Experimental and numerical investigations of fracture and fatigue behaviour of implant-supported bars with distal extension made of three different materials

Evaluation of the Influence of Build Orientation on the Surface Roughness and Flexural Strength of 3D-Printed Denture Base Resin and Its Comparison with CAD-CAM Milled Denture Base Resin

OBJECTIVES

 The purpose of this study was to determine the surface roughness and flexural strength of a three-dimensional (3D)-printed denture base resin printed with two different build plate orientations and to compare them with a computer-aided design-computer-aided manufacture (CAD-CAM) milled denture base resin.

MATERIALS AND METHODS

 Sixty-six specimens (n = 22/group) were prepared by 3D printing and CAD-CAM technology. The group A and B specimens were 3D-printed bar-shaped denture base specimens printed at 120-degree and 135-degree build orientation, respectively, whereas group C specimens were milled using a CAD-CAM technology. The surface roughness was assessed using a noncontact profilometer with a 0.01 mm resolution and the flexural strength was determined using a three-point bend test. The maximum load in Newtons (N) at fracture, the flexural stress (MPa), and strain (mm/mm) was also measured.

STATISTICAL ANALYSIS

 Data were analyzed by a statistical software package. One-way analysis of variance test was applied to determine whether significant differences existed among the study groups, followed by Bonferroni post-hoc test to determine which resin group significantly differed from the others in terms of flexural strength and surface roughness (p ≤ 0.05).

RESULTS

 The flexural stress (MPa) of group C was 200% of group A and 166% of group B. The flexural modulus was 192% of group A and 161% of group B. In contrast, group A had the lowest mean value among the three groups for all the parameters. No significant difference was seen between group A and group B. The mean roughness values of the CAD-CAM denture base resin specimens (group C) were the least (127356 nm) among all the three groups. The mean surface roughness of the 3D-printed denture base specimens (group A) was 1,34,234 nm and that of group B was (1,45,931 nm); however, it was statistically nonsignificant (p > 0.05) CONCLUSIONS:  The CAD-CAM resin displayed superior surface and mechanical properties compared to the 3D-printed resin. The two different build plate angles did not have any significant effect on the surface roughness of the 3D-printed denture base resin.

Effect of bar designs on peri implant tissues health in implant-supported removable prostheses: a systematic review

Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues.Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues.Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023.Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures' survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information.Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.

Stress Distribution on Various Implant-Retained Bar Overdentures

The purpose of this study was to evaluate the effects of various fabrication techniques and materials used in implant-supported mandibular overdentures with a Hader bar attachment over added stress distribution. Three-dimensional geometric solid models, consisting of two implants (3.3 mm × 12 mm) placed at the bone level on both mandibular canine regions and a Hader bar structure, were prepared. Model 1 simulated a bar retentive system made from Titanium Grade 5 material by Computer Numerical Control (CNC) milling technique without using any converting adapter/multi-unit element on the implants, while Model 2 simulated the same configuration, but with converting adapters on the implants. Model 3 simulated a bar retentive system made from Cobalt-Chromium material, made by using conventional casting technique with converting adapters on the implants. Static loads of 100 Newton were applied on test models from horizontal, vertical and oblique directions. ANSYS R15.0 Workbench Software was used to compare Von Mises stress distribution and minimum/maximum principal stress values, and the results were evaluated by using Finite Element Analysis method. As a result, the highest stress distribution values under static loading in three different directions were obtained in Model 1. Stress was observed intensely around the necks of the implants and the surrounding cortical bone areas in all models. In scope of the results obtained, using converting adapters on implants has been considered to decrease transmission of forces onto implants and surrounding bone structures, thus providing a better stress distribution. It has also been observed that the type of material used for bar fabrication has no significant influence on stress values in those models where converting adapters were used.

The effects of bar holder material, cantilever and vertical misfit on stresses in implant supported overdentures: Three dimensional finite element analysis

Background/Aim: The aim of this study is to examine with finite element analysis the distal bar extension, the bar substructure material type and the amount of bar substructure-abutment mismatch, and the stress caused by the implant at the surrounding bone tissue in bar-retained prostheses. Material and Methods: A bar-retained prosthesis model has been designed on three implants placed in the fully toothless lower jaw at the places of both canines and the midline. Bar holder according to distal cantilever lengths was modeled to be 0 mm, 8 mm and 14 mm. The vertical incompatibility of the bar holder substructure with the abutment was modeled to be 0 µm, 100 µm and 200 µm. A total of twenty-seven (3x3x3) different models were obtained with three different bar infrastructure materials (titanium, gold and chromium-cobalt). 150 N occlusal force was applied to the central fossa of the left 1st molar tooth with a rigid food stuff. Results: In the cortical bone, the highest maximum principle stress value (2.78 MPa) was analyzed around the anterior implant socket in the model 13 (gold, cantilever 0mm, misfit 100 µm). The highest von Mises stress value (343.43 MPa, which occurred at the selected joints in bar holders) was observed in model 27 (chrome-cobalt, cantilever 14mm, misfit 200 µm). Conclusions: When the length of the cantilever is 14 mm, it causes a significant increase in stress around the implant, especially near the cantilever. It has been observed that bar infrastructures with high elastic modulus create higher stress values.