Stress analysis in oral obturator prostheses over parallel and tilted implants: photoelastic imaging

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Microstrain Around Dental Implants Supporting Fixed Partial Prostheses Under Axial and Non-Axial Loading Conditions, In Vitro Strain Gauge Analysis

The current study used strain gauge analysis to perform an in vitro evaluation of the effect of axial and non-axial loading on implant-supported fixed partial prostheses, varying the implant placement configurations and the loading points. Three internal hexagon implants were embedded in the center of each polyurethane block with in-line and offset placements. Microunit abutments were connected to the implants using a torque of 20 N.cm, and plastic prosthetic cylinders were screwed onto the abutments, which received standard patterns cast in Co-Cr alloy (n = 10). Four strain gauges (SGs) were bonded onto the surfaces of the blocks, 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 using a 10-N.cm torque, and axial and non-axial loads of 30 kg were applied at 5 predetermined points. The data obtained from the strain gauge analyses were analyzed statistically through the repeated measures analysis of variance and the Tukey test, with a conventional level of significance of P < 0.05. The results showed a statistically significant difference for the loading point (P = 0.0001), with point E (nonaxial) generating the highest microstrain (327.67 mu epsilon) and point A (axial) generating the smallest microstrain (208.93 mu epsilon). No statistically significant difference was found for implant placement configuration (P = 0.856). It was concluded that the offset implant placement did not reduce the magnitude of microstrain around the implants under axial and non-axial loading conditions, although loading location did influence this magnitude.

Photoelastic stress analysis of splinted and unitary implant-supported prostheses

The aim of this study was to evaluate the effects that splinting and different lengths of implants have on the stress distribution in implant-supported prostheses by photoelastic analysis. A total of five photoelastic resin models were made with different proposed situations, and 400 load applications were performed for the analysis. Compared with the unitary prosthesis, the splinted implant-supported prosthesis acted favorably in the distribution of stresses and strains to the implant (p < 0.001). The increase in length was a significant factor in the stress distribution (p < 0.05) and, ultimately, the overall reduction in stress. It was concluded that the splinted implant-supported prosthesis behaved better biomechanically compared with the unitary prosthesis.

Effect of Beverages and Mouthwashes on the Hardness of Polymers Used in Intraoral Prostheses

PurposeThe mechanical properties of acrylic resins used in intraoral prostheses may be altered by frequent exposure to liquids such as beverages and mouthwashes. This study aimed to evaluate the effect of thermocycling and liquid immersion on the hardness of four brands of acrylic resins commonly used in removable prostheses (Onda Cryl, QC-20, Classico, Lucitone).Materials and MethodsFor each brand of resin, seven specimens were immersed in each of six solutions (coffee, cola, red wine, Plax-Colgate, Listerine [LI], Oral B), and seven more were placed in artificial saliva (control). The hardness was tested using a microhardness tester before and after 5000 thermocycles and after 1, 3, 24, 48, and 96 hours of immersion. The results were analyzed using three-way repeated-measures ANOVA and Tukey's test (p < 0.05).ResultsThe hardness of the resins decreased following thermocycling and immersion in the solutions. Specimens immersed in cola and wine exhibited significant decreases in hardness after immersion for 96 hours, although the greatest significant decrease in hardness occurred in specimens immersed in LI. However, according to American Dental Association specification 12, the Knoop hardness of acrylic resins for intraoral prostheses should not be below 15. Thus, the median values of superficial hardness observed in most of the acrylic resins in this study are considered clinically acceptable.ConclusionsThe microhardness of polymers used for intraoral prostheses decreases following thermocycling. Among specimens immersed in beverages, those immersed in cola or wine experienced the greatest decrease in microhardness. Immersion of acrylic resins in LI significantly decreased the microhardness in relation to the initial value. Among the resins assessed, QC-20 exhibited the lowest initial hardness.

Stress analysis in oral obturator prostheses, part II: photoelastic imaging

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Axial loads on implant-supported partial fixed prostheses for external and internal hex connections and machined and plastic copings: strain gauge analysis

The aim of this in vitro study was to use strain gauge (SG) analysis to compare the effects of the implant-abutment joint, the coping, and the location of load on strain distribution in the bone around implants supporting 3-unit fixed partial prostheses. Three external hexagon (EH) implants and 3 internal hexagon (IH) implants were inserted into 2 polyurethane blocks. Microunit abutments were screwed onto their respective implant groups. Machined cobalt-chromium copings and plastic copings were screwed onto the abutments, which received standard wax patterns. The wax patterns were cast in a cobalt-chromium alloy (n = 5): group 1 = EH/machined. group 2 = EH/plastic, group 3 = IH/machined, and group 4 = IH/plastic. Four SGs were bonded onto the surface of the block tangentially to the implants. Each metallic structure was screwed onto the abutments and an axial load of 30 kg was applied at 5 predetermined points. The magnitude of microstrain on each SG was recorded in units of microstrain (mu epsilon). The data were analyzed using 3-factor repeated measures analysis of variance and a Tukey test (alpha = 0.05). The results showed statistically significant differences for the type of implant-abutment joint, loading point, and interaction at the implant-abutment joint/loading point. The IH connection showed higher microstrain values than the EH connection. It was concluded that the type of coping did not interfere in the magnitude of microstrain, but the implant/abutment joint and axial loading location influenced this magnitude.

Electrical activity of the orbicularis muscles before and after installation of ocular prostheses

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

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts (R) total joint prostheses Part I - Skeletal and dental stability

The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total join, prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). Forty-seven females were studied; the average post-surgical follow-up was 40.6 months. Lateral cephalograms were analyzed to estimate surgical and post-surgical changes. During surgery, the occlusal plane angle decreased 14.9 +/- 8.0 degrees. The maxilla moved forward and upward. The posterior nasal spine moved downward and forward. The mandible advanced 7.9 +/- 3.5 mm at the lower incisor tips, 12.4 +/- 5.4 mm at Point B, 17.3 +/- 7.0 mm at menton, 18.4 +/- 8.5 mm at pogonion, and 11.0 +/- 5.3 mm at gonion. Vertically, the lower incisors moved upward -2.9 +/- 4.0 mm. At the longest follow-up post surgery, the maxilla showed minor horizontal changes while all mandibular measurements remained stable. TMJ reconstruction and mandibular advancement with TMJ Concepts total joint prosthesis in conjunction with maxillary osteotomies for counter-clockwise rotation of the rnaxillo-mandibular complex was a stable procedure for these patients at the longest follow-up.

Root-supported overdentures associated with temporary immediate prostheses: a case-report

Complete denture fabrication can be a treatment challenge for many dentists, especially when the patient has remaining teeth. So, planning for use of clinical alternatives to improve the treatment prognosis and to enable greater comfort to patient must be considered. This case report describes the use of remaining roots to aid in the stability, support and retention of root-supported overdentures. Thus, immediate prostheses were planned for temporary rehabilitation prior to definitive overdentures. The aim of this study was to demonstrate the planning of root-supported overdentures attached with a ball system for retention associated with immediate dentures between the periods of preparation to fabrication of the definitive overdentures. The proposed treatment met the patient's needs such as being able to carry on normal activities during the sequencing of procedures to be performed over a period of time. The treatment had longevity with patient's knowledge about the necessity of oral hygiene and periodic controls.

Obturator prostheses versus free tissue transfers: a systematic review of the optimal approach to improving the quality of life for patients with maxillary defects

Patient perspectives on the treatment options for maxillary defects, which include free tissue transfers or obturator prostheses, may help eliminate current uncertainty as to the best choice of treatment plan. The purpose of this systematic review was to evaluate the quality of life (QoL) of patients with maxillary defects who had undergone restoration with obturator prostheses and/or free tissue transfers. A systematic search of Medline/PubMed and Web of Science databases for articles published before April 2015 was performed by 2 independent reviewers. A manual search of articles published from January 2005 to March 2015 was also conducted. Studies published in English that evaluated the QoL in patients with head and neck cancers were included. The Cohen kappa method was used to calculate inter-reviewer agreement. Ten studies were included. The University of Washington Head and Neck Questionnaire (UW-QOL) was most commonly used to measure QoL. The majority of maxillary defects were Class IIa-b. Two studies reported that the global QoL for patients with obturator prostheses is equivalent to or even better than that of other chronic disease populations. One study revealed no significant difference in QoL when the 2 treatment options were compared. The limited data indicate that the QoL of patients treated with obturator prostheses and that of patients free of tumors is similar. Well-designed clinical studies are necessary to draw definitive conclusions about how obturator prostheses compare with free tissue transfers in terms of affecting patient QoL.

Three-dimensional finite element analysis of anterior single implant-supported prostheses with different bone anchorages

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

Esthetics in implant-supported prostheses: a literature review

Esthetics is important for success of implant-supported prostheses. This study aimed to review esthetics concepts for implant treatment. Research in the PubMed database included studies published from 1995 to 2010 with the keywords implant esthetics, implant-supported prostheses, and esthetics. Forty-five studies were evaluated regarding the presurgical planning, surgical phase, and temporary and final restoration phases. It was concluded that esthetics in implant-supported prostheses results from a multidisciplinary approach from planning until insertion of the final restoration.

Fabrication techniques for ocular prostheses: an overview

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

Measurement of the concentration and size of aerosol particles and identification of the sources in orthopedic surgeries

In this study, the measurement of the concentration and size of particles and the identification of their sources were carried out at five orthopedic surgeries. The aerosol concentration and particle size distribution, ranging from 0.3 mu m 10 mu m, were measured and related to the type of indoor activity. The handling of surgical linen and gowns, handling of the patient, use of electrosurgical apparatus, use of a bone saw, handling of equipment, and cleaning of the room were identified as the most important sources of particles, with each of these activities posing different risks to the health of the patients and workers. The results showed that most of the particles were above 0.5 mu m and that there was a strong correlation among all particles of sizes above 1 mu m. Particles with diameters in the range of 0.3 mu m-0.5 mu m had a good correlation only with particles in the ranges of 0.5 mu m-1.0 mu m and 1.0 mu m-3.0 mu m in three of the surgeries analyzed. Findings led to the conclusion that most of the events responsible for generating aerosol particles in an orthopedic surgery room are brief, intermittent, and highly variable, thus requiring the use of specific instrumentation for their continuous identification and characterization.

FINITE ELEMENT ANALYSIS OF MAXILLARY BONE STRESS CAUSED BY ARAMANY CLASS IV OBTURATOR PROSTHESES

Statement of problem. The retention of an Aramany Class IV removable partial dental prosthesis can be compromised by a lack of support. The biomechanics of this obturator prosthesis result in an unusual stress distribution on the residual maxillary bone. Purpose. This study evaluated the biomechanics of an Aramany Class IV obturator prosthesis with finite element analysis and a digital 3-dimensional (3-D) model developed from a computed tomography scan; bone stress was evaluated according to the load placed on the prosthesis. Material and methods. A 3-D model of an Aramany Class IV maxillary resection and prosthesis was constructed. This model was used to develop a finite element mesh. A 120 N load was applied to the occlusal and incisal platforms corresponding to the prosthetic teeth. Qualitative analysis was based on the scale of maximum principal stress; values obtained through quantitative analysis were expressed in MPa. Results. Under posterior load, tensile and compressive stresses were observed; the tensile stress was greater than the compressive stress, regardless of the bone region, and the greatest compressive stress was observed on the anterior palate near the midline. Under an anterior load, tensile stress was observed in all of the evaluated bone regions; the tensile stress was greater than the compressive stress, regardless of the bone region. Conclusions. The Aramany Class IV obturator prosthesis tended to rotate toward the surgical resection when subjected to posterior or anterior loads. The amount of tensile and compressive stress caused by the Aramany Class IV obturator prosthesis did not exceed the physiological limits of the maxillary bone tissue. (J Prosthet Dent 2012;107:336-342)