Implant Inclination and Horizontal Misfit in Metallic Bar Framework of Overdentures: Analysis By 3D-FEA Method

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.

Biomechanical evaluation of stress distributions at the implant-abutment complex and peri-implant bone around mandibular dental implants with different neck geometries and inclinations

This study aimed to investigate the effects of the different dental implant neck designs, diameters, and inclinations, on the stress distributions at the mandibular crestal bone and implant-abutment complex, using three-dimensional (3D) finite element stress analysis (FEA) method. Finite element models of three-unit fixed partial dentures supported with two same length implants (10 mm), placed on the second premolar and second molar regions, were designed. Eight different models were designed according to the implants' neck designs (platform switching/traditional), diameters (4.1 mm/4.8 mm) and the tilting angles of the posterior implants (0°/15°). The anterior implants' widths were 4.1 mm and the neck design of the anterior implants matched the posterior implants. Two types of 100-N loads in vertical and 30° oblique directions were applied separately onto each central fossae and functional cusps of the fixed partial dentures crowns. Algor Fempro Software was used for the simulation and evaluation of the stress levels at the implant-abutment complex and the crestal bone. Stress levels measured at the crestal bone were found to be lower for the platform switching models. However, the platform switching design generated higher stress magnitudes within the implant-abutment complex. Inclined placement of posterior implants increased the amount of stress at the crestal bone around both implants. Biomechanically, selection of the largest diameter possible when using tilted platform switched implants may be recommended at the posterior mandible.

3D Finite Element Study on Incomplete Osseointegration: Locator Attachment versus Ball Attachment

BACKGROUND: Incomplete implant osseointegration may affect the choice of the type of attachment to ensure less amount of bone resorption, periods of maintenance, and longer implant/attachment life-time. AIM: The aim of this study was to evaluate, using 3D FE analysis (FEA), the influence of two different types of attachments on the rate of bone resorption, need for maintenance and implant/attachment life time in cases of unpredictable osseointegration in various bone types and using different implant angulations. METHODS: Six finite element models were prepared; three for the locator attachment while the other three for the ball attachment. Each of the three models simulates vertical implant and inclined implants by 10° and 20° degrees. Frictional contact between implant and cortical bone simulated the incomplete osseointegration scenario. RESULTS: Non-linear static analysis results showed that locator attachment and its cap may have longer time life in comparison with the ball attachment and its cap. CONCLUSIONS: Both attachments were safe for cortical and spongy bone, while the cortical bone receives less Von Mises stress by up to 33% with the increased implant angulation.

Implant framework misfit: A systematic review on assessment methods and clinical complications

BACKGROUND

The fit of implant-supported prostheses is of prime importance for the long-term success of implant therapy.

PURPOSE

This systematic review aimed to evaluate recent evidence on current techniques for assessing implant-framework misfit, its associated strain/stress, and whether these misfits are related to mechanical, biological, and clinical consequences.

MATERIALS AND METHODS

An electronic search for publications from January 2010 to October 2020 was performed using the Pubmed, Embase, Web of Science, and Cochrane Library databases with combined keywords on implant-framework misfit assessments and related clinical complications. Inclusion and exclusion criteria were applied. After full-text analyses, data extraction was implemented on current techniques of misfit assessment and the relationship between the misfit and the induced strain/stress.

RESULTS

A total of 3 in vivo and 92 in vitro studies were selected, including 47 studies on quantifying the degree of implant-framework misfit with dimensional techniques, 24 studies measuring misfit-induced strain/stress with modeling techniques, and 24 studies using both methods. The technical details, advantages, and limitations of each technique were illustrated. The correlation between the implant-framework misfit and the induced strain/stress has been revealed in vitro, while that with the biological complications and implant/prostheses failure was weak in clinical studies.

CONCLUSIONS

Dimensional and modeling techniques are available to measure the implant-framework misfit. The passivity of implant-supported fixed prostheses appeared related to the induced strain/stress, but not the clinical complications. Further studies combining three-dimensional (3D) assessments using dimensional and modeling techniques was needed.