after single tightening, multiple tightening and multiple tightening followed by mechanical cycling. Materials and Methods: 180 Klockner implants divided in 4 groups: 15 SK2 external connection, 25 Ncm tightening torque; 15 KL external connection, 30 Ncm tightening torque; 15 Vega internal connection, 25 Ncm tightening torque; 15 Essential internal connection, 30 Ncm tightening torque. In each group removal torque values (RTV) were evaluated with a digital torque meter, in 3 distinct phases: after one single tightening, 10 multiple tightenings and 10 multiple tightenings and cyclic loading (500 N × 1000 cycles). Results: After one single tightening, and for all connections, RTV were lower than those of insertion, but only for Essential and Vega internal connections this result was statistically significant. After multiple tightening, RTV were significantly lower in all connections. After repeated tightening followed by cyclic loading, mean RTV were significantly lower, when compared to insertion torque. The multiple tightening technique resulted in higher RTV than the single tightening technique, except for Vega implant. The multiple tightening followed by cyclic load, compared to the other phases, was the one that generated the lowest RTV, for all connections. Conclusions: The connection design, in our study, did not seem to influence the maintenance of preload. Loading influenced the loss of preload, in the sense that significantly decreased the removal torque values. The multiple re-tightening technique resulted in higher removal torque values than the single tightening technique. Clinically, our results recommend to retighten retaining screws, a few minutes after insertion.
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Matos JD, Arcila LV, Ortiz LP, Lopes GR, Anami LC, Ramos NC, Saavedra GS, Tribst JP, Bottino MA. Hybrid abutment during prosthetic planning and oral rehabilitation. Minerva Dent Oral Sci 2021; 71:107-116. [PMID: 33929134 DOI: 10.23736/s2724-6329.21.04479-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The present study aims to describe through a literature review, the characteristics and properties of hybrid abutments, as well as their proper use as a new rehabilitation strategy. METHODS A bibliographic search was conducted in the main health databases Pubmed (www.pubmed.gov) and Google Scholar (www.scholar.google.com.br), in which studies published from 2001 to 2020 were collected. Laboratory studies, case reports, systematic and literature reviews were included. Therefore, articles that do not adress the characteristics and properties of hybrid abutments were excluded. In addition, studies that did not report the use of hybrid abutments as a new rehabilitation strategy. RESULTS According to the inclusion and exclusion criteria, 80 research articles were selected and 20 were excluded, while 25 in vitro, 17 in vivo and 9 in silico studies were reviewed. CONCLUSIONS The literature demonstrates that hybrid abutments are an excellent alternative in cases of implant-supported rehabilitation, presenting high esthetic results, associated with good soft tissue response, periimplant marginal bone stability and adequate stress distribution during the masticatory loads dissipation.
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Affiliation(s)
- Jefferson D Matos
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil -
| | - Laura V Arcila
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Laura P Ortiz
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Guilherme R Lopes
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Lilian C Anami
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Nathália C Ramos
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Guilherme S Saavedra
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - João P Tribst
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
| | - Marco A Bottino
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil
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AKIN H, ÜNAL Y, YİLMAZER K. Effect of different crown removing procedures on the implant stability quotient and removal torque values of dental implants. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.789728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Anchieta RB, Machado LS, Hirata R, Coelho PG, Bonfante EA. Survival and failure modes: platform-switching for internal and external hexagon cemented fixed dental prostheses. Eur J Oral Sci 2016; 124:490-497. [DOI: 10.1111/eos.12298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Rodolfo B. Anchieta
- Department of Dentistry; Centro Universitário do Norte Paulista; São José do Rio Preto SP Brazil
| | - Lucas S. Machado
- Department of Operative Dentistry; Universidade Federal do Rio Grande do Sul; Porto Alegre RS Brazil
| | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics; New York University; New York NY USA
| | - Paulo G. Coelho
- Department of Biomaterials and Biomimetics; New York University; New York NY USA
| | - Estevam A. Bonfante
- Department of Prosthodontics and Periodontology; Bauru School of Dentistry; University of São Paulo; Bauru SP Brazil
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Fracture strength of implant abutments after fatigue testing: A systematic review and a meta-analysis. J Mech Behav Biomed Mater 2016; 62:333-346. [DOI: 10.1016/j.jmbbm.2016.05.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/06/2016] [Accepted: 05/09/2016] [Indexed: 11/27/2022]
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Bonfante EA, Suzuki M, Hirata R, Bonfante G, Fardin VP, Coelho PG. Resin composite repair for implant-supported crowns. J Biomed Mater Res B Appl Biomater 2016; 105:1481-1489. [DOI: 10.1002/jbm.b.33683] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/29/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Estevam A. Bonfante
- Department of Prosthodontics; University of São Paulo, Bauru College of Dentistry; Bauru SP Brazil
| | - Marcelo Suzuki
- Department of Operative Dentistry and Prosthodontics; Tufts University School of Dental Medicine; Boston Massachusetts
| | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York 10010
| | - Gerson Bonfante
- Department of Prosthodontics; University of São Paulo, Bauru College of Dentistry; Bauru SP Brazil
| | - Vinicius P. Fardin
- Department of Prosthodontics; University of São Paulo, Bauru College of Dentistry; Bauru SP Brazil
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York 10010
| | - Paulo G. Coelho
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York 10010
- Director for Research; Department of Periodontology and Implant Dentistry; New York University College of Dentistry; New York New York
- Affiliated Faculty; Division of Engineering; New York University Abu Dhabi; Abu Dhabi United Arab Emirates
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Silva NRFA, Teixeira HS, Silveira LM, Bonfante EA, Coelho PG, Thompson VP. Reliability and Failure Modes of a Hybrid Ceramic Abutment Prototype. J Prosthodont 2016; 27:83-87. [DOI: 10.1111/jopr.12461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 11/26/2022] Open
Affiliation(s)
- Nelson RFA Silva
- Department of Restorative Dentistry; Federal University of Minas Gerais-School of Dentistry (UFMG/FO); Belo Horizonte Minas Gerais Brazil
| | - Hellen S. Teixeira
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York NY
- Department of Orthodontics; University of Pennsylvania School of Dental Medicine; Philadelphia PA
| | - Lucas M. Silveira
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York NY
| | - Estevam A. Bonfante
- Department of Prosthodontics; Bauru School of Dentistry; University of Sao Paulo; Bauru Sao Paulo Brazil
| | - Paulo G. Coelho
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York NY
| | - Van P. Thompson
- Department of Tissue Engineering and Biophotonics; King's College London; Guy's Hospital London UK
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Hirata R, Bonfante EA, Anchieta RB, Machado LS, Freitas G, Fardin VP, Tovar N, Coelho PG. Reliability and failure modes of narrow implant systems. Clin Oral Investig 2015; 20:1505-13. [PMID: 26526325 DOI: 10.1007/s00784-015-1636-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Narrow implants are indicated in areas of limited bone width or when grafting is nonviable. However, the reduction of implant diameter may compromise their performance. This study evaluated the reliability of several narrow implant systems under fatigue, after restored with single-unit crowns. MATERIALS AND METHODS Narrow implant systems were divided (n = 18 each), as follows: Astra (ASC); BioHorizons (BSC); Straumann Roxolid (SNC), Intra-Lock (IMC), and Intra-Lock one-piece abutment (ILO). Maxillary central incisor crowns were cemented and subjected to step-stress accelerated life testing in water. Use level probability Weibull curves and reliability for a mission of 100,000 cycles at 130- and 180-N loads (90 % two-sided confidence intervals) were calculated. Scanning electron microscopy was used for fractography. RESULTS Reliability for 100,000 cycles at 130 N was ∼99 % in group ASC, ∼99 % in BSC, ∼96 % in SNC, ∼99 % in IMC, and ∼100 % in ILO. At 180 N, reliability of ∼34 % resulted for the ASC group, ∼91 % for BSC, ∼53 % for SNC, ∼70 % for IMC, and ∼99 % for ILO. Abutment screw fracture was the main failure mode for all groups. CONCLUSIONS Reliability was not different between systems for 100,000 cycles at the 130-N load. A significant decrease was observed at the 180-N load for ASC, SNC, and IMC, whereas it was maintained for BSC and ILO. CLINICAL RELEVANCE The investigated narrow implants presented mechanical performance under fatigue that suggests their safe use as single crowns in the anterior region.
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Affiliation(s)
- Ronaldo Hirata
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - Estevam A Bonfante
- Department of Prosthodontics, Bauru College of Dentistry, University of São Paulo, Alameda Otávio Pinheiro Brisola 9-75, Bauru, SP, 17.012-901, Brazil.
| | - Rodolfo B Anchieta
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA.,Universidade do Norte Paulista-UNORP, São José do Rio Preto, SP, Brazil.,Department of Operative Dentistry, São Paulo State University, Araçatuba, SP, Brazil
| | - Lucas S Machado
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA.,Department of Operative Dentistry, São Paulo State University, Araçatuba, SP, Brazil
| | - Gileade Freitas
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA.,Department of Dental Surgery and Traumatology, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Vinicius P Fardin
- Department of Prosthodontics, Bauru College of Dentistry, University of São Paulo, Alameda Otávio Pinheiro Brisola 9-75, Bauru, SP, 17.012-901, Brazil
| | - Nick Tovar
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA.,Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA.,Division of Engineering, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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Abstract
OBJECTIVES To investigate the effect of implant-abutment connection types on reliability and failure modes of anterior single-unit crowns. METHODS Fifty-four implants were divided in 3 groups (n = 18 each): external hexagon (EH), internal hexagon (IH), and Morse taper (MT) connection. Abutments were screwed to the implants, and maxillary central incisor metal crowns were cemented and subjected to step-stress accelerated life testing. RESULTS The beta values derived from use-level probability Weibull calculations for groups IH (2.52), EH (1.67), and MT (0.88) indicated that fatigue influenced the failure only of IH and EH groups. The reliability for a mission of 100,000 cycles at 175 N was 0.99 (0.98-1.00), 0.84 (0.62-0.94) and 0.97 (0.87-0.99) for the EH, IH, and MT, respectively. The characteristic strength was not significantly different between EH (290 N) and IH (251 N) but significantly higher for MT (357 N). For IH and EH groups, failure involved screw fracture, and the MT implants primary failure mode was abutment fracture. CONCLUSIONS Reliability was higher for the EH and MT relative to IH groups, whereas the characteristic strength was significantly higher for implants with MT connection.
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Goiato MC, Pellizzer EP, da Silva EVF, Bonatto LDR, dos Santos DM. Is the internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? A systematic review. Oral Maxillofac Surg 2015; 19:229-242. [PMID: 25910993 DOI: 10.1007/s10006-015-0494-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 03/26/2015] [Indexed: 05/28/2023]
Abstract
PURPOSE This systematic review aimed to evaluate if the internal connection is more efficient than the external connection and its associated influencing factors. METHODS A specific question was formulated according to the Population, Intervention, Control, and Outcome (PICO): Is internal connection more efficient than external connection in mechanical, biological, and esthetical point of views? An electronic search of the MEDLINE and the Web of Knowledge databases was performed for relevant studies published in English up to November 2013 by two independent reviewers. The keywords used in the search included a combination of "dental implant" and "internal connection" or "Morse connection" or "external connection." Selected studies were randomized clinical trials, prospective or retrospective studies, and in vitro studies with a clear aim of investigating the internal and/or external implant connection use. RESULTS From an initial screening yield of 674 articles, 64 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full texts of these articles were obtained with 29 articles fulfilling the inclusion criteria. Morse taper connection has the best sealing ability. Concerning crestal bone loss, internal connections presented better results than external connections. The limitation of the present study was the absence of randomized clinical trials that investigated if the internal connection was more efficient than the external connection. CONCLUSIONS The external and internal connections have different mechanical, biological, and esthetical characteristics. Besides all systems that show proper success rates and effectiveness, crestal bone level maintenance is more important around internal connections than external connections. The Morse taper connection seems to be more efficient concerning biological aspects, allowing lower bacterial leakage and bone loss in single implants, including aesthetic regions. Additionally, this connection type can be successfully indicated for fixed partial prostheses and overdenture planning, since it exhibits high mechanical stability.
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Affiliation(s)
- Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontics, Aracatuba School of Dentistry, São Paulo State University (UNESP), José Bonifácio, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015-295, Brazil,
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Anchieta RB, Machado LS, Hirata R, Bonfante EA, Coelho PG. Platform-Switching for Cemented Versus Screwed Fixed Dental Prostheses: Reliability and Failure Modes: An In Vitro Study. Clin Implant Dent Relat Res 2015; 18:830-9. [DOI: 10.1111/cid.12363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Rodolfo Brunieira Anchieta
- Department of Biomaterials and Biomimetics; New York University; College of Dentistry; New York NY USA
- Department of Dental Materials and Prosthodontics; São Paulo State University; Araçatuba Dental School; Araçatuba SP Brazil
- Centro Universitario do Norte Paulista-UNORP; São José do Rio Preto SP Brazil
| | - Lucas Silveira Machado
- Department of Biomaterials and Biomimetics; New York University; College of Dentistry; New York NY USA
- Department of Dental Materials and Prosthodontics; São Paulo State University; Araçatuba Dental School; Araçatuba SP Brazil
| | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics; New York University; College of Dentistry; New York NY USA
| | - Estevam Augusto Bonfante
- Department of Prosthodontics; University of São Paulo - Bauru College of Dentistry; Bauru SP Brazil
| | - Paulo G. Coelho
- Department of Biomaterials and Biomimetics; New York University; College of Dentistry; New York NY USA
- Department of Periodontology and Implant Dentistry; New York University; College of Dentistry; New York NY USA
- Division of Engineering; New York University Abu Dhabi; Abu Dhabi United Arab Emirates
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Bonfante EA, Suzuki M, Lorenzoni FC, Sena LA, Hirata R, Bonfante G, Coelho PG. Probability of survival of implant-supported metal ceramic and CAD/CAM resin nanoceramic crowns. Dent Mater 2015; 31:e168-77. [DOI: 10.1016/j.dental.2015.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 03/28/2015] [Accepted: 05/15/2015] [Indexed: 01/22/2023]
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Delben JA, Barão VA, Ferreira MB, da Silva NR, Thompson VP, Assunção WG. Influence of abutment-to-fixture design on reliability and failure mode of all-ceramic crown systems. Dent Mater 2014; 30:408-16. [DOI: 10.1016/j.dental.2014.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 01/07/2014] [Accepted: 01/14/2014] [Indexed: 11/16/2022]
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Sghaireen MG. Fracture Resistance and Mode of Failure of Ceramic versus Titanium Implant Abutments and Single Implant-Supported Restorations. Clin Implant Dent Relat Res 2013; 17:554-61. [DOI: 10.1111/cid.12160] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mohd G. Sghaireen
- Department of Prosthodontics; Faculty of Dentistry; Al-Jouf University; Sakaka Saudi Arabia
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