Stress evaluation of implant-abutment connections under different loading conditions: a 3D finite element study.

This study evaluated the effects of axial and oblique occlusal loading on implant-supported partial dentures with different connection systems (external hexagon, internal hexagon, and Morse taper). Upon axial loading, all systems presented similar stress values. Stress values increased under oblique loading. Stress distribution changed for some of the internal connection structures. It can be concluded that oblique load increases stress on bone structures and prosthetic components. Internal connection system implants present more favorable stress distribution patterns than do external connection system implants.

Influence of crown-to-implant ratio on stress around single short-wide implants: a photoelastic stress analysis.

PURPOSE: The aim of this study was to evaluate the photoelastic fringe patterns around two short-wide implants supporting single crowns with different crown-to-implant (C/I) ratios. MATERIALS AND METHODS: External hexagon (EH) cylindrical implants (5 × 7 mm) or Morse Taper (MT) conical implants (5 × 6 mm) were embedded individually into photoelastic resin blocks. Each implant received a single metal-ceramic crown, with a C/I ratio of 1:1 or 2:1 (n = 10). Each set was positioned in a polariscope and submitted to a 0.5 kgf compressive load, applied axially or obliquely (30°). The polariscope images were digitally recorded, and based on isoclinal and isochromatic fringes, the shear stress was calculated at 5 predetermined points around each implant. Data were analyzed by two-way ANOVA (α = 0.05). RESULTS: Under axial loading, the stress was concentrated at the crestal region, and there were no differences between C/I ratio or implant types. In contrast, under oblique loading, EH implants showed lower stress values than the MT group and the 2:1 C/I ratio showed higher stress concentration for both implant types (p < 0.05). Moreover, MT implants showed stress distribution through a higher area than the EH implant did, with a tendency to direct the stress toward the implant's apex under oblique loading. CONCLUSION: MT conical short-wide implants showed higher stress values that were distributed through a higher area directed to the implant apex. The C/I ratio influences the stress distribution only under oblique loading.

Photoelastic stress analysis of mandibular fixed prostheses supported by 3 dental implants.

PURPOSE: To observe the photoelastic stress patterns generated around implants in relation to variations in the diameter and total number of implants supporting fixed complete-arch mandibular frameworks. MATERIALS AND METHODS: Three different implant configurations were analyzed (n = 3): 5 standard implants with diameters of 3.75 mm (C), 3 standard implants with diameters of 3.75 mm (3S), and 3 wide implants with diameters of 5.0 mm (3W). The samples were subjected to a vertical compressive load (1.33 kgf) applied at the end of the distal cantilever of the framework. The shear stresses were calculated around the implants, and the data were analyzed using one-way analysis of variance. RESULTS: The implants nearest to the loading showed higher stress values regardless of the group. The C group showed lower shear stress when compared with the other groups (P = 0.001). No significant difference was observed between the 3W and 3S groups (P = 0.785). CONCLUSION: A reduction in the number of implants, regardless of the implant diameter, showed higher stress concentration around the implants. Five-implant configuration showed lower stress concentration and seems to be more biomechanically predictable.

Photoelastic analysis of the distribution of stress in different systems of overdentures on osseous-integrated implants.

OBJECTIVE: The aim of this study was to evaluate the distribution of generated stress around implants and adjacent bone tissue using different implant-retained overdenture designs through photoelastic analysis. METHODS: Over an edentulous human mandible, achieved from a human model, 2 or 4 microunit analog abutments were embedded (Master; Conexao Systems Prosthodontics, São Paulo, Brazil), settled in the interforaminal region. Three models of photoelastic resin (Araltec Chemicals Ltda, Hunstman, Guarulhos, São Paulo, Brazil), with 2 or 4 incorporated implants and microunit abutments, were obtained from molds using silicone for duplication. Inclusion, finishing, and polishing procedures were applied on the frameworks. This study was based on 3 different mechanisms of implant-retained mandibular overdentures: O'ring (GI), bar-clip (GII) (both with 2 implants), and their association (GIII) (with 4 implants). After the adaptation of each overdenture system on the photoelastic models, 100-N alternate occlusal loads were applied on back-side and front-side regions. The photoelastic analysis was made with the aid of a plain polariscope linked to a digital camera, Sony Cybershot α100, which allowed visualization of the fringes and registration of images on digital photographs. RESULTS: The results demonstrated higher tension concentrated over the GIII, with a flat distribution of stress to the posterior ridge and overload on the posterior implants. GI showed the smaller stress level, and GII, intermediate level; there was distribution of stress to the posterior ridge in these 2 groups. CONCLUSION: The use of bar attachment proved to be a better alternative, because it showed a moderate level of tension with a more uniform stress distribution and possessed higher retention than did the ball system.

Influence of prosthetic screw material on joint stability in passive and non-passive implant-supported dentures.

OBJECTIVES: This study evaluated the influence of prosthetic screw material on joint stability in implantsupported dentures at two levels of fit. METHODS: Ten mandibular implant-supported dentures were fabricated. Twenty cast models were fabricated using these dentures. Four groups (n=10) were tested, according to the vertical fit of the dentures [passive and non-passive] and prosthetic screw materials [titanium (Ti) or gold (Au) alloy]. The one-screw test was performed to quantify the vertical misfits using an optic microscope. The loosening torque for the prosthetic screws was measured 24 hours after the tightening torque (10 Ncm) using a digital torque meter. Data were analyzed by two-way ANOVA and Tukey's test (alpha=0.05). RESULTS: Overall, dentures with passive fit and Ti screws resulted in significantly higher loosening torque of the prosthetic screws (p<0.05). No significant interaction was found between fit level and screw material (p=0.199). The prosthetic screw material and fit of implant-supported dentures have an influence on screw joint stability. Ti screws presented higher joint stability than Au screws and minimum of misfit should be found clinically to improve the mechanical behavior of the screw joint.

Influence of laser-welding and electroerosion on passive fit of implant-supported prosthesis.

This study investigated the influence of laser welding and electroerosion procedure on the passive fit of interim fixed implant-supported titanium frameworks. Twenty frameworks were made from a master model, with five parallel placed implants in the inter foramen region, and cast in commercially pure titanium. The frameworks were divided into 4 groups: 10 samples were tested before (G1) and after (G2) electroerosion application; and another 10 were sectioned into five pieces and laser welded before (G3) and after (G4) electroerosion application. The passive fit between the UCLA abutment of the framework and the implant was evaluated using an optical microscope Olympus STM (Olympus Optical Co., Tokyo, Japan) with 0.0005mm of accuracy. Statistical analyses showed significant differences between G1 and G2, G1 and G3, G1 and G4, G2 and G4. However, no statistical difference was observed when comparing G2 and G3. These results indicate that frameworks may show a more precise adaptation if they are sectioned and laser welded. In the same way, electroerosion improves the precision in the framework adaptation.

Influence of simulated microwave disinfection on complete denture base adaptation using different flask closure methods.

STATEMENT OF PROBLEM: Denture microwave disinfection may result in dimensional changes that may distort the acrylic resin base, causing discomfort to the patient. PURPOSE: The purpose of this study was to determine the effect of simulated microwave disinfection on maxillary denture base adaptation using 2 different flask closure methods. MATERIAL AND METHODS: Forty stone cast-wax base sets were prepared for flasking by the traditional flask closure (TFC) and Restriction System flask closure (RSFC) methods (n=20). The RSFC consists of 2 iron plates to hold the flask during definitive flask closure, maintaining the flask in a closed position after release of pressure. Acrylic resin (Classico) was prepared according to the manufacturer's instructions. After polymerization in water at 74 degrees C for 9 hours, the bases were removed following flask cooling and submitted to conventional finishing with abrasive stones and pumice slurry. Ten bases for each TFC or RSFC method (n=10) were submitted to simulated disinfection (SD) in 150 mL distilled water in a microwave oven at 650 W for 3 minutes; control bases for each TFC or RSFC method (n=10) were not disinfected (ND). Three transverse cuts were made through each stone cast-resin base set, corresponding to the distal of canines, mesial of first molars, and posterior palatal region. Measurements were made in the bases using an optical micrometer at 5 points for each cut to determine adaptation: left and right marginal limits of the flanges, left and right ridge crests, and midline. Collected data were submitted to 3-way ANOVA followed by the Tukey HSD test (alpha=.05). RESULTS: Dimension gap values (mm) for ND denture bases prepared by the RSFC method were significantly lower (0.16 +/- 0.05) when compared to the TFC method (0.21 +/- 0.05) (P<.027). Simulated disinfection statistically improved the base adaptation in bases prepared by the TFC method (0.17 +/- 0.03), compared to the ND bases (0.21 +/- 0.05) (P<.027). Simulated disinfection statistically significantly improved base adaptation (P<.0001) only in the distal of canines (ND=0.13 +/- 0.01; SD=0.11 +/- 0.03) and the posterior palatal region (ND=0.25 +/- 0.04; SD=0.21 +/- 0.01) when bases were prepared by the TFC method. CONCLUSION: Simulated disinfection by microwave energy improved denture base adaptation when the TFC method was used, but did not statistically alter base adaptation for the RSFC method.

Immediate function in the edentulous mandible: replacement of a lost implant using prefabricated guides.

This article describes a technique for replacement of a lost implant. The procedure involves the use of templates, drill guides, and drills of the system to replace a 4.5-mm-wide lost implant with a 5.0-mm-wide implant. The surgical procedure was simplified to optimize the healing process and to be more comfortable for the patient. The accuracy of the templates and guides allowed for ideal position of the implant and the immediate use of the original fixed implant-supported prosthesis.