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Mously HA, Naguib GH, Hashem ABH, Abougazia AO, Binmahfooz AM, Hamed MT. Influence of Connector Design on Displacement and Micromotion in Tooth-Implant Fixed Partial Dentures Using Different Lengths and Diameters: A Three-Dimensional Finite Element Study. MATERIALS (BASEL, SWITZERLAND) 2024; 17:4416. [PMID: 39274806 PMCID: PMC11395790 DOI: 10.3390/ma17174416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/28/2024] [Accepted: 09/04/2024] [Indexed: 09/16/2024]
Abstract
The literature presents insufficient data evaluating the displacement and micromotion effects resulting from the combined use of tooth-implant connections in fixed partial dentures. Analyzing the biomechanical behavior of tooth-implant fixed partial denture (FPD) prothesis is vital for achieving an optimum design and successful clinical implementation. The objective of this study was to determine the relative significance of connector design on the displacement and micromotion of tooth-implant-supported fixed dental prostheses under occlusal vertical loading. A unilateral Kennedy class I mandibular model was created using a 3D reconstruction from CT scan data. Eight simulated designs of tooth-implant fixed partial dentures (FPDs) were split into two groups: Group A with rigid connectors and Group B with non-rigid connectors. The models were subjected to a uniform vertical load of 100 N. Displacement, strain, and stress were computed using finite element analysis. The materials were defined as isotropic, homogeneous, and exhibiting linear elastic properties. This study focused on assessing the maximum displacement in various components, including the bridge, mandible, dentin, cementum, periodontal ligament (PDL), and implant. Displacement values were predominantly higher in Group B (non-rigid) compared to Group A (rigid) in all measured components of the tooth-implant FPDs. Accordingly, a statistically significant difference was observed between the two groups at the FPD bridge (p value = 0.021 *), mandible (p value = 0.021 *), dentin (p value = 0.043 *), cementum (p value = 0.043 *), and PDL (p value = 0.043 *). Meanwhile, there was an insignificant increase in displacement values recorded in the distal implant (p value = 0.083). This study highlighted the importance of connector design in the overall stability and performance of the prosthesis. Notably, the 4.7 mm × 10 mm implant in Group B showed a displacement nearly 92 times higher than its rigid counterpart in Group A. Overall, the 5.7 mm × 10 mm combination of implant length and diameter showcased the best performance in both groups. The findings demonstrate that wider implants with a proportional length offer greater resistance to displacement forces. In addition, the use of rigid connection design provides superior biomechanical performance in tooth-implant fixed partial dentures and reduces the risk of micromotion with its associated complications such as ligament overstretching and implant overload, achieving predictable prognosis and enhancing the stability of the protheses.
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Affiliation(s)
- Hisham A Mously
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ghada H Naguib
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Oral Biology, School of Dentistry, Cairo University, Cairo 12613, Egypt
| | | | | | - Abdulelah M Binmahfooz
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mohamed T Hamed
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Fixed Prosthodontics, School of Dentistry, Cairo University, Cairo 12613, Egypt
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Muhsin SA, Mohammed EK, Bander K. Finite Element Analysis: Connector Designs and Pontic Stress Distribution of Fixed Partial Denture Implant-Supported Metal Framework. J Long Term Eff Med Implants 2024; 34:33-47. [PMID: 38842231 DOI: 10.1615/jlongtermeffmedimplants.2023048378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
This virtual study was designed to evaluate the stress-deformation of a metal fixed partial dentures (FPDs) pontic under different loads using two different connectors. The STL file was generated for a RPD of two implant-supported restorations. The Co-Cr metal substructure was designed with two types of connector design. The pontic is connected to implant-supported crowns with square and round shape connectors. This study was designed for a cementless-retained implant-supported FPD. Finite element modeling (FEM) is used to assess the stress and deformation of the pontic within a metal substructure as the FEM might provide virtual values that could have laboratory and clinical relevance. The Co-Cr alloy mechanical properties like the Poisson ratio and modulus of elasticity were based on the parameters of the three-dimensional structure additive method. Nonparametric analyses (Mann-Whitney U test) was used. The use of square or round connectors often resulted in non-significant changes in stress, and deformation under either three or each loaded point on the occlusal surface of a pontic (P > 0.05). However, the deformation revealed distinct variations between loads of the three points compared to each loaded point (P ≤ 0.05). According to this study data, the pontic occlusal surface appears to be the same in stress and deformation under different loads depending on whether square or round connectors are used. While at the same connector designs, the pontic occlusal surface deformed significantly at three loaded points than it did at each point.
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Affiliation(s)
| | | | - Khalid Bander
- Middle Technical University, College of Health and Medical Techniques, Baghdad, Iraq
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Taneja S, Khalikar A, Wankhade S, Deogade S, Uchale P, Lalsare S. Survival of tooth-implant connections: A systematic review and meta-analysis. J Indian Prosthodont Soc 2023; 23:310-321. [PMID: 37861608 PMCID: PMC10705009 DOI: 10.4103/jips.jips_161_23] [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: 04/12/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 10/21/2023] Open
Abstract
Implant-supported prostheses have considerable biomechanical advantages in partially edentulous patients when compared to other prosthetic options. Given the steady drop in the frequency of patients reporting with complete edentulism, it is not unusual to see situations where teeth and implants can be splinted to provide support for fixed prostheses. A tooth implant prosthesis differs majorly from an implant-supported prosthesis in terms of force dissipation and design. The aim of this systematic review was to compare the survival rates of tooth-implant-supported prostheses with fully implant-supported and fully tooth-supported prostheses. Using the appropriate search terms, PubMed, Google Scholar, and other indexed journals were used to search the English-language literature. According to the review protocols and the PICOS inclusion criteria, the pertinent studies were chosen. The screening of appropriate studies, evaluation of study quality, and data extraction were carried out independently by two reviewers. The pooling of survival data by prostheses failure, implant failure, and marginal bone loss was used in the meta-analysis. The cumulative data of all included studies indicated that tooth-implant-supported prostheses showed a 5-year survival rate of 77%-84% and a 10-year survival rate of 72%. The pooled risk ratio for prostheses failure and implant failure was 0.99 and 1.76, respectively. These results were not statistically significant (P > 0.05). The pooled standard mean difference for marginal bone loss was 0.59, and the results were statistically significant (P < 0.05). A tooth-implant-supported fixed partial denture (FPD) has a similar survival rate when compared to implant-supported FPD or T-FPD.
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Affiliation(s)
- Sukrit Taneja
- Department of Prosthodontics, Crown and Bridge, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Arun Khalikar
- Department of Prosthodontics, Crown and Bridge, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Sattyam Wankhade
- Department of Prosthodontics, Crown and Bridge, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Suryakant Deogade
- Department of Prosthodontics, Crown and Bridge, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Pooja Uchale
- Department of Prosthodontics, Crown and Bridge, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Samiksha Lalsare
- Department of Prosthodontics, Crown and Bridge, Government Dental College and Hospital, Nagpur, Maharashtra, India
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Altayyar S, Al‐zordk W, Algabri R, Rajah E, Al‐baadani A, Alqutaibi AY, Madina MA, Ghazy MH. Prospective evaluation of implants-supported, tooth-implant supported, and teeth-supported 3-unit posterior monolithic zirconia fixed restorations: Bite force and patient satisfaction. Clin Exp Dent Res 2023; 9:810-819. [PMID: 37703213 PMCID: PMC10582233 DOI: 10.1002/cre2.780] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/12/2023] [Accepted: 08/27/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the maximum bite force (MBF) and satisfaction of patients restored with implants, combined tooth-implants, and teeth-supported monolithic zirconia fixed dental prostheses (FDPs). MATERIALS AND METHODS Thirty partially edentulous patients in need of three units of FDPs in their mandibular posterior region were divided into three equal groups (n = 10) as follows: Group-1 patients received two implants for each at the second premolar and second molar regions, Group-2 patients received one implant for each at the second molar region, and Group-3 patients with missing lower first molar. All the restorations were constructed from monolithic zirconia. Patients were evaluated 1 week after placement of restorations (baseline) and then after 6, 12, and 24-month intervals for MBF using force transducer occlusal force meter and satisfaction (function, esthetic, and overall satisfaction) using a visual analog scale. RESULTS The mean MBF for Group 1 was higher than Group 2 (p = .044) but not that of Group 3 (p = .923). Additionally, Group 3 displayed a higher MBF than Group 2, although this difference was not statistically significant (p = .096). Concerning patient satisfaction, all study groups reported high levels of satisfaction across all satisfaction elements, and no significant differences were observed between the groups. CONCLUSION Within the limitations of this study, it can be concluded that Group 1 gives comparable anticipated treatment outcomes as Group 3 concerning biting force and patient satisfaction. However, Group 2 gives comparable satisfaction results with biting force value within the normal range; thus, it might be used as a treatment option in a specific situation.
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Affiliation(s)
- Sadeq Altayyar
- Prosthodontic Department, Faculty of DentistryIBB UniversityIbbYemen
| | - Walid Al‐zordk
- Fixed Prosthodontic Department, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Radwan Algabri
- Prosthodontic Department, Faculty of DentistryIBB UniversityIbbYemen
- Prosthodontic Department, National UniversityIbb‐BranchIbbYemen
| | - Eshraq Rajah
- Prosthodontic Department, Faculty of DentistrySana'a UniversitySana'aYemen
| | | | - Ahmed Yaseen Alqutaibi
- Department of Prosthodontic and Implant Dentistry, College of DentistryTaibah UniversityAl MadinahSaudi Arabia
- Department of Prosthodontics, College of DentistryIbb UniversityIbbYemen
| | - Manal Abo Madina
- Fixed Prosthodontic Department, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Mohammed H. Ghazy
- Fixed Prosthodontic Department, Faculty of DentistryMansoura UniversityMansouraEgypt
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D'Orto B, Chiavenna C, Leone R, Longoni M, Nagni M, Capparè P. Marginal Bone Loss Compared in Internal and External Implant Connections: Retrospective Clinical Study at 6-Years Follow-Up. Biomedicines 2023; 11:biomedicines11041128. [PMID: 37189746 DOI: 10.3390/biomedicines11041128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023] Open
Abstract
The aim of this study was to assess and compare the marginal bone loss between two different categories of implants (Winsix, Biosafin, Ancona, Italy) having the same diameter and belonging to the Torque Type® (TT®) line, in the internal hexagon version (TTi, Group A) and in the external hexagon configuration (TTx, Group B). Patients with one or more straight implants (insertion parallel to the occlusal plane) in the molar and premolar regions in association with tooth extraction at least 4 months prior to implant insertion, who have a fixture diameter of 3.8 mm, who followed up for at least 6 years, and whose radiographic records were available were enrolled in this study. Depending on implant connections (externally or internally), the sample was divided into groups A and B. For externally connected implants (66), the marginal resorption was 1.1 ± 0.17 mm. The subgroup of single and bridge implants showed no statistically significant differences with a marginal bone resorption of 1.07 ± 0.15 mm and 1.1 ± 0.17 mm, respectively. Internally connected implants (69) showed an overall marginal resorption of 0.91 ± 0.17 mm, while the subgroup of single and bridge implants showed resorption of 0.90 ± 0.19 mm and 0.90 ± 0.17 mm, respectively, with no statistically significant differences. According to the obtained results, internally connected implants showed less marginal bone resorption than externally connected implants.
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Affiliation(s)
- Bianca D'Orto
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Carlo Chiavenna
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Renato Leone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Fixed Prosthodontics, "Federico II" University of Naples, 80100 Naples, Italy
| | - Martina Longoni
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Matteo Nagni
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Paolo Capparè
- Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy
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Kadkhodazadeh M, Amid R, Moscowchi A, Lakmazaheri E. Short-term and long-term success and survival rates of implants supporting single-unit and multiunit fixed prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00008-2. [PMID: 36781339 DOI: 10.1016/j.prosdent.2022.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 02/13/2023]
Abstract
STATEMENT OF PROBLEM Whether placing implants to replace each missing tooth or using implant-supported fixed partial dentures provides better outcomes is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to assess the success and survival rates of implants supporting single-unit and multiunit fixed prostheses by using conventional protocols for placement and loading in short- and long-term follow-ups. MATERIAL AND METHODS An electronic search was conducted in PubMed, Scopus, and Web of Science for studies published up to March 17, 2022. Comparative studies that reported the success or survival rates of both single-unit and splinted multiunit prostheses were considered for qualitative and quantitative analyses. RESULTS A total of 68 publications comprising 11 271 implants were included. Compared with the single prostheses, the splinted multiunit group showed no significant differences in implant success rates in the short-term (risk difference=-0.004; 95% confidence interval (CI)=-0.033 to 0.025; P=.780) and long-term (risk difference=0.003; 95% confidence interval (CI)=-0.029 to 0.034; P=.874) follow-ups. Significant statistical differences were also not found in terms of the survival rates of the 2 groups (short-term risk difference=-0.004; 95% CI=-0.031 to 0.023; P=.779, long-term risk difference=-0.002; 95% CI=-0.029 to 0.025; P=.887). CONCLUSIONS Implants supporting single-unit or splinted multiunit prostheses seem to be a predictable treatment in terms of survival and success over short and long periods. Nonetheless, it seems that cantilever and nonsplinted multiunit prostheses should be used with more caution.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Professor, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Associate Professor, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Associate Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Assistant Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Lakmazaheri
- Undergraduate student, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
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Effect of Application of a Bio-Adhesive on the Removal Torque Value and Rotational Misfit at the Implant-Abutment Junction: An In Vitro Study. MATERIALS 2021; 14:ma14226832. [PMID: 34832236 PMCID: PMC8618869 DOI: 10.3390/ma14226832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 12/26/2022]
Abstract
The aim of this study was to assess the effect of application of a recently developed bio-adhesive (Impladhesive) to abutment screw threads on the removal torque value and rotational misfit at the implant–abutment junction. This in vitro study evaluated 20 implant fixtures and 20 straight abutments. Specimens were randomly divided into two groups (n = 10) with/without adhesive application. In the adhesive group, the abutment was dipped in Impladhesive before torquing. In the control group, the abutment was torqued conventionally without adhesive application. The removal torque value was recorded after completion of the cyclic loading of 500,000 cycles with 2 Hz frequency and 75 N load. Rotational misfit was recorded using a video measuring machine. After applying the torque, the change in the bisector angle on the abutment hex was recorded for each implant. The biocompatibility of Impladhesive was evaluated using a MTT cell vitality assay. Normal distribution of data was assessed using the Kolmogorov–Smirnov test. Data were analyzed using a t-test and Pearson’s correlation coefficient The application of Impladhesive at the implant–abutment interface resulted in significantly greater mean removal torque value compared to the control group (p = 0.008). In addition, the mean rotational misfit at the implant–abutment interface was significantly lower in the use of Impladhesive compared to the control group (p = 0.001). In addition, the cell vitality was found to be greater than 80% at all evaluated time points. It can be concluded that the application of Impladhesive on the abutment screw significantly decreased rotational misfit and increased the removal torque value. Future studies are needed to evaluate the efficacy of this bio-adhesive an in vivo setting.
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de Oliveira JC, Sordi MB, da Cruz ACC, Zanetti RV, Betiol EAG, Vieira SR, Zanetti AL. Number of dental abutments influencing the biomechanical behavior of tooth‒implant-supported fixed partial dentures: A finite element analysis. J Dent Res Dent Clin Dent Prospects 2020; 14:228-234. [PMID: 33575012 PMCID: PMC7867679 DOI: 10.34172/joddd.2020.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/21/2020] [Indexed: 11/09/2022] Open
Abstract
Background. Local or systemic issues might prevent installing a sufficient number of dental implants for fixed prosthetic rehabilitation. Splinting dental implants and natural teeth in fixed dentures could overcome such limitations. Therefore, this study aimed to evaluate the influence of the number of dental abutments in the biomechanics of tooth‒implant-supported fixed partial dentures (FPDs). The null hypothesis was that increasing the number of abutment teeth would not decrease the stress over the abutments and surrounding bone. Methods. Left mandibular lateral incisor, canine, premolars, and molars were reconstructed through computed tomography and edited using image processing software to represent a cemented fixed metal‒ceramic partial denture. Three models were set to reduce the number of abutment teeth: 1) lateral incisor, canine, and first premolar; 2) canine and first premolar; 3) the first premolar. The second premolar and first molar were set as pontics, and the second molar was set as an implant abutment in all the models. Finite element analyses were performed under physiologic masticatory forces with axial and oblique loading vectors. Results. After simulation of axial loads, the stress peaks on the bone around the implant, the bone around the first premolar, and prosthetic structures did not exhibit significant changes when the number of abutment teeth decreased. However, under oblique loads, decreasing the number of abutment teeth increased stress peaks on the surrounding bone and denture. Conclusion. Increasing the number of dental abutments in tooth‒implant-supported cemented FPD models decreased stresses on its constituents, favoring the prosthetic biomechanics.
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Affiliation(s)
| | - Mariane Beatriz Sordi
- Postgraduate in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | | | | | - Artêmio Luiz Zanetti
- Department of Prosthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
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