Biomechanical Evaluation of a Novel Apatite-Wollastonite Ceramic Cage Design for Lumbar Interbody Fusion: A Finite Element Model Study.

OBJECTIVES: Cage design and material properties play a crucial role in the long-term results, since interbody fusions using intervertebral cages have become one of the basic procedures in spinal surgery. Our aim is to design a novel Apatite-Wollastonite interbody fusion cage and evaluate its biomechanical behavior in silico in a segmental spinal model. MATERIALS AND METHODS: Mechanical properties for the Apatite-Wollastonite bioceramic cages were obtained by fitting finite element results to the experimental compression behavior of a cage prototype. The prototype was made from hydroxyapatite, pseudowollastonite, and frit by sintering. The elastic modulus of the material was found to be 32 GPa. Three intact lumbar vertebral segments were modelled with the ANSYS 12.0.1 software and this model was modified to simulate a Posterior Lumbar Interbody Fusion. Four cage designs in different geometries were analyzed in silico under axial loading, flexion, extension, and lateral bending. RESULTS: The K2 design had the best overall biomechanical performance for the loads considered. Maximum cage stress recorded was 36.7 MPa in compression after a flexion load, which was within the biomechanical limits of the cage. CONCLUSION: Biomechanical analyses suggest that K2 bioceramic cage is an optimal design and reveals essential material properties for a stable interbody fusion.

A pilot study of joint stability at the zirconium or titanium abutment/titanium implant interface.

PURPOSE: To compare the interfaces of loaded and unloaded zirconium and titanium abutments with titanium implants using scanning electron microscopy (SEM). MATERIALS AND METHODS: Zirconium and titanium abutments (n = 5 per group; four test and one control) were torque-tightened into titanium implants secured into metal blocks, and computer-aided design/computer-assisted manufacture-based zirconium oxide copings were fabricated and cemented to the abutments with temporary resin-based cement. Specimens of each restoration were subjected to cyclic axial and lateral loading of 30 N at 2 Hz for 500,000 cycles using a servohydraulic test system; control specimens were left unloaded. Then, the abutment/implant assemblies were embedded in acrylic resin, sectioned longitudinally along the midline, and inspected under SEM with x-ray microanalysis. RESULTS: Loosening or fracture of the copings and implant components was not observed after dynamic loading in both groups. SEM and x-ray microanalysis revealed unexpected microleakage of acrylic resin at the interface. Acrylic resin in the implants tightened to the titanium abutments was limited to the cervical part, and the components displayed scratched and smashed regions, suggesting slight deformation of the implant neck. Microleakage and pooling of acrylic resin were observed approaching the screw joint in loaded implants tightened to zirconia abutments, and the amount of microleakage was greater than in the unloaded control specimens, which had a larger microgap than the titanium abutment/titanium implant interface. Loaded zirconia abutments were associated with wear, scratches, and, in one sample, chipping. CONCLUSIONS: Zirconium abutment/titanium implant interface may be susceptible to wear of the abutment coupled with deformation of the implant neck greater than that associated with the conventional titanium abutment/titanium implant interface under dynamic loading.

Fatigue resistance of 2 different CAD/CAM glass-ceramic materials used for single-tooth implant crowns.

PURPOSE: To evaluate the fatigue resistance of 2 different CAD/CAM in-office monoceramic materials with single-tooth implant-supported crowns in functional area. MATERIALS AND METHODS: A metal experimental model with a dental implant was designed to receive in-office CAD/CAM-generated monoceramic crowns. Laterally positioned axial dynamic loading of 300 N at 2 Hz was applied to implant-supported crowns machined from 2 different glass materials for 100,000 cycle. Failures in terms of fracture, crack formation, and chipping were macroscopically recorded and microscopically evaluated. RESULTS: Four of 10 aluminasilicate glass-ceramic crowns fractured at early loading cycles, the rest completed loading with a visible crack formation. Crack formation was recorded for 2 of 10 leucite glass-ceramic crowns. Others completed test without visible damage but fractured upon removal. DISCUSSION: Lack in chemical adhesion between titanium abutment and dental cement likely reduces the fatigue resistance of machinable glass-ceramic materials. However, relatively better fractural strength of leucite glass-ceramics could be taken into consideration. Accordingly, progress on developmental changes in filler composition of glass-ceramics may be promising. CONCLUSION: Machinable glass-ceramics do not possess sufficient fatigue resistance for single-tooth implant crowns in functional area.

Structure and mechanical properties of Cresco-Ti laser-welded joints and stress analyses using finite element models of fixed distal extension and fixed partial prosthetic designs.

STATEMENT OF PROBLEM: The Cresco-Ti System uses a laser-welded process that provides an efficient technique to achieve passive fit frameworks. However, mechanical behavior of the laser-welded joint under biomechanical stress factors has not been demonstrated. PURPOSE: This study describes the effect of Cresco-Ti laser-welding conditions on the material properties of the welded specimen and analyzes stresses on the weld joint through 3-dimensional finite element models (3-D FEM) of implant-supported fixed dentures with cantilever extensions and fixed partial denture designs. MATERIAL AND METHODS: Twenty Grade III (ASTM B348) commercially pure titanium specimens were machine-milled to the dimensions described in the EN10002-1 tensile test standard and divided into test (n = 10) and control (n = 10) groups. The test specimens were sectioned and laser-welded. All specimens were subjected to tensile testing to determine yield strength (YS), ultimate tensile strength (UTS), and percent elongation (PE). The Knoop micro-indentation test was performed to determine the hardness of all specimens. On welded specimens, the hardness test was performed at the welded surface. Data were analyzed with the Mann-Whitney U test and Student's t test (alpha=.05). Fracture surfaces were examined by scanning electron microscopy to characterize the mode of fracture and identify defects due to welding. Three-dimensional FEMs were created that simulated a fixed denture with cantilever extensions supported by 5 implants (M1) and a fixed partial denture supported by 2 implants (M2), 1 of which was angled 30 degrees mesio-axially. An oblique load of 400 N with 15 degrees lingual-axial inclinations was applied to both models at various locations. RESULTS: Test specimens fractured between the weld and the parent material. No porosities were observed on the fractured surfaces. Mean values for YS, UTS, PE, and Knoop hardness were 428 +/- 88 MPa, 574 +/- 113 MPa, 11.2 +/- 0.4%, 270 +/- 17 KHN, respectively, for the control group and 642 +/- 2 MPa, 772 +/- 72 MPa, 4.8 +/- 0.7%, 353 +/- 23 KHN, respectively, for the test group. The differences between the groups were significant for all mechanical properties ( P <.05). For both models, the FEA revealed that maximum principal stresses were concentrated at the framework-weld junction but did not exceed the UTS of the weld joint. CONCLUSION: Within the constraints of the finite element models, mechanical failure of the welded joint between the support and the framework may not be expected under biomechanical conditions simulated in this study.