Biomechanical three-dimensional finite element analysis of monolithic zirconia crown with different cement type

Three-Dimensional Finite Element Analysis of Stress Distribution in Dental Implant Prosthesis and Surrounding Bone Using PEEK Abutments

(1) Background: Polyetheretherketone (PEEK) has been used as an alternative to titanium in implant prosthetic systems, but its impact on stress distribution in implant systems needs to be investigated. This study aimed to compare the effect of polyetheretherketone (PEEK) and titanium abutments on implant prosthetic systems and the supporting bone using three-dimensional finite element analysis (FEA). (2) Methods: Three-dimensional finite element analysis was conducted using CATIA V5 and Abaqus V6.12 software to model mandibular first-molar implant systems with titanium and PEEK abutments. Under external loading conditions, finite element analysis was conducted for the stresses in the implant components and surrounding bones of each group. (3) Results: The implant fixture of the PEEK model exhibited the highest von Mises stress (VMS). The lowest VMS was observed in the abutment screw of the titanium model. Both implant systems demonstrated similar stress distributions and magnitudes in cortical and cancellous bones. (4) Conclusion: PEEK abutments show a similar stress distribution in the surrounding bone compared to titanium. However, PEEK absorbs the stresses within the implant system and exhibits the highest VMS values due to its low mechanical and physical properties. Therefore, PEEK abutments need improved mechanical properties for better clinical application.

A 3D-FEA study on the impact of different preparation forms and materials on posterior occlusal veneers

OBJECTIVES

To study the stress distribution and bonding performance in posterior occlusal veneers and tooth bodies under different preparation forms and materials.

METHODS

An isolated lower right first molar was prepared with non-retention type (type A), cavity-retained type (type B), and encircling-retention type (type C) forms. MicroCT images of the tooth were obtained and digitally converted into three-dimensional solid models. Three-dimensional models of veneers for the three abutment teeth were designed, fabricated, and divided into nine models (AEM, ALU, AVE, BEM, BLU, BVE, CEM, CLU, and CVE) according to the material used (E.max CAD [EM], Lava Ultimate [LU] and Vita Enamic [VE]). Three-dimensional finite element stress analysis was performed by applying vertical and oblique forces (200 N) to simulate chewing loads using ABAQUS. Finally, an adhesive stiffness degradation diagram was obtained using the rotatory dislocation simulation method.

RESULTS

The BEM model had the largest equivalent stress extreme value (160.50 MP A) when a vertical load was applied to the veneers, while there was no significant difference when it was applied to dental tissues. The equivalent stress extreme values of each part under an oblique load were significantly greater than those under a vertical load. The AEM model had the largest values when the loads were applied to the veneers (350.60 MP A) and the dental tissues (40.13 MP A). The equivalent stress extreme values of the veneers were ranked as LU < VE < EM for different materials, and LU > VE > EM for dental tissues. Bonding performance results were C > B ≈ A and LU > VE > EM.

CONCLUSIONS

The cavity-retained type better protected the veneers and dental tissues than the non-retention and encircling-retention types under lateral forces. E.max CAD material, with a high elastic modulus, reduced the stress transmitted to the remaining dental tissues. Lava Ultimate exhibited the best bonding performance.

Biomechanical influence of narrow-diameter implants placed at the crestal and subcrestal level in the maxillary anterior region. A 3D finite element analysis

PURPOSE

To evaluate the tendency of movement, stress distribution, and microstrain of single-unit crowns in simulated cortical and trabecular bone, implants, and prosthetic components of narrow-diameter implants with different lengths placed at the crestal and subcrestal levels in the maxillary anterior region using 3D finite element analysis (FEA).

MATERIALS AND METHODS

Six 3D models were simulated using Invesalius 3.0, Rhinoceros 4.0, and SolidWorks software. Each model simulated the right anterior maxillary region including a Morse taper implant of Ø2.9 mm with different lengths (7, 10, and 13 mm) placed at the crestal and subcrestal level and supporting a cement-retained monolithic single crown in the area of tooth 12. The FEA was performed using ANSYS 19.2. The simulated applied force was 178 N at 0°, 30°, and 60°. The results were analyzed using maps of displacement, von Mises (vM) stress, maximum principal stress, and microstrain.

RESULTS

Models with implants at the subcrestal level showed greater displacement. vM stress increased in the implant and prosthetic components when implants were placed at the subcrestal level compared with the crestal level; the length of the implants had a low influence on the stress distribution. Higher stress and strain concentrations were observed in the cortical bone of the subcrestal placement, independent of implant length. Non-axial loading influenced the increased stress and strain in all the evaluated structures.

CONCLUSIONS

Narrow-diameter implants positioned at the crestal level showed a more favorable biomechanical behavior for simulated cortical bone, implants, and prosthetic components. Implant length had a smaller influence on stress or strain distribution than the other variables.

Endocrown Feasibility for Primary Molars: A Finite Element Study

OBJECTIVE

 To study the possibility of using pediatric endocrowns to restore the second primary molar using three-dimensional (3D) finite element analysis.

DESIGN

 A 3D finite element model was built for a pediatric mandibular molar, starting with laser scanning a naturally extracted tooth. The access cavity had an elliptic shape with 6 mm width, 4 mm height, and 2 mm depth with a wall taper angle of 5 degrees.Two materials (Zr and E-max) were tested for the endocrown and two cementing materials (glass ionomer and resin cement) with 20 to 40 μm thickness. Twelve case studies were reported within this research as the applied load of 330 N was tested with three angulations vertical, oblique at 45 degrees, and laterally.

RESULTS

 Twelve linear static stress analyses were performed. The resultant stresses and deformations' distribution patterns did not alter much, and values were within the threshold of physiological tolerance. Deformations were negligibly changed with changing endocrown and cement materials. In contrast, endocrown stresses indicated zirconia endocrown would have a long lifetime, while E-max one will have a relatively short lifetime.

CONCLUSIONS

 Analysis results indicated that bone was negligibly affected by changing endocrowns and cementing materials. Both tested endocrown materials can be used safely. Zirconia endocrowns may have a much longer lifetime than E-max.

FEA Comparison of the Mechanical Behavior of Three Dental Crown Materials: Enamel, Ceramic, and Zirconia

The restoration of endodontically treated teeth is one of the main challenges of restorative dentistry. The structure of the tooth is a complex assembly in which the materials that make it up, enamel and dentin, have very different mechanical behaviors. Therefore, finding alternative replacement materials for dental crowns in the area of restorative care isa highly significant challenge, since materials such as ceramic and zirconia have very different stress load resistance values. The aim of this study is to assess which material, either ceramic or zirconia, optimizes the behavior of a restored tooth under various typical clinical conditions and the masticatory load. A finite element analysis (FEA) framework is developed for this purpose. The 3D model of the restored tooth is input into the FEA software (Ansys Workbench R23)and meshed into tetrahedral elements. The presence of masticatory forces is considered: in particular, vertical, 45° inclined, and horizontal resultant forces of 280 N are applied on five contact points of the occlusal surface. The numerical results show that the maximum stress developed in the restored tooth including a ceramic crown and subject to axial load is about 39.381 MPa, which is rather close to the 62.32 MPa stress computed for the natural tooth; stresses of about 18 MPa are localized at the roots of both crown materials. In the case of the zirconia crown, the stresses are much higher than those in the ceramic crown, except for the 45° load direction, while, for the horizontal loads, the stress peak in the zirconia crown is almost three times as large as its counterpart in the ceramic crown (i.e., 163.24 MPa vs. 56.114 MPa, respectively). Therefore, the zirconia crown exhibits higher stresses than enamel and ceramic that could increase in the case of parafunctions, such as bruxism. The clinician's choice between the two materials should be evaluated based on the patient's medical condition.

Post-fatigue fracture load, stress concentration and mechanical properties of feldspathic, leucite- and lithium disilicate-reinforced glass ceramics

Objective

To evaluate the mechanical properties of different CAD/CAM ceramic systems and the post-fatigue fracture and stress distribution when used as cemented crowns.

Materials and methods

Sixty (60) CAD/CAM monolithic crowns were milled using three different ceramic materials (FD - Feldspathic [Vita Mark II]), LE - Leucite-based ceramic [IPS Empress CAD] and LD - Lithium Disilicate [IPS e.max CAD]) and adhesively cemented on resin composite dyes. Specimens were stored in distillated water (37 °C) for 7 days. After, half of the crowns were submitted to immediate fracture load test while the other half was submitted to fatigue cycling. The average cement layer of approximately 80 μm was assessed using scanning electron microscopy (SEM). The average thickness was used in the three-dimensional (3D) Finite Element Analysis (FEA). For each ceramic material, the density, Poisson ratio, shear modulus, Young modulus, fracture toughness, and true hardness were assessed (n = 3). The data was used to assess the Maximum Principal Stress throughout 3D-FEA according to each material during load to fail and post-fatigue. Data were submitted to two-way ANOVA and Tukey test (α = 0.05).

Results

LD showed the highest compression load, density, shear modulus, Young modulus, fracture toughness and true hardness values. While LE presented the lowest mechanical properties values. There is no difference in the Poisson ratio between the evaluated ceramics.

Conclusion

LD was susceptible to aging process but presented stronger physicomechanical properties, showing the highest post-fatigue fracture load and highest stress magnitude.

Evaluation of Biomechanical Stability of Teeth Tissue According to Crown Materials: A Three-Dimensional Finite Element Analysis

The biomechanical effects of dental tissue according to various dental crown materials were investigated using finite element analysis. Bone, prepared tooth, root canal, and periodontal ligament were modeled based on computed tomography. Depending on the characteristics of the crown material, it was classified into zirconia, hybrid ceramic, gold alloy, and acrylic resin. A loading force of 200 N was applied in the vertical direction to the occlusal surface of the crown, and analysis was performed under the condition that all interfaces were tied. The results demonstrate that the highest von Mises stress was shown in the prepared tooth of the acrylic resin model, which is a temporary prosthesis, and the pulpal pressure was also the highest. Additionally, among the final prosthesis, the highest stress was shown in the hybrid ceramic model prepared teeth. The properties of restoration materials can be a factor influencing the tooth structure. Thus, in order to make a correct decision when selecting a material for restorative treatment, it is necessary to understand, analyze, and evaluate the properties of these restoration materials.

Influence of Restorative Material on the Distribution of Loads to the Bone in Hybrid Abutment Crowns-In Vitro Study

Background: The objective of this study was to evaluate the load transmitted to the peri-implant bone by seven different restorative materials in single-unit rehabilitations with morse taper implants using a strain gauge. Materials: In a polyurethane block that simulated type III bone, a morse taper platform implant was installed (3.5 × 11 mm) in the center and 1 mm below the test base surface, and four strain gauges were installed around the implant, simulating the mesial, distal, buccal and lingual positions. Seven similar hybrid abutment crowns were crafted to simulate a lower premolar using different materials: 1-PMMA; 2-glass ceramic over resin matrix; 3-PEEK + lithium disilicate; 4-metal-ceramic; 5-lithium disilicate; 6-zirconia + feldspathic; 7-monolithic zirconia. All groups underwent axial and oblique loads (45 degrees) of 150 N from a universal testing machine. Five measurements (n = 5) were performed with each material and for each load type; the microdeformation data underwent statistical analysis. The data were obtained in microdeformation (με), and the significance level was set at p ≤ 0.05. Results: There was no statistically significant difference in the evaluation among the materials under either the axial load or the oblique load at 45 degrees. In turn, in the comparison between axial load and oblique load, there was a difference in load for all materials. Conclusion: The restorative material did not influence the load transmitted to the bone. Furthermore, the load transmitted to the bone was greater when it occurred obliquely at 45° regardless of the material used. In conclusion, it appeared that the different elastic modulus of each material did not influence the load transmission to the peri-implant bone.

Stress distribution in pediatric zirconia crowns depending on different tooth preparation and cement type: a finite element analysis

BACKGROUND

In clinical settings, tooth preparation for prefabricated zirconia crowns (PZCs) in the primary dentition varies widely. However, knowledge about the biomechanical behavior of PZCs in various clinical settings is limited. This study was conducted to evaluate the biomechanical behavior of PZCs in different clinical settings using 3-dimensional finite element analysis.

METHODS

3-dimensional models of the PZC, cement, and tooth with six different conditions were simulated in primary molar teeth, incorporating cement thickness (100, 500, and 1000 μm) and cement type (resin-modified glass ionomer cement and resin cement). A total of 200 N of occlusal force was applied to the models, both vertically and obliquely as representative cases. A general linear model univariate analysis with partial eta-squared (ηp²) was performed to evaluate the relative effects of the variables.

RESULTS

The overall stress of tooth was increased as the cement space increases under oblique loading. The von Mises stress values of the resin cements were significantly higher than those of the resin-modified glass ionomer cements for all cement thicknesses (p < .05). The effect size of the cement type (η_p² = .519) was more dominant than the cement thickness (η_p² = .132) in the cement layer.

CONCLUSIONS

Within the limits of this study, cement type has a greater influence on the biomechanical behavior of PZCs than cement thickness.

Finite Element Analysis of a New Non-Engaging Abutment System for Three-Unit Implant-Supported Fixed Dental Prostheses

(1) Background: The stability of implants plays a significant role in the success of osseointegration. The stability of the connection between the fixture and the abutment is one of the critical factors affecting osseointegration. When restoring multiple, non-parallel, and splinted implants, achieving a passive fit can be complicated and challenging. A new EZ post non-engaging abutment system of the BlueDiamond^® (BD) implant allows a wide connection angle while achieving a passive prosthesis fit. This study aimed to confirm the new abutment system's clinical applicability by evaluating its biomechanical characteristics using finite element analysis (FEA). (2) Methods: The implant-supported fixed three-unit dental prostheses model was reproduced for two groups of AnyOne^® (AO) and BD implants using FEA. The loading conditions were a preload of 200 N in the first step and loads of 100 N (axial), 100 N (15°), or 30 N (45°) in the second step. (3) Results: The peak Von Mises stress (PVMS) value of the fixture in the BD group was more than twice that in the AO group. In contrast, the PVMS values of the abutment and abutment screws were lower in the BD group than in the AO group. The AO group revealed higher maximal principal stress (MPS) values than that of the BD group in the cortical bone, cancellous bone, and crown. The average stress of the outer surface of the abutment was lower in the AO group than in the BD group. The stress distribution for the inner surface of the fixture confirmed that the BD group displayed a lower stress distribution than the AO group under axial and 15° loads; however, the average stress was 1.5 times higher at the 45° load. The stress values of the entire surface where the cortical and cancellous bone were in contact with the fixture were measured. The AO group showed a higher stress value than the BD group in both cortical and cancellous bone. (4) Conclusions: In the AO group, the PVMS value of the fixture and the stress distribution at the contact surface between the fixture and the abutment were lower than those of the BD group, suggesting that the stability of the fixture would be high. However, due to the high stress in the fastening area of the abutment and abutment screw, the risk of abutment fracture in the AO group is higher than that of the BD group. Therefore, the new EZ post non-engaging abutment of the BD implant can be used without any problems in clinics, similar to the non-engaging abutment of the AO implant, which has been widely used in clinical practice.

Impact of peri-implant bone resorption, prosthetic materials, and crown to implant ratio on the stress distribution of short implants: a finite element analysis

The purpose of this study was to determine the effects of prosthetic materials and crown/implant (C/I) ratio on short implants with a marginal bone resorption. Three-dimensional finite element analysis was used to simulate stress distribution under static loading in non-resorption and resorption scenarios (3-mm vertical bone loss) in implants restored with single crowns and C/I ratios of 1:1, 1.5:1, and 2:1 were evaluated. Different crown materials were used: porcelain-fused to metal, porcelain-fused to zirconia, monolithic zirconia, and zirconia-based crown veneered with indirect composite resin. The C/I ratio, the peri-implant bone resorption, and the loading conditions were the key factors affecting the generated stress in short implants. In non-resorption models, von Mises stress ranged between 50 and 105 MPa whereas in resorption models, the values ranged from 168 to 322 MPa, both increasing with the higher C/I ratio under oblique forces. Under axial loading, the C/I ratio did not influence the stress values as the presence of resorption was the only parameter increasing, 57 MPa for the non-resorption models and 101 MPa for the resorption models, respectively. Preference of a prosthetic material was ineffective on the distribution of stress in the bone and implant structure under static loading in any models. The peri-implant bone resorption and a higher C/I ratio in short implants increase the stress values under both axial and oblique forces, whereas the crown material does not influence stress distribution in the surrounding bone and implant structure.

Effects of sintering time on translucency and color of translucent zirconia ceramics

OBJECTIVE

To investigate the effect of sintering time on translucency and color of translucent zirconia ceramics.

MATERIALS AND METHODS

Sixty translucent zirconia (5Y-TZP) specimens (12 × 1.6 mm, Katana (KAT) and NexxZr (NEX)) were divided into six groups (n = 10) according to sintering time; 1, 2 (specified by manufacturer-control), and 3 hs. Color differences (ΔEab) within same material when sintered using different times and between materials when same sintering time was used were calculated, as well as translucency parameters (TP) after the use of each sintering time. Data for ΔEab and TP were analyzed with two-way ANOVAs, pairwise comparisons, and Fisher's LSD Test (Post-hoc).

RESULTS

When 1 or 3 h were used, color difference from the color of specimens when manufacturer-specified time (2 h) was used was similar for both KAT and NEX. ΔEab values of NEX were significantly higher than KAT when sintered for 1 or 3 h (P < 0.001). TP increased for KAT when sintered for 1 h, and was higher than NEX. TP for NEX increased when sintered for 3 h (P < 0.001), but was not significantly different than that of KAT.

CONCLUSIONS

Effect of 1 or 3-h sintering on color was similar for both zirconias. For NEX, this effect resulted in greater differences from the color of specimens when manufacturer-specified time was used. Sintering for 1 h increased the translucency of KAT.

CLINICAL SIGNIFICANCE

When high translucency is desired, clinicians may prefer 1-h sintering for KAT zirconia. When lower translucency is desired, 3-h sintering for NEX can be used. However, for NEX, the color after 1- or 3-h sintering was different than the color obtained with manufacturer-specified time, and this difference may affect the final color of restoration compared to the final color when manufacturer-specified time is used.

Minimal tooth preparation for posterior monolithic ceramic crowns: Effect on the mechanical behavior, reliability and translucency

OBJECTIVE

Despite the increased use of monolithic crowns, their performance has yet to be determined when the minimal tooth preparation (MTP) principle is considered. The goal of this study was to evaluate the effect of MTP on the mechanical behavior, reliability and translucency of posterior monolithic ceramic crowns.

METHODS

Dentin analogues were machined using two preparation designs (0.5 or 1 mm reduction) to receive first molar crowns in order to evaluate the monolithic crown performance. Next, 126 crowns were divided (21/g) according to the material (High translucent zirconia - YZHT, Zirconia reinforced lithium silicate - ZLS and Hybrid ceramic - HC) and thickness (0.5 or 1 mm). Tensile stress concentration was calculated using the finite element method. The crowns were adhesivelly cemented and step stress fatigued to calculate reliability for missions at 600 and 1000 N. Translucency was analyzed in 10 discs of each material and thickness.

RESULTS

Higher stress concentration was found in thinner crowns and those with higher elastic modulus. YZHT crowns were suspended when fatigue reached 1500 N load, thus 1-parameter Weibull was used to analyze the data. Reliability was only affected by thickness at 1000 N. ZLS.5 showed lower survival than HC.5, which was similar to the groups that presented 100% survival. YZHT showed the highest strength and data scattering. ZLS1 (22.3 ± 1.4) presented higher translucency than HC1 (19.2 ± 0.6) and YZHT1 (12.0 ± 2.9), whereas ZLS.5 and HC.5 were similar to each other (26.5 ± 2.3, 26.7 ± 2.2) and superior to YZHT.5 (12.7 ± 1.2).

SIGNIFICANCE

HC.5 combined high reliability and translucency with low stress concentration, yielding better crown performance and tooth preservation.

Effects of material and coefficient of friction on taper joint dental implants

PURPOSE

The aim of this study was: (1) to compare the coefficients of friction between commercially pure titanium (cpTi), titanium (Ti) alloy, and yttria-stabilized zirconia (YSZ) and: (2) to investigate the dynamic behavior of an implant system before, during, and after loading, by transient dynamic three-dimensional finite element analysis (FEA).

METHODS

Coefficients of friction were measured by a ball-on-disk frictional wear testing device. The preload in the screw shaft was calculated from geometric parameters. Two abutment model designs were created, namely a Ti alloy abutment model with a porcelain-fused-to-metal super structure and a YSZ abutment model with a porcelain-fused-to-zirconia super structure. Transient dynamic three-dimensional FEA was performed on ANSYS Workbench Ver. 15.0.

RESULTS

The coefficients of friction of YSZ/cpTi, YSZ/Ti alloy, Ti alloy/cpTi, and Ti alloy/Ti alloy were 0.4417, 0.3455, 0.3952, and 0.3489, respectively. The preload generated in the abutment screw of the FEA model was set to be 158 N. Significantly differences were not found in the maximum von Mises equivalent stress between the Ti alloy and YSZ abutment models before, during, and after loading.

CONCLUSION

The findings indicate differences in the coefficients of friction of cpTi, Ti alloy, and YSZ before, during, and after loading. Fractures caused by stress did not depend on the use of different materials (Ti alloy and YSZ) at the abutment.

Evaluation of zirconia and zirconia-reinforced glass ceramic systems fabricated for minimal invasive preparations using a novel standardization method

OBJECTIVE

Currently, minimal invasive approaches combining less invasive finish line preparations and reduced ceramic thickness are required. The aim of this study was to evaluate the fracture resistance of two ceramic systems fabricated with two preparation designs using CAD/CAM standardization technology.

MATERIALS AND METHODS

Forty intact human maxillary premolars were divided into two main groups according to the preparation technique. Group H (Horizontal): teeth with shoulder finish line and group V (Vertical): teeth with feather edge. Each main group was subdivided randomly into two subgroups according to the material used. Group CD (Celtra Duo) zirconia-reinforced glass ceramics and group K (KATANA) monolithic zirconia. CAD/CAM was used for standardization of natural teeth preparation. After cementation using self-adhesive resin cement, all specimens were subjected to 5000 thermal cycles and then were loaded until fracture. Failure types were evaluated using Stereomicroscopy and Scanning Electron Microscopy (SEM).

RESULTS

Nonsignificant; the higher mean value was recorded with VCD group (482.5 ± 103.8 N) and VK group (1347.6 ± 177.4 N) vs HCD group (471 ± 107.6 N) and HK group (1255.6 ± 121.3 N). SEM findings showed that fractures occurred mainly at the occlusal side of the crowns.

CONCLUSIONS

Vertical preparation showed a promising alternative to horizontal preparation. Moreover, both Celtra Duo and KATANA crowns can be used in premolar area with 0.5 mm margin thickness.

CLINICAL SIGNIFICANCE

Zirconia-reinforced glass ceramic and monolithic zirconia crowns may not necessitate the preparation of invasive finish lines as the type of finish line did not impair the strength after aging conditions.

Optimized Dental Implant Fixture Design for the Desirable Stress Distribution in the Surrounding Bone Region: A Biomechanical Analysis

The initial stability of a dental implant is known to be an indicator of osseointegration at immediate loading upon insertion. Implant designs have a fundamental role in the initial stability. Although new designs with advanced surface technology have been suggested for the initial stability of implant systems, verification is not simple because of various assessment factors. Our study focused on comparing the initial stability between two different implant systems via design aspects. A simulated model corresponding to the first molar derived from the mandibular bone was constructed. Biomechanical characteristics between the two models were compared by finite element analysis (FEA). Mechanical testing was also performed to derive the maximum loads for the two implant systems. CMI IS-III active (IS-III) had a more desirable stress distribution than CMI IS-II active (IS-II) in the surrounding bone region. Moreover, IS-III decreased the stress transfer to the nerve under the axial loading direction more than IS-II. Changes of implant design did not affect the maximum load. Our analyses suggest that the optimized design (IS-III), which has a bigger bone volume without loss of initial fixation, may minimize the bone damage during fixture insertion and we expect greater effectiveness in older patients.

Finite Element Analysis of Novel Separable Fixture for Easy Retrievement in Case with Peri-Implantitis

Peri-implantitis is a common complication following dental implant placement, which may lead to bone loss and fixation failure. With the conventional fixture, it is difficult to perfectly clear-up the infection. To solve this, we have designed a separable fixture of which the top part is replaceable. This study aimed to compare the structural and biomechanical stability of the separable and conventional fixture. A single surgical model corresponding to the first molar in a virtual mandible model and conventional/separable implants were reproduced to compare the biomechanical characteristics of the implants using finite element analysis (FEA). The loading condition was 200N preload in the first step, and 100N (Axial), 100N (15°), and 30N (45°) in the second step. The stress distribution on the cortical bone in the separable implant was lower than the conventional implant. In particular, the Peak von Mises Stress (PVMS) values of the separable implant under lateral load was found to be about twice as low as that of the conventional implant. In this study, we suggest that the separable implant has an equivalent biomechanical stability compared to the conventional implant, is easy to retrieve in the case of peri-implantitis, and has an excellent initial stability after the surgery when used in stage 2.

In-vitro performance and fracture strength of thin monolithic zirconia crowns

PURPOSE

All-ceramic restorations required extensive tooth preparation. The purpose of this in vitro study was to investigate a minimally invasive preparation and thickness of monolithic zirconia crowns, which would provide sufficient mechanical endurance and strength.

MATERIALS AND METHODS

Crowns with thickness of 0.2 mm (group 0.2, n=32) or of 0.5 mm (group 0.5, n=32) were milled from zirconia and fixed with resin-based adhesives (groups 0.2A, 0.5A) or zinc phosphate cements (groups 0.2C, 0.5C). Half of the samples in each subgroup (n=8) underwent thermal cycling and mechanical loading (TCML)(TC: 5℃ and 55℃, 2×3,000 cycles, 2 min/cycle; ML: 50 N, 1.2×10⁶ cycles), while the other samples were stored in water (37℃/24 h). Survival rates were compared (Kaplan-Maier). The specimens surviving TCML were loaded to fracture and the maximal fracture force was determined (ANOVA; Bonferroni; α=.05). The fracture mode was analyzed.

RESULTS

In both 0.5 groups, all crowns survived TCML, and the comparison of fracture strength among crowns with and without TCML showed no significant difference (P=.628). Four crowns in group 0.2A and all of the crowns in group 0.2C failed during TCML. The fracture strength after 24 hours of the cemented 0.2 mm-thick crowns was significantly lower than that of adhesive bonded crowns. All cemented crowns provided fracture in the crown, while about 80% of the adhesively bonded crowns fractured through crown and die.

CONCLUSION

0.5 mm thick monolithic crowns possessed sufficient strength to endure physiologic performance, regardless of the type of cementation. Fracture strength of the 0.2 mm cemented crowns was too low for clinical application.

Evaluation of stress distribution in bone and three-unit fixed implant-supported prostheses with zirconia and titanium abutments: A 3D finite element analysis

Background. For esthetic considerations in anterior regions, abutments with high-strength ceramics such as alumina and zirconia have been developed as substitutes for titanium abutments. The present study was designed to investigate the distribution of stress in prosthesis and bone components of an implant-supported FPD with different abutments by using 3D finite element analysis. Methods. Ceramic FPDs were made from the canine to the upper left second premolar with titanium fixtures. In order to investigate the stress distribution, forces of 100 and 300 N were applied at angles of 0, 15 and 35 degrees to the central fossa of the second premolar and pontic, as well as the cingulum of the canine crown. Force loading was static. After analyzing the mechanical properties of the materials, boundary conditions and loading were performed according to the existing averages, and subsequently, the results obtained from this analysis were analyzed. Results. The highest level of stress was observed in the distal crest of the posterior implant (23.20 MPa) under lateral forces (15 and 35 degrees) in a model with both titanium abutments. Conclusion. Lateral forces induced higher accumulation of stress in the implant and surrounding bone, while abutment change did not affect the distribution of stress.

Methodology in specimen fabrication for in vitro dental studies: Standardization of extracted tooth preparation

Background

Specimen preparation for in vitro study suffers a general lack of methodological homogeneity, as well as a lack of uniformity in the materials selected for fabricating them. This situation prevents comparisons between studies. When a specimen is not of dental origin it is not possible to study adhesion or bonding techniques realistically. The objective is to design and implement a method of specimen preparation that permits universal standardization for use in in vitro studies.

Material and Methods

A metal stump of specified dimensions was designed and fabricated by hand. It was scanned, the data digitalized, perfecting and standardizing the dimensions. Ten human molars were adapted to the size and shape of a standard milling block. A Cerec 3D inLab Cerec milling unit was used to prepare the molars to match the digitalized model.

Results

Ten specimens with identical dimensions were obtained.

Conclusions

CAD-CAM technology allows the preparation of natural extracted teeth to be standardized and could be used to establish a reproducible method that would facilitate comparison between different in vitro studies, and reduce bias arising from variations in sample fabrication.

Key words:Test ceramic, dentin analog, dentin model, dentin samples, methodology.

Post and core build-ups in crown and bridge abutments: Bio-mechanical advantages and disadvantages

Dentists often place post and core buildups on endodontically treated abutments for crown and bridge restorations. This article analyzes the bio-mechanical purposes, advantages and disadvantages of placing a core or a post and core in an endodontically treated tooth and reviews literature on post and core biomechanics. The author assesses the scientific rationale of the claim that the main purpose of a post is to retain a core, or the claim that posts weaken teeth. More likely, the main function of a post is to help prevent the abutment, on which a crown is cemented, from fracturing such that the abutment separates from the tooth root, at a fracture plane that is located approximately and theoretically at the level of the crown (or ferrule) margin. A post essentially improves the ferrule effect that is provided by the partial fixed denture prosthesis. This paper also explores the difference between bio-mechanical failures of crowns caused by lack of retention or excess taper, versus failures due to a sub-optimal ferrule effect in crown and bridge prostheses.