Comparison of stress distribution between complete denture and implant-retained overdenture-2D FEA

The aim of this study was to compare the stress distribution induced by posterior functional loads on conventional complete dentures and implant-retained overdentures with different attachment systems using a two-dimentional Finite Element Analysis (FEA-2D). Three models representative of edentulous mandible were constructed on AutoCAD software; Group A (control), a model of edentulous mandible supporting a complete denture; Group B, a model of edentulous mandible supporting an overdenture over two splinted implants connected with the bar-clip system; Group C, a model of edentuluos mandible supporting an overdenture over two unsplinted impants with the O-ring system. Evaluation was conducted on Ansys software, with a vertical force of 100 N applied on the mandibular left first molar. When the stress was evaluated in supporting tissues, groups B (51.0 MPa) and C (52.6 MPa) demonstrated higher stress values than group A (10.1 MPa). Within the limits of this study, it may be conclued that the use of an attachment system increased stress values; furthermore, the use of splinted implants associated with the bar-clip attachment system favoured a lower stress distribution over the supporting tissue than the unsplinted implants with an O-ring abutment to retain the manibular overdenture.

Implant Platform Switching: Biomechanical Approach Using Two-Dimensional Finite Element Analysis

In implant therapy, a peri-implant bone resorption has been noticed mainly in the first year after prosthesis insertion. This bone remodeling can sometimes jeopardize the outcome of the treatment, especially in areas in which short implants are used and also in aesthetic cases. To avoid this occurrence, the use of platform switching (PS) has been used. This study aimed to evaluate the biomechanical concept of PS with relation to stress distribution using two-dimensional finite element analysis. A regular matching diameter connection of abutment-implant (regular platform group [RPG]) and a PS connection (PS group [PSG]) were simulated by 2 two-dimensional finite element models that reproduced a 2-piece implant system with peri-implant bone tissue. A regular implant (prosthetic platform of 4.1 mm) and a wide implant (prosthetic platform of 5.0 mm) were used to represent the RPG and PSG, respectively, in which a regular prosthetic component of 4.1 mm was connected to represent the crown. A load of 100 N was applied on the models using ANSYS software. The RPG spreads the stress over a wider area in the peri-implant bone tissue (159 MPa) and the implant (1610 MPa), whereas the PSG seems to diminish the stress distribution on bone tissue (34 MPa) and implant (649 MPa). Within the limitation of the study, the PS presented better biomechanical behavior in relation to stress distribution on the implant but especially in the bone tissue (80% less). However, in the crown and retention screw, an increase in stress concentration was observed.

Implant image quality in dental radiographs recorded using a customized imaging guide or a standard film holder

Objective: To compare a customized imaging guide and a standard film holder for obtaining optimally projected intraoral radiographs of dental implants.Material and methods: Intraoral radiographs of four screw-type implants with different inclination placed in an upper or lower dental phantom model were recorded by 32 groups of examiners after a short instruction in the use of the RB-RB/LB-LB mnemonic rule. Half of the examiners recorded the images using a standard film holder and the other half used a customized imaging guide. Each radiograph was assessed under blinded conditions with regard to rendering of the implant threads and was assigned to one of four quality categories: (1) perfect, (2) not perfect, but clinically acceptable, (3) not acceptable, and (4) hopeless.Results: For the upper jaw, the same number of exposures per implant were made to achieve an acceptable image (P = 0.86) by the standard film holder method (median = 2) and the imaging guide method (median = 2). For the lower jaw, medians for the imaging guide method and the film holder method were 1 and 2, respectively (P = 0.004). For the imaging guide method, the first exposure was rated as perfect/acceptable in 62% of the cases and for the film holder method in 41% of the cases (P = 0.013). After <= 2 exposures, 78% (imaging guide method) and 69% (film holder method) of the implant images were perfect/acceptable (P=0.23). The implant inclination did not have a major influence on the outcomes.Conclusion: Perfect or acceptable images were achieved after two exposures with the same frequency either using a customized imaging guide method or a standard film holder method. However, the use of a customized imaging guide method was overall significantly superior to a standard film holder method in terms of obtaining perfect or acceptable images with only one exposure.

Effect of Platelet-Rich Plasma on Peri-Implant Bone Repair: A Histologic Study in Dogs

The present study evaluated the effect of platelet-rich plasma (PRP) on pen-implant bone healing. A total of 9 mongrel dogs received 36 dental implants with sandblasted acid-etched surface in lower jaws in a split-mouth design: in the PRP group (n = 18 implants) the implants were placed in association with PRP, and in the control group (n = 18 implants) the implants were placed without PRP. Biopsies were obtained and prepared for histologic and histometric analysis after 15, 30, and 55 days of healing. The biopsies retrieved at 15 days showed delicate bone trabeculae formed by immature bone with presence of numerous osteoblasts for both groups. At 30 days the trabeculae presented reversal lines and evident lamellar disposition, where some thread spaces were filled by bone and dense connective tissue. At 55 days, bone healing was not altered in the control group, and histologic aspects were variable for the group treated with PRP. There was no significant difference between the groups for bone-to-implant contact (P > .05). PRP did not enhance bone formation around sandblasted acid-etched implants.

Strain Gauge Analysis of the Effect of Porcelain Firing Simulation on the Prosthetic Misfit of Implant-Supported Frameworks

Objectives: This study investigated the effect of porcelain firing on the misfit of implant-supported frameworks and analyzed the influence of preheat treatment on the dimensional alterations.Materials and Methods: Four external-hex cylindrical implants were placed in polyurethane block. Ten frameworks of screw-retained implant-supported prostheses were cast in Pd-Ag using 2 procedures: (1) control group (CG, n = 5): cast in segments and laser welded; and test group (TG, n = 5): cast in segments, preheated, and laser welded. All samples were subjected to firing to simulate porcelain veneering firing. Strain gauges were bonded around the implants, and microstrain values (mu epsilon = 10(-6)epsilon) were recorded after welding (M1), oxidation cycle (M2), and glaze firing (M3). Data were statistically analyzed (2-way analysis of variance, Bonferroni, alpha = 0.05).Results: The microstrain value in the CG at M3 (475.2 mu epsilon) was significantly different from the values observed at M1 (355.6 mu epsilon) and M2 (413.9 mu epsilon). The values at M2 and M3 in the CG were not statistically different. Microstrain values recorded at different moments (M1: 361.6 mu epsilon/M2: 335.3 mu epsilon/M3: 307.2 mu epsilon) did not show significant difference.Conclusions: The framework misfit deteriorates during firing cycles of porcelain veneering. Metal distortion after porcelain veneering could be controlled by preheat treatment. (Implant Dent 2012;21:225-229)

Marginal and Internal Discrepancies Related to Margin Design of Ceramic Crowns Fabricated by a CAD/CAM System

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fibrin adhesive implant in wound healing repair of dental sockets with topical application of epsilon aminocaproic acid: Histological analysis

The aim of the study was to evaluate wound healing repair of dental sockets after topical application of 5% epsilon-aminocaproic acid (EACA) and the use of fibrin adhesive implant in rats under anticoagulant therapy with warfarin. Sixty Albinus wistar rats were used, divided into three groups of 20. In Group I, the animals were given 0.1 mL/100 mg of 0.9% saline solution per day, beginning 6 days before dental extraction and continuing throughout the experimental period. In Group II, the animals received 0.03 mL of sodium warfarin daily, beginning 6 days before the surgery and continuing until the day of sacrifice; after tooth extractions, the sockets were filled with fibrin adhesive material. In Group III the animals were treated as in Group II, and after extractions, the sockets were irrigated with 5 mL of 5% EACA and filled with the same fibrin adhesive material. All groups presented biological phases of wound healing repair, the differences being evident only in the chronology. The results obtained in Group III were very similar to those of Group I in the last period of wound repair, whereas Group II presented a late chronology compared to the other groups. © 2005 Wiley Periodicals, Inc.

A clinical follow-up study of the periodontal conditions of RPD abutment and non-abutment teeth

The purpose of this study was to evaluate the periodontal conditions of removable partial denture (RPD) wearers, comparing direct and indirect abutment teeth, and the teeth not involved in the denture design before denture placement and 1 year later. Fifty patients (32 women and 18 men), average age 45, were assessed by the same examiner at the moment of denture insertion and 3, 6, 9 and 12 months later. The following items were verified in each assessment: probing depth (PD), plaque index (PI) and gingival index (GI). PD and PI data were evaluated by ANOVA test for linear trend followed by Tukey-Kramer post-test, while GI data were analysed by Friedman's test. Results showed that the teeth not involved in the denture design were the least affected for all variables studied. It was also verified that PD and GI mean values increased from the initial assessment to 1 year of RPD wearing in every group, but that only PI showed a significant increase. This study indicated that direct and indirect retainer elements tend to undergo more damaging periodontal effects associated with RPD wearing when compared with non-abutment elements. Plaque index values were significantly higher after 1 year of denture use.

Influence of various implant platform configurations on peri-implant tissue dimensions: an experimental study in dog

AimTo evaluate the influence (i) of various implant platform configurations and (ii) of implant surface characteristics on peri-implant tissue dimensions in a dog model.Material and methodsMandibular premolars and first molars were extracted bilaterally in six Labrador dogs. After 3 months of healing, two implants, one with a turned and a second with a moderately rough surface, were installed on each side of the mandible in the premolar region. on the right side of the mandible, implants with a tapered and enlarged platform were used, while standard cylindrical implants were installed in the left side of the mandible. Abutments with the diameter of the cylindrical implants were used resulting in a mismatch of 0.25 mm at the tapered implant sites. The flaps were sutured to allow a non-submerged healing. After 4 months, the animals were sacrificed and ground sections were obtained for histometric assessment.ResultsAll implants were completely osseointegrated. A minimal buccal bone resorption was observed for both implant configurations and surface topographies. Considering the animals as the statistical unit, no significant differences were found at the buccal aspect in relation to bone levels and soft tissue dimensions. The surface topographies did not influence the outcomes either.ConclusionsThe present study failed to show differences in peri-implant tissue dimensions when a mismatch of 0.25 mm from a tapered platform to an abutment was applied. The surface topographies influence a neither marginal bone resorption or peri-implant soft tissue dimension.To cite this article:Baffone GM, Botticelli D, Pantani F, Cardoso LC, Schweikert MT, Lang NP. Influence of various implant platform configurations on peri-implant tissue dimensions: an experimental study in dog.Clin. Oral Impl. Res. 22, 2011; 438-444.

In vitro evaluation of the precision of working casts for implant-supported restoration with multiple abutments

Objective: The purpose of this study was to compare the accuracy of two working cast fabrication techniques using strain-gauge analysis. Methods: Two working cast fabrication methods were evaluated. Based on a master model, 20 working casts were fabricated by means of an indirect impression technique using polyether after splinting the square transfer copings with acrylic resin. Specimens were assigned to 2 groups (n=10): Group A (GA): type IV dental stone was poured around the abutment analogs in the conventional way; Group B (GB), the dental stone was poured in two stages. Spacers were used over the abutment analogs (rubber tubes) and type IV dental stone was poured around the abutment analogs in the conventional way. After the stone had hardened completely, the spacers were removed and more stone was inserted in the spaces created. Six strain-gauges (Excel Ltd.), positioned in a cast bar, which was dimensionally accurate (perfect fit) to the master model, recorded the microstrains generated by each specimen. Data were analyzed statistically by the variance analysis (ANOVA) and Tukey's test (α= 5%). Results: The microstrain values (με) were (mean±SD): GA: 263.7±109.07με, and GB: 193.73±78.83με. Conclusion: There was no statistical difference between the two methods studied.

Histological findings following the use of a space-making device for bone reformation and implant integration in the maxillary sinus of primates

Background: Previous studies have shown that membrane elevation results in predictable bone formation in the maxillary sinus provided that implants can be placed as tent poles. In situations with an extremely thin residual crest which impairs implant placement, it is possible that a space-making device can be used under the sinus membrane to promote bone formation prior to placement of implants. Purpose: The present study was conducted to test the hypothesis that the use of a space-making device for elevation of the sinus membrane will result in predictable bone formation at the maxillary sinus floor to allow placement of dental implants. Materials and Methods: Eight tufted capuchin primates underwent bilateral sinus membrane elevation surgery, and a bioresorbable space-making device, about 6 mm wide and 6 mm in height, was placed below the elevated membrane on the sinus floor. An oxidized implant (Nobel Biocare AB, Gothenburg, Sweden) was installed in the residual bone protruding into the created space at one side while the other side was left without an implant. Four animals were sacrificed after 6 months of healing. The remaining four animals received a second implant in the side with a space-making device only and followed for another 3 months before sacrifice. Implant stability was assessed through resonance frequency analysis (RFA) using the Osstell™ (Osstell AB, Gothenburg, Sweden) at installation, 6 months and 9 months after the first surgery. The bone-implant contact (BIC) and bone area inside the threads (BA) were histometrically evaluated in ground sections. Results: Histologically there were only minor or no signs of bone formation in the sites with a space-making device only. Sites with simultaneous implant placement showed bone formation along the implant surface. Sites with delayed implant placement showed minor or no bone formation and/or formation of a dense fibrous tissue along the apical part of the implant surface. In the latter group the apical part of the implant was not covered with the membrane but protruded into the sinus cavity. Conclusions: The use of a space-making device, with the design used in the present study, does not result in bone formation at the sinus floor. However, membrane elevation and simultaneous placement of the device and an implant does result in bone formation at the implant surface while sites with implants placed 6 months after membrane elevation show only small amounts of bone formation. It is suggested that lack of stabilization of the device and/or a too extensive elevation of the membrane may explain the results. © 2009, Wiley Periodicals, Inc.

Effect of axial loads on implant-supported partial fixed prostheses by strain gauge analysis

Objectives: The present study used strain gauge analysis to perform an in vitro evaluation of the effect of axial loading on 3 elements of implant-supported partial fixed prostheses, varying the type of prosthetic cylinder and the loading points. Material and methods: Three internal hexagon implants were linearly embedded in a polyurethane block. Microunit abutments were connected to the implants applying a torque of 20 Ncm, and prefabricated Co-Cr cylinders and plastic prosthetic cylinders were screwed onto the abutments, which received standard patterns cast in Co-Cr alloy (n = 5). Four strain gauges (SG) were bonded onto the surface of the block tangentially to the implants, SG 01 mesially to implant 1, SG 02 and SG 03 mesially and distally to implant 2, respectively, and SG 04 distally to implant 3. Each metallic structure was screwed onto the abutments with a 10 Ncm torque and an axial load of 30 kg was applied at five predetermined points (A, B, C, D, E). The data obtained from the strain gauge analyses were analyzed statistically by RM ANOVA and Tukey's test, with a level of significance of p<0.05. Results: There was a significant difference for the loading point (p=0.0001), with point B generating the smallest microdeformation (239.49 με) and point D the highest (442.77 με). No significant difference was found for the cylinder type (p=0.748). Conclusions: It was concluded that the type of cylinder did not affect in the magnitude of microdeformation, but the axial loading location influenced this magnitude.

In vitro comparisons of casting retention on implant abutments among commercially available and experimental castor oil-containing dental luting agents

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of Abutment Type and Esthetic Veneering on Preload Maintenance of Abutment Screw of Implant-Supported Crowns

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of Platform and Abutment Angulation on Peri-Implant Bone. A Three-Dimensional Finite Element Stress Analysis

The aim of this study was to evaluate stress distribution on the pen-implant bone, simulating the influence of Nobel Select implants with straight or angulated abutments on regular and switching platform in the anterior maxilla, by means of 3-dimensional finite element analysis. Four mathematical models of a central incisor supported by external hexagon implant (13 mm x 5 mm) were created varying the platform (R, regular or S. switching) and the abutments (S, straight or A, angulated 15 degrees). The models were created by using Mimics 13 and Solid Works 2010 software programs. The numerical analysis was performed using ANSYS Workbench 10.0. Oblique forces (100 N) were applied to the palatine surface of the central incisor. The bone/implant interface was considered perfectly integrated. Maximum (sigma(max)) and minimum (sigma(min)) principal stress values were obtained. For the cortical bone the highest stress values (sigma(max)) were observed in the RA (regular platform and angulated abutment, 51 MPa), followed by SA (platform switching and angulated abutment, 44.8 MPa), RS (regular platform and straight abutment, 38.6 MPa) and SS (platform switching and straight abutment, 36.5 MPa). For the trabecular bone, the highest stress values (sigma(max)) were observed in the RA (6.55 MPa), followed by RS (5.88 MPa), SA (5.60 MPa), and SS (4.82 MPa). The regular platform generated higher stress in the cervical periimplant region on the cortical and trabecular bone than the platform switching, irrespective of the abutment used (straight or angulated).