A Nonlinear Three-Dimensional Finite Element Analysis of Stress Distribution and Microstrain Evaluation in Short Dental Implants with Three Different Implant-Abutment Connections in Single and Splinted Conditions in the Posterior Mandible.

Background: Stress distribution plays a vital role in the longevity and success of implant-supported prosthesis. This study evaluated the von Mises stress and microstrain in the peri-implant bone and the implant-abutment junction of short dental implants with three different implant-abutment connections in splinted and unsplinted conditions using finite element analysis (FEA). Materials and Methods: In this experimental study, nine transversely isotropic finite element models were developed, and randomly divided into three equal groups (n = 3): control, (Group AC) single-standard 4.3 × 10 mm bone level implant-supported restorations with external hexagonal (EH) connection, internal conical (IC) and internal trichannel (ITC) connection, single short implant-supported restorations (Group AT), and splinted short implant-supported restorations (Group B) for each of the three implant-abutment connections, respectively. A 200 N load was applied along the long axis of the implants and a 100 N (45°) oblique load was applied and von Mises stress and microstrain values were evaluated. Results: Single standard implants demonstrated the highest von Mises stress and microstrain values followed by single short implants and splinted short implants, respectively. Among the implant-abutment connections, the IC connection showed the highest values and the ITC connection showed the least values. Conclusion: Within the limitations of this study, it was concluded that splinting of short dental implants demonstrated lesser and more homogeneous stress and microstrain, especially on oblique loading. The microstrain values for all connections evaluated were within the physiological loading limit (200-2,500 N) and were hence considered safe for clinical use.

An In Vitro Study on the Shear Bond Strength of Feldspathic Porcelain to Nickel Chromium Alloy and Cobalt Chromium Alloy after Various Surface Treatments.

Background: To evaluate and compare the shear bond strength of feldspathic porcelain to four distinctively surface-treated Ni-Cr and Co-Cr alloys and to assess the impact of oxidation-heat treatment on porcelain to base metal alloy bond strength. Methods: 40 specimens each of nickel-chromium alloy and cobalt-chromium alloy were cast. A total of four groups of specimens were created. Group I was surface-treated by sandblasting with 50 µm alumina particles, Group II was surface-treated by sandblasting with 110 µm alumina particles, Group III and Group IV were surface-treated with 250 µm alumina particles. In Group IV, after sandblasting initially with 250 µm alumina particles, the alloys were subjected to oxidation and resandblasting with 250 µm alumina particles. Each of the specimen was coated with opaque and body porcelain and fired to a total thickness of 2 mm porcelain. A universal measuring machine was used to assess shear bond strength at a crosshead speed of 0.5 mm/min. Results: Two-way ANOVA followed by Tukey's post hoc test was used to assess the significant difference within the groups. Unpaired t-test was used for the intergroup comparison of the obtained data. The study showed that the size of the air abrasion particles used for sandblasting significantly influenced the porcelain to metal surface bond strength, with p value <0.001. The bond strength values of the two alloys tested showed no major variations. Result also showed that oxidation influences the metal-ceramic bond strength. Conclusions: The bond strength of the metal-ceramic interface is influenced by the alloy's surface treatment. The oxidation process impacts the bond strength of the metal-ceramic system.

Effect of Different Surface Treatments on the Micro-Shear Bond Strength and Surface Characteristics of Zirconia: An In Vitro Study.

Purpose: To study the effect of different surface treatments on the micro-shear bond strength and surface characteristics of zirconia. Methods: Two types of zirconia ceramics were tested: opaque (O) and translucent (T). Each type of zirconia was further allotted into four groups based on the type of surface treatment method. The four groups were: control (C), air abrasion with 110 µm Al2O3 particles (A), etching with Zircos-E Etching solution for 2 hours (E), and a combination of air abrasion and etching (AE). After the surface treatment, all specimens were ultrasonically cleaned and 10 resin cement cylinders were attached to the zirconia discs in each group. A micro-shear bond strength test was performed in a universal testing machine at a crosshead speed of 0.5 mm/min. The fracture surfaces were assessed under a compound microscope. SEM, EDAX, and AFM analyses were done for the zirconia specimens after being subjected to surface treatment. Statistical analysis for the bond strength test was done using the Shapiro-Wilk test, one-way analysis of variance (ANOVA), and Post hoc Tukey test. Results: The micro-shear bond strength values for the groups were as follows in megapascals (MPa): OC 18.96 (5.54), OA 22.66 (2.51), OE 28.48 (4.50), OAE 28.63 (4.53), TC 22.82 (5.46), TA 25.36 (5.17), TE 28.12 (4.76), and TAE 32.00 (3.47). The one-way analysis of variance (ANOVA) and post hoc Tukey HSD tests were done which showed significant results in the groups. In opaque zirconia, significant differences were seen in the etching and air abrasion with etching groups when compared with the control and air abrasion groups. There was no difference between the etching and air abrasion with etching groups. For translucent zirconia, the only significant difference was seen in the air abrasion with etching group in comparison with the control and air abrasion groups. The mode of failure was majorly adhesive. The surface topography and surface roughness showed significant differences between the groups. The EDAX results showed material loss that occurred due to sandblasting in the air abrasion groups. Conclusions: Etching with Zircos-E Etching solution significantly increased the bond strength of zirconia to resin cement when compared with other surface treatment methods. In translucent zirconia, the best results can be achieved by combining etching with air abrasion.

Biomechanical Stress Analysis of Platform Switch Implants of Varying Diameters on Different Densities of Bone.

PURPOSE: The purpose of this study was to evaluate and compare the strain developed in D2 and D3 types of bones on vertical loading by platform switch implants of different diameters. MATERIALS AND METHODS: Implants of diameters 3.25 mm, 4.2 mm, and 5.0 mm and of length 11.5 mm were taken and placed each on D2 and D3 bone models. Strain gauges were attached on the buccal and the lingual sides on each of these samples, and a vertical load of 190N was placed on the samples. The strain was recorded using a data logger. The data obtained was analysed using one-way ANOVA and post hoc Tukey test. RESULTS: In D2 and D3 bone models, 3.25 mm significantly showed greater bone strain values. The buccal side strain was higher irrespective of the implant diameter and density of bone. CONCLUSION: Within the limitations of the study, it may be concluded that the narrow diameter implant produces greater strain than 4.2 and 5.0 mm diameter implants, respectively. The buccal side consistently produced higher bone strain values.

Cytotoxicity of Dental Cements on Soft Tissue Associated with Dental Implants.

PURPOSE: To investigate and compare the cellular host response of human gingival fibroblasts (HGF) on four currently used cements. Methods and Material. 5 cement pellet samples were made for each of the 4 test cements (n = 20). The cements used for this study were zinc phosphate, zinc oxide noneugenol (ZOE), RelyX U200, and glass ionomer cement (GIC). One commercially available cell line was used to investigate the cytotoxicity of peri-implant tissues. Direct contact cell culture testing was conducted following International Organization for Standardization (ISO) methods 10993-5 and 10993-12 (MTT assay test). Cell cultures without dental cement were considered as control. Cells were allowed to grow and confluence over 48 hours after subcultivation according to standard laboratory procedures. The cells were kept in direct contact with the cement samples for 24 hours before being subjected to analysis. All specimens were tested in triplicate to validate the results. Quantitative evaluation of cytotoxicity was done to measure cell death and inhibition of cell growth. Results were analyzed using 1-way ANOVA (a = 0.05) followed by Tukey B post hoc test. RESULTS: The results of the study showed that HGF was vulnerable to the dental cement test material. GIC, zinc phosphate, ZOE, and resin cement were cytotoxic in decreasing order, respectively, and significantly reduced the cell viability after exposure to HGF (p < 0.001). CONCLUSIONS: Within the limitations of this in vitro cellular study, results indicated that the test dental cements were cytotoxic to HGF. The highest cytotoxicity was observed in GIC followed by zinc phosphate, ZOE, and resin cement.

Evaluation of Stress Generated with Different Abutment Materials and Angulations under Axial and Oblique Loading in the Anterior Maxilla: Three-Dimensional Finite Element Analysis.

PURPOSE: The aim of this study was to assess and correlate the stress distribution in an anterior maxillary implant-supported prosthesis with 0°(degree), 15°, and 25° angulated titanium and zirconia abutments using a three-dimensional (3D) finite element analysis (FEA). MATERIALS AND METHODS: Six FEA models consisting of a dentate anterior maxilla with a single bone-level implant of dimension 4.2 × 10 mm placed in the region of left maxillary central incisor and abutments of dimension 4.2 mm made of titanium and zirconia each with angulation 0° (IA and IB), 15° (IIA and IIB), and 25° (IIIA and IIIB) and ANSYS Workbench software were utilized to design a layered zirconia crown. Unilateral axial and oblique loads of 178 N were applied on the palatal aspect of the crown of left maxillary central incisor. Average von Mises stress values were evaluated in the implant and the peri-implant bone quantitatively and qualitatively. RESULTS: Stress was shown to increase with an increase in angulation in all the areas that were examined. Zirconia abutments showed lesser stress in the implant and surrounding bone than titanium abutments. When compared with the body and apex of the implant, the implant neck values were higher in all models. In between cortical and cancellous bone, the stress recorded was higher in the cortical bone. CONCLUSION: Within the limitations of this study, straight abutments generated a more uniform and minimal stress in implant and peri-implant bone than angulated abutments. Titanium abutments generated higher stress levels than zirconia abutments. The stresses generated are directly proportional to an increase in abutment angulation, and therefore, straight abutments are most suitable for favourable stress transmission.

Evaluation of chemical disinfection and microwave irradiation on denture base materials: An in vitro study.

OBJECTIVE: This study evaluated the effect of chemical disinfection and microwave irradiation on the surface hardness and roughness of two commercially available hard relining materials (Ufi Gel hard, GC Kooliner) and one denture base resin (Trevalon). MATERIALS AND METHODS: A total of 72 specimens (n = 24) were divided into four groups. C: Not disinfected, Cl: disinfected with 4% chlorhexidine solution, Gl: disinfected with 2% glutaraldehyde solution, Mw: disinfected with microwave irradiation (650 W; 6 min). Hardness and roughness measurements were made after polymerisation, 1st day, 14th day and 28th day. RESULTS: Ufi Gel hard showed an increased roughness after 1st day (P = 0.021) following chemical disinfection and GC Kooliner showed similar results after 14th day (P < 0.05). Microwave irradiation showed a significant increase in surface roughness value after 1st day (P < 0.05) for both Ufi Gel hard and GC Kooliner. Hardness of both Ufi Gel (12.131 to 7.333 VHN) and Kooliner (9.133 to 5.276 VHN) was significantly reduced by chemical disinfection, while microwave irradiation resulted in an increased surface hardness of Kooliner (from 9.126 to 12.713 VHN) and Ufi Gel hard (from 11.698 to 14.940VHN). Results for Trevalon were not significant for both the disinfection methods. CONCLUSIONS: Microwave irradiation increased the surface roughness and hardness of Ufi Gel hard and Kooliner, while chemical disinfection resulted in a decreased hardness and increased roughness of both hard relining materials. There was no effect of either of the disinfection methods on Trevalon.

Effect of post etching cleansing on surface microstructure, surface topography, and microshear bond strength of lithium disilicate.

AIM: This study assessed the effect of postetch cleansing on the surface microstructure, surface topography, and microshear bond strength (µSBS) of lithium disilicate and the resin cement. SETTING AND DESIGN: In Vitro analytical study. MATERIALS AND METHODS: Fifteen discs (10 mm diameter and 2 mm thickness) were fabricated from highly translucent lithium disilicate IPS Emax 2 ceramic (Ivoclar Vivadent, Schaan, Liechtenstein). Four resin cement (RelyX Ultimate, 3M ESPE) cylinders (0.9 mm diameter and 4 mm high) were placed on each ceramic disc (total n = 60). The samples were divided into three groups based on the surface treatment of the ceramic discs (20 resin cement cylinders on 5 discs in each group). Group I (HF) (control) etched with 9.6% HF with no postetch cleansing, Group II (HFP) etched with 9.6% HF for 20 s followed by rinsing with water and postetching cleansing with 37% phosphoric acid, and Group III (HFPU) etched with 9.6% HF followed by active application of 37% phosphoric acid followed by postetch cleansing in ultrasonic bath for 5 min. µSBS of resin cement to ceramic surfaces was tested following a standard protocol. Surface roughness was evaluated using an atomic force microscope. Surface topography and elemental analysis were analyzed using SEM/EDX. Mode of failure was also assessed. STATISTICAL ANALYSIS USED: The data were analysed using one way analysis of variance and post hoc tukeys test. RESULTS: The µSBS were found to be highest for Group III (HFPU), followed by Group II (HFP) followed by Group I (HF) and were statistically significant. There was a difference in the surface topography and surface microstructure between the three groups. Mode of failure was predominantly adhesive. CONCLUSION: The µSBS, surface topography, and surface microstructure were found to be superior in the groups, in which postetch cleansing was done as compared to the control in which no postetch cleansing was done.

A Comparative Evaluation of Stress Distribution with Two Attachment Systems of Varying Heights in a Mandibular Implant-Supported Overdenture: A Three-Dimensional Finite Element Analysis.

PURPOSE: To analyze and compare the stress distribution in an implant-retained overdenture complex using ball and Locator attachments of three heights by means of a 3D finite element analysis (FEA). MATERIALS AND METHODS: Six finite element models comprising an edentulous mandible with two interforaminal bone-level implants and ball attachments of heights 1 mm (A1), 3 mm (A3), and 5 mm (A5), and Locator attachments of heights 1 mm (B1), 3 mm (B3), and 5 mm (B5), were designed using ANSYS Workbench Software. Unilateral vertical (100 N) and oblique loads (100 N at 30° to the longitudinal axis of the implant in buccolingual direction) were applied. Average von Mises stress values were evaluated quantitatively and qualitatively. RESULTS: Locator attachments showed lower stress values as compared to the ball attachments in all examined areas. The increase in the height of both resulted in increased stress values. Higher values were observed at the implant neck in all models, as compared to the body and the apex. The recorded stress was higher in the cortical bone as compared to the cancellous bone. CONCLUSIONS: Within the limitations of the study, Locator attachments demonstrated lesser and more homogenous stress distribution in the implant-overdenture complex in comparison to ball attachments. The stresses generated within the tissues increase with an increase in collar height of the attachment system and therefore, attachments should be as short as possible for more favorable stress transmission.

Evaluation of effect of recasting of nickel-chromium alloy on its castability using different investment materials: An in vitro study.

CONTEXT: Castability has been found to be affected by many aspects of the entire casting system. Very few references in dental literature are available regarding recasting of the base metal alloys. AIMS: To evaluate and compare the castability of fresh and reused nickel-chromium alloy and to evaluate the effect of two brands of investment materials on castability of nickel-chromium alloy. SUBJECTS AND METHODS: For the experimental purpose of evaluation of the effect of recasting of nickel-chromium alloy on its castability, different percentages of new and casted alloy (Nickel-chromium alloy-(Wirolloy NB, Type 4 (Ni-67%; Cr-25%; Mo-5%; Si-1.5%; Mn, Nb, B, C each <1%) and two commercial brands of investment materials namely, Deguvest Impact (Degudent; Dentsply Germany) and Bellavest SH (Degudent; Dentsply Germany) was used to obtain 30 samples. Castability value was obtained using Whitlock's formula. Student t-test and one way ANOVA using SPSS 20.0 software was done. RESULTS: The results of this study confirm earlier works that demonstrate that there is no significant difference in castability values of new and recast alloys. In addition, it also demonstrated, there was no difference in castability using Deguvest Impact and Bellavest SH investment materials. CONCLUSIONS: Within the limitations of the study, it was concluded that there was no significant difference found in castability of different percentage combinations of new and once casted alloy using two investment materials. The addition of new alloy during recasting to maintain the castability of nickel-chromium alloy may therefore not be required.

Comparative evaluation of antifungal action of tea tree oil, chlorhexidine gluconate and fluconazole on heat polymerized acrylic denture base resin - an in vitro study.

OBJECTIVE: Candida albicans-associated denture stomatitis is the most common type of denture stomatitis seen in denture wearers. This study evaluates and compares the antifungal action of fluconazole, chlorhexidine gluconate and tea tree oil on heat-polymerised denture base resin, which has been previously contaminated with C. albicans grown in BHI broth. MATERIAL AND METHODS: Seventy-five specimens were immersed in BHI broth previously inoculated with C. albicans and stored for 3 h at 37°C. They were divided into five groups (n = 15): G1: 2% chlorhexidine solution; G2: 100% pure pharmaceutical grade tea tree oil; G3: 65 µg/ml fluconazole solution; C1: specimens not disinfected; C2: specimens not contaminated with Candida. Each specimen was then transferred to individual tubes containing BHI broth and incubated for 24 h. Culture media turbidity was evaluated for absorbance over a period of 14 days using a microplate reader. It was observed that the lower the absorbance, the stronger the antimicrobial action. Statistical analysis was performed (two-way anova and Bonferroni test, p < 0.001). RESULTS: Chlorhexidine and tea tree oil inhibited Candida up to the 14th day, whereas antifungal effect of fluconazole was not significant after the 7th day. CONCLUSION: Tea tree oil and chlorhexidine gluconate are more effective than fluconazole in inhibiting C. albicans growth on heat-polymerised acrylic resin.

Resilient liners: a review.

Resilient liners when used intelligently are an excellent adjunct in removable prosthodontics. However, currently they have to be best considered as temporary expedients because none of the advocated permanent liners have life expectancy comparable to resin denture base. This article reviews the literature regarding their composition, functions, gelation characteristics, bond strength and influence on denture bases. It also presents their drawbacks and attempts made to extend their longevity. A Medline search was completed for the period from 1986 to 2007, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks.