RESUMEN
OBJECTIVE: To assess the reliability of implant stability measurements recorded with the Periotest device and to investigate the differences in values when these measurements were taken on implant retained crowns and healing abutments. MATERIALS AND METHODS: Fifty-six implants in eight synthetic bone blocks were used to carry out implant stability measurements using the Periotest device by two different operators. Each block constituted an example of bone of density D1, D2, D3, or D4, and two blocks of each density were used. The healing abutments placed were of a height to allow approximately 6 mm of the implant-abutment complex to be supracrestal and temporary crowns were made to match the dimensions of an average central incisor. Descriptive statistics were used to describe the perio test values (PTVs) at each of the different heights on the implant abutments and implant crowns. Means for each site were calculated and distribution of data assessed using the Kruskal Wallis test. The interclass correlation coefficient (ICC) was used to determine the relationship between the PTVs recorded on the implant abutments and implant crowns. RESULTS: The mean PTV (±standard devidation) recorded across all sites was 5.57 ± 11.643 on the implant abutments, and 12.27 ± 11.735 on the temporary crowns. Excellent/good inter-operator ICCs were recorded for the mid-abutment site in all bone blocks D1-D4 (ICC = 0.814, p < 0.001, ICC = 0.922, p < 0.001, ICC = 0.938, p < 0.001, ICC = 776, p < 0.001). For mid crown sites, ICC between operators was excellent/good only for recordings in D2 bone (ICC = 0.897, p < 0.001). CONCLUSIONS: Periotest device seems to be able to reliably measure implant stability across all types of bones when the implant stability is assessed at approximately 3 mm coronal to the implant platform for abutments and 4.5 mm for implant supported single crowns.
Asunto(s)
Coronas , Pilares Dentales , Humanos , Retención de Prótesis Dentales/instrumentación , Retención de Prótesis Dentales/métodos , Reproducibilidad de los Resultados , Implantes Dentales , Prótesis Dental de Soporte Implantado/instrumentación , Prótesis Dental de Soporte Implantado/métodos , Técnicas In Vitro , Diseño de Implante Dental-Pilar/instrumentación , Diseño de Implante Dental-Pilar/métodos , Densidad ÓseaRESUMEN
OBJECTIVES: To evaluate and compare the magnitude and distribution of stresses generated on implants, abutments and first molar metal-ceramic crowns using finite element analysis. METHODS: Preliminary three-dimensional models were created using the computer-aided design software SolidWorks. Stress and strain values were observed for two distinct virtual models: model 1 - Morse taper and solid abutment; model 2 - Morse taper and abutment with screw. A load (250 N) was applied to a single point of the occlusal surface at 15° to the implant long axis. Von Mises stresses were recorded for both groups at four main points: 1) abutment-retaining screws; 2) abutment neck; 3) cervical bone area; 4) implant neck. RESULTS AND CONCLUSION: Model 1 showed a higher stress value (1477.5 MPa) at the abutment-retaining screw area than the stresses found in model 2 (1091.1 MPa for the same area). The cervical bone strain values did not exceed 105 µm for either model.
Asunto(s)
Humanos , Implantes Dentales , Diseño de Prótesis Dental/instrumentación , Análisis de Elementos Finitos , Análisis del Estrés Dental , Diseño de Implante Dental-Pilar/instrumentación , Estrés Mecánico , Diseño de Prótesis Dental/métodos , Diseño Asistido por Computadora , Coronas , Módulo de Elasticidad , Diseño de Implante Dental-Pilar/métodos , Mandíbula/diagnóstico por imagen , Modelos AnatómicosRESUMEN
The present study evaluated the interchangeability of prosthetic components for external hexagon implants by measuring the precision of the implant/abutment (I/A) interface with scanning electron microscopy. Ten implants for each of three brands (SIN, Conexão, Neodent) were tested with their respective abutments (milled CoCr collar rotational and non-rotational) and another of an alternative manufacturer (Microplant) in randomly arranged I/A combinations. The degree of interchangeability between the various brands of components was defined using the original abutment interface gap with its respective implant as the benchmark dimension. Accordingly, when the result for a given component placed on an implant was equal to or smaller then that gap measured when the original component of the same brand as the implant was positioned, interchangeability was considered valid. Data were compared with the Kruskal-Wallis test at 5% significance level. Some degree of misfit was observed in all specimens. Generally, the non-rotational component was more accurate than its rotational counterpart. The latter samples ranged from 0.6-16.9 µm, with a 4.6 µm median; and the former from 0.3-12.9 µm, with a 3.4 µm median. Specimens with the abutment and fixture from Conexão had larger microgap than the original set for SIN and Neodent (p<0.05). Even though the latter systems had similar results with their respective components, their interchanged abutments did not reproduce the original accuracy. The results suggest that the alternative brand abutment would have compatibility with all systems while the other brands were not completely interchangeable.
O presente estudo avaliou a intercambiabilidade dos componentes protéticos de implantes de hexágono externo medindo-se a precisão da interface implante/pilar com microscopia eletrônica de varredura. Foram utilizados dez implantes para cada uma de três marcas (SIN, Conexão, Neodent) com seus respectivos pilares (base metálica de CoCr , rotacional e não rotacional) e um de marca alternativa (Microplant) em um arranjo com todas as combinações de implante/pilar possíveis. O valor de referência para a intercambiabilidade das várias marcas de componentes foi definido pela diferença do pilar original para com seu respectivo implante. Dessa maneira, a intercambiabilidade foi considerada válida quando o resultado para um dado pilar colocado sobre um implante fosse igual ou menor que a diferença medida quando o pilar da mesma marca do implante fora posicionado. Os dados foram comparados pelo teste de Kruskal-Wallis com nível de significância de 5%. Um grau de desajuste foi observado em todos os espécimes. De uma maneira geral, o pilar anti-rotacional foi mais preciso do que o rotacional. Estes variaram de 0,6-16,9 µm, com mediana 4,6 µm; enquanto o anti-rotacional foi de 0,3-12,9 µm, com mediana de 3,4 µm. Os espécimes com o pilar e o implante Conexão tiveram uma diferença maior que o conjunto original para SIN e Neodent (p<0,05). Apesar destes últimos apresentarem resultados semelhantes com seus respectivos pilares, quando trocados não mantiveram a mesma precisão original. Os resultados sugerem que a marca alternativa seria a única que apresentaria compatibilidade com todos os sistemas, enquanto as outras marcas não seriam completamente intercambiáveis.
Asunto(s)
Aleaciones de Cromo/química , Diseño de Implante Dental-Pilar/métodos , Implantes Dentales/normas , Ajuste de Prótesis/métodos , Diseño de Implante Dental-Pilar/instrumentación , Microscopía Electrónica de RastreoRESUMEN
El propósito de esta revisión fue explorar el concepto de Plataforma modificada en Implantología y su desempeño clínico. La definición de plataforma modificada será considerada junto con una revisión de literatura pertinente, con la finalidad de proveer directrices basadas en evidencias científicas. Fueron utilizadas las siguientes bases de datos: Pubmed, Biblioteca Cochrane e ISI. Los criterios de inclusión fueron: artículos clínicos, de laboratorio y de revisión sobre el tema, en lengua inglesa. Fueron seleccionados 40 artículos, utilizando los descriptores "plataforma switching dental implants", "platform shifting and dental implants", "expanded platform dental implant". De acuerdo con esta revisión, los implantes plataforma modificada presentan una tasa de remodelación ósea ( media < 1mm) más favorable que los implantes convencionales. Este hecho parece ser resultante de un conjunto de factores biológicos y mecánicos. El concepto de plataforma modificada tiene importante relevancia en el área estética
The purpose of this revision was to explore the concept of Platform Switching in implantology and its acting in the clinical practice. The concept of platform switching will be considered together with a revision of pertinent literature, with the purpose of providing guidelines based on scientific evidences. The following databases were used: Pubmed, Library Cochrane and ISI in the last 17 years. The inclusion approaches were: clinical articles, laboratorials and of revision on the topic, in English language. 41 articles were selected, using the describers "platform switching dental implants", "platform shifting and dental implants", "expanded platform dental implant". In accordance with this revision, implant them platform switching they present a rate of more favorable bony remodeling that you implant them conventional. This fact seems to be resulting of a group of biological factors and mechanics. The concept of platform switching has important relevance in the aesthetic area