Evaluation of Implant Location on Fiber-Reinforced Maxillary Overdentures with Finite Element Method.

PURPOSE: To examine and compare stress values of implants, highest tensile and compressive values, and their distribution in cortical and trabecular bone near and around the implant region using different materials (aramid fiber, glass fiber, polyethylene fiber, carbon fiber, and cobalt-chromium [Co-Cr] alloy). Four dental implants were placed in the maxillary crest with two different location scenarios, and the 3D finite element analysis method was used to evaluate stress characteristics. MATERIALS AND METHODS: Two maxillary models were created in which the implants were placed in different locations (lateral and first premolar, canine and second premolar). Four implant-supported overdenture prostheses were reinforced, applying Co-Cr alloy, glass fiber, aramid fiber, and carbon fiber. Static loads of 200 N were applied on the first molar region using the food stuff method. Stresses around the implants and denture-bearing areas and compression and tensile stresses on the cortical and trabecular bone were evaluated. RESULTS: In all tested models, the highest von Mises stresses on implants and prostheses were observed in aramid fiber-reinforced overdentures. This was followed by glass fiber, Co-Cr alloy, and carbon fiber groups, respectively. It was observed that the lowest tensile and highest compression stress values in cortical and trabecular bone occurred in prostheses supported with carbon fiber. In all infrastructure materials, the design in which the implants were placed bilaterally in the lateral teeth and the first premolar region was found to be advantageous in terms of stress levels and distribution. CONCLUSION: High elastic modulus fiber-reinforced overdenture prostheses transmitted less stress to implants and surrounding tissues than Co-Cr alloy. Anteriorly placed implant design illustrated lower stress values in the prosthesis, implant, and cortical and trabecular bone, and this placement design may increase the survival rates of both dental implants and overdentures. In light of this study, fibers can be recommended for clinical use and securely applied as an alternative material to metal support. Int J Oral Maxillofac Implants 2023;38:523-532. doi: 10.11607/jomi.9946.

Evaluation of Efficacy of Various Surface Conditioning Methods on the Repair Bond Strength of Composite to Different Fracture Types of Zirconia Ceramics.

The aim of this study was to investigate the effects of different surface treatment methods on shear bond strength between composite resin and different levels of zirconia ceramic. Laser surface-conditioning procedures have been reported as effective method to increase repair bond strength of composite to zirconia ceramics. Detailed information of effects of Er,Cr:YSGG laser treatment with different pulse rates on the zirconia ceramics is lacking in the literature. 120 disc-shaped specimens were prepared including zirconia, veneering ceramic, and 50% veneering ceramic-50% zirconia surfaces. Four different surface treatments were applied to the specimens. These were grinding with diamond bur, sandblasting, and short and long pulse rates of Er,Cr:YSGG laser irradiation. An intraoral ceramic repair kit was used to repair specimens, and shear bond strength was performed on the composite resin to each specimen. The highest mean bond strength was seen in the veneering ceramic surface that was ground using a diamond bur, and the lowest mean bond strength value was observed in the same surface that was treated with long pulse laser irradiation. The sandblasting with alumina particles exhibited lower mean repairing bond strength among the rest of used methods in this study for the group which contained half of the veneering ceramic and half of the zirconia. Sandblasting and Er,Cr:YSGG laser using surface treatment procedures obtained appropriate bond strength for the group that included 50% veneering ceramic-50% zirconia, because of no significant differences observed among the applied surface conditioning methods in this group.

Repair bond strength of composite to Er,Cr:YSGG laser irradiated zirconia and porcelain surfaces.

BACKGROUND: Fracture or chipping are major concerning failures of an all-ceramic restoration. Repairing of the failure restoration using intra-oral technique is time saving and cost effective treatment modality. The present study was proposed to evaluate effect of Er,Cr:YSGG laser irradiation on shear bond strength between zirconia/porcelain and composite resin. METHODS: Thirty zirconia and thirty zirconia based porcelain disc shape specimens were prepared. Three different surface treatment procedure were applied the specimens. For control groups (Group ZC and PC), instruction manual of an intra-oral porcelain repair system was followed. Different pulse rates of Er,Cr:YSGG laser irradiation (short and long pulses) were applied to zirconia and porcelain surfaces for other groups (Group ZS, ZL, PS, and PL). Porcelain repair kit was used to repair specimens using standard cylindrical teflon mold (2 × 2 mm). Repair bond strength of the repaired specimens was tested using a universal testing machine. RESULTS: Highest mean bond strength value was observed at Group PC that was significantly higher than laser applied porcelain groups. Long pulse laser irradiation illustrated that increased mean bond strength compared to short pulse application on to the porcelain surface. Laser applied zirconia groups showed better mean bond strength than Group ZC, but differences between the groups were not statistically significant. CONCLUSION: Different modes of Er,Cr:YSGG laser irradiation enhanced repair bond strength of the composite resin to zirconia, but these were not significant. Following the instruction manual for surface treatment on the porcelain surface was better method than Er,Cr:YSGG laser surface conditioning.

Effects of Low-Profile Stud Attachment Configurations on Stress Distribution Characteristics of Implant-Retained Overdentures.

PURPOSE: Implant-retained mandibular overdentures are a proven treatment modality for edentulous patients. Low-profile stud attachments may allow divergence between the abutments up to 40 degrees. The purpose of this study was to investigate load transfer characteristics of various locations and nylon male configurations of low-profile stud attachment-retained overdentures. MATERIALS AND METHODS: Three tapered dental implants were placed into three photoelastic mandibular models. The center implants were placed vertically onto the midline, and the distal implants were inclined 20 degrees corresponding to centralized implants. Three different distances (11, 18, and 25 mm) between the centralized and the distal implants were set on the models. Low-profile stud attachment (Locator)-retained mandibular overdentures were fabricated for each photoelastic model. Five different nylon male configurations of this stud attachment were established. The load transfer characteristics of the configurations were tested using a circular polariscope. RESULTS: The observed stress levels for the tested configurations were moderate except for group 25C (photoelastic model with 25-mm interimplant distances and clear nylon male), which illustrated a high stress level. For the 11-mm photoelastic model, little or no discernible stress was noted around the dental implants for group 11R (red nylon male), group 11G (green nylon male), and configurations of clear and red or green nylon males (group 11CR [clear and red nylon males] and group 11CG [clear and green nylon males]). CONCLUSION: The applied loads were distributed to the supported dental implants and denture-bearing areas for tested designs. Equitable load distribution and less stress may be gathered using nylon males for angulated implants (red and green) when dental implants are placed inclined.

Evaluation of the retention characteristics of various stud attachment systems for implant retained overdenture.

PURPOSE: The purpose of the study was to analyze and compare retention characteristics of different stud attachments including a standard and two low profile attachments on two implant embedded test models. METHODS: Three different stud attachment systems (Ball attachment and two different low profile stud attachments - Equator and Locator) were used in this study. Two dental implants were placed vertically into a custom-made acrylic resin block within a 22 mm distance. Strong and soft nylon inserts of each attachment system were tested using cyclic dislodgement test for 24 months simulation. Maximum forces during the test were recorded and 10 consecutive data at baseline, 1st to 24th months were analyzed. Repeated measures ANOVA and post-hoc Tukey's test (p ≤0.05) were used for statistical analysis. RESULTS: Retentive forces of the tested attachments varied from 30.7 to 93.75 N at the baseline. The highest initial mean retention (93.75 N) was observed in Group LC (locator attachment with clear nylon inserts) and the lowest initial mean retention (30.7 N) was detected in both Group BO (ball attachment with orange nylon inserts) and Group EY (equator with yellow nylon inserts). After the 24 months simulation, locator groups illustrated more light retention than other tested attachment systems. CONCLUSIONS: All tested attachment systems showed a significant decrease in retention value at the end of the simulated period. The locator attachment had significantly higher reduction in retention values compared to other low profile stud attachment equator and ball attachment.

Load Transfer Characteristics of Three-Implant-Retained Overdentures with Different Interimplant Distances.

PURPOSE: Implant-retained overdentures are the first choice of rehabilitation for edentulous mandibles. Bone morphology and anatomical landmarks may be influenced by the location and angulation of implants and distances between the implants. The purpose of this study was to investigate stress distribution characteristics and to compare stress levels of three different attachment designs of three-implant-retained mandibular overdentures with three different interimplant distances. MATERIALS AND METHODS: Three photoelastic mandibular models with three implants were fabricated using an edentulous mandible cast with moderate residual ridge resorption. The center implants were embedded parallel to the midline, and the distal implants were aligned at a 20-degree angulation corresponding to the center implants. Distances between the center and distal implants were set at 11, 18, and 25 mm at the photoelastic models. Bar, bar-ball, and Locator attachment-retained overdentures were prepared for the models. Vertical loads were applied to the overdentures, and stress levels and distribution were evaluated by a circular polariscope. RESULTS: The greatest observed stress level was moderate for the tested overdenture designs. The Locator attachment system showed the lowest stress level for the 11-mm and 25-mm photoelastic models. The bar attachment design transmitted less stress compared with the other tested designs for the 18-mm photoelastic model. CONCLUSION: Stresses were observed on the loaded side of the photoelastic models. The lowest stress was found with the Locator and bar attachments for the 11-mm photoelastic model, which transmitted little or no discernible stress around the implants.

Efficacy of Palatal Applications on Fracture Resistance of Reattached Maxillary Central Incisors: An In Vitro Study.

The purpose of this study was to evaluate the effects of different palatal applications on fracture strength of the fractured anterior tooth. Sixty caries-free human maxillary incisors were used. Endodontic treatments of the teeth were performed. Then, the teeth were divided randomly into five groups (n = 12). Crowns of all teeth in groups A-D were cut with diamond discs at a fixed distance of 3 mm from the incisal margin in a plane normal to the buccal surface. In all groups, coronal fragments were reattached to the remaining teeth by bonding with hybrid composite resin. After then, the teeth were restored to the following; group A, bonding and palatal laminate; group B, bonding and creation of a vertical groove; group C, bonding and creation of two slot grooves; group D, bonding only; and group E, intact tooth. It was lesser in group B than in groups C and E (p = 0.007 and p = 0.006, resp.) and lesser in group D than in groups A, C, and E (p = 0.002, p < 0.001, and p < 0.001, resp.). Within the limitations of this in vitro study, it can be concluded that methods employing palatinal laminate and small grooves are clinically feasible for the reattachment of tooth fragments to incisors.

Load Transfer Characteristics of Various Designs of Three-Implant-Retained Mandibular Overdentures.

PURPOSE: Many different attachment systems (eg, bars, studs, magnets, telescopic copings) have been used to retain overdentures. The current study aimed to investigate the load transfer characteristics and to compare the stress levels of four attachment designs for mandibular overdentures retained by one central implant and two inclined distal implants. MATERIALS AND METHODS: Photoelastic mandibular models fabricated with three screw-type implants (Tapered Screw-Vent, 3.75 × 13 mm) were placed in the parasymphyseal area. The center implant was vertically oriented to the midline, and the other implants were embedded in the canine areas with a 20-degree angulation relative to the center implant. Four overdentures with different attachment designs (bar, bar/ball, bar/distally placed Rk-1s, and Locators) were studied in the context of this model. Vertical loads (100 N) were applied to the central fossa of the right first molar area of each overdenture. Stress levels that developed in the denture-bearing areas and around the implants were observed photoelastically and evaluated visually. RESULTS: The studied attachment designs showed low and moderate stress levels. The greatest stress was found with the bar/ball design, while the lowest stress levels were observed with the Locator attachment design. CONCLUSION: Stresses were concentrated on the loaded side for each design. All tested designs experienced moderate stress around the posterior edentulous area. None of the designs experienced more than moderate stress. The lowest stress was noted with the Locator attachments, which transmitted little discernible stress around the implants.

A technique for retrofitting a metal ceramic crown to an attachment-retained removable partial denture: a clinical report.

In dental applications, precision attachments have been used to retain removable partial dentures (RPDs) for several decades. Various types of extracoronal attachments are commonly used in combination with fixed partial dentures and RPDs to achieve retention and stability. Fracture of the framework, fracture of the roots or teeth, and irretrievable decrease of retention are common reasons for a failed attachment-retained RPD. Another complication of metal ceramic crowns with precision attachment is decementation of the crowns. When fixed components of the attachment-retained RPD fail, the traditional treatment approach requires remaking both the fixed and removable components of the attachment-retained RPD. This technique describes retrofitting of a metal ceramic crown to a resilient attachment-retained RPD.

A simplified technique for solving the transfer problem of implant-supported fixed partial dentures for patients with microstomia.

Techniques for treating a fully or partially edentulous patient with microstomia have been developed to overcome the challenge of accessing the oral cavity. Management of the problems associated with providing implant-supported fixed partial dentures for patients with microstomia has not been well reported. This article describes a solution for the transfer problem that occurs when making an impression of an implant-supported fixed partial dentures for patients with microstomia.

Addition of a pontic to all-ceramic Turkom-Cera fixed partial denture restorations.

High-strength all-ceramic materials are commonly used in dentistry. When complications occur in an all-ceramic restoration, the restoration is usually replaced. This article describes the time-saving ability and cost-effectiveness of this novel technique for the addition of a pontic in two complicated clinical cases. Turkom-Cera(™) [Turkom-Ceramic (M) Sdn. Bhd.] with aluminum oxide (99.98%) is an all-ceramic system that offers the option of addition of a new pontic to the sintered framework. The new pontic was cut off from an alumina blank [Turkom-Ceramic (M) Sdn. Bhd.], moistened, and attached to the framework using alumina gel [Turkom-Ceramic (M) Sdn. Bhd.]. The framework was veneered with veneering porcelain (Vita VM 7; VITA Zahnfabrik). The two cases presented here involving the addition of a pontic to sintered framework were followed up for at least 1 year. No complication was detected or reported by the patients. Alumina- and zirconia-based ceramics are particularly suitable for for all-ceramic restorations in high-stress bearing areas. However, replacement of a failed all-ceramic restoration is not the most practical solution, considering both cost and tooth-related factors. This attractive feature of the Turkom-Cera allows the repair of a fractured ceramic coping or the addition of a new pontic to restorations.

A technique for fabrication of an extracoronal attachment-retained removable partial denture to fit an existing fixed partial denture.

Precision attachments have been used for many years to retain removable partial dentures (RPDs). Common reasons for a failed attachment-retained RPD are fracture of the framework, fracture of the roots or teeth, and irretrievable decrease of retention. When an RPD framework major connector has been fractured, it should be remade. This article describes a technique to remake a fractured mandibular RPD using cast round profile attachment analogs without the need for replacement of the fixed partial denture.