Browse > Article
http://dx.doi.org/10.4047/jap.2016.8.2.116

Strains around distally inclined implants retaining mandibular overdentures with Locator attachments: an in vitro study  

Elsyad, Moustafa Abdou (Removable Prosthodontics, Faculty of Dentistry, Mansoura University)
Setta, Fathi Abo (Bachelor degree student, Faculty of Dentistry, Tripoli University)
Khirallah, Ahmed Samir (Removable Prosthodontics, Faculty of Dentistry, Mansoura University)
Publication Information
The Journal of Advanced Prosthodontics / v.8, no.2, 2016 , pp. 116-124 More about this Journal
Abstract
PURPOSE. The aim of the present study was to evaluate, by means of strain gauge analysis, the effect of different implant angulations on strains around two implants retaining mandibular overdenture with Locator attachments. MATERIALS AND METHODS. Four duplicate mandibular acrylic models were constructed. Two implants were inserted in the canine regions using the following degrees of distal inclinations: group I (control); $0^{\circ}$, group II; $10^{\circ}$, group III; $20^{\circ}$, and group IV; $30^{\circ}$. Locator pink attachments were used to connect the overdenture to the implants and Locator red (designed for severely angled implants) was used for group IV (group $IV_{red}$). For each group, two linear strain gauges were attached at the mesial and distal surfaces of the acrylic resin around each implant. Peri-implant strain was measured on loading and non-loading sides during bilateral and unilateral loading. RESULTS. For all groups, the mesial surfaces of the implants at loading and non-loading sides experienced compressive (negative) strains, while the distal implant surfaces showed tensile (positive) strains. Group IV showed the highest strain, followed by group III, group II. Both group I and group $IV_{red}$ showed the lowest strain. The strain gauges at the mesial surface of the loading side recorded the highest strain, and the distal surface at non-loading side showed the lowest strain. Unilateral loading recorded significantly higher strain than bilateral loading. CONCLUSION. Peri-implant strains around two implants used to retain mandibular overdentures with Locator attachments increase as distal implant inclination increases, except when red nylon inserts were used.
Keywords
Strain; Inclined implants; Locator; Overdentures;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Alsabeeha N, Atieh M, Swain MV, Payne AG. Attachment systems for mandibular single-implant overdentures: an in vitro retention force investigation on different designs. Int J Prosthodont 2010;23:160-6.
2 Szmukler-Moncler S, Salama H, Reingewirtz Y, Dubruille JH. Timing of loading and effect of micromotion on bone-dental implant interface: review of experimental literature. J Biomed Mater Res 1998;43:192-203.   DOI
3 Feingold GM, Grant AA, Johnson W. The effect of variation of residual ridge angle on partial denture abutment tooth movement. J Oral Rehabil 1988;15:379-84.   DOI
4 Akca K, Cehreli MC, Iplikcioglu H. A comparison of threedimensional finite element stress analysis with in vitro strain gauge measurements on dental implants. Int J Prosthodont 2002;15:115-21.
5 Mericske-Stern R, Zarb GA. Overdentures: an alternative implant methodology for edentulous patients. Int J Prosthodont 1993;6:203-8.
6 Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, Head T, Lund JP, MacEntee M, Mericske-Stern R, Mojon P, Morais J, Naert I, Payne AG, Penrod J, Stoker GT Jr, Tawse-Smith A, Taylor TD, Thomason JM, Thomson WM, Wismeijer D. The McGill Consensus Statement on Overdentures. Montreal, Quebec, Canada. May 24-25, 2002. Int J Prosthodont 2002;15:413-4.
7 Heckmann SM, Winter W, Meyer M, Weber HP, Wichmann MG. Overdenture attachment selection and the loading of implant and denture-bearing area. Part 2: A methodical study using five types of attachment. Clin Oral Implants Res 2001; 12:640-7.   DOI
8 Chikunov I, Doan P, Vahidi F. Implant-retained partial overdenture with resilient attachments. J Prosthodont 2008;17: 141-8.   DOI
9 Kleis WK, Kammerer PW, Hartmann S, Al-Nawas B, Wagner W. A comparison of three different attachment systems for mandibular two-implant overdentures: one-year report. Clin Implant Dent Relat Res 2010;12:209-18.
10 Krennmair G, Seemann R, Fazekas A, Ewers R, Piehslinger E. Patient preference and satisfaction with implant-supported mandibular overdentures retained with ball or locator attachments: a crossover clinical trial. Int J Oral Maxillofac Implants 2012;27:1560-8.
11 Duyck J, Ronold HJ, Van Oosterwyck H, Naert I, Vander Sloten J, Ellingsen JE. The influence of static and dynamic loading on marginal bone reactions around osseointegrated implants: an animal experimental study. Clin Oral Implants Res 2001;12:207-18.   DOI
12 ELsyad MA, Errabti HM, Mustafa AZ. Mandibular Denture Base Deformation with Locator and Ball Attachments of Implant-Retained Overdentures. J Prosthodont. 2015 Sep 16. doi: 10.1111/jopr.12356.   DOI
13 Sadig W. A comparative in vitro study on the retention and stability of implant-supported overdentures. Quintessence Int 2009;40:313-9.
14 Porter JA Jr, Petropoulos VC, Brunski JB. Comparison of load distribution for implant overdenture attachments. Int J Oral Maxillofac Implants 2002;17:651-62.
15 Gotfredsen K, Berglundh T, Lindhe J. Bone reactions adjacent to titanium implants subjected to static load of different duration. A study in the dog (III). Clin Oral Implants Res 2001;12:552-8.   DOI
16 Geng JP, Tan KB, Liu GR. Application of finite element analysis in implant dentistry: a review of the literature. J Prosthet Dent 2001;85:585-98.   DOI
17 Ogawa T, Dhaliwal S, Naert I, Mine A, Kronstrom M, Sasaki K, Duyck J. Effect of tilted and short distal implants on axial forces and bending moments in implants supporting fixed dental prostheses: an in vitro study. Int J Prosthodont 2010; 23:566-73.
18 Krennmair G, Furhauser R, Krainhofner M, Weinlander M, Piehslinger E. Clinical outcome and prosthodontic compensation of tilted interforaminal implants for mandibular overdentures. Int J Oral Maxillofac Implants 2005;20:923-9.
19 Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants 2000;15: 405-14.
20 Walton JN, Huizinga SC, Peck CC. Implant angulation: a measurement technique, implant overdenture maintenance, and the influence of surgical experience. Int J Prosthodont 2001;14:523-30.
21 Sadowsky SJ, Caputo AA. Effect of anchorage systems and extension base contact on load transfer with mandibular implant-retained overdentures. Prosthet Dent 2000;84:327-34.   DOI
22 Tokuhisa M, Matsushita Y, Koyano K. In vitro study of a mandibular implant overdenture retained with ball, magnet, or bar attachments: comparison of load transfer and denture stability. Int J Prosthodont 2003;16:128-34.
23 Federick DR, Caputo AA. Effects of overdenture retention designs and implant orientations on load transfer characteristics. J Prosthet Dent 1996;76:624-32.   DOI
24 Kenney R, Richards MW. Photoelastic stress patterns produced by implant-retained overdentures. J Prosthet Dent 1998;80:559-64.   DOI
25 Ichikawa T, Horiuchi M, Wigianto R, Matsumoto N. In vitro study of mandibular implant-retained overdentures: the influence of stud attachments on load transfer to the implant and soft tissue. Int J Prosthodont 1996;9:394-9.
26 Hong HR, Pae A, Kim Y, Paek J, Kim HS, Kwon KR. Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis. Int J Oral Maxillofac Implants 2012;27:e69-76.
27 Celik G, Uludag B. Photoelastic stress analysis of various retention mechanisms on 3-implant-retained mandibular overdentures. J Prosthet Dent 2007;97:229-35.   DOI
28 Pigozzo MN, Lagana DC, Sesma N, Souza GF, Ichi AL. Photoelastic stress analysis in mandibular bone surrounding bar-clip overdenture implants. Braz Oral Res 2014;28. pii: S1806-83242013005000034.
29 Rabbani S, Juszczyk AS, Clark RK, Radford DR. Investigation of retentive force reduction and wear of the locator attachment system with different implant angulations. Int J Oral Maxillofac Implants 2015;30:556-63.   DOI
30 Al-Ghafli SA, Michalakis KX, Hirayama H, Kang K. The in vitro effect of different implant angulations and cyclic dislodgement on the retentive properties of an overdenture attachment system. J Prosthet Dent 2009;102:140-7.   DOI
31 Stephens GJ, di Vitale N, O'Sullivan E, McDonald A. The influence of interimplant divergence on the retention characteristics of locator attachments, a laboratory study. J Prosthodont 2014;23:467-75.   DOI
32 Gonda T, Ikebe K, Dong J, Nokubi T. Effect of reinforcement on overdenture strain. J Dent Res 2007;86:667-71.   DOI
33 Dong J, Ikebe K, Gonda T, Nokubi T. Influence of abutment height on strain in a mandibular overdenture. J Oral Rehabil 2006;33:594-9.   DOI
34 el Charkawi HG, el Wakad MT. Effect of splinting on load distribution of extracoronal attachment with distal extension prosthesis in vitro. J Prosthet Dent 1996;76:315-20.   DOI
35 Takeshita S, Kanazawa M, Minakuchi S. Stress analysis of mandibular two-implant overdenture with different attachment systems. Dent Mater J 2011;30:928-34.   DOI
36 ELsyad MA, Elsaadawy MG, Abdou AM, Habib AA. Effect of different implant positions on strain developed around four implants supporting a mandibular overdenture with rigid telescopic copings. Quintessence Int 2013;44:679-86.
37 Elsyad MA, Al-Mahdy YF, Salloum MG, Elsaih EA. The effect of cantilevered bar length on strain around two implants supporting a mandibular overdenture. Int J Oral Maxillofac Implants 2013;28:e143-50.   DOI
38 Yang TC, Maeda Y, Gonda T, Kotecha S. Attachment systems for implant overdenture: influence of implant inclination on retentive and lateral forces. Clin Oral Implants Res 2011;22:1315-9.   DOI
39 Uludag B, Polat S, Sahin V, Comut AA. Effects of implant angulations and attachment configurations on the retentive forces of locator attachment-retained overdentures. Int J Oral Maxillofac Implants 2014;29:1053-7.   DOI
40 Evtimovska E, Masri R, Driscoll CF, Romberg E. The change in retentive values of locator attachments and hader clips over time. J Prosthodont 2009;18:479-83.   DOI
41 Gulizio MP, Agar JR, Kelly JR, Taylor TD. Effect of implant angulation upon retention of overdenture attachments. J Prosthodont 2005;14:3-11.   DOI
42 Koutouzis T, Wennstrom JL. Bone level changes at axial- and non-axial-positioned implants supporting fixed partial dentures. A 5-year retrospective longitudinal study. Clin Oral Implants Res 2007;18:585-90.   DOI
43 Heckmann SM, Winter W, Meyer M, Weber HP, Wichmann MG. Overdenture attachment selection and the loading of implant and denture-bearing area. Part 1: In vivo verification of stereolithographic model. Clin Oral Implants Res 2001;12: 617-23.   DOI
44 Bevilacqua M, Tealdo T, Pera F, Menini M, Mossolov A, Drago C, Pera P. Three-dimensional finite element analysis of load transmission using different implant inclinations and cantilever lengths. Int J Prosthodont 2008;21:539-42.
45 Watanabe F, Hata Y, Komatsu S, Ramos TC, Fukuda H. Finite element analysis of the influence of implant inclination, loading position, and load direction on stress distribution. Odontology 2003;91:31-6.   DOI