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Comparison of stress in implant-supported monolithic zirconia fixed partial dentures between canine guidance and group function occlusal patterns: A finite element analysis.

ABSTRACT: Background. Monolithic zirconia is an emerging material for crowns and bridges. The possibility of full digital design has made it an attractive alternative material for implant-supported prostheses. A proper design is vital in the success of such a prosthesis like any other. This study, in the shortage of scientific evidence, has tried to assess the stress distribution of occlusal forces inside the implant-prosthesis system of a 3-unit bridge made of monolithic zirconia. Methods. A 3-unit monolithic zirconia bridge supported by two implant fixtures placed on the teeth #13 and #15 was digitalized. It was converted to a mesh of 59000 nodes and 34000 elements. Five types of occlusal forces (one as vertical centric, two at 15º and 30º simulating canine pattern of lateral movement, and two at 15º and 30º simulating group function pattern) were applied. The stress distribution among all the components of the implant-bridge system was assessed using Ansys Workbench 14 software and finite element analysis. Results. The maximum stress was between 286 and 546 MPa, which were found in either the fixture?abutment screw area or in the upper part of the pontic connector between the canine and first premolar. The maximum pressure increased with an increase in the angle of occlusal force. Significantly higher stress was recorded in the group function occlusal pattern. Conclusion. Monolithic zirconia can be promising in designing bridges in the canine?premolar area. However, proper design is necessary with more attention to the connectors and types of occlusal forces.

SUBMITTER: Robati Anaraki M

PROVIDER: S-EPMC6773921 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Comparison of stress in implant-supported monolithic zirconia fixed partial dentures between canine guidance and group function occlusal patterns: A finite element analysis.

Robati Anaraki Mahmood M Torab Ali A Mounesi Rad Taymaz T

Journal of dental research, dental clinics, dental prospects 20190814 2

Background. Monolithic zirconia is an emerging material for crowns and bridges. The possibility of full digital design has made it an attractive alternative material for implant-supported prostheses. A proper design is vital in the success of such a prosthesis like any other. This study, in the shortage of scientific evidence, has tried to assess the stress distribution of occlusal forces inside the implant-prosthesis system of a 3-unit bridge made of monolithic zirconia. Met ...[more]

PMID: 31592107

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Project description:BACKGROUND:Artificial intelligence (AI) is a branch of computer science concerned with building smart software or machines capable of performing tasks that typically require human intelligence. We present a protocol for the use of AI to fabricate implant-supported monolithic zirconia crowns (MZCs) cemented on customized hybrid abutments. METHODS:The study protocol consisted of: (1) intraoral scan of the implant position; (2) design of the individual abutment and temporary crown using computer-aided design (CAD) software; (3) milling of the zirconia abutment and the temporary polymethyl-methacrylate (PMMA) crown, with extraoral cementation of the zirconia abutment on the relative titanium bonding base, to generate an individual hybrid abutment; (4) clinical application of the hybrid abutment and the temporary PMMA crown; (5) intraoral scan of the hybrid abutment; (6) CAD of the final crown with automated margin line design using AI; (7) milling, sintering and characterisation of the final MZC; and (8) clinical application of the MZC. The outcome variables were mathematical (quality of the fabrication of the individual zirconia abutment) and clinical, such as (1) quality of the marginal adaptation, (2) of interproximal contact points and (3) of occlusal contacts, (4) chromatic integration, (5) survival and (6) success of MZCs. A careful statistical analysis was performed. RESULTS:90 patients (35 males, 55 females; mean age 53.3?±?13.7?years) restored with 106 implant-supported MZCs were included in the study. The follow-up varied from 6 months to 3 years. The quality of the fabrication of individual hybrid abutments revealed a mean deviation of 44??m (± 6.3) between the original CAD design of the zirconia abutment, and the mesh of the zirconia abutment captured intraorally at the end of the provisionalization. At the delivery of the MZCs, the marginal adaptation, quality of interproximal and occlusal contacts, and aesthetic integration were excellent. The three-year cumulative survival and success of the MZCs were 99.0% and 91.3%, respectively. CONCLUSIONS:AI seems to represent a reliable tool for the restoration of single implants with MZCs cemented on customised hybrid abutments via a full digital workflow. Further studies are needed to confirm these positive results.

Project description:ObjectivesSingle denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular prosthetics. Therefore, this study assessed patients' occlusal equilibration, muscle activity, and oral health-related quality of life (OHRQoL) receiving milled removable or fixed mandibular implant retained prostheses.Materials and methodsTwenty-two edentulous mandibular ridges patients were randomly distributed into two groups based on the definitive prosthesis received. Group I: Removable mandibular implant-supported overdenture, Group II: Implant retained fixed prosthesis. Occlusal equilibration was evaluated utilizing Occlusense, muscle activity via Electromyograph (EMG) at delivery, after one, and three months. The OHRQoL was evaluated by Oral Health Impact Profile questionnaire (OHIP-19) before delivery and after follow-ups. Data were collected, tabulated, and analyzed, utilizing independent t-test and One-way ANOVA followed Tukey`s post-hoc test. Significance level set at P ≤ 0.05.ResultsGroups I &II showed significant improvement in occlusal equilibration, muscle activity and OHRQoL. Group II demonstrated significantly higher improvement than group I in occlusal equilibration associated with muscle activity after 1 month, and in functional limitations domain in OHRQoL questionnaire after 3 months.ConclusionImplant retained mandibular prosthesis showed improvement in occlusal equilibration, muscle activity, and OHRQoL regardless of prosthesis type employed. Fixed implant-supported prosthesis revealed better outcomes than removable mandibular implant-supported overdenture concerning occlusal equilibration, muscle activity, and OHRQoL regarding functional limitations.Clinical relevanceImplant retained mandibular prosthesis is one of best treatment options for single mandibular completely edentulous patients, as dental implants improved occlusal equilibration, muscle activity, and OHRQoL.

Project description:BackgroundThe success rate of implant-supported prostheses for edentulous patients is relatively high. However, the incidence of biological complications, especially peri-implant mucositis and peri-implantitis, increases yearly after the placement of prostheses. The accumulation of pathogenic bacteria adjacent to a prosthesis is the main cause of biological complications. Titanium, one of the classical materials for implant-supported prostheses, performs well in terms of biocompatibility and ease of maintenance, but is still susceptible to biofilm formation. Zirconia, which has emerged as an appealing substitute, not only has comparable properties, but presents different surface properties that influence the adherence of oral bacteria. However, evidence of a direct effect on oral flora is limited. Therefore, the aim of the present study was to assess the effects of material properties on biofilm formation and composition.MethodsThe proposed study is designed as a 5-year randomized controlled trial. We plan to enroll 44 edentulous (mandible) patients seeking full-arch, fixed, implant-supported prostheses. The participants will be randomly allocated to one of two groups: group 1, in which the participants will receive zirconia frameworks with ceramic veneering, or group 2, in which the participants will receive titanium frameworks with acrylic resin veneering. Ten follow-up examinations will be completed by the end of this 5-year trial. Mucosal conditions around the implants will be recorded every 6 months after restoration. Peri-implant submucosal plaque will be collected at each reexamination, and bacteria flora analysis will be performed with 16S rRNA gene sequencing technology in order to compare differences in microbial diversity between groups. One week before each visit, periodontal maintenance will be arranged. Each participant will receive an X-ray examination every 12 months as a key index to evaluate the marginal bone level around the implants.DiscussionThe current study aims to explore the oral microbiology of patients following dental restoration with zirconia ceramic frameworks or titanium frameworks. The features of the microbiota and the mucosal condition around the two different materials will be evaluated and compared to determine whether zirconia is an appropriate material for fixed implant-supported prostheses for edentulous patients.Trial registrationInternational Clinical Trials Registry Platform (ICTRP) ChiCTR2000029470. Registered on 2 February 2020. http://www.chictr.org.cn/searchproj.aspx?

Dataset Information

Comparison of stress in implant-supported monolithic zirconia fixed partial dentures between canine guidance and group function occlusal patterns: A finite element analysis.

Publications

Comparison of stress in implant-supported monolithic zirconia fixed partial dentures between canine guidance and group function occlusal patterns: A finite element analysis.

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