Effect of cantilever length and framework alloy on the stress distribution of mandibular-cantilevered implant-supported prostheses

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Planning for Immediate Loading of Implant-Supported Prostheses: Literature Review

The aim of this study was to present the factors that influence planning for immediate loading of implants through a literature review for treatment success. Research was conducted in the PubMed database including the key words immediate implant loading, implant-supported prostheses, and implant planning for studies published from 2000 to 2011. Forty-eight articles were used in this review to describe the indications and counterindications, presurgical planning, and technologies available for planning of this treatment alternative.

Influence of Cusp Inclination on Stress Distribution in Implant-Supported Prostheses. A Three-Dimensional Finite Element Analysis

Purpose: The aim of this study was to assess the influence of cusp inclination on stress distribution in implant-supported prostheses by 3D finite element method.Materials and Methods: Three-dimensional models were created to simulate a mandibular bone section with an implant (3.75 mm diameter x 10 mm length) and crown by means of a 3D scanner and 3D CAD software. A screw-retained single crown was simulated using three cusp inclinations (10 degrees, 20 degrees, 30 degrees). The 3D models (model 10d, model 20d, and model 30d) were transferred to the finite element program NeiNastran 9.0 to generate a mesh and perform the stress analysis. An oblique load of 200 N was applied on the internal vestibular face of the metal ceramic crown.Results: The results were visualized by means of von Mises stress maps. Maximum stress concentration was located at the point of application. The implant showed higher stress values in model 30d (160.68 MPa). Cortical bone showed higher stress values in model 10d (28.23 MPa).Conclusion: Stresses on the implant and implant/abutment interface increased with increasing cusp inclination, and stresses on the cortical bone decreased with increasing cusp inclination.

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

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

The Effect of Mechanical Cycling and Different Misfit Levels on Vicker's Microhardness of Retention Screws for Single Implant-Supported Prostheses

Purpose: The aim of this study was to evaluate the effect of mechanical cycling and different misfit levels on Vicker's microhardness of retention screws for single implant-supported prostheses.Materials and Methods: Premachined UCLA abutments were cast with cobalt-chromium alloy to obtain 48 crowns divided into four groups (n = 12). The crowns presented no misfit in group A (control group) and unilateral misfits of 50 mu m, 100 mu m, and 200 mu m in groups B, C, and D, respectively. The crowns were screwed to external hexagon implants with titanium retention screws (torque of 30 N/cm), and the sets were submitted to three different periods of mechanical cycling: 2 x 10(4), 5 x 10(4), and 1 x 10(6) cycles. Screw microhardness values were measured before and after each cycling period. Data were evaluated by two-way ANOVA and Tukey's test (p < 0.05).Results: Mechanical cycling statistically reduced microhardness values of retention screws regardless of cycling periods and groups. In groups A, B, and C, initial microhardness values were statistically different from final microhardness values (p < 0.05). There was no statistically significant difference for initial screw microhardness values (p > 0.05) among the groups; however, when the groups were compared after mechanical cycling, a statistically significant difference was observed between groups B and D (p < 0.05).Conclusions: Mechanical cycling reduced the Vicker's microhardness values of the retention screws of all groups. The crowns with the highest misfit level presented the highest Vicker's microhardness values.

Effect of Misfit on Preload Maintenance of Retention Screws of Implant-Supported Prostheses

The aim of this study was to evaluate the effect of unilateral misfit at different levels on a crown-implant-retention screw system of implant-supported crowns. Hexagon castable UCLA abutments were cast in Co-Cr alloy to fabricate 48 metallic crowns divided into four groups (n = 12). Group A: crowns did not present misfit; Groups B, C and D: crowns were fabricated with unilateral misfit of 50, 100, and 200 mu m, respectively. The crowns were attached by titanium retention screw with 30 N/cm to external hexagonal osseointegrated implants embedded in acrylic resin. After 2 min, the retention screw of each replica was submitted to detorque evaluation by an analogic torque gauge. Three retention screws were used to perform detorque evaluation at each replica and the procedure was repeated twice with each screw. Each group was submitted to 72 detorque measurements. Data were evaluated by ANOVA and Tukey test (P < 0.05). All groups exhibited significant decrease (P < 0.05) in preload and the lowest decrease occurred in Group A. Groups B, C, and D were statistically significant different from Group A (P < 0.05), but there was no statistically significant difference between Groups B and D (P > 0.05). Crowns with unilateral misfit presented higher preload decrease than crowns completely fitted to osseointegrated implants.

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.

Straight and Offset Implant Placement under Axial and Nonaxial Loads in Implant-Supported Prostheses: Strain Gauge Analysis

Purpose: The aim of this in vitro study was to quantify strain development during axial and nonaxial loading using strain gauge analysis for three-element implant-supported FPDs, varying the arrangement of implants: straight line (L) and offset (O). Materials and Methods: Three Morse taper implants arranged in a straight line and three implants arranged in an offset configuration were inserted into two polyurethane blocks. Microunit abutments were screwed onto the implants, applying a 20 Ncm torque. Plastic copings were screwed onto the abutments, which received standard wax patterns cast in Co-Cr alloy (n = 10). Four strain gauges were bonded onto the surface of each block tangential to the implants. The occlusal screws of the superstructure were tightened onto microunit abutments using 10 Ncm and then axial and nonaxial loading of 30 Kg was applied for 10 seconds on the center of each implant and at 1 and 2 mm from the implants, totaling nine load application points. The microdeformations determined at the nine points were recorded by four strain gauges, and the same procedure was performed for all of the frameworks. Three loadings were made per load application point. The magnitude of microstrain on each strain gauge was recorded in units of microstrain (mu). The data were analyzed statistically by two-way ANOVA and Tukey's test (p < 0.05). Results: The configuration factor was statistically significant (p= 0.0004), but the load factor (p= 0.2420) and the interaction between the two factors were not significant (p= 0.5494). Tukey's test revealed differences between axial offset (mu) (183.2 +/- 93.64) and axial straight line (285.3 +/- 61.04) and differences between nonaxial 1 mm offset (201.0 +/- 50.24) and nonaxial 1 mm straight line (315.8 +/- 59.28). Conclusion: There was evidence that offset placement is capable of reducing the strain around an implant. In addition, the type of loading, axial force or nonaxial, did not have an influence until 2 mm.

Effects of mandibular fixed implant-supported prostheses on masticatory and swallowing functions in completely edentulous elderly individuals

Purpose: To evaluate the effect of oral rehabilitation with immediately loaded fixed implant-supported mandibular prostheses on chewing and swallowing in elderly individuals. Materials and Methods: Fifteen completely edentulous patients aged more than 60 years (10 women and rive men), wearing removable dentures in both arches, had a mandibular denture replaced by an implant-supported prosthesis. All individuals were evaluated before surgery and again 3, 6, and 18 months later with regard to mastication and swallowing conditions. Examinations entailed an interview, evaluation of tactile sensitivity of the face, and observation of food intake, masticatory type, formations of bolus, and pain during mastication. The swallowing evaluation comprised observation of clinical signs related to the oral and pharyngeal stages of swallowing, as well as the presence of oral residue. The findings of different evaluations before and 3, 6, and 18 months after the surgical-prosthetic procedure were statistically compared by analysis of variance for repeated measurements at a significance level of 5%. Results: The questionnaire revealed a reduction in complaints of masticatory and swallowing disturbances, a decreased need for liquid ingestion, and reduced choking and coughing. Clinical evaluations showed improved oral function and bolus propulsion for both solid and paste-consistency foods; pain during mastication was also resolved. Conclusion: Treatment with mandibular implant-supported dentures had positive effects on the clinical aspects of mastication and swallowing in elderly individuals.

Evaluation of a two-step pouring technique for implant-supported prostheses impression

The aim of this study was to evaluate the efficacy of a pouring technique for implant-supported prostheses impressions. A metallic matrix (control group) with two implants positioned at 90 and 65 degrees was fabricated. The matrix was submitted to the direct transfer impression technique. In group CP (conventional pouring - n = 10), casts were obtained by the conventional pouring technique. In group EP (experimental pouring - n = 10), the analogs were embraced with latex tubes before the first pouring and then submitted to a second pouring. Vertical misfit and implants/analogs inclinations were evaluated. Data were analyzed by analysis of variance and Tukey's test (p < .05). Results demonstrated significant difference (p < .05) between control and experimental groups for misfit measurement in perpendicular implant/analog and between control group and group EP in leaning implant/analog. Considering inclination, there were significant differences (p < .05) between control and experimental groups for leaning analogs. Independently of the pouring technique, perpendicular implants produced more accurate casts.

Effect of unilateral misfit on preload of retention screws of implant-supported prostheses submitted to mechanical cycling

Purpose: The aim of this study was to evaluate the effect of different levels of unilateral angular misfit on preload maintenance of retention screws of single implant-supported prostheses submitted to mechanical cycling. Materials and methods: Premachined UCLA abutments were cast with cobalt-chromium alloy to obtain 48 crowns divided into four groups (n=12). The crowns presented no misfit in Group A (control group) and unilateral misfits of 50μm, 100μm and 200μm in the groups B, C and D, respectively. The crowns were attached to external hexagon implants with a titanium retention screw with torque of 30N/cm. Oblique loading of 130N at 2Hz was applied on each replica, totalizing 5×104 and 1×106cycles. Detorque values were measured initially and after each cycling period. Data were evaluated by analysis of variance and Tukey's HSD test (p<0.05). Results: All groups presented reduced initial detorque values (p< 0.05) in comparison to the insertion torque (30. ± 0.5. N/cm) and Group A (25.18. N/cm) exhibited the lowest reduction. After mechanical cycling, all groups presented detorque values from 19.5. N/cm to 22.38. N/cm and the mechanical cycling did not statistically influence the detorque values regardless the misfit level of the replicas. Conclusion: The unilateral misfit influenced the preload maintenance only before mechanical cycling. The mechanical cycling did not influence the torque reduction. © 2010 Japan Prosthodontic Society.

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.

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.