• Title/Summary/Keyword: Prostheses and Implants

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Does the prosthesis weight matter? 3D finite element analysis of a fixed implant-supported prosthesis at different weights and implant numbers

  • Tribst, Joao Paulo Mendes;Dal Piva, Amanda Maria de Oliveira;Borges, Alexandre Luiz Souto;Rodrigues, Vinicius Aneas;Bottino, Marco Antonio;Kleverlaan, Cornelis Johannes
    • The Journal of Advanced Prosthodontics
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    • v.12 no.2
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    • pp.67-74
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    • 2020
  • PURPOSE. This study evaluated the influence of prosthesis weight and number of implants on the bone tissue microstrain. MATERIALS AND METHODS. Fifteen (15) fixed full-arch implant-supported prosthesis designs were created using a modeling software with different numbers of implants (4, 6, or 8) and prosthesis weights (10, 15, 20, 40, or 60 g). Each solid was imported to the computer aided engineering software and tetrahedral elements formed the mesh. The material properties were assigned to each solid with isotropic and homogeneous behavior. The friction coefficient was set as 0.3 between all the metallic interfaces, 0.65 for the cortical bone-implant interface, and 0.77 for the cancellous bone-implant interface. The standard earth gravity was defined along the Z-axis and the bone was fixed. The resulting equivalent strain was assumed as failure criteria. RESULTS. The prosthesis weight was related to the bone strain. The more implants installed, the less the amount of strain generated in the bone. The most critical situation was the use of a 60 g prosthesis supported by 4 implants with the largest calculated magnitude of 39.9 mm/mm, thereby suggesting that there was no group able to induce bone remodeling simply due to the prosthesis weight. CONCLUSION. Heavier prostheses under the effect of gravity force are related to more strain being generated around the implants. Installing more implants to support the prosthesis enables attenuating the effects observed in the bone. The simulated prostheses were not able to generate harmful values of peri-implant bone strain.

OCCLUSAL FORCE AND ORAL TACTILE SENSIBILITY MEASURED IN PARTIALLY EDENTULOUS PATIENTS WITH BR NEMARK IMPLANTS AND NATURAL TEETH: A CLINICAL STUDY (기능 노출 기간에 따른 골 유착성 임플란트의 촉각 감지도와 최대 교합력의 변화)

  • Jung, Bock-Young;Jeon, Young-Sik;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.1
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    • pp.23-41
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    • 1999
  • During the previous several decades the osseointegrated implants have been considered as the most ideal therapy for the fully edentulous or partially edentulous patients. Although the research on the biocompatibility of osseointegration, the oral tactile function, and the histo-neurologic study had been performed, the change of the oral tactile sensibility and maximal occlusal force according to the postinsertion time of implant prostheses has not been studied. The purpose of this study was to compare the oral tactile sensibility and maximal occlusal force of implant pros-theses to natural teeth according to the specific postinsertion time intervals. The fifty seven patients treated with $Br{\aa}nemark$ implants during the recent seven years were involved in this study. The oral tactile sensibility and maximal occlusal force were measured according to the postinsertion time (${\leqq}6\;months,\;{\leqq}12\;{\leqq}\;18\;months\;{\leqq}\;24\;months,\;and\;{\geqq}20\;months$) 1. The passive tactile threshold of implants was higher than 6-7 times when comparing to natural teeth(P<0.05) 2. The absolute pressure threshold in horizontal and vertical direction for the passive tactile sensibility had decreased significantly in the post insertion time 13-18 months group and had increased significantly in the post insertion time over 25 months group (P<0.05) 3. 50% limit thickness and 100% absolute thickness for the active tactile sensibility had decreased significantly in the postinsertion time 7-12 months group ($AT_{50}:P<0.005,\;AT_{100}:P<0.05$) 4. The maximal occlusal force of the implants prostheses had decreased when comparing with natural teeth in the postinsertion time 1-6 months group(P<0.05) and after that there was no significant difference between the implant prostheses and natural teeth(P<0.05) 5. Maximal occlusal force according to the postinsertion time had increased significantly in the 13-18 months group (P<0.05) after that there was no significant difference. 6. There was positive correlation between age and oral tactile sensibility tested in horizontal and vertical direction ($P_{H:r}=0.39,\;P_{v:r}=0.41$) and there was no correlation between age and maximal occlusal force, age and active tactile sensibility 7. According to the results or the questionnaire, 76.6% of the patients were satisfied with the function and 96.7% of the patients were satisfied with the sensibility. In conclusion oral tactile sensibility and maximal occlusal force of implants have changed with the postinsertion time. Oral tactile function of implants was lower than that of the natural teeth, but for the maximal occlusal force there was no difference between implants and natural teeth.

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Analysis of factors affecting crestal bone loss around the implants

  • Park, Ji-Hoon;Kim, Young-Kyun;Yun, Pil-Young;Yi, Yang-Jin;Yeo, In-Sung;Lee, Hyo-Jung;Park, Jin-Young
    • Journal of Korean Dental Science
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    • v.2 no.2
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    • pp.12-17
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    • 2009
  • Purpose : To determine whether peri-implant crestal bone loss could be affected by systemic disease, primary ISQ value, implantation method (submerged vs. non-submerged), surface treatment, and bone density Materials and methods : Patients who underwent fixture installation from June 24, 2005 to October 23, 2008 at Seoul National University Bundang Hospital were evaluated. A total of 157 patients (male: 52, female: 85) had 346 fixtures installed. Among them, 49 patients had periapical radiographs taken 1 year after prostheses were first set. A total of 97 fixtures were implanted. In particular, 30 fixtures were installed in patients with systemic diseases such as diabetes mellitus, cardiovascular disease, hypertension, and liver disease. The immediate stability of implants was measured with $Osstell^{tm}$. Implant surface treatment was classified into two groups (RBM, Cellnest (Anodized)), and bone density, into four groups (D1~D4). The bone resorption on the mesial and distal areas of fixtures was measured with periapical radiographs using the paralleling technique, and the mean value was calculated. The length determination program in IMPAX (AGFA, Belgium) was used. Results : At least 332 out of 346 (96%) installed GS II implants were successfully osseointegrated 1 year after prostheses were first set. The mean value of the bone resorption of the installed GS II implants was 0.44mm. The minimum value was 0mm, and the maximum value, 2.85mm. There was a statistically significant difference between the implantation methods (submerged, non-submerged) with regard to the amount of alveolar bone loss 1 year after prostheses were first set (p<0.05). Non-submerged implants showed less crestal bone loss. Note, however, that other variables had no correlation with crestal bone loss (p>0.05). Conclusion : There was a statistically significant difference between the 1-stage method and 2-stage method with regard to the amount of alveolar bone loss 1 year after prostheses were first set. Systemic disease, primary ISQ value, surface treatment, and bone density were not associated with alveolar bone loss. Other variables were assumed to have a correlation with alveolar bone loss.

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Silicone radial head prostheses revisited: do they have a role in today's practice? A systematic review of literature on clinical outcomes

  • Erik M van Bussel;Anneluuk L. Lindenhovius;Bertram The;Denise Eygendaal
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.312-322
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    • 2023
  • Background: Silicone radial head prostheses (SRHP) are considered obsolete due to reports of frequent failure and destructive silicone-induced synovitis. Considering the good outcomes of modern non-radial silicone joint implants, the extent of scientific evidence for this negative view is unclear. The aim of this research was to systematically analyze the clinical evidence on complications and outcomes of SRHP and how SRHP compare to both non-SRHP and silicone prostheses of other joints. Methods: A systematic literature review was conducted through the Cochrane, PubMed, and Embase databases. Results: Eight cohort studies were included, consisting of 142 patients and follow-up periods ranging from 23 months to 8 years. Average patient satisfaction was 86%, range of 71%-100%, and 58 complications were seen, but no cases of synovitis. These outcomes were in line with non-SRHP. Four case series with 11 cases of synovitis were found, all due to implant fractures years to decades after implantation. Six systematic reviews of currently used non-radial silicone joint implants showed excellent outcomes with low complication rates. Conclusions: Since SRHP have satisfactory clinical results and an acceptable complication rate when selecting a patient group in suitable condition for surgical indications, it is considered that SRHP can still be chosen as a potential surgical treatment method in current clinical practice.

Complete mouth rehabilitation with fixed implant-supported prosthesis using temporary denture and dental CAD-CAM (완전 무치악 환자에서 임시 의치와 치과용 CAD-CAM을 활용한 전악 고정성 임플란트 회복 증례)

  • Jeon, Sol;Yoon, Hyung-In;Lee, Jae-Hyun;Yeo, In-Sung Luke;Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.100-109
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    • 2022
  • Installation of dental implants at optimal angles and positions is critical in long-term stable implant-supported restorations. Surgery and prosthodontic procedures should be performed accurately as the treatment is planned. In this clinical case, Computer aided design and manufacturing technology was used not only to establish a precise surgical plan, but also to fabricate both provisional and definitive fixed prostheses. A surgical guide was designed to install the implants at proper positions for the definitive prostheses. The patient's esthetic information, which was necessary for the new provisional and definitive fixed prostheses, was obtained from the existing temporary dentures. Finally, the complete mouth fixed implant-supported rehabilitation using monolithic zirconia provided the patient with functionally and esthetically satisfactory prostheses.

Five-year retrospective radiographic follow-up study of dental implants with sandblasting with large grit, and acid etching-treated surfaces

  • Kim, Hak-Kyun;Lee, Eun-Young;Kim, Jae-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.6
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    • pp.317-321
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    • 2015
  • Objectives: The purpose of this study is to evaluate five-year radiographic follow-up results of the Korean sandblasting with large grit, and acid etching (SLA)-treated implant system. Materials and Methods: The subjects of the study are 54 patients who have been followed-up to date, of the patients who underwent implant surgery from May 1, 2009 to April 30, 2011. In all, 176 implant placements were performed. Radiographs were taken before the first surgery, immediately after the first and second surgeries, immediately and six months after the final prosthesis installation, and every year after that. Bone loss was evaluated by the method suggested by Romanos and Nentwig. Results: A total of 176 implant placements were performed - 122 in men and 54 in women. These patients have been followed-up for an average of 4.9 years. In terms of prosthetic appliances, there were 156 bridges and 20 single prostheses. Nine implants installed in the maxillary molar area, three in the mandibular molar area and two in the maxillary premolar area were included in group M, with bone loss less than 2 mm at the crestal aspect of the implant. Of these, eight implants were single prostheses. In all, six implants failed - four in the mandible and two in the maxilla. All of these failures occurred in single-implant cases. The implant survival rate was 98.1% on the maxilla and 94.3% on the mandible, with an overall survival of 96.6%. Conclusion: Within the limitations of this study, implants with the SLA surface have a very superior survival rate in relatively poor bone environments such as the maxilla.

A THREE DIMENSIONAL FINITE ELEMENT STRESS ANALYSIS OF OSSEOINTEGRATED PROSTHESIS ACCORDING TO THE LOCATION AND LENGTH OF CANTILEVER (골유착성 임플랜트 보철물의 캔틸레버 위치와 길이변화에 따른 삼차원 유한요소법적 응력분석)

  • Jang, Bok-Sook;Kim, Chang-Whe;Kim, Yung-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.34 no.3
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    • pp.501-532
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    • 1996
  • This study investigated the effects of cantilever length, location and load condition on stress distribution developed in the implants, prostheses and supporting tissues. The osseointegrated prostheses with two 10mm Branemark implants at 2nd premolar and 1st molar sites with cantilever extensions at 1st premolar, 2nd and 3rd molar sites were constructed. Under 100N, 200N of vertical and $45^{\circ}$ oblique loads at the cantilever pontics, stress distribution patterns and displacement were analyzed with three dimensional finite element method. The results were as follows : 1. The stress was concentrated at the joint of the cantilever pontic and implant superstructure, the neck of implant and the ridge crest near the cantilever But there was little load transfer to the lower supporting tissues of implants. 2. The implant near the cantilever was displaced inferiorly while the implant far from the cantilever was displaced superiorly. In horizontal direction the implants were displaced to the direction where the loads were applied, except the apexes of the implants. 3. In case of anterior cantilever, the stress and displacement were higher than the prosthesis connected with natural tooth. 4. The stress developed in the posterior cantilevered type was higher than in the anterior cantilevered type. The greastest stress was concentrated at the ridge crest near the posterior cantilever. 5. The longer the cantilever, the more the stress was developed and was concentrated at the joint of the cantilever pontic and implant superstructure. 6. Under oblique load, the stress was concentrated at the necks of implants and the ridge crests, but decreased at the joint of the cantilever pontic and implant superstructure than under vertical load.

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RADIOGRAGHIC STUDY OF MARGINAL BONE LOSS AROUND OSSEOINTEGRATED IMPLANTS AFTER FUNCTIONAL LOADING (보철물 장착후 골 유착성 임플란트 변연골 소실에 관한 방사선학적 연구)

  • Park, Ki-Hyun;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.6
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    • pp.806-815
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    • 1998
  • Regular radiographic examination has been considered as an essential diagnostic method for the osseointegrated dental implantation. This study investigated the marginal bone loss through the measurement on the periapical radiograph around 46 endosseous dental implants. Marginal bone loss have been observed for 5 years after delivery of prostheses. The results were as follows : 1. According to the experimental periods, average marginal bone loss in total implant was 1.821mm in the first year, 1.833mm in the second, 1.892mm at third, 1.910mm at forth and 1.957mm at fifth after delivery of prostheses(P<0.05). 2. The average bone loss was 1.832mm in the maxillae and 1.819mm in the mandible in three years but there was no significant difference between the upper and lower jaw(P>0.05). 3. The average bone loss was 1.824mm in males and 1.818mm in females in five years but there was no significant difference according to the sex(P>0.05). These results indicate that the most of the alveolar bone loss occur within the first year after delivery of dental prostheses resulting in the exposure of polished neck positions, and the bone level stabilizes at first thread portion of the implant fixtures.

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Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts

  • Yuan, Judy Chia-Chun;Sukotjo, Cortino
    • Journal of Periodontal and Implant Science
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    • v.43 no.2
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    • pp.51-57
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    • 2013
  • Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial. In this study, the current status of implant occlusion was reviewed and discussed. Further randomized clinical research to investigate the correlation between implant occlusion, the implant success rate, and its risk factors is warranted to determine best clinical practices.

Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report

  • Agustin-Panadero, Ruben;Penarrocha-Oltra, David;Gomar-Vercher, Sonia;Ferreiroa, Alberto;Penarrocha-Diago, Miguel
    • The Journal of Advanced Prosthodontics
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    • v.7 no.3
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    • pp.264-270
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    • 2015
  • This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene.