A finite element analysis to study the stress distribution on distal implants in an all-on-four situation in atrophic maxilla as affected by the tilt of the implants and varying cantilever lengths.

AIM: The aim of this work was to evaluate stress distribution on implants in All-on-Four situation with varying distal implant angulations (30°,40°,45°) and varying cantilever lengths (4 mm, 8 mm, 12 mm, 16 mm) in atrophic maxilla using finite element analysis. SETTING AND DESIGN: A in vitro study, finite element analysis. MATERIALS AND METHODOLOGY: Three-dimensional finite element model of an edentulous maxilla restored with a prosthesis supported by four implants was reconstructed to carry out the analysis. Three different configurations, corresponding to 3 tilt degrees of the distal implants (30°, 40°, and 45°) were subjected to 4 loading simulations. STATISTICAL ANALYSIS USED: The results of the simulations obtained were evaluated in terms of Von Mises equivalent stress levels at the bone-implant interface. RESULT: From a stress-level viewpoint, the 45° model was revealed to be the most critical for peri-implant bone. In all the loading simulations, the maximum stress values were always found at the neck of the distal implants. With increasing distal implant tilt, cantilever length reduces depending on the quality of bone. At 30° angulation of distal implant a maximum cantilever length of 16 mm may be given if the quality of bone is D3 but only 8 mm cantilever may be recommended if bone quality is D4. At 40° angulation, 16 mm in D3 bone and 0 mm in D4 bone whereas at 45° angulation, it reduces to 12 mm in D3 bone and no cantilever is recommended with D4 bone. CONCLUSION: The 45° tilt induced higher stress values at the bone-implant interface, especially in the distal aspect, than the other 2 tilts analyzed. Stress values increased with increased cantilever length which was further influenced by the distal implant tilt and the quality of the bone.

Comparing two intraoral porcelain repair systems for shear bond strength in repaired cohesive and adhesive fractures, for porcelain-fused-to-metal restorations: An in vitro study.

AIM: The objective of research was to evaluate the shear bond strength of two commercially available intraoral porcelain repair systems, Clearfil repair system (Kuraray) and P and R repair system (Shofu) for repairing cohesive and adhesive fracture in metal-ceramic restorations. SETTINGS AND DESIGN: In vivo - comparative study. MATERIALS AND METHODS: Ninety samples of Nickel-Chromium metal discs were fabricated. Each disc was veneered with 2 mm thickness of ceramic material using custom made metal jig. Samples were divided into control (Group I n = 10) and two test groups (Group II n = 40 and Group III n = 40). Adhesive and cohesive fractures were created in test group samples, Group II (Ceramic substrate or cohesive defect) and Group III (metal substrate or adhesive defect). The samples of ceramic substrate (Group II) and metal substrate (Group III) were further subdivided into A and B containing 20 samples each according to the repair material used (A; Clearfil porcelain repair system and B; P and R porcelain repair system). All specimens were subjected to a standard shear load in the UTM until fracture occurred. Data were analyzed using one-way analysis of variance and post hoc Bonferroni test. STATISTICAL ANALYSIS USED: One-way analysis of variance (ANOVA) and post hoc Bonferroni test. RESULTS: Clearfil repair system showed significantly higher shear bond strength value (29.16 Mpa) as compared to P and R repair system (27.23 Mpa) for cohesive fractures. Whereas if compared for repairing adhesive fractures P and R repair system had significantly higher shear bond strength values (26.59 Mpa) than Clearfil repair system (25.74 Mpa). CONCLUSIONS: From the present study, it was be concluded that for cohesive fracture Clearfil repair system is a better material and for adhesive fractures P and R repair material gives better results.