Search Results (8)

Background: This study aimed to develop an algorithm for modelling tooth–tooth or implant–implant support configurations for a given 4-unit fixed partial denture (FPD). Methods: The algorithm was implemented in Rhinoceros/Grasshopper to automatically generate geometries with varying bone loss (0 mm to 3 mm), support type (tooth–tooth and implant–implant support) and bone quality (D1 to D4) for a 4-unit FPD. Afterward, a finite element analysis was carried out with a load applied to the central connector of the FPD. Stresses in the FPD and the bone around the support were analysed. Results: The results indicated that stresses in the bone were influenced by both the depth of bone loss and bone quality across both support types. The maximum stress in the tested FPD models for tooth–tooth support was not significantly influenced by bone quality; instead, the stress peaks were primarily influenced by the depth of bone loss. For D1 bone, the stresses in FPD and bone increased by 4.79% and 8.86%, respectively, for tooth–tooth support and about 32.67% and 100.96%, respectively, for implant–implant support. Conclusions: The proposed algorithm allows for the automatic, parametrised generation of support for 4-unit fixed partial dentures, which can be used to predict the effect of bone loss and bone quality on stresses for patient-specific geometries. The optimal treatment for support type should be adapted to the patient’s specific needs to ensure long-term stability. A decision support involving automatic modelling, e.g., of support, and simulation might improve clinical treatment planning from a long-term perspective. Full article

Choosing an appropriate prosthetic material for the superstructure of an implant-supported or tooth-implant supported fixed partial denture (FPD) is crucial for the success of the prostheses. The objective of this study was to examine the effect of prosthetic material type and tooth-to-implant support on stress distribution of FPDs using three-dimensional finite element analysis (3D FEA). Two FEA models were generated, distinguished by their support configurations: Model I representing an FPD supported by implants, and Model II depicting an FPD supported by both a tooth and an implant. Two different restorative materials, porcelain-fused-to-metal (PFM) and monolithic zirconia, were evaluated for stress distribution under axial and oblique loads of 300 N applied to the pontic. Under both axial and oblique loading conditions, the maximum von Mises stress values were observed to be higher in the implant-abutment complex of both zirconia implant-supported and tooth-implant-supported FPDs compared to PFM FPDs. In the case of axial loading, comparable stress values were found in the cortical bone for PFM (12.65 MPa) and zirconia implant-supported FPDs (12.71 MPa). The zirconia tooth-implant-supported FPD exhibited the highest stress values in the implant-abutment system. Full article

The literature presents insufficient data evaluating the displacement and micromotion effects resulting from the combined use of tooth-implant connections in fixed partial dentures. Analyzing the biomechanical behavior of tooth-implant fixed partial denture (FPD) prothesis is vital for achieving an optimum design and successful clinical implementation. The objective of this study was to determine the relative significance of connector design on the displacement and micromotion of tooth-implant-supported fixed dental prostheses under occlusal vertical loading. A unilateral Kennedy class I mandibular model was created using a 3D reconstruction from CT scan data. Eight simulated designs of tooth-implant fixed partial dentures (FPDs) were split into two groups: Group A with rigid connectors and Group B with non-rigid connectors. The models were subjected to a uniform vertical load of 100 N. Displacement, strain, and stress were computed using finite element analysis. The materials were defined as isotropic, homogeneous, and exhibiting linear elastic properties. This study focused on assessing the maximum displacement in various components, including the bridge, mandible, dentin, cementum, periodontal ligament (PDL), and implant. Displacement values were predominantly higher in Group B (non-rigid) compared to Group A (rigid) in all measured components of the tooth-implant FPDs. Accordingly, a statistically significant difference was observed between the two groups at the FPD bridge (p value = 0.021 *), mandible (p value = 0.021 *), dentin (p value = 0.043 *), cementum (p value = 0.043 *), and PDL (p value = 0.043 *). Meanwhile, there was an insignificant increase in displacement values recorded in the distal implant (p value = 0.083). This study highlighted the importance of connector design in the overall stability and performance of the prosthesis. Notably, the 4.7 mm × 10 mm implant in Group B showed a displacement nearly 92 times higher than its rigid counterpart in Group A. Overall, the 5.7 mm × 10 mm combination of implant length and diameter showcased the best performance in both groups. The findings demonstrate that wider implants with a proportional length offer greater resistance to displacement forces. In addition, the use of rigid connection design provides superior biomechanical performance in tooth-implant fixed partial dentures and reduces the risk of micromotion with its associated complications such as ligament overstretching and implant overload, achieving predictable prognosis and enhancing the stability of the protheses. Full article

In this study, an approach for automated parametric remodelling of the connector cross-sectional area in a CAD model of a given fixed partial denture (FPD) geometry was developed and then applied to a 4-unit FPD. The remodelling algorithm was implemented using Rhinoceros and the Grasshopper plugin. The generated CAD models were used to perform a finite element analysis with Ansys to analyse the stress distribution in an implant-supported 4-unit FPD for different connector designs. The results showed that the type of connector adjustment matters and that the resulting stress can be significantly different even for connectors with the same cross-sectional area. For tensile stresses, a reduction in the connector cross-sectional area from the gingival side showed the highest influence on each connector type. It can be concluded that the developed algorithm is suitable for automatic connector detection and adjustment. Full article

The goals of this research were to determine the influence of several factors on implants’ biological and technical complications in posterior fixed implant prosthetic therapy. Materials and methods: The study group consisted of 67 edentulous patients (mean age: 63.88 ± 11.709 yrs; 20 males, 47 females) with implant prosthetic therapy for posterior edentulism. A total of 76 implant-supported fixed partial dentures (IP-FPDs) and 178 implants were assessed using clinical and paraclinical assessments. Risk factors for biological complications (peri-implantitis) and technical complications were determined by using the Pearson Chi-squared test and multivariate analysis. Results: The implant success (the absence of biological and mechanical/technical complications) was 66.30%. The prevalence of biological complications was 13.5%. The prevalence of technical complications was 28.70%. Variables that were associated with a higher risk of peri-implantitis were poor oral hygiene and bruxism. In univariate analysis, poor oral hygiene increased the risk of peri-implantitis 5.778 times and bruxism 5.875 times. Variables that were associated with a higher risk of mechanical/technical complications were age group > 60 yrs, smoking, history of periodontal disease, and bruxism. In univariate analysis, the risk of technical complications increased 4.14 times for patients in the age group > 60 years (vs. age group 40–60 years) and 20.5 times for patients with bruxism. Bruxism and smoking were significant predictors of mechanical/technical complications in the multivariate model. Conclusions: In univariate models, patients with poor oral hygiene and bruxism have an increased risk of peri-implantitis. In multivariate models, we did not identify significant predictors of peri-implantitis. Age group > 60 yrs, smoking, history of periodontal disease, bone grafting, and bruxism are risk factors for the increase in the mechanical/technical complication rate. In the multivariate model, smoking and bruxism are significant predictors of the mechanical/technical complications. Full article

The goals of this research are: (1) to compare the survival and prosthetic success of metal-ceramic 3-unit tooth- versus implant-supported fixed dental prostheses; (2) to evaluate the influence of several risk factors on the prosthetic success of tooth- and implant-supported fixed dental prostheses (FPDs). A total of 68 patients with posterior short edentulous spaces (mean age 61.00 ± 1.325 years), were divided into two groups: 3-unit tooth-supported FPDs (40 patients; 52 FPD; mean follow-up 10.27 ± 0.496 years) and 3-unit implant-supported FPDs (28 patients; 32 FPD; mean follow-up 8.656 ± 0.718 years). Pearson-chi tests were used to highlight the risk factors for the prosthetic success of tooth- and implant-supported FPDs and multivariate analysis was used to determine significant risk predictors for the prosthetic success of the tooth-supported FPDs. The survival rates of 3-unit tooth- versus implant-supported FPDs were 100% and 87.5%, respectively, while the prosthetic success was 69.25% and 68.75%, respectively. The prosthetic success of tooth-supported FPDs was significantly higher for patients older than 60 years (83.3%) vs. 40–60 years old (57.1%) (p = 0.041). Periodontal disease history decreased the prosthetic success of tooth- versus implant-supported FPDs when compared with the absence of periodontal history (45.5% vs. 86.7%, p = 0.001; 33.3% vs. 90%, p = 0.002). The prosthetic success of 3-unit tooth- vs. implant-supported FPDs was not significantly influenced by gender, location, smoking, or oral hygiene in our study. In conclusion, similar rates of prosthetic success were recorded for both types of FPDs. In our study, prosthetic success of tooth- versus implant-supported FPDs was not significantly influenced by gender, location, smoking, or oral hygiene; however, history of periodontal disease is a significant negative predictor of success in both groups when compared with patients without periodontal history. Full article

Purpose: This study aims to investigate the ultimate fractural strength and marginal integrity of a three-unit implant-supported fixed partial denture (FPD) framework fabricated of polyetherketoneketone (PEKK) after simulated five-year clinical aging. Materials and Methods: Twelve FPD frameworks were milled (n = 6 per group). All experimental frameworks were cemented on identical stainless-steel abutment models and subjected to five years of clinically simulated thermomechanical aging. The vertical marginal gap values were analyzed using a scanning electron microscope before and after being subjected to each aging condition. A universal testing machine was used to evaluate the ultimate fracture load. Results: A significant increase in marginal gap values of the PEKK group was observed after five years of simulation aging (p < 0.001), while no significant difference was seen in the titanium group (p = 0.071). After thermocycling, the PEKK group showed a higher statistically significant mean marginal gap value (84.99 + 44.28 μm) than before (81.75 + 44.53 μm). The titanium group exhibited superior mechanical strength, with a fracture load significantly higher than that of the PEKK group (3050 + 385.30 and 1359.14 + 205.49 N, respectively). Conclusions: Thermocycling affects the marginal gap discrepancy of PEKK restoration. However, the mean vertical marginal gap values in PEKK and titanium groups after a five-year clinical aging simulation were clinically acceptable. The ultimate fracture load values were higher than the maximum bite force reported in the posterior region. Thus, PEKK could serve as a suitable alternative material to metal in the framework of fixed dental prostheses. Full article

This study was performed as an adjunct to an existing clinical study to validate the effect of veneer: framework thickness ratio on stress distribution in an implant-supported all-ceramic fixed partial denture. Two commercially available titanium dental implants with corresponding customized abutments and a patient-retrieved all-ceramic fixed partial denture were scanned using a high-resolution micro-CT scanner. Reconstructed 3D objects, along with a simulated bone surface, were incorporated into a non-manifold assembly and meshed simultaneously using Simpleware software (Synopsys Simpleware ScanIP Version P-2019.09; Mountain View, CA). Three such volume meshes (Model A, Model B, Model C) corresponding to veneer: framework thickness ratios of 3:1, 1:1, and 1:3 respectively were created, and exported to a finite element analysis software (ABAQUS). An axial load of 110 N was applied uniformly on the occlusal surfaces to calculate the static stresses and contour plots were generated in the post-processing module. From the data obtained, we observed optimum stress distribution in Model B. Also, the tensile stresses were concentrated in the posterior connector region of the prosthesis in all three models tested. Within the limitations of this study, we can conclude that equal thickness of veneer and framework layers would aid in better stress distribution. Full article