Biomechanical Effect of Prosthetic Connection and Implant Body Shape in Low-Quality Bone of Maxillary Posterior Single Implant-Supported Restorations.

PURPOSE: Dental implant macrogeometry parameters, such as the prosthetic connection and implant body shape, can influence the biomechanical behavior of the restoration. Using tridimensional finite element analysis (3D-FEA), this study evaluated the biomechanical behavior of two implant macrodesign parameters (prosthetic connection and implant body shape) in low-quality bone. MATERIALS AND METHODS: Four groups were obtained by the combination of external hexagon and Morse taper connections, and cylindrical and conical body shapes. Implants (4ø × 10-mm) with a microthread collar and triangular thread shape received a single abutment and monolithic zirconia crown on the maxillary first molar. Bone was constructed on the basis of cross-sectional images of the posterior human maxilla obtained by cone beam computed tomography. A 200-N axial loading was distributed on five points of the occlusal surface. Data were acquired as shear stress (τmax, in megapascals) and strain (εmax, in micrometers) in the cortical and trabecular bone. RESULTS: The external hexagon groups generated higher shear stress/strain values compared with Morse taper groups in the cortical bone, regardless of implant body shape. In the trabecular bone, the highest τmax and εmax values were observed in the Morse taper conical implant group (6.94 MPa and 21.926 × 10⁻4 µm, respectively), and the lowest values were observed in the external hexagon cylindrical implant group (4.47 MPa and 9.3155 × 10⁻4 µm, respectively). CONCLUSION: The magnitudes of shear stress and strain in the peri-implant region of low-quality bone was lower with the use of Morse taper connection and cylindrical implants compared with external hexagon connection and conical implants.

Direct adhesive pin-retained restorations for severely worn dentition treatment: a 1.5-year follow-up report.

Excessive occlusal surface wear can result in occlusal disharmony, functional and esthetic impairment. As a therapeutic approach, conventional single crowns have been proposed, but this kind of treatment is complex, highly invasive and expensive. This case report describes the clinical outcomes of an alternative minimally invasive treatment based on direct adhesive-pin retained restorations. A 64-year-old woman with severely worn dentition, eating problems related to missing teeth and generalized tooth hypersensitivity was referred for treatment. Proper treatment planning based on the diagnostic wax-up simulation was used to guide the reconstruction of maxillary anterior teeth with direct composite resin over self-threading dentin pins. As the mandibular remaining teeth were extremely worn, a tooth-supported overdenture was installed. A stabilization splint was also used to protect the restorations. This treatment was a less expensive alternative to full-mouth rehabilitation with positive esthetic and functional outcomes after 1.5 years of follow-up.