Mechanical resistance of a 2.9 mm diameter dental implant with a Morse-taper implant-abutment connection

Among the complications that can occur at dental implants, the fracture of any implant component is a relatively infrequent but clinically relevant problem. Due to their mechanical characteristics, small diameter implants are at higher risk of such complication. The aim of this laboratory and FEM study was to compare the mechanical behavior of a 2.9 mm and a 3.3 mm diameter implant with a conical connection under standard static and dynamic conditions, following the ISO 14801:2017. Finite element analysis was performed to compare the stress distribution on the tested implant systems under a 300 N, 30° inclined force. Static tests were performed with a load cell of 2 kN; the force was applied on the experimental samples at 30° with respect to the implant-abutment axis, with an arm of 5.5 mm. Fatigue tests were performed with decreasing loads, at 2 Hz frequency, until three specimens survived without any damage after 2 million cycles. The emergence profile of the abutment resulted the most stressed area in finite element analysis, with a maximum stress of 5829 MPa and 5480 MPa for 2.9 mm and 3.3 mm diameter implant complex respectively. The mean maximum load resulted 360 N for 2.9 mm diameter and 370 N for 3.3 mm diameter implants. The fatigue limit was recorded to be 220 N and 240 N respectively. Despite the more favorable results of 3.3 mm diameter implants, the difference between the tested implants could be considered clinically negligible. This is probably due to the conical design of the implant-abutment connection, which has been reported to present low stress values in the implant neck region, thus increasing the fracture resistance.

Systematic Review of the Current In Vitro Experience of the Endovascular Treatment of Juxtarenal Abdominal Aortic Aneurysms by Fenestrated and Parallel Endografting

OBJECTIVE

To identify and analyze the published in vitro benchtop experiments for the assessment of endovascular techniques used for the treatment of juxtarenal abdominal aortic aneurysms (jAAAs).

DATA SOURCES

Scopus, PubMed, and Web of Science.

REVIEW METHODS

A systematic literature search was carried out throughout March 2021 following PRISMA guidelines. Two investigators independently performed title and abstract screening to reveal all benchtop testing evaluating the endovascular treatment of jAAA.

RESULTS

A total of 19 studies were included, 8 evaluating fenestrated (FEVAR) and 11 parallel grafts (PGs). FEVAR studies used different custom testing apparatus (n=7) or 3D-printed models (n=1) to analyze dislodgement and migration resistance, misalignment consequences and causation, and bridging stents' radial force, flareability, fatigue, and fracture resistance. All PG studies used silicone-based models to analyze optimal oversizing, sealing length, gutter behavior, and possible reduction. Test evaluation in FEVAR in vitro testing was based on pullout force analysis (N=5), photo evaluation (n=1), fluoroscopy (n=1), X-rays (n=4), CT analysis (n=3), macro- and microscopic evaluation (n=4), water permeability (n=1), and fatigue simulator testing (n=1), while it was based on CT analysis in all PG studies adding ECG-gate in one study. The most frequently tested devices were Zenit (Cook) (n=7), Endurant (Medtronic) (n=5), and Excluder (Gore) (n=5) as main grafts, and Advanta V12 (n=14) as the bridging device.

CONCLUSIONS

This systematic review presents a broad analysis of the current in vitro methods evaluating the endovascular treatment of jAAA. Fundamental issues have been benchtop tested in both FEVAR and PGs. The analysis of the included studies allowed to recommend an optimal testing design. In vitro testing is a potential tool to further elucidate points of attention hard to investigate in vivo to finally enhance the endovascular treatment outcomes. Future in vitro studies are needed to evaluate the in vitro performance of all indistinctively used devices in the clinical practice.

Biomechanical Comparison of a Novel Multiplanar, Perpendicular Whipstitch With the Krackow Stitch and Standard Commercial Whipstitch

Background:

Using alternating orthogonal suture throws with the looped whipstitch technique may allow enhanced suture fixation.

Hypothesis:

It was hypothesized that this novel multiplanar, perpendicular looped whipstitch (MP) technique would have improved biomechanical properties compared with the standard looped whipstitch (WS) and Krackow stitch (KS).

Study Design:

Controlled laboratory study.

Methods:

A total of 30 cadaveric tibialis anterior tendons were randomly assigned into 3 groups of 10. Tendons were secured to a custom clamp, and the other end was sutured using 1 of 3 techniques: the KS, WS, or novel MP. The MP was performed with alternating orthogonal throws starting right to left, then front to back, left to right, and back to front. Each technique used 4 passes of No. 2 FiberWire spaced 5 mm apart and ending 10 mm from the tendon end. Tendons were preloaded to 5 N, pretensioned to 50 N at 100 mm/min for 3 cycles, returned to 5 N for 1 minute, cycled from 5 to 100 N at 200 mm/min for 100 cycles, and then loaded to failure at 20 mm/min. Elongation was recorded after pretensioning and cycling and was measured both across the suture-tendon interface and from the base of the suture-tendon interface to markings on the suture limbs (construct elongation). One-way analyses of variance were performed, with Bonferroni post hoc analysis when appropriate.

Results:

There were no differences in cross-sectional area or stiffness among the 3 techniques. The ultimate load for WS (183.33 ± 57.44 N) was less compared with both MP (270.76 ± 39.36 N) and KS (298.90 ± 25.94 N) (P ≤ .001 for both). There was less construct elongation for KS compared with WS and MP for total displacement, measured from pretensioning to the end of cycling (P < .001). All 3 techniques saw a decrease in length (shortening) at the suture-tendon interface during testing. There was more shortening at the suture-tendon interface for WS compared with KS (P = .006).

Conclusion:

The KS appears superior, as it maximized strength while minimizing construct elongation or graft shortening. The ultimate load of the MP technique was greater than that of the standard technique but not significantly different from that of the KS technique.

Clinical Relevance:

The KS is preferred. If using a WS, multiplanar, perpendicular passes should be considered.

Development and Experimental Assessment of Friction-Type Shear Connectors for FRP Bridge Girders with Composite Concrete Decks

This paper details the development and experimental assessment of a friction-type connector, designed to transfer shear flow between the top flange of a fiber-reinforced polymer (FRP) tub girder and a composite concrete deck for bridge applications. In contrast with previously used bearing-type connectors, this system relies on a deformed FRP surface to transfer shear via direct interlock with the concrete deck. The connector is materially efficient, simple to fabricate, can be used with lower-grade structural or stainless-steel fasteners, and provides a high degree of interface stiffness. Six compression-shear specimens were tested to assess the connector fatigue resistance and ultimate connection strength. Additionally, two short beam specimens were tested in three-point bending, one of which was subjected to fatigue loading. Based on the compression-shear tests and short beam tests, the connection exhibited strength exceeding that predicted by AASHTO for frictional concrete-concrete connections. The connection strengths were significantly greater than the factored demand required by AASHTO for a typical model FRP bridge girder. The cyclic loading of the connection in both compression-shear and beam bending showed that connection stiffness and strength do not significantly degrade, due to the application of 1 × 10⁶ to 6 × 10⁶ cycles of traffic-induced factored fatigue load.

Influence of Strain Gradient on Fatigue Life of Carbon Steel for Pressure Vessels in Low-Cycle and High-Cycle Fatigue Regimes

This paper discusses how the strain gradient influences the fatigue life of carbon steel in the low-cycle and high-cycle fatigue regimes. To obtain fatigue data under different strain distributions, cyclic alternating bending tests using specimens with different thicknesses and cyclic tension–compression tests were conducted on carbon steel for pressure vessels (SPV235). The crack initiation life and total failure life were evaluated via the strain-based approach. The experimental results showed that the crack initiation life became short with decreasing strain gradient from 10² to 10⁶ cycles in fatigue life. On the other hand, the influence of the strain gradient on the total failure life was different from that on the crack initiation life: although the total failure life of the specimen subjected to cyclic tension–compression was also the shortest, the strain gradient did not affect the total failure life of the specimen subjected to cyclic bending from 10² to 10⁶ cycles in fatigue life. This was because the crack propagation life became longer in a thicker specimen. Hence, these experimental results implied that the fatigue crack initiation life could be characterized by not only strain but also the strain gradient in the low-cycle and high-cycle fatigue regimes.

Characteristic Features of Ultrafine-Grained Ti-45 wt.% Nb Alloy under High Cycle Fatigue

The paper presents the results of fatigue-testing ultrafine-grained and coarse-grained Ti-45 wt.% Nb alloy samples under very high cycle fatigue (gigacycle regime), with the stress ratio R = -1. The ultrafine-grained (UFG) structure in the investigated alloy was formed by the two-stage SPD method, which included multidirectional forging (abc-forging) and multipass rolling in grooved rollers, with further recrystallization annealing. The UFG structure of the Ti-45 wt.% Nb alloy samples increased the fatigue limit under the high-cycle fatigue conditions up to 1.5 times compared with that of the coarse-grained (CG) samples. The infrared thermography method was applied to investigate the evolution of temperature fields in the samples under cyclic loading. Based on numerical morphology analysis, the scale invariance (the Hurst exponent) and qualitative differences for UFG and CG structures were determined. The latter resulted from the initiation and propagation of fatigue cracks in both ultra-fine grained and coarse-grained alloy samples under very high-cycle fatigue loading.

Nitinol, Stainless Steel, and Titanium Kirschner Wire Durability

Kirschner wires (K wires) are a common fixation device in foot and ankle surgery, particularly in lesser-toe fixation. Fatigue failure is a known complication of this fixation. The material properties of the K wire are a factor in the strength and durability of the wire. The purpose of this study is to compare the durability of K wires made of stainless steel, titanium, and Nitinol. Ten samples each of stainless steel, titanium. and Nitinol underwent cyclic durability testing using a rotating beam approach, and S-N curves (applied stress vs the number of cycles to failure) were generated. The results demonstrate that, generally, Nitinol K wires have a shorter life for the same applied stress than the stainless steel or titanium wires. Titanium had a longer life at low stresses compared with stainless steel, and stainless steel had a longer life at higher stresses. This study provides comparative durability data for K wires made of different metals, which have not been previously reported. Although there was a statistically significant difference in durability for wires used in K wire fixation, all 3 metal types are reasonable choices for temporary K wire fixation.Levels of Evidence: Level 5: Mechanical study.

Fatigue Testing of Wearable Sensing Technologies: Issues and Opportunities

Standards for the fatigue testing of wearable sensing technologies are lacking. The majority of published fatigue tests for wearable sensors are performed on proof-of-concept stretch sensors fabricated from a variety of materials. Due to their flexibility and stretchability, polymers are often used in the fabrication of wearable sensors. Other materials, including textiles, carbon nanotubes, graphene, and conductive metals or inks, may be used in conjunction with polymers to fabricate wearable sensors. Depending on the combination of the materials used, the fatigue behaviors of wearable sensors can vary. Additionally, fatigue testing methodologies for the sensors also vary, with most tests focusing only on the low-cycle fatigue (LCF) regime, and few sensors are cycled until failure or runout are achieved. Fatigue life predictions of wearable sensors are also lacking. These issues make direct comparisons of wearable sensors difficult. To facilitate direct comparisons of wearable sensors and to move proof-of-concept sensors from "bench to bedside", fatigue testing standards should be established. Further, both high-cycle fatigue (HCF) and failure data are needed to determine the appropriateness in the use, modification, development, and validation of fatigue life prediction models and to further the understanding of how cracks initiate and propagate in wearable sensing technologies.

Constant Temperature Approach for the Assessment of Injection Molding Parameter Influence on the Fatigue Behavior of Short Glass Fiber Reinforced Polyamide 6

Short glass fiber reinforced plastics (SGFRP) offer superior mechanical properties compared to polymers, while still also enabling almost unlimited geometric variations of components at large-scale production. PA6-GF30 represents one of the most used SGFRP for series components, but the impact of injection molding process parameters on the fatigue properties is still insufficiently investigated. In this study, various injection molding parameter configurations were investigated on PA6-GF30. To take the significant frequency dependency into account, tension-tension fatigue tests were performed using multiple amplitude tests, considering surface temperature-adjusted frequency to limit self-heating. The frequency adjustment leads to shorter testing durations as well as up to 20% higher lifetime under fatigue loading. A higher melt temperature and volume flow rate during injection molding lead to an increase of 16% regarding fatigue life. In situ X-ray microtomography analysis revealed that this result was attributed to a stronger fiber alignment with larger fiber lengths in the flow direction. Using digital volume correlation, differences of up to 100% in local strain values at the same stress level for different injection molding process parameters were identified. The results prove that the injection molding parameters have a high influence on the fatigue properties and thus offer a large optimization potential, e.g., with regard to the component design.

Mechanical testing of four-unit implant-supported prostheses with extensive pink gingiva porcelain: The dentogingival prostheses proof of concept

OBJECTIVE

To investigate the probability of survival and failure modes of four-unit implant-supported porcelain fused to metal (PFM) dentogingival prostheses subjected to step-stress accelerated life testing (SSALT).

MATERIALS AND METHODS

Eighteen implant-supported PFM dentogingival prostheses with thin metallic infrastructures, which provided minimal ceramic support and improved esthetics were fabricated over external hexagonal connection UCLA abutments. SSALT was performed until specimen failure. Use level probability Weibull curve and reliability were calculated and plotted. Weibull modulus (m) and characteristic strength (η) were also calculated. Polarized light microscope and scanning electron microscope were used to characterize fractures.

RESULTS

Failures were dictated by material strength rather than fatigue damage accumulation. The probability of survival for loads reaching 100 and 150 N in 100,000 cycles was 92 and 61%, respectively. No cracks or fractures were identified in the veneered porcelain, whereas abutment fixation screw fracture was the chief failure mode.

CONCLUSION

Implant-supported PFM four-unit dentogingival prostheses with minimum metal framework dimensions presented favorable lifetime prediction under fatigue testing. Fractures were restricted to fixation screws.

CLINICAL SIGNIFICANCE

In-vitro fatigue testing and failure mode analyses evidenced favorable lifetime prediction for 4-unit implant-supported dentogingival prostheses with minimum metal frameworks. Abutment fixation screw fracture might be the most frequent clinical complication. Since this proof of concept has been tested in-vitro, further studies including different restorative materials, as well as long-term clinical trials are warranted.

Enamel and Dentin Bond Durability of Self-Adhesive Restorative Materials

PURPOSE

To use shear bond strength (SBS) and shear fatigue strength (SFS) testing to determine the durability of adhesion of self-adhesive restorative materials compared to composite resin bonded with a universal adhesive.

MATERIALS AND METHODS

A universal adhesive, Prime & Bond Active, was used in self-etch mode to bond Z-100 composite resin to enamel and dentin. Three commercially available restorative materials and one experimental material with self-adhesive properties, Activa (A), Fuji II LC(F), and Equia Forte (E) and ASAR-MP4 (S) were also bonded to enamel and dentin. The SBS and SFS were determined for all materials. A staircase method was used to determine the SFS with 10 Hz frequency for 50,000 cycles or until failure occurred.

RESULTS

On enamel, S generated similar values to the adhesive/composite materials and higher values than F, E, and A. On dentin, the composite/universal adhesive showed significantly higher SBS and SFS than the self-adhesive materials. S, F, and E generated higher values than A on dentin.

CONCLUSION

SBS and SFS values to enamel were similar for all materials tested except Activa which generated lower enamel values. On dentin surfaces, the self-adhesive materials generated similar SBS and SFS, with the exception of Activa. Those values were lower than that generated with composite resin and a universal adhesive.

The Effect of Hot Working on the Mechanical Properties of High Strength Biomedical Ti-Nb-Ta-Zr-O Alloy

Beta titanium alloy Ti-35Nb-6Ta-7Zr-0.7O (wt%) was developed as a material intended for the manufacturing of a stem of a hip joint replacement. This alloy contains only biocompatible elements and possesses a very high yield strength already in the cast condition (900 MPa). However, the porosity, large grain size and chemical inhomogeneity reduce the fatigue performance below the limits required for utilization in the desired application. Two methods of hot working, die forging and hot rolling, were used for processing of this alloy. Microstructural evolution, tensile properties and fatigue performance of the hot worked material were investigated and compared to the cast material. Microstructural observations revealed that porosity is removed in all hot-worked conditions and the grain size is significantly reduced when the area reduction exceeds 70%. Static tensile properties were improved by both processing methods and ultimate tensile strength (UTS) of 1200 MPa was achieved. Fatigue results were more reproducible in the hot rolled material due to better microstructural homogeneity, but forging leads to an improved fatigue performance. Fatigue limit of 400 MPa was achieved in the die-forged condition after 70% of area reduction and in the hot rolled condition after 86% of area reduction.

Increasing Fatigue Endurance of Hydroxyapatite and Rutile Plasma Sprayed Biocomponents by Controlling Deposition In-Flight Properties

Three sets of hydroxyapatite and rutile-TiO₂ coatings were plasma sprayed onto metallic substrates. The spray parameters of the sets were modified so as to obtain different in-flight temperatures and velocities of the powder particles within the plasma jet (ranging from 1778 to 2385 K and 128 to 199 m s^-1, respectively). Fatigue endurance of the coated specimens was then tested. The samples were subjected to a symmetric cyclical bend loading, and the crack propagation was monitored until it reached a predefined cross-section damage. The influence of the coating deposition was evaluated with respect to a noncoated reference set and the in-flight characteristics. Attributed to favorable residual stress development in the sprayed samples, it was found that the deposition of the coatings generally led to a prolongation of the fatigue lives. The highest lifetime increase (up to 46% as compared to the noncoated set) was recorded for the coatings deposited under high in-flight temperature and velocity. Importantly, this was achieved without significantly compromising the microstructure or phase composition of the deposited HA and TiO₂ layers.

Fatigue Bending Strength of Jones Fracture Specific Screw Fixation

BACKGROUND

Intramedullary screw fixation is a common method of treating proximal metadiaphyseal fifth metatarsal (ie, Jones) fractures. Fatigue failure is a complication of this fixation. There are many screw designs available, including Jones fracture specific fixation, but the optimal choice of screw design is unknown. The purpose of this study was to compare the fatigue strength of Jones fracture specific screw designs as well as other commonly used screw designs. Our hypothesis was that there would be no difference in fatigue strength for Jones fracture specific screw designs at similar screw diameters.

METHODS

A study was performed to determine the fatigue bending strength of 5 different screw designs including Jones fracture specific screw designs at 3 different screw diameters. Six screws of each size and design underwent cyclic fatigue testing, and a median fatigue limit (MFL) was determined for each screw design and size.

RESULTS

The Stryker Asnis JFX solid 4.0-mm, 5.0-mm, and 6.0-mm screws had a higher MFL than all other screws with similar diameter tested (all P < .0001). Both Jones fracture specific screw designs (Stryker Asnis JFX solid screws and Charlotte Carolina Jones screws) had higher MFLs than the other screw designs tested.

CONCLUSION

This study provides comparative fatigue strength data on larger screw diameters, which have not been previously reported. There was a statistically significant difference in screw fatigue properties at the screw diameters tested.

CLINICAL RELEVANCE

The clinical significance of this study is that it provides surgeons with fatigue strength data to aid in screw selection for Jones fracture fixation.

Static and Fatigue Behavior Investigation of Artificial Notched Steel Reinforcement

Pitting corrosion is one of the most common forms of localized corrosion. Corrosion pit results in a stress concentration and fatigue cracks usually initiate and propagate from these corrosion pits. Aging structures may fracture when the fatigue crack reaches a critical size. This paper experimentally simulates the effects of pitting morphologies on the static and fatigue behavior of steel bars. Four artificial notch shapes are considered: radial ellipse, axial ellipse, triangle and length-variable triangle. Each shape notch includes six sizes to simulate a variety of pitting corrosion morphologies. The stress-strain curves of steel bars with different notch shape and depth are obtained based on static tensile testing, and the stress concentration coefficients for various conditions are determined. It was determined that the triangular notch has the highest stress concentration coefficient, followed by length-variable triangle, radial ellipse and axial ellipse shaped notches. Subsequently, the effects of notch depth and notch aspect ratios on the fatigue life under three stress levels are investigated by fatigue testing, and the equations for stress range-fatigue life-notch depth are obtained. Several conclusions are drawn based on the proposed study. The established relationships provide an experimental reference for evaluating the fatigue life of concrete bridges.

Customized mandibular reconstruction plates improve mechanical performance in a mandibular reconstruction model

The purpose of this paper was to analyze the biomechanical performance of customized mandibular reconstruction plates with optimized strength. The best locations for increasing bar widths were determined with a sensitivity analysis. Standard and customized plates were mounted on mandible models and mechanically tested. Maximum stress in the plate could be reduced from 573 to 393 MPa (−31%) by increasing bar widths. The median fatigue limit was significantly greater (p < 0.001) for customized plates (650 ± 27 N) than for standard plates (475 ± 27 N). Increasing bar widths at case-specific locations was an effective strategy for increasing plate fatigue performance.

Dynamic fatigue performance of implant-abutment assemblies with different tightening torque values

Implant-abutment assemblies are usually subject to long-term cyclic loading. To evaluate the dynamic fatigue performance of implant-abutment assemblies with different tightening torque values, thirty implant-abutment assemblies (Zimmer Dental, Carlsbad, CA, USA) were randomly assigned to three tightening groups (24 Ncm; 30 Ncm; 36 Ncm), each consisted of 10 implants. Five specimens from each group were unscrewed, and their reverse torque values recorded. The remaining specimens were subjected to a load between 30 N~300 N at a loading frequency of 15 Hz for 5 × 10(6) cycles. After fatigue tests, residual reverse torque values were recorded if available. In the 24 Ncm tightening group, all the implants fractured at the first outer thread of the implant after fatigue loading, with fatigue crack propagation at the fractured surface showed by SEM observation. For the 30 Ncm and 36 Ncm tightening groups, a statistical significant difference (p<0.05) between the unloaded and loaded groups was revealed. Compared with the unloaded specimens, the specimens went through fatigue loading had decreased reverse torque values. It was demonstrated that insufficient torque will lead to poor fatigue performance of dental implant-abutment assemblies and abutment screws should be tightened to the torque recommended by the manufacturer. It was also concluded that fatigue loading would lead to preload loss.