Effect of implant- and occlusal load location on stress distribution in Locator attachments of mandibular overdenture. A finite element study.

PURPOSE: The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS: Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS: Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION: The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

Influence of Implant Positions and Occlusal Forces on Peri-Implant Bone Stress in Mandibular Two-Implant Overdentures: A 3-Dimensional Finite Element Analysis.

The aim of this study was to evaluate and compare the bone stress around implants in mandibular 2-implant overdentures depending on the implant location and different loading conditions. Four 3-dimensional finite element models simulating a mandibular 2-implant overdenture and a Locator attachment system were designed. The implants were located at the lateral incisor, canine, second premolar, and crossed-implant levels. A 150 N unilateral and bilateral vertical load of different location was applied, as was 40 N when combined with midline load. Data for von Mises stress were produced numerically, color coded, and compared between the models for peri-implant bone and loading conditions. With unilateral loading, in all 4 models much higher peri-implant bone stress values were recorded on the load side compared with the no-load side, while with bilateral occlusal loading, the stress distribution was similar on both sides. In all models, the posterior unilateral load showed the highest stress, which decreased as the load was applied more mesially. In general, the best biomechanical environment in the peri-implant bone was found in the model with implants at premolar level. In the crossed-implant model, the load side greatly altered the biomechanical environment. Overall, the overdenture with implants at second premolar level should be the chosen design, regardless of where the load is applied. The occlusal loading application site influences the bone stress around the implant. Bilateral occlusal loading distributes the peri-implant bone stress symmetrically, while unilateral loading increases it greatly on the load side, no matter where the implants are located.

The selection criteria of temporary or permanent luting agents in implant-supported prostheses: in vitro study.

PURPOSE: The use of temporary or permanent cements in fixed implant-supported prostheses is under discussion. The objective was to compare the retentiveness of one temporary and two permanent cements after cyclic compressive loading. MATERIALS AND METHODS: The working model was five solid abutments screwed to five implant analogs. Thirty Cr-Ni alloy copings were randomized and cemented to the abutments with one temporary (resin urethane-based) or two permanent (resin-modified glass ionomer, resin-composite) cements. The retention strength was measured twice: once after the copings were cemented and again after a compressive cyclic loading of 100 N at 0.72 Hz (100,000 cycles). RESULTS: Before loading, the retention strength of resin composite was 75% higher than the resin-modified glass ionomer and 2.5 times higher than resin urethanebased cement. After loading, the retentiveness of the three cements decreased in a non-uniform manner. The greatest percentage of retention loss was shown by the temporary cement and the lowest by the permanent resin composite. However, the two permanent cements consistently show high retention values. CONCLUSION: The higher the initial retention of each cement, the lower the percentage of retention loss after compressive cyclic loading. After loading, the resin urethane-based cement was the most favourable cement for retrieving the crowns and resin composite was the most favourable cement to keep them in place.