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Fahmy MM, Al-Afandy MH, Mohamed HT, Abdelfattah Mohamed AM. Effect of different framework materials on stresses induced in distal extension removable partial dentures: A strain gauge analysis. J Prosthodont 2024. [PMID: 38520400 DOI: 10.1111/jopr.13847] [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: 10/21/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024] Open
Abstract
PURPOSE Evaluation of the strain transmitted to the abutments and residual ridge by polyetherketoneketone material compared to the cobalt-chromium one in distal extension removable partial dentures (RPDs) to fulfill the objective of preservation of the supporting structures. MATERIALS AND METHODS A virtual model simulating a Kennedy class I partially edentulous mandibular arch was designed. Two models, one for each group, were printed. Five RPDs were made in each group. In group CR, the framework was milled from a cobalt-chromium alloy. While in group PK, it was milled from a polyetherketoneketone blank. Strain gauge rosettes were bonded distal to the last abutment and posteriorly in the distal end of the residual ridge. Unilateral vertical and oblique loadings were applied. Mann-Whitney U test was used for inter-group comparisons while the Friedman test was used for intra-group comparisons and corrected by Wilcoxon Signed-Rank Sum. The significance level was set at p ≤ 0.05. RESULTS During unilateral vertical load application, a statistically significant difference was found between both groups distal to the abutment in the loaded and unloaded sides as well as the residual ridge on the unloaded side. During oblique load application, a statistically significant difference was found between both groups in all slots. CONCLUSION Polyetherketoneketone material induces less stress on the abutments and more stress on the residual ridges compared to the cobalt-chromium ones. Therefore, it may be recommended for weak abutments supporting RPDs.
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Affiliation(s)
- Maha Mahmoud Fahmy
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Mahmoud Hassan Al-Afandy
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Hebatallah Tarek Mohamed
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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Patil PG, Seow LL, Uddanwadikar R, Pau A, Ukey PD. Crestal strain of two-implant mandibular overdentures with implants placed at different positions: An in vitro 3D printed simulation study. J Prosthet Dent 2024; 131:281.e1-281.e9. [PMID: 37985307 DOI: 10.1016/j.prosdent.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
STATEMENT OF PROBLEM The 2-implant mandibular overdenture (2IMO) is a popular treatment for patients with mandibular edentulism. However, information on the influence of implant positions on crestal strain is lacking. PURPOSE The purpose of this in vitro study was to evaluate the crestal strain around 2 implants to support mandibular overdentures when placed at different positions. MATERIAL AND METHODS Edentulous mandibles were 3-dimensionally (3D) designed separately with 2 holes for implant placement at similar distances of 5, 10, 15, and 20 mm from the midline, resulting in 4 study conditions. The complete denture models were 3D designed and printed from digital imaging and communications in medicine (DICOM) images after scanning the patient's denture. Two 4.3×12-mm dummy implants were placed in the preplanned holes. Two linear strain gauges were attached on the crest of the mesial and distal side of each implant (CH1, CH2, CH3, and CH4) and connected to a computer to record the electrical signals. Male LOCATOR attachments were attached, the mucosal layer simulated, and the denture picked up with pink female nylon caps. A unilateral and bilateral force of 100 N was maintained for 10 seconds for each model in a universal testing machine while recording the maximum strains in the DCS-100A KYOWA computer software program. Data were analyzed by using 1-way analysis of variance, the Tukey post hoc test, and the paired t test (α=.05). RESULTS Under bilateral loading, the strain values indicated a trend with increasing distance between the implants with both right and left distal strain gauges (CH4 and CH1). The negative (-ve) values indicated the compressive force, and the positive (+ve) values indicated the tensile force being applied on the strain gauges. The strain values for CH4 ranged between -166.08 for the 5-mm and -251.58 for the 20-mm position; and for CH1 between -168.08 for the 5-mm and -297.83 for the 20-mm position. The remaining 2 mesial strain gauges for all 4 implant positions remained lower than for CH4 and CH1. Under unilateral-right loading, only the right-side distal strain gauge CH4 indicated the increasing trend in the strain values with -147.5 for the 5-mm, -157.17 for the 10-mm, -209.33 for the 15-mm, and -234.75 for the 20 mm position. The remaining 3 strain gauges CH3, CH2, and CH1 ranged between -28.33 and -107.17. For each position for both implants, significantly higher (P<.05) strain values were observed on the distal strain gauge channels CH4 and CH1 than on the mesial channels CH3 and CH2 under bilateral loading and on the right side under unilateral loading. CONCLUSIONS Peri-implant crestal strains in the 2IMO increased by increasing the distance of the implants from the midline. The stress values progressively increased from 5 to 10 mm to 15 to 20 mm from midline, represented as lateral incisor, canine, and premolar positions. The distal side of the implants exhibits higher strains than the mesial side of the implants.
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Affiliation(s)
- Pravinkumar G Patil
- Associate Professor in Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Liang Lin Seow
- Professor, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Rashmi Uddanwadikar
- Professor, Department of Mechnical Engeneering, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Allan Pau
- Professor, Division of Oral Health Sciences, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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El Haron AM, Askar OMR, Said Ahmed W, Elsyad MA. Rehabilitation of distal extension maxillary ridges with fixed and removable implant-supported prostheses: Preliminary 12-month randomized clinical trial. Clin Implant Dent Relat Res 2023; 25:795-806. [PMID: 37154012 DOI: 10.1111/cid.13212] [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: 02/28/2023] [Revised: 04/07/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE This trial evaluated clinical outcomes of fixed and removable implant-supported prostheses for rehabilitation of atrophied distal extension maxillary ridges. MATERIALS AND METHODS A total of 54 participants with atrophied distal extension maxillary ridges were randomly assigned into three groups (n = 18/group). Group I (SLF); participants treated with fixed restoration supported by three long implants after sinus augmentation, Group II (SF); participants treated with fixed restoration supported by one long and two short implants, and Group III (OD): participants treated with removable partial denture assisted by one long implant that was placed mesial to maxillary sinus (IARPD). Modified plaque index (MPI), modified gingival index (MGI), pocket depth (PD), implant stability (IS), and crestal bone loss (CBL) were measured after prosthesis insertion (T0), 6 (T6), and 12 months (T12) after insertion. Patient satisfaction was measured at T12 using a visual analog scale (VAS). RESULTS The implant survival rates were 96.8%, 92.4%, and 84.6% for SLF, SF, and OD groups respectively. The SLF recorded the highest MPI, MGI, PD, and IS values, followed by the SF, and the OD showed the lowest values. The OD recorded the highest CBL followed by the SF and the SLF showed the lowest CBL. With exception of satisfaction with surgery and cleaning, SLF and SF groups recorded significantly higher patient satisfaction than the OD for all VAS questions. CONCLUSION Fixed restorations supported with either long or short implants were associated with improved implant stability, reduced bone loss, and increased patient satisfaction compared to implant-assisted RPDs. However, implant-assisted RPDs were associated with more favorable peri-implant soft tissue health and increased satisfaction with surgery, healing, and cleaning.
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Affiliation(s)
- Ahmed Mahmoud El Haron
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Removable Prosthodontics, Faculty of Dentistry, Delta University, Belqas, Egypt
| | - Osama Mohammed Raouf Askar
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Wael Said Ahmed
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
| | - Moustafa Abdou Elsyad
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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A modal analysis of implant-supported overdentures installed on differently positioned sets of dental implants. J Mech Behav Biomed Mater 2023; 137:105492. [PMID: 36368187 DOI: 10.1016/j.jmbbm.2022.105492] [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: 08/19/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022]
Abstract
This study evaluated the three vibration characteristics, namely, natural frequency, damping ratio, and natural mode, together with maximum displacement of a two-implant-supported overdenture (IOD) at different locator attachment positions using experimental modal analysis (EMA). Edentulous mandibular models with a gingival thickness of 1 mm or 3 mm were prepared, into which dental implants were placed using a fully guided surgical template designed with simulation software, the locator abutments were fastened, and the IODs were then fabricated. The implant positions were bilaterally marked at the lateral incisor, first premolar, and first molar regions. EMA was performed by hammering the test structures to measure the impulse response and obtain the vibration characteristics (n = 5). The Kruskal-Wallis test was performed for natural frequency and maximum displacement, and the Games-Howell test for damping ratio. The significance level was set at α = 0.05. The study indicated that the gingival thickness had a significant effect on the vibration characteristics. Moreover, the natural frequency and damping ratio results showed that the vibration subsided faster when the attachment was placed on the molar implants in the thick gingival model. Furthermore, according to the effect of lateral force on IODs, the difference in maximum displacement between the anterior and posterior regions of the IOD was smaller when the attachments were designed on the pair of lateral incisors. Thus, within the limits of this experiment, our results suggested that two anterior implant-supported IODs are preferable treatment designs in terms of vibration engineering, especially when the gingiva is thick; the molar attachment design could be considered for thin gingival conditions. The differences in gingival thickness and abutment position affected the vibration characteristics of the IOD. Further in vivo studies would be necessary to validate the implant positions and their IOD designs for the mandibular edentulous shapes and the occlusal relationship.
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Abdelfattah Mohamed AM, El Homossany MEMB, Abdelmoniem SM, Abdelrahman TY. Comparison of tensile bond strength of ball attachments made of different materials to root canal dentin after chewing simulation. BMC Oral Health 2022; 22:254. [PMID: 35751090 PMCID: PMC9229525 DOI: 10.1186/s12903-022-02282-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Debonding of ball attachments is one of the complications that annoy teeth supported overdenture wearers. The polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers are widely applied in the dental field. The purpose of the current study was to compare the tensile bond strength of ball attachments made of such materials and the commonly used titanium ones after 5 years of overdenture insertion and removal (5000 cycles) in addition to chewing simulation (1,200,000 cycle). METHODS Extracted mandibular canines (N = 60) were randomly allocated into three groups and received ball attachments; titanium (group TI; N = 20), PEEK (group PE; N = 20), PEKK (group PK; N = 20). In each group, the samples were divided into two subgroups whereas tensile bond strength was measured pre aging (T0; n = 10) and post aging (T1; n = 10). Tensile bond strength was measured by the Pull out test using the Universal testing machine. Failure mode analysis was determined by examination of the samples' surfaces under 65X stereomicroscope. The resulting data followed normal distribution and the significance level was set at (α = 0.05). RESULTS One Way Anova showed statistically significant difference between the three groups (P < .00001). PostHoc Tukey test showed statistically significant difference between the groups TI and PE, TI and PK and no statistically significant difference between the groups PE and PK. Paired t test showed statistically significant difference in the tensile bond strength pre and post aging in each group. CONCLUSIONS PEEK and PEKK ball attachments could be concluded to have a higher tensile bond strength compared to the titanium ones when bonded to root dentin. Tensile bond strength of such attachments may decrease with aging as well. Clinically, the higher tensile bond strength may have a lesser rate of debonding and thus reduced patient apprehension.
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Affiliation(s)
- Ahmed Mostafa Abdelfattah Mohamed
- Oral and Maxilofacial Prosthodontics Department, Faculty of Dentistry, AinShams University, Organization of African Unity Street, Cairo, 11561, Egypt.
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ELsyad MA, Abdraboh AE, Denewar MM, Mohamed SS. Prosthetic complications and maintenance of different attachments used to stabilize mandibular 2‐implant overdentures in patients with atrophied ridges. A 5‐year randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:497-509. [DOI: 10.1111/cid.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/30/2022] [Accepted: 04/10/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Prosthodontics, Faculty of Dentistry Mansoura University Eldakahlia Egypt
| | | | - Mohamed Mahmoud Denewar
- Department of Removable Prosthodontics, Faculty of Dentistry Delta University for Science and Technology Eldakahlia Egypt
| | - Shahinaz Sayed Mohamed
- Department of Removable Prosthodontics, Faculty of Dentistry Beni Suef University Beni Suef Egypt
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Geometric Reproducibility of Three-Dimensional Oral Implant Planning Based on Magnetic Resonance Imaging and Cone-Beam Computed Tomography. J Clin Med 2021; 10:jcm10235546. [PMID: 34884244 PMCID: PMC8658654 DOI: 10.3390/jcm10235546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/04/2022] Open
Abstract
This study aimed to investigate the geometric reproducibility of three-dimensional (3D) implant planning based on magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT). Four raters used a backward-planning approach based on CBCT imaging and standard software to position 41 implants in 27 patients. Implant planning was repeated, and the first and second plans were analyzed for geometric differences regarding implant tip, entry-level, and axis. The procedure was then repeated for MRI data of the same patients. Thus, 656 implant plans were available for analysis of intra-rater reproducibility. For both imaging modalities, the second-round 3D implant plans were re-evaluated regarding inter-rater reproducibility. Differences between the modalities were analyzed using paired t-tests. Intra- and inter-rater reproducibility were higher for CBCT than for MRI. Regarding intra-rater deviations, mean values for MRI were 1.7 ± 1.1 mm/1.5 ± 1.1 mm/5.5 ± 4.2° at implant tip/entry-level/axis. For CBCT, corresponding values were 1.3 ± 0.8 mm/1 ± 0.6 mm/4.5 ± 3.1°. Inter-rater comparisons revealed mean values of 2.2 ± 1.3 mm/1.7 ± 1 mm/7.5 ± 4.9° for MRI, and 1.7 ± 1 mm/1.2 ± 0.7 mm/6 ± 3.7° for CBCT. CBCT-based implant planning was more reproducible than MRI. Nevertheless, more research is needed to increase planning reproducibility—for both modalities—thereby standardizing 3D implant planning.
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ELsyad MA, Maryod WH, Mostafa AZ. Effect of Implant Position on Clinical and Radiographic Outcomes of Locator-Retained Mandibular Overdentures: A 1-Year Prospective Study. J Prosthodont 2018; 28:e699-e704. [DOI: 10.1111/jopr.12780] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, Faculty of Dentistry; University of Mansoura; Eldakahlia Egypt
| | - Waleed Hamed Maryod
- Department of Removable Prosthodontics, Faculty of Dentistry; University of Modern Science and Arts; Cairo Egypt
| | - Aisha Zakaria Mostafa
- Department of Removable Prosthodontics, Faculty of Dentistry; University of Mansoura; Eldakahlia Egypt
- Department of Removable Prosthodontics, Faculty of Dentistry; University of Hail; Hail Saudia Arabia
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ELsyad MA, Emera RM, Ashmawy TM. Effect of Distal Implant Inclination on Dislodging Forces of Different Locator Attachments Used for Mandibular Overdentures: An In Vitro Study. J Prosthodont 2017; 28:e666-e674. [DOI: 10.1111/jopr.12710] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, University of Mansoura; Faculty of Dentistry; Eldakahlia Egypt
| | - Radwa Mohsen Emera
- Department of Removable Prosthodontics, University of Mansoura; Faculty of Dentistry; Eldakahlia Egypt
| | - Tarek Mohy Ashmawy
- Department of Maxillofacial Prosthodontics, University of Cairo; National Cancer Institute; Cairo Egypt
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