A modal analysis of implant-supported overdentures installed on differently positioned sets of dental implants

This study evaluated the three vibration characteristics, namely, natural frequency, damping ratio, and natural mode, together with maximum displacement of a two-implant-supported overdenture (IOD) at different locator attachment positions using experimental modal analysis (EMA). Edentulous mandibular models with a gingival thickness of 1 mm or 3 mm were prepared, into which dental implants were placed using a fully guided surgical template designed with simulation software, the locator abutments were fastened, and the IODs were then fabricated. The implant positions were bilaterally marked at the lateral incisor, first premolar, and first molar regions. EMA was performed by hammering the test structures to measure the impulse response and obtain the vibration characteristics (n = 5). The Kruskal-Wallis test was performed for natural frequency and maximum displacement, and the Games-Howell test for damping ratio. The significance level was set at α = 0.05. The study indicated that the gingival thickness had a significant effect on the vibration characteristics. Moreover, the natural frequency and damping ratio results showed that the vibration subsided faster when the attachment was placed on the molar implants in the thick gingival model. Furthermore, according to the effect of lateral force on IODs, the difference in maximum displacement between the anterior and posterior regions of the IOD was smaller when the attachments were designed on the pair of lateral incisors. Thus, within the limits of this experiment, our results suggested that two anterior implant-supported IODs are preferable treatment designs in terms of vibration engineering, especially when the gingiva is thick; the molar attachment design could be considered for thin gingival conditions. The differences in gingival thickness and abutment position affected the vibration characteristics of the IOD. Further in vivo studies would be necessary to validate the implant positions and their IOD designs for the mandibular edentulous shapes and the occlusal relationship.

Effect of mucosa thicknesses on stress distribution of implant-supported overdentures under unilateral loading: Photoelastic analysis

INTRODUCTION

The aim of this study was to evaluate the effect of different heights of attachment and mucosa thicknesses on the stress distribution of two implant-retained mandibular overdenture designs under loading using the photoelastic stress analysis method.

MATERIALS AND METHODS

Six photoelastic models of an edentulous mandibula were fabricated with two solitary implants that were placed in the canine regions. The attachment systems studied were ball and locator stud attachments. Both the ball and locator groups included three models that had different residual ridge heights so as to provide different mucosa thicknesses (1 mm-1 mm, 1 mm-2 mm, 1 mm-4 mm). A static vertical force of 135 N was applied unilaterally (each on the right then the left side) to the central fossa of the first molars. Models were positioned in the field of a circular polariscope to observe the distribution of isochromatic fringes around the implants and the interimplant areas under loading. The photoelastic stress fringes were monitored and recorded photographically.

RESULTS

The ball attachment groups showed higher stress values than did the locator groups under loading. Both attachment systems produced the lowest stress values in stimulated 1 mm-1 mm mucosa thickness models. The models with 1 mm-2 mm mucosa thicknesses showed higher stress values than did other models for both attachment systems. The highest stress value observed around both attachment systems was the moderate level in all test models.

CONCLUSION

In different height mucosa thicknesses, locator attachment models distributed the load to the other side of the implant and its surrounding tissue, whereas the ball attachment did not. Regardless of mucosal thickness and attachment type, the implant on the loading side was subjected to the highest stress concentration.

Evaluation of Stress Distribution on Mandibular Implant-Supported Overdentures With Different Bone Heights and Attachment Types: A 3D Finite Element Analysis

The biomechanical behavior of the edentulous mandible with bone irregularities that has been rehabilitated with implant-supported overdentures has become an important factor for treatment planning. Restorative options, including dental implants with various attachments, affect the stress distribution. The purpose of this study was to evaluate the stress distribution of cortical bone around the implant neck and implant structures in overdentures with two different attachment types at the edentulous mandible and with different bone heights using three-dimensional finite element analysis. Five three-dimensional models of an edentulous mandible were designed and implemented. Ten models were constructed with ball and locator attachments. Static bilateral and unilateral vertical and oblique occlusal loads with magnitudes of 100 N were applied to the overdentures. The principal stresses were higher in the presence of oblique loads compared to vertical loads in all the analyzed models. Maximum principal stresses were observed around the mesial side of the contralateral implant, and the minimum principal stresses were noted around the distal side of ipsilateral implant during unilateral vertical loading. These patterns were reversed during oblique loadings. The ball attachment models yielded lower von Mises stress values than the locator models at all the loading conditions, while the stress distributions were similar in the models with the same and different bone levels. Correspondingly, bone corrections due to irregularities may not be necessary in terms of biomechanics. The results of this study may provide clinicians a better understanding for the mandibular overdenture design in the cases at which different bone heights exist.

The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth

Objectives:

To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth.

Methods:

A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group received overdentures with cuspless teeth. The rate of implant success was assessed clinically and radiographically at 3, 6, 9, and 12 months. The data were collected by a questionnaire, an observation checklist, and radiography. The data were then analyzed using computerized methods.

Results:

Overdentures with cusped teeth showed a significant improvement in the clinical criteria, including the absence of clinical implant mobility, pain, and bone resorption, while the clinical criteria for the absence of peri-implant radiolucency were insignificantly different between the 2 groups (p>0.05). There were no significant differences in the clinical evaluations for bone levels at the time of insertion or 3 months after insertions, while significant differences were found at 6, 9, and 12 months after insertion.

Conclusion:

Overdentures with cusped teeth supported by immediate implants were found superior regarding many clinical criteria than those cuspless counterparts.

Effects of posterior ridge resorption and attachment wear on periimplant strain in mandibular two-implant-supported overdentures

STATEMENT OF PROBLEM

Progressive resorption of the posterior residual ridge and attachment wear increase the rotational movement of mandibular 2-implant-supported overdentures (IODs). Limited information is available regarding the biomechanical effects of rotational movement on anterior implants during mastication.

PURPOSE

The purpose of this in vitro investigation was to analyze the effects of posterior ridge resorption and attachment wear, using simulated IODs to examine periimplant strain changes under dynamic loading conditions.

MATERIAL AND METHODS

Two dental implants were positioned in the canine regions of a mandibular edentulous cast. Two mandibular edentulous models were fabricated from the cast by using a fixture-level impression technique, and IODs reinforced with a cobalt-chromium cast framework were prepared using the laboratory models. Two different types of stud attachments (Locator and O-ring) were connected to each paired model and to the IOD. Using a dynamic load of 100 N, continuous stress-strain changes were recorded under 3 conditions: the original condition of the paired laboratory models and the IODs, following a 1-mm reduction of the posterior residual ridge support, and after performing a fatigue test to simulate attachment wear after reduction of the posterior ridge support. After these measurements, a scanning electron microscope (SEM) was used to analyze attachment wear.

RESULTS

In all implants, the 1-mm posterior ridge reduction and attachment wear procedure did not remarkably elevate tensile forces compared with their original condition. All stress-strain curves showed phased strain changes caused by the rotational movement of the IODs. After the fatigue test, the shape of the stress-strain curve changed from a smooth curve to a polygonal line compared with that in the previous records. The Locator matrices showed more wear than the other attachment components.

CONCLUSIONS

Neither attachment wear nor an increase of the IOD rotational movement caused by an approximately 1-mm decrease in the posterior mucosal support led to significant changes in the periimplant strain in IODs.

Effect of Implant Height Differences on Different Attachment Types and Peri-Implant Bone in Mandibular Two-Implant Overdentures: 3D Finite Element Study

Implant-supported overdentures with self-aligning attachment systems are preferred to improve the stability and retention of complete dentures. The positioning of the implant attachments is a very important aspect of two-implant overdentures in obtaining better stress distribution. Therefore, the objective of this study was to compare two different attachment systems in a two-implant overdenture by evaluating the stress distributions in peri-implant bone and stresses on the attachments with positioning at different height levels using the 3D FEA method. Six models with ball attachments and 6 models with locator attachments-totaling 12 models (including 2 controls)-with the left implant positioned unilaterally at different height levels were subjected to 3 loading conditions (anterior, right posterior, and left posterior). Data for Von Misses stresses were produced numerically, color coded, and compared among the models for attachments and peri-implant cortical bone. The configurations in which implants presented 3 mm height differences in the bone level showed the most successful results in the peri-implant bone. When stresses on the attachments were compared, greater stress values were obtained from the ball attachments. As a conclusion, the configurations with a considerable (3 mm) height difference between quadrants of the mandible in the anterior segment showed the most successful results in the peri-implant bone. On the contrary, peak stress values around the implant observed from the models with less (1 mm) bone height difference may require leveling of the bone during surgery. However, these findings should be corroborated with clinical studies.

Force transfer and stress distribution in an implant-supported overdenture retained with a hader bar attachment: a finite element analysis

Background and Objectives. A key factor for the long-term function of a dental implant is the manner in which stresses are transferred to the surrounding bone. The effect of adding a stiffener to the tissue side of the Hader bar helps to reduce the transmission of the stresses to the alveolar bone. But the ideal thickness of the stiffener to be attached to the bar is a subject of much debate. This study aims to analyze the force transfer and stress distribution of an implant-supported overdenture with a Hader bar attachment. The stiffener of the bar attachments was varied and the stress distribution to the bone around the implant was studied. Methods. A CT scan of edentulous mandible was used and three models with 1, 2, and 3 mm thick stiffeners were created and subjected to loads of emulating the masticatory forces. These different models were analyzed by the Finite Element Software (Ansys, Version 8.0) using von Mises stress analysis. Results. The results showed that the maximum stress concentration was seen in the neck of the implant for models A and B. In model C the maximum stress concentration was in the bar attachment making it the model with the best stress distribution, as far as implant failures are concerned. Conclusion. The implant with Hader bar attachment with a 3 mm stiffener is the best in terms of stress distribution, where the stress is concentrated at the bar and stiffener regions.

Analysis of stress on mucosa and basal bone underlying complete dentures with different reliner material thicknesses: a three-dimensional finite element study

The aim of this study was to determine the optimal thickness of reliner material that provides the least amount of stress on thin mucosa and supporting bone in patients with complete removable dentures using a three-dimensional finite element analyses. The model was obtained from two CT scans of edentulous mandibles with dentures supported by the alveolar ridge. After virtual reconstruction, the three-dimensional models were exported to the solidworks cad software and divided into six groups based on the thickness of the reliner material as follows: (i) without material, (ii) 0·5 mm, (iii) 1 mm, (iv) 1·5 mm, (v) 2 mm and (vi) 2·5 mm. The applied load was 60 N and perpendicular to the long axis of the alveolar ridge of all the prosthetic teeth, and the mucosal thickness used was 1 mm. The analyses were based on the maximum principal stress in the fibromucosa and the minimum principal stress in the basal bone. Stress concentration was observed in the anterior zone of the mandible in the mucosa and in the bone. The maximum and minimum principal stress in the mucosa and bone, respectively, decreased, whereas the thickness of the reliner material increased until 2 mm, which transmitted the lowest stress, compared with the control. Reliner materials with a thickness of 2·5 mm showed higher stress values than those with a thickness of 2 mm. In conclusion, reliner material with a thickness of 2 mm transmitted the lowest amount of stress to the mucosa and bone in 1 mm of mucosa thickness.

Finite Element Analysis of the Influence of Implant Inclination on Stress Distribution in Mandibular Overdentures

The purpose of this finite element study was to evaluate the influence of implant inclination on the stress pattern in the bone surrounding the implants that support mandibular overdentures. The models used in this study were 3-implant-supported mandibular overdentures with a bar-and-clip attachment system. Each model was modified according to the distal implant inclination (0 and 20°). A unilateral vertical load was applied unilaterally to the first molar and first premolar of the overdenture, and the stress distribution in the bone was analyzed. Implant inclination decreased the stress distribution pattern in bone surrounding the implants when the load was applied on the molar site, but when applied at the premolar site, similar stress value changes were not found. Within the limitation of this study, it seems that the inclination of splinted implants in mandibular overdentures does not have any adverse effect on stress distribution pattern values around the implant.

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.

Effects of mucosal thickness on the stress distribution and denture stability of mandibular implant-supported overdentures with unsplinted attachments in vitro

The aim of this study was to compare the effects of mucosal thickness on the stress pattern around implants and movement of implant-supported overdentures with ball/female and three different types of magnetic attachments. After insertion of two root-form implants into a mandibular model, the surface of the model was covered with a 1.5- or 3-mm layer of impression material to simulate the oral mucosa, and removable overdentures were fabricated on each model. A 50-N vertical force was applied to the right first molar, and the resultant stress distribution and denture movement were measured. In the 1.5-mm mucosal model, the magnetic attachments showed significantly lower bending moments than did the ball attachment. The denture base displacement was the lowest on a magnetic attachment. In this study, use of magnetic attachments could be advantageous for mandibular implant-supported overdentures based on lower stress and better denture stability especially in the thin mucosal model.