Photoelastic Analysis of Cemented or Screwed Implant-Supported Prostheses With Different Prostheses Connections

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

Three-Dimensional Finite Element Analysis of Vertical and Angular Misfit in Implant-Supported Fixed Prostheses

Purpose: Three-dimensional finite element analysis was used to evaluate the effect of vertical and angular misfit in three-piece implant-supported screw-retained fixed prostheses on the biomechanical response in the peri-implant bone, implants, and prosthetic components. Materials and Methods: Four three-dimensional models were fabricated to represent a right posterior mandibular section with one implant in the region of the second premolar (2PM) and another in the region of the second molar (2M). The implants were splinted by a three-piece implant-supported metal-ceramic prosthesis and differed according to the type of misfit, as represented by four different models: Control = prosthesis with complete fit to the implants; UAM (unilateral angular misfit) = prosthesis presenting unilateral angular misfit of 100 pm in the mesial region of the 2M; UVM (unilateral vertical misfit) = prosthesis presenting unilateral vertical misfit of 100 pm in the mesial region of the 2M; and TVM (total vertical misfit) = prosthesis presenting total vertical misfit of 100 pm in the platform of the framework in the 2M. A vertical load of 400 N was distributed and applied on 12 centric points by the software Ansys, ie, a vertical load of 150 N was applied to each molar in the prosthesis and a vertical load of 100 N was applied at the 2PM. Results: The stress values and distribution in peri-implant bone tissue were similar for all groups. The models with misfit exhibited different distribution patterns and increased stress magnitude in comparison to the control. The highest stress values in group UAM were observed in the implant body and retention screw. The groups UVM and TVM exhibited high stress values in the platform of the framework and the implant hexagon, respectively. Conclusions: The three types of misfit influenced the magnitude and distribution of stresses. The influence of misfit on peri-implant bone tissue was modest. Each type of misfit increased the stress values in different regions of the system. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:788-796

Postsurgical Care for Rehabilitation With Implant-Retained Extraoral Prostheses

The health of a peri-implant tissue is a critical factor for the long-term success of treatment with extraoral implants. However, infection and inflammation may occur and lead to implant loss and prostheses failure. Therefore, some postsurgical care as hygiene with soap and water, soft toothbrush, and Superfloss type dental floss and medication with anti-inflammatory and antibiotic are suggested to avoid complications. In addition, a thin and smooth layer of subcutaneous tissue in the peri-implant area should be preserved during implant insertion to favor the assistance recommended in this phase.

Photoelastic Analysis of Biomechanical Behavior of Single and Multiple Fixed Partial Prostheses With Different Prosthetic Connections

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

Photoelastic Analysis of Implant-Retained and Conventional Obturator Prostheses With Different Attachment Systems and Soft Relining

Complete and partial loss of maxillary bone may jeopardize oral physiology and generate complications as oral-sinus-nasal communication. Palatal obturator prostheses are a treatment alternative for rehabilitation of these patients. The aim of this study was to assess stress distribution, through photoelasticity, on palatal obturator prostheses associated with different attachment systems (o'ring, bar clip, and o'ring/bar clip) of implants and submitted to relining. Two photoelastic models were fabricated according to an experimental maxillary model with oral-sinus-nasal communication. One model did not present implants, whereas the other included 2 implants with 13.0 mm in length in the left ridge. Four colorless maxillary obturator prostheses were fabricated and relined with soft silicone. One of these prostheses presented no attachment system, whereas the remaining prostheses included attachment systems adapted to the implants. The assembly (model/attachment system/prosthesis) was positioned in a circular polariscope during loading with 100 N at 10 mm/s. The results were based on observation during the experiment and photographic records of stress on the photoelastic model. The bar clip system exhibited the highest stress concentration followed by o'ring/bar clip and o'ring systems. The attachment systems presented different stress distribution with greater concentration surrounding the implants and homogenous stress distribution on the photoelastic model without implants. The highest concentration of fringes occurred, in ascending order, with o'ring, o'ring/bar clip, and bar clip systems.

Analysis of mechanical behavior of implant-supported prostheses in the anterior maxilla: analysis by speckle pattern interferometry

The use of implants to rehabilitation of total edentulous, partial edentulous or single tooth is increasing, it is due to the high rate of success that this type of treatment present. The objective of this study was to analyze the mechanical behavior of different positions of two dental implants in a rehabilitation of 4 teeth in the region of maxilla anterior. The groups studied were divided according the positioning of the implants. The Group 1: Internal Hexagonal implant in position of lateral incisors and pontic in region of central incisors; Group 2: Internal Hexagonal implant in position of central incisors and cantilever of the lateral incisors and Group3 - : Internal Hexagonal implants alternate with suspended elements. The Electronic Speckle Pattern Interferometry (ESPI) technique was selected for the mechanical evaluation of the 3 groups performance. The results are shown in interferometric phase maps representing the displacement field of the prosthetic structure.

Clinical and radiographic changes around dental implants inserted in different levels in relation to the crestal bone, under different restoration protocols, in the dog model

Background: The aim of the present study was to evaluate clinical and radiographic changes that occur around dental implants inserted in different levels in relation to crestal bone under different restoration protocols.Methods: Thirty-six implants were inserted in the edentulous mandible of six mongrel dogs. Each implant was assigned to an experimental group according to the distance from the top of the implant to the crestal bone: Bone Level (at crestal bone level), Minus 1 (1 mm below crestal bone), or Minus 2 (2 mm below crestal bone). Each hemimandible was submitted to a restoration protocol: conventional (prosthesis was installed 120 days after implant placement, including 30 days with healing cap) or immediate (prosthesis was installed 24 hours after implant placement). Fixed partial prostheses were installed bilaterally in the same day. After 90 days, clinical and radiographic parameters were evaluated.Results: As long as the implants were inserted in more apical positions, the first bone-to-implant contact (fBIC) was positioned more apically (P<0.05). However, the apical positioning of the implants did not influence the ridge loss or the position of the soft tissue margin (PSTM) (P>0.05). In addition, in immediately restored sites, the PSTM was located significantly more coronally than that in conventionally restored sites (P=0.02).Conclusions: Despite the more apical positioning of the fBIC, the height of the peri-implant soft tissues and ridge was not jeopardized. Moreover, the immediate restoration protocol was beneficial to the maintenance of the PSTM. Further studies are suggested to evaluate the significance of these results in longer healing periods.

A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses

Objectives: To verify the consequences of implant-supported fixed oral rehabilitation on the quality of life (QL) of elderly individuals.Material and methods: Fifteen patients were studied, being 10 females and five males; all were aged > 60 years, were completely edentulous, wore removable dentures on both arches, and were treated with implant-supported fixed dentures. Three QL questionnaires were applied, two related to the oral conditions (Oral Impact on Daily Performance - OIDP - and Oral Health Impact Profile, short version - OHIP-14) and one dealing with global aspects (World Health Organization Quality of Life - WHOQOL-BREF), before 3, 6, and 18 months after surgical placement of implants.Results: Scores in the OIDP and OHIP-14 questionnaires were better after dental treatment. The WHOQOL-BREF was less sensitive, confirming the higher reliability of specific questionnaires (focal) compared with general questions in such situations.Conclusion: Treatment with implant-supported fixed prostheses improved QL in the elderly; these effects are better detected by specific instruments focused on the subject.

Effect of axial loads on implanted-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 mu epsilon) and point D the highest (442.77 mu epsilon). 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.

Machined and plastic copings in three-element prostheses with different types of implant-abutment joints: a strain gauge comparative analysis

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

Infrared laser photobiomodulation (lambda 830 nm) on bone tissue around dental implants: A Raman spectroscopy and scanning electronic microscopy study in rabbits

Objective: the aim of this study was to assess, through Raman spectroscopy, the incorporation of calcium hydroxyapatite (CHA; similar to 960 cm(-1)), and scanning electron microscopy (SEM), the bone quality on the healing bone around dental implants after laser photobiomodulation ( lambda 830 nm). Background Data: Laser photobiomodulation has been successfully used to improve bone quality around dental implants, allowing early wearing of prostheses. Methods: Fourteen rabbits received a titanium implant on the tibia; eight of them were irradiated with lambda 830 nm laser ( seven sessions at 48-h intervals, 21.5 J/cm(2) per point, 10 mW, phi similar to 0.0028 cm(2), 86 J per session), and six acted as control. The animals were sacrificed 15, 30, and 45 days after surgery. Specimens were routinely prepared for Raman spectroscopy and SEM. Eight readings were taken on the bone around the implant. Results: the results showed significant differences on the concentration of CHA on irradiated and control specimens at both 30 and 45 days after surgery ( p < 0.001). Conclusion: It is concluded that infrared laser photobiomodulation does improve bone healing, and this may be safely assessed by Raman spectroscopy or SEM.

Laser weld: microstructure and corrosion study of Ag-Pd-Au-Cu alloy of the dental application

The laser Welding process was introduced into dentistry by the end of the 1980s, resulting on a great impulse to that area with the development of cheaper and smaller equipment, using simpler technique. This allowed greater use of that process on the confection of prostheses compared to the brazing process since the heat source for that process is a concentrated light beam of high power, which minimizes distortion problems on the prosthetic pieces. Ag-Pd-Au-Cu alloy used on the confection of dental implant prostheses was observed before and after subjection to the laser welding process. The microstructure was analyzed with the. use of optic microscopy and the corrosion resistance was studied by the traditional electrochemical techniques and by electrochemical impedance, under environmental conditions simulating the aggressiveness found in the mouth cavity. A structural change was detected on the weld area, which presented a refined microstructure deriving from the high-speed cooling. The base metal out of the weld area presented a fusion coarse microstructure. The electrochemical essays showed differences on the potentiodynamic polarization behavior in both weld and metal base areas, indicating superior corrosion resistance in the weld area. The impedance spectra were characterized by capacitive distorted components, presenting linear impedance in the low frequencies area. (C) 2002 Elsevier B.V. B.V. All rights reserved.