1
|
Fayed MS, Elsherbini NN, Mohsen B, Osman R. Digital wear analysis and retention of poly-ether-ether-ketone retentive inserts versus conventional nylon inserts in locator retained mandibular overdentures: in-vitro study. Clin Oral Investig 2024; 28:468. [PMID: 39105859 PMCID: PMC11303480 DOI: 10.1007/s00784-024-05831-y] [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: 04/10/2024] [Accepted: 07/14/2024] [Indexed: 08/07/2024]
Abstract
OBJECTIVE this study aimed to digitally compare wear behavior and retention between PEEK and nylon retentive inserts used in locator-retained, mandibular implant overdentures when attachment design and size were standardized. MATERIALS AND METHODS A total of sixty-four inserts (32 PEEK and 32 nylon inserts); were picked-up in implant overdentures. Overdentures of both groups were submerged in artificial saliva and mounted to chewing simulator. After 480,000 chewing cycles (equivalent to 2 years of clinical use) all inserts were scanned by scanning electron microscope (SEM), then all acquired images were digitally analyzed by software to detect and compare quantitative and qualitative changes of inserts in both groups. On the other hand, retention of both groups was measured by universal testing machine and the collected data was statistically analyzed using one-way Analysis of Variance (ANOVA) test with significance level set at P ≤ 0.05. RESULTS PEEK inserts showed significantly higher mean retentive values compared to the nylon inserts in the control group. Also, PEEK retentive inserts exhibited statistically lower mean wear values than the control group P ≥ 0.000. Qualitative investigation revealed significant and more pronounced changes in the surface roughness of nylon inserts compared to PEEK ones. CONCLUSIONS Regarding retention, wear behavior and dimension stability, PEEK can be recommended as retentive insert material in cases of locator-retained mandibular implant overdentures. CLINICAL RELEVANCE PEEK inserts offer enhanced retention, reduced wear, and greater dimensional stability over two years time interval. Clinically, this reduces prosthodontic maintenance and adjustments, improving patient satisfaction and long-term prosthetic success.
Collapse
Affiliation(s)
- Mahmoud Saleh Fayed
- Department of Prosthodontics, Future University in Egypt, St. Teseen, New Cairo 1, Cairo Governorate, New Cairo, 11835, Egypt.
| | | | - Bassem Mohsen
- Department of Prosthodontics, Future University in Egypt, St. Teseen, New Cairo 1, Cairo Governorate, New Cairo, 11835, Egypt
| | - Reham Osman
- Department of Prosthodontics, Cairo University in Egypt, Giza, Egypt
| |
Collapse
|
2
|
Wakam R, Ramalingam S, Mawussi KB, Gorin C, Benoit A. Retention loss and wear assessment of three attachment systems for implant retained-mandibular overdentures: An in vitro study. J Mech Behav Biomed Mater 2024; 150:106269. [PMID: 38043259 DOI: 10.1016/j.jmbbm.2023.106269] [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: 10/04/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The stud-shaped attachment systems (AS) with different shape designs (ball, cylindrical, conical) and materials (metallic, plastic, or a combination of both) are commonly used to provide better retention and stability in implant-retained mandibular overdentures (IRMO). PURPOSE The purpose of the present study was to evaluate and compare the retention loss and the wear (patterns, location, material loss) of three resilient unsplinted AS: a well-established ball attachment system (BAS) and two more recent cylindrical attachment systems (CAS), Locator R-Tx® and Novaloc®. MATERIALS AND METHODS The implants, their corresponding abutments, the color-coded or position-coded retention devices (RD), the matrix metal housing were incorporated within CAD/CAM resin blocks and cyclically loaded with 19.6 N along the implant axis in a chewing machine to simulate 10,000 insertion-removal cycles (IRC). At cycle 10, 100, 1,000, 5,000, and 10,000, the retention force was measured using a universal testing machine. The wear was qualitatively examined using a binocular magnifier for both systems, and quantitatively assessed from micro-computed tomography acquisitions for CAS. Material loss exceeding 50 μm was considered significant. RESULTS The three AS showed different retentive behavior along time. All the Locator R-Tx® RD lost more than 50 % of their retention after 10,000 IRC. The retention of the Ball System slightly varied over time, the final retention loss in Bmed and Bmax groups being lower than 25 % of the initial retention. Wear was located at the tip of their gold RD and at the equator area of their ball abutment. For Locator R-Tx®, the more retentive the plastic RD, the greater its wear and retention loss. Only Novaloc® maintained a stable retention with even a slight tendency to increase and showed a negligible wear. Implant abutments of the CAS showed no significant wear. CONCLUSION After 10,000 IRC, corresponding to approximately 5-years clinical use, almost all RD provided retention force over 5 N, which could be sufficient to maintain satisfaction in most of the patients. The retention loss observed most prominently for the Locator R-Tx®, then for the Ball System, seemed to correlate with the wear observed on their RD. The practitioner may expect less RD maintenance with the Novaloc® stable retention overtime.
Collapse
Affiliation(s)
- Raphaël Wakam
- Département de Prothéses, Faculté de Chirurgie Dentaire, Université de Lille, France; Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France
| | - Srilakshmi Ramalingam
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France
| | - Kwamivi Bernardin Mawussi
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Sorbonne Paris Nord, Bobigny, France
| | - Caroline Gorin
- Département de Biologie Orale, Faculté de Chirurgie Dentaire, URP2496, Pathologie, Imagerie et Biothérapies Orofaciales, Université Paris Cité, Montrouge, France; Service d'Odontologie, Département de Prothèses, AP-HP / GH Nord, Paris, France.
| | - Aurélie Benoit
- Unité de Recherche Biomatériaux Innovants et Interfaces, Université Paris Cité, Montrouge, France.
| |
Collapse
|
3
|
Friedrichsen M, Dirksen D, Runte C. In vitro measurement of the retention force of two stud attachment systems during cyclic load. J Prosthodont 2024; 33:164-170. [PMID: 36779671 DOI: 10.1111/jopr.13665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/27/2023] [Accepted: 02/05/2023] [Indexed: 02/14/2023] Open
Abstract
PURPOSE To investigate the retentive behavior of the Locator legacy and Novaloc attachment systems with different retention inserts both within and across systems under cyclic load. MATERIALS AND METHODS Three retention inserts of each system (green, yellow, and white for Novaloc; green, orange, and red inserts for extended range for legacy Locator) were tested on abutments of both systems with a sample number of 10 per force and 10,000 cycles of insertion and removal. The loading was applied in the axial direction of the abutments, which were placed in artificial saliva. The retention force was measured in each cycle. The results were compared with the manufacturer's specifications and evaluated for a simulated period of use of 10 years. Characteristic time constants were determined, and subsequently, the two systems were compared regarding their wear behavior. RESULTS The manufacturer's specifications could only be confirmed for the green Novaloc retention insert on a Novaloc abutment (t-test: p = 0.50); for all other inserts, the baseline exceeded the manufacturer's specifications by 30%-75% (Novaloc; t-test: p < 0.001) and 75%-550% (Locator; t-test: p < 0.001). After 10,000 cycles performed, the manufacturer's specifications were confirmed on a Novaloc abutment for the white Novaloc retention insert (t-test: p = 0.86) and on a Locator abutment for the green Novaloc retention insert (t-test: p = 0.32). Both systems lost retention force during the experiment. Overall, Novaloc inserts on both abutments showed less wear (decrease to 56%-85% of initial force) and a slower decrease in retention force compared to Locator inserts (decrease to 6%-31% of initial force). CONCLUSIONS In both systems, wear leads to a varying loss of retention; therefore, regular checks with possible replacement of the inserts are necessary in clinical use. Novaloc attachments seem to be more resistant to the loss of retention than Locator attachments. A cross-combination may be clinically useful in some cases.
Collapse
Affiliation(s)
- Momme Friedrichsen
- Department of Prosthetic Dentistry, University of Muenster, Muenster, Germany
| | - Dieter Dirksen
- Department of Prosthetic Dentistry, University of Muenster, Muenster, Germany
| | - Christoph Runte
- Department of Prosthetic Dentistry, University of Muenster, Muenster, Germany
| |
Collapse
|
4
|
El Charkawi HG, Abdelaziz MS. Novel CAD-CAM fabrication of a custom-made ball attachment retentive housing: an in-vitro study. Eur J Med Res 2023; 28:520. [PMID: 37968756 PMCID: PMC10652503 DOI: 10.1186/s40001-023-01498-5] [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: 08/24/2022] [Accepted: 11/02/2023] [Indexed: 11/17/2023] Open
Abstract
PURPOSE This study aims to evaluate the digitally designed ball attachment housing in its initial retentive force and after 2 years of simulated clinical use and to compare it with the regular nylon ball attachment housing. MATERIALS AND METHODS Twenty implants with their corresponding ball abutments (diameter 4.5 × 4.0 mm) were inserted in resin blocks. They were divided into two groups. In Group I, ten ball abutments each received their corresponding conventional attachment with nylon rings. In Group II, ten ball abutments received the novel CAD-CAM polyetheretherketone ball attachment housing. A universal testing machine was used to measure the retention force. The achieved maximum values of retention force were recorded at the beginning of the study (initial retention) and after 2 years of artificial ageing (2000 cycles of insertion and removal). Results were statistically analyzed using an independent sample T test. RESULTS The PEEK attachment housing showed high retention forces (25.12 ± 0.99 N) compared to the conventional attachment with a nylon ring (15.76 ± 0.93 N) in the initial dislodgement test. There was a statistically significant difference in mean retention at the initial retention test and after 2 years of stimulated usage between the two studied groups, p = 0.000. CONCLUSIONS Within the limitations of this study, the novel CAD-CAM-PEEK attachment showed high retention characteristics compared to the conventional attachment with nylon rings, initially and after simulated long-term use.
Collapse
Affiliation(s)
- Hussein G El Charkawi
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University, Fifth Settlement, End of 90 Street, Cairo, Egypt.
| | - Medhat Sameh Abdelaziz
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University, Fifth Settlement, End of 90 Street, Cairo, Egypt
| |
Collapse
|
5
|
Fekri LK, Abdelaziz MS. Digital duplication of maxillary complete denture: A dental technique. J ESTHET RESTOR DENT 2023; 35:1139-1143. [PMID: 37078539 DOI: 10.1111/jerd.13055] [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: 01/27/2023] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE This technique aims to construct a virtual, well-adapted maxillary denture from an existing, ill-fitting denture in completely edentulous patients. CLINICAL CONSIDERATIONS A functional impression is made using the loose maxillary denture, and a cone beam computed tomography (CBCT) of the entire old denture is carried out. The obtained digital imaging and communication in medicine (DICOM) file was segmented using an image computing platform software (3D slicer). The resultant Standard Tessellation Language (STL) file was 3D printed in porcelain white-like resin, then colored and characterized. CONCLUSIONS The technique introduces a high-quality digital denture replicate with good retention, that can replace the traditional duplication technique. It can also be used as a relining method for old dentures. This proposed digital technique reduces the number of clinical appointments while also providing a digital library for future denture manufacture. CLINICAL SIGNIFICANCE The proposed technique offers a high-quality digital denture replicate that can replace the traditional duplication technique. This digital technique also reduces the number of clinical appointments required for denture duplication.
Collapse
Affiliation(s)
- Lina Khalaf Fekri
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
| | - Medhat Sameh Abdelaziz
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
| |
Collapse
|
6
|
Βei M, Kamalakidis SN, Pissiotis AL, Michalakis K, Naka O. Retentive force variations in three polyamide and a polyetheretherketone denture attachments for implant-supported overdentures: An in vitro study. J Prosthet Dent 2023:S0022-3913(23)00275-5. [PMID: 37244792 DOI: 10.1016/j.prosdent.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/29/2023]
Abstract
STATEMENT OF PROBLEM The loss in the retentive capability of implant-supported overdenture attachments has been related to the wear of the retentive inserts. Wear of the abutment coating material when following the replacement period for the retentive inserts requires investigation. PURPOSE The purpose of this in vitro study was to compare the changes in retentive force of 3 polyamide and a polyetheretherketone denture attachments under repeated insertion and removal cycles in wet conditions while following their manufacturers' replacement time recommendations. MATERIAL AND METHODS Four different denture attachments (LOCKiT, OT-Equator, Ball attachment, and Novaloc) with their retentive inserts were tested. Four implants were embedded into individual acrylic resin blocks, and 10 abutments for each attachment were used. Forty metal housings with their retentive inserts were attached to polyamide screws with autopolymerizing acrylic resin. A customized universal testing machine was used to simulate insertion and removal cycles. The specimens were mounted on a second universal testing machine at 0, 540, 2700, and 5400 cycles, and the maximum retentive force was recorded. The retentive inserts for LOCKiT (light retention), OT-Equator (soft retention), and Ball attachment (soft retention) were replaced every 540 cycles, while the Novaloc (medium retention) attachments were never replaced. All the abutments were weighed with a precision scale at 0, 2700, and 5400 cycles. The surface of every abutment was examined under a stereomicroscope at ×10 magnification. Data were analyzed with descriptive statistics. Two-way repeated measures ANOVA was used to compare the mean retentive force and mean abutment mass of all groups and time evaluation points. Bonferroni corrections were made to adjust for multiple tests (α=.05). RESULTS The mean retention loss for LOCKiT was 12.6% after 6 months and 45.0% after 5 years of simulated use. The mean retention loss for OT-Equator was 16.0% after 6 months and 50.1% after 5 years of simulated use. The mean retention loss for Ball attachment was 15.3% after 6 months and 39.1% after 5 years of simulated use. The mean retention loss for Novaloc was 31.0% after 6 months and 59.1% after 5 years of simulated use. The mean abutment mass difference was statistically significant (P<.05) for LOCKiT and Ball attachment but not statistically significant (P>.05) for OT-Equator and Novaloc at baseline, 2.5 years, and 5 years. CONCLUSIONS All tested attachments recorded retention loss under the experimental conditions, even when their manufacturers' recommendations for replacement time for the retentive inserts were followed. Patients should be aware that implant abutments should be replaced after a recommended period since their surfaces also change over time.
Collapse
Affiliation(s)
- Maria Βei
- Postgraduate student, Department of Prosthodontics, Faculty of Health Sciences, School of Dentistry, Aristotle University, Thessaloniki, Greece
| | - Savvas N Kamalakidis
- Researcher, Department of Prosthodontics, Faculty of Health Sciences, School of Dentistry, Aristotle University, Thessaloniki, Greece; Adjunct Assistant Professor, Division of Post-graduate Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
| | - Argirios L Pissiotis
- Professor and Director of Postgraduate Prosthodontics, Department of Prosthodontics, Faculty of Health Sciences, School of Dentistry, Aristotle University, Thessaloniki, Greece
| | - Konstantinos Michalakis
- Professor and Chair, Department of Restorative Sciences and Biomaterials, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass
| | - Olga Naka
- Assistant Professor, Department of Prosthodontics, Faculty of Health Sciences, School of Dentistry, Aristotle University, Thessaloniki, Greece
| |
Collapse
|
7
|
Accuracy of digital auricular impression using intraoral scanner versus conventional impression technique for ear rehabilitation: A controlled clinical trial. J Plast Reconstr Aesthet Surg 2022; 75:4254-4263. [PMID: 36117136 DOI: 10.1016/j.bjps.2022.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/13/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022]
|
8
|
Nassar HI, Abdelaziz MS. Retention of bar clip attachment for mandibular implant overdenture. BMC Oral Health 2022; 22:227. [PMID: 35681163 PMCID: PMC9178882 DOI: 10.1186/s12903-022-02262-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip materials (digitally designed PEEK bar clip and regular Nylon bar clip). MATERIALS AND METHODS An epoxy model was constructed for a completely edentulous mandible. Two implants were placed according to prosthetically driven implant placement by a computer-guided surgical stent. Bar clips were digitally designed, 3D printed, and pressed into Poly Ether Ether Ketone (PEEK). Pick up of PEEK and nylon clips was performed on the dentures fitting surface using self-cured acrylic resin. Each study group was subjected to an insertion and removal fatigue test simulating 3 years of patient usage. Retention values were recorded using the universal testing machine at initial retention and after 1, 2, and 3 years of simulated usage. For proper sample sizing, 24 models and dentures (12 for each group) were used. An independent sample t-test and repeated measures analysis of variance were used to compare the data. RESULTS There were statistically significant differences in retention between the PEEK and nylon bar clips at the beginning of the experiment (p = 0.000*). But after 3 years of simulated use, there was no significant difference in retention between the test groups (p = 0.055, NS). After 3 years of simulated use, the retention of PEEK clips decreased by - 58.66% recording 17.37 ± 1.07 N, while the retention of nylon clip increased by + 2.99% recording 16.56 ± 0.88 N. CONCLUSION The digitally designed PEEK clip showed comparable retention results to the nylon clip after 3 years of simulated use. CLINICAL RELEVANCE Maintenance of bar attachment with PEEK clip offers a clinical solution after the wear of normal plastic clips, which is a cheap solution that is easily fabricated and picked up into the denture. Digital fabricated PEEK bar retentive inserts can be used in cases of bar attachment wear.
Collapse
Affiliation(s)
- Hossam I Nassar
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Fifth Settlement, End of 90 Street, Cairo, New Cairo City, Egypt
| | - Medhat Sameh Abdelaziz
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Fifth Settlement, End of 90 Street, Cairo, New Cairo City, Egypt.
| |
Collapse
|