Effect of platform switching on peri-implant bone: A 3D finite element analysis.

STATEMENT OF PROBLEM: A consensus regarding the effects of platform switching on peri-implant marginal bone levels is lacking. Finite element studies have reported contradictory results. PURPOSE: The purpose of this finite element analysis study was to evaluate stress distribution in platform-switched (PS) and platform-matched (PM) implants and their surrounding bone. MATERIAL AND METHODS: An implant (4.5×11 mm) was modeled and screwed into a human mandibular bone block using a computer-aided design (CAD) software program. Two separate models were generated: (1) PM, 4.5-mm implant with 4.5-mm-wide abutment and (2) PS, 4.5-mm implant with 3.5-mm-wide abutment. Implant components were modeled with linear isotropic properties and bones with anisotropic properties. Vertical (200 to 800 N) and oblique (50 to 150 N) forces were applied to each model to simulate occlusal loads. Linear elastic analysis was performed using ANSYS Workbench 16. von Mises equivalent stresses in the implant assemblies and peri-implant bone were calculated and compared with independent samples t test (α=.05). RESULTS: von Mises equivalent stress values under simulated axial and nonaxial occlusal loads were lower for PM than for PS implant assemblies. However, the differences were not statistically significant. Stress within the peri-implant bone was significantly higher for the PM group than for the PS group (P<.001). CONCLUSIONS: Platform switching decreased stress within peri-implant bone and may help limit marginal bone resorption.

Ceramic Fracture in Metal-Ceramic Restorations: The Aetiology.

All dental restorations are liable to failure during function. Failure could be biologic, aesthetic, mechanical or a combination. Ceramic restorations in particular, including metal-ceramics, are prone to mechanical fracture, especially the fracture of veneering porcelain. Fracture of a metal-ceramic restoration jeopardizes function as well as aesthetics. It is equally onerous to manage for both patient and dentist. Optimal management of such cases requires a detailed knowledge of the aetiology behind this phenomenon. The current paper aims to highlight possible causative factors involved in the mechanical failures of metal-ceramic restorations. Clinical relevance: Ceramic fracture in metal-ceramic crowns and fixed partial dentures is routinely encountered in dental clinics. Knowledge of the aetiology is required to diagnose and manage such cases accurately as well as to avoid these errors in future.