Effects of Prosthetic Material and Framework Design on Stress Distribution in Dental Implants and Peripheral Bone: A Three-Dimensional Finite Element Analysis

Automated Remodelling of Connectors in Fixed Partial Dentures

In this study, an approach for automated parametric remodelling of the connector cross-sectional area in a CAD model of a given fixed partial denture (FPD) geometry was developed and then applied to a 4-unit FPD. The remodelling algorithm was implemented using Rhinoceros and the Grasshopper plugin. The generated CAD models were used to perform a finite element analysis with Ansys to analyse the stress distribution in an implant-supported 4-unit FPD for different connector designs. The results showed that the type of connector adjustment matters and that the resulting stress can be significantly different even for connectors with the same cross-sectional area. For tensile stresses, a reduction in the connector cross-sectional area from the gingival side showed the highest influence on each connector type. It can be concluded that the developed algorithm is suitable for automatic connector detection and adjustment.

Mechanical and Biological Characterization of PMMA/Al2O3 Composites for Dental Implant Abutments

The mechanical and biological behaviors of PMMA/Al2O3 composites incorporating 30 wt.%, 40 wt.%, and 50 wt.% of Al2O3 were thoroughly characterized as regards to their possible application in implant-supported prostheses. The Al2O3 particles accounted for an increase in the flexural modulus of PMMA. The highest value was recorded for the composite containing 40 wt.% Al2O3 (4.50 GPa), which was about 18% higher than that of its unfilled counterpart (3.86 GPa). The Al2O3 particles caused a decrease in the flexural strength of the composites, due to the presence of filler aggregates and voids, though it was still satisfactory for the intended application. The roughness (Ra) and water contact angle had the same trend, ranging from 1.94 µm and 77.2° for unfilled PMMA to 2.45 µm and 105.8° for the composite containing the highest alumina loading, respectively, hence influencing both the protein adsorption and cell adhesion. No cytotoxic effects were found, confirming that all the specimens are biocompatible and capable of sustaining cell growth and proliferation, without remarkable differences at 24 and 48 h. Finally, Al2O3 was able to cause strong cell responses (cell orientation), thus guiding the tissue formation in contact with the composite itself and not enhancing its osteoconductive properties, supporting the PMMA composite's usage in the envisaged application.

Clinical performance of short and extrashort dental implants with wide diameter: A systematic review with meta-analysis

STATEMENT OF PROBLEM

Rehabilitation with wide-diameter reduced-length implants has become popular for patients with minimal vertical bone. However, a consensus on the benefits of this approach is lacking.

PURPOSE

The purpose of this systematic review with meta-analysis was to evaluate the influence of wide compared with regular diameter on the clinical performance of short (<10 mm) and extrashort (≤6 mm) dental implants used for rehabilitations with single crowns, fixed partial dentures, or both, in the posterior region.

MATERIAL AND METHODS

A search in 6 databases was conducted to select randomized controlled trials (RCTs) and nonrandomized controlled trials (N-RCTs). Five meta-analyses were performed, where the risk ratio (RR) was evaluated. The certainty of evidence was evaluated, and the risk of bias was determined from the Joanna Briggs Institute checklist.

RESULTS

Fourteen articles were included, 272 wide- and 478 regular-diameter implants. One study presented a low, 3 an unclear, and 11 a high risk of bias. Meta-analyses showed no statistical difference: implant survival, short dental implants in N-RCTs (up to 1 year - RR 1.01 [0.98; 1.03], 1 to 5 years - RR 1.01 [0.94; 1.08], more than 5 years - RR 1.01 [0.97; 1.06]), extrashort dental implants in N-RCTs (RR 1.04 [0.90; 1.20]), RCTs (RR 1.05 [0.88; 1.25]); implant success in N-RCTs (RR 1.01 [0.97; 1.05]); prosthesis success in N-RCTs (RR 1.01 [0.97; 1.05]).

CONCLUSIONS

Short and extrashort dental implants with a wide and regular diameter appear to be clinically appropriate options for implant-supported posterior restorations, with high survival, success, and prosthesis success rates.

[Stress in an implant-supported unitary fixed partial prosthesis with different materials in the first lower premolar through finite elements]

AIM

To analyze stress in a metal-ceramic, zirconia and lithium disilicate implant-supported unitary fixed partial prosthesis in the first lower premolar through finite element analysis at a 500 N force.

MATERIALS AND METHODS

Three study models were carried out, metal-ceramic, lithium disilicate and zirconium implant-supported crowns in the first lower premolar. The dental implant was made of titanium grade 5 based on the Bolt® model of UniDentalDirect with internal grooved connection (18 grooves) and the implant had a size of 11,0 x 4,5 mm, preformed abutment and integrated screw. The three designs had vertical and oblique (45°) forces applications at 500 N. The geometric modeling was performed with the SolidWorks® 2017 program and the results were obtained through the Von mises analysis using the CosmoWorks®2017 program.

RESULTS

The lowest value of maximum stress on crown level, under vertical and oblique forces, was found in the lithium disilicate crown with 21,9 MPa and 33,2 MPa, and with a minimum difference with the zirconium crown with 22,1 MPa and 35,1 MPa; on the abutment level, the zirconium crown had the lowest value of maximum stress with 18,6 MPa and 28,1 MPa; at the screw level, there were no significant differences.

CONCLUSION

Metal-ceramic, lithium disilicate, and zirconia crowns proved to be materials of good compressive and tensile strength, but it was concluded that the zirconia crown design generated lower overall stress.

Finite Element Analysis of an Implant-Supported FDP with Different Connector Heights

All-ceramic fixed dental prostheses (FDPs) tend to fracture in the connector areas, due to the concentration of tensile stresses. This study aimed to evaluate the role of connector height on the stress distribution of a posterior three-unit implant-supported all-ceramic FDP using finite element analysis (FEA). Two titanium dental implants, their abutments, screws, and a three-unit all-ceramic FDP were scanned using a micro-CT scanner. Three 3D models with altered distal connector heights (3, 4, and 5 mm) were generated and analyzed on ABAQUS FEA software. The maximum principal stress values in MPa observed for each model with different connector heights and their respective locations (MA = mesial abutment; DA = distal abutment; F = framework; V = veneer) were: 3 mm—219 (MA), 88 (DA), 11 (F), 16 (V); 4 mm—194 (MA), 82 (DA), 8 (F), 18 (V); 5 mm—194 (MA), 80 (DA), 8 (F), and 18 (V). All the assembled models demonstrated the peak stresses at the neck area on the mesial abutments. The connector height had a significant influence on the stress distribution of the prosthesis. The models with higher distal connectors (4 and 5 mm) had a lower and more uniform distribution of maximum principal stresses (except for the veneer layer) when compared with the model with the smallest distal connector.

Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials

The aim of this study was to assess and compare the stress–strain pattern of zygomatic dental implants supporting different superstructures using 3D finite element analysis (FEA). A model of a tridimensional edentulous maxilla with four dental implants was designed using the computer-aided design (CAD) software. Two standard and two zygomatic implants were positioned to support the U-shaped bar superstructure. In the computer-aided engineering (CAE) software, different materials have been simulated for the superstructure: cobalt–chrome (CoCr) alloy, titanium alloy (Ti), zirconia (Zr), carbon-fiber polymers (CF) and polyetheretherketone (PEEK). An axial load of 500 N was applied in the posterior regions near the zygomatic implants. Considering the mechanical response of the bone tissue, all superstructure materials resulted in homogeneous strain and thus could reconstruct the edentulous maxilla. However, with the aim to reduce the stress in the zygomatic implants and prosthetic screws, stiffer materials, such Zr, CoCr and Ti, appeared to be a preferable option.

Biomechanical Analysis of Different Framework Design, Framework Material and Bone Density in the Edentulous Mandible With Fixed Implant-Supported Prostheses: A Three-Dimensional Finite Element Study

PURPOSE

The objective of this finite element study was to investigate the effect of different framework designs, framework materials, and bone densities on the stress distribution of fixed implant-supported prostheses for edentulous mandibles.

MATERIALS AND METHODS

Under the condition of 2-mm cortical bone, 16 models were created in the edentulous mandible to simulate different framework designs (1-piece or 3-piece frameworks) with different framework material (pure titanium, zirconia, polyetheretherketone, or carbon fiber-reinforced polyetheretherketone) in-high or low-density trabecular bone. Then, vertical loading and oblique loading at 75° were applied to the anterior and posterior regions. The stress distribution and stress concentration region of implant and peri-implant bone with different combinations were compared by finite element analysis.

RESULTS

The use of the 1-piece zirconia framework in high-density trabecular bone improved stress distribution on implants and peri-implant bone. The region of stress concentration is located in the buccal cervix of the distal implants and the distobuccal portion of the cortical bone in all models. To improve the stress distribution on fixed implant-supported dentures for edentulous mandibles, the 1-piece framework and zirconia represent the better combinations.

CONCLUSION

Under the condition of 2-mm cortical bone thickness, the full-arch zirconia framework had minimum von Mises stress on implants and peri-implant bone in all models, and high trabecular bone density greatly decreased the stress on cortical bone. This article is protected by copyright. All rights reserved.

Implant insertion angle and depth: Peri-implant bone stress analysis by the finite element method

Background

The study aimed to assess the influence of different implant insertion angles and depths on the stresses produced on the surface of peri-implant bone tissue under axial and oblique loading.

Material and Methods

The entire study followed the recommendations of the Checklist for Reporting In-vitro Studies (CRIS). The implant was placed in the region of element 36, according to the following models: M1 (0 mm / 0°); M2 (0 mm / 17°); M3 (0 mm / 30°); M4 (2 mm / 0°); M5 (2 mm / 17°); M6 (2 mm / 30°). The models were subjected to loading, with intensity of 100 N. The stress assessment followed the Mohr-Coulomb criterion and qualitative and quantitative analyses were performed.

Results

Angled implants and installed below the bone crest produced the highest stresses on the cortical bone, and the axial load presented the highest stress peaks on the buccal side of implants perpendicular to the bone crest. Regardless of the type of load (axial or oblique), inclined implants presented the highest stress peaks on the lingual side of the cortical bone.

Conclusions

Implants installed perpendicular to and with a prosthetic platform at bone crest height provided the lowest stresses to peri-implant bone tissue under both axial and oblique loading.

Key words:Finite element analysis, dental implants, axial loading, biomechanical phenomena.

Evaluation of Fatigue Life for Dental Implants Using FEM Analysis

The purpose of this study is to numerically analyze a 3D model of an implant under fatigue loads. A bone and a V shape implant were modeled using SolidWorks2008 software. In order to obtain an exact model, the bone was assumed as a linear orthotropic material. Mechanical loads were applied in terms of fastening torque to the abutment and mastication force applied at the top of the crown. The abutment was tightened into the implant by applying a 35 N.cm torque causing tensile stress within the abutment screw as a preload that is harmful not only for the fatigue life of the abutment, but also for the stability of the implant-abutment interface. A 700 N force at an angle of 30 degrees to the vertical direction was applied to the crown. The mechanical analysis results showed that the abutment is the critical component of the implant system in terms of fatigue failure. This is due to the fact that the tensile preloads originated from the fastening torque. The results were presented in terms of fatigue life in the abutment. Fatigue life of the abutment and implant were calculated based on the Goodman, Soderberg, Smith–Watson–Topper (SWT), and Marrow theories. According to the results of the fatigue life prediction, abutment screws may fail after about 3 × 105 cycles. The predicted results by the Goodman theory are at a very good accordance with the clinical data.

Finite Element Analysis of a New Dental Implant Design Optimized for the Desirable Stress Distribution in the Surrounding Bone Region

Dental implant macro- and micro-shape should be designed to maximize the delivery of optimal favorable stresses in the surrounding bone region. The present study aimed to evaluate the stress distribution in cortical and cancellous bone surrounding two models of dental implants with the same diameter and length (4.0 × 11 mm) and different implant/neck design and thread patterns. Sample A was a standard cylindric implant with cylindric neck and V-shaped threads, and sample B was a new conical implant with reverse conical neck and with “nest shape” thread design, optimized for the favorable stress distribution in the peri-implant marginal bone region. Materials and methods: The three-dimensional model was composed of trabecular and cortical bone corresponding to the first premolar mandibular region. The response to static forces on the samples A and B were compared by finite element analysis (FEA) using an axial load of 100 N and an oblique load of 223.6 N (resulting from a vertical load of 100 N and a horizontal load of 200 N). Results: Both samples provided acceptable results under loadings, but the model B implant design showed lower strain values than the model A implant design, especially in cortical bone surrounding the neck region of the implant. Conclusions: Within the limitation of the present study, analyses suggest that the new dental implant design may minimize the transfer of stress to the peri-implant cortical bone.

Biomechanical Effect of an Exposed Dental Implant's First Thread: A Three-Dimensional Finite Element Analysis Study

Background

The purpose of this study was to assess the effect of different exposure levels of a dental implant’s first thread on adjacent bone stress and strain using the finite element analysis method.

Material/Methods

Three-dimensional models of 2 threaded implants and abutments with a mandibular bone segment were constructed to represent the covered (C) and exposed models. In the exposed models, the implant was first placed in the bone, and rotated around its axis a quarter-turn each time to simulate 4 different levels of first thread exposure at the mid-lingual side: Upper Flank (UF), Thread Crest (TC), Lower Flank (LF), and Thread Root (TR) models. Oblique forces were applied and analysis was performed.

Results

Maximum compressive stress magnitude and distribution varied according to the exposed thread profile. In the exposed group, peak stress ranged from 136 MPa to 197 MPa in TC and LF models, respectively, compared to 141 MPa in C model. In LF, UF, and C models, peak stress was observed at the mid-lingual side of the crestal region, while in TC and TR models, peak stress shifted distally in accordance with thread profile. However, alveolar bone volumes which exhibited compressive microstrain levels within the physiological loading and maintenance windows were relatively close in all models.

Conclusions

Results suggest that the exposed thread profile influences stress and strain outcomes in the adjacent bone; however, this influence is only limited to a small region around the exposed thread.

A Three-Dimensional Finite Element Analysis of Aramany Class I Obturator Fabricated with Different Alloys

Aim

The aim of the research was to develop a model that accurately represents an Aramany class I defect and its obturator prostheses fabricated with cobalt-chromium alloy and titanium alloy to compare the deflection and the stress distribution in the rehabilitated area.

Materials and Methods

Aramany class I defect and the obturator prostheses were generated geometrically using ANSYS 14.5; both were superimposed on each other to mimic the prostheses and the maxilla as one unit. Meshing of models was carried out using hypermesh software and materialistic properties were assigned. The 120 newton load was constituted on the teeth in different directions.

Statistical Analysis Used

Statistical analysis of Finite element was not possible. Self-explanatory decoding results in the software were used.

Results

The stress distribution and deflection executed by ANSYS provided results that enabled the tracing of Von Mises stress and deflection field in the form of color-coded bands with values in mega pascal.

Conclusions

The study shows that Von Mises stresses are higher for the frame work fabricated with cobalt-chromium alloy compared to titanium alloy. The framework made of titanium alloy showed more deflection than cobalt-chromium alloy.