Journal of Dental Rehabilitation and Applied Science
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v.23
no.1
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pp.31-42
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2007
The purpose of this study was to compare the stress distribution according to the splinting condition and non-splinting conditions on the finite element models of the two units implant prostheses. The finite element model was designed with the parallel placement of two fixtures ($4.0mm{\times}11.5mm$) on the mandibular 1st and 2nd molars. A cemented abutment and gold screw were used for superstructures. A FEA models assumed a state of optimal osseointegration, as the bone quality, inner cancellous bone and outer 2 mm compact bone was designed. This concluded that the cortical and trabecular bone were assumed to be perfectly bonded to the implant. Splinting condition had 2 mm contact surface and non-splinting condition had $8{\mu}m$ gap between two implant prosthesis. Two group (Splinting and non-splinting) were loaded with 200 N magnitude in vertical axis direction and were divided with subdivision group. Subdivision group was composed of three loading point; Center of central fossa, the 2 mm and 4 mm buccal offset point from the central fossa. Von Mises stress value were recorded and compared in the fixture-bone interface and bucco-lingual sections. The results were as follows; 1. In the vertical loading condition of central fossa, splinting condition had shown a different von Mises stress pattern compared to the non-splinting condition, while the maximum von Mises stress was similar. 2. Stresses around abutment screw were more concentrated in the splinting condition than the non-splinting condition. As the distance from central fossa increased, the stress concentration increased around abutment screw. 3. The magnitude of the stress in the cortical bone, fixture, abutment and gold screw were greater with the 4 mm buccal offset loading of the vertical axis than with the central loading.
PURPOSE. The aim of this study was to evaluate the effect of dimensional stability of splinting material on the accuracy of master casts. MATERIALS AND METHODS. A stainless steel metal model with 6 implants embedded was used as a master model. Implant level impressions were made after square impression copings were splinted using 5 different techniques as follows. (1) Splinted with autopolymerizing resin and sectioned, reconnected to compensate polymerization shrinkage before the impression procedure. (2) Splinted with autopolymerizing resin just before impression procedure. (3) Primary impression made with impression plaster and secondary impression were made over with polyether impression material. (4) Splinted with impression plaster. (5) Splinted with VPS bite registration material. From master model, 5 impressions and 5 experimental casts, total 25 casts were made for each of 5 splinting methods. The distortion values of each splinting methods were measured using coordinate measuring machine, capable of recordings in the x-, y-, z- axes. A one-way analysis of variance (ANOVA) at a confidence level of 95% was used to evaluate the data and Tukey's studentized range test was used to determine significant differences between the groups. RESULTS. Group 1 showed best accuracy followed by Group 3 & 4. Group 2 and 5 showed relatively larger distortion value than other groups. No significant difference was found between group 3, 4, 5 in x-axis, group 2, 3, 4 in y-axis and group 1, 3, 4, 5 in z-axis (P<.0001). CONCLUSION. Both Splinting impression copings with autopolymerizing resin following compensation of polymerization shrinkage and splinting method with impression plaster can enhance the accuracy of master cast and impression plaster can be used simple and effective splinting material for implant impression procedure.
The purpose of this study was to evaluate the effect of splinting methods on the rearrangement of periodontal fibers after experimental tooth movement. Orthodontic force was applied by placing closed coil spring between upper third incisor and canine in seven dogs, weighing 20 kg or more. After 3 weeks of force application, 0.0215 inch multistrand wire and polyethylene ribbon were bonded to each side, as a flexible and rigid splinting respectively in 6 experimental animals. The remaining one served as a control. Each two animals were sacrificed at 4, 8 and 12 weeks after splinting respectively and prepared histologically for hematoxylin-eosin and Masson's trichrome staining. The results of this study were obtained as follows: 1. After tooth movement, periodontal space was narrowed and periodontal titers were thick on pressure side while elongated fibers were observed on tension side. 2. After 4 weeks of retention, the rearrangement of periodontal fibers was observed in the flexible splinting group, but not in the rigid splinting group. 3. After 8 weeks of retention, the rearrangement of periodontal titers was observed in both groups, but the difference could not be detected between two groups. 4. During the retention period, the rearrangement of periodontal fibers was faster in tension side than in pressure side. These results show that the rearrangement of periodontal fibers is also obtained by rigid splinting after tooth movement. It is suggested that the rigid splinting by polyethylene ribbon can be used as a way of postorthodontic retention.
The effect of splinting on aqbutment tooth distal movement was performed in vitro study. An acrylic resin mandibular model with missing 2nd premolars, molars and a removable partial denture framework were constructed. The roots of the canines, 1st premolars and edentulous ridges were coated with silicone rubber. A modified Ney Surveyor was used for vertical load appkication, and abutment tooth distal movement were measured with a dial gauge with four conditions of splinting methods were tested by applying unilateral vertical loadings. The results are follows; 1. The magnitude of abutment tooth distal movement on the non-load side was less 40$\sim$69% than that occurred on the load side. 2. On the load side, reducing effect of splinting on abutment tooth movement in the condition of load side double abutment(30%), non-load side double abutment(10%), double abutments of both sides(40%) was compared with single abutments of both sides. 3. On the non-load side, reducing effect of splinting on abutment tooth movement in the condition of load side double abutment(5%), non-load side double abutment(22%), double abutments of both sides(59%) was compared with single abutments of both sides. 4. The magnitude of abutment tooth distal movement in the condition of double abutments of both sides was less 40$\sim$59% than that in the condition of single abutments of both sides.
Splint therapy, the immobilization of teeth, has been done for patient's masticatory comforts and an adjunctive aid in periodontal therapy. Mandibular premolars are frequently splinted in many distal extension removable partial denture cases. But splinting is an extensive restoration that may not be conservative of tooth structure and may prove to be quite costly to the patient. The two dimensional finite element analysis method was used to determine the magnitude and mode of distribution of the stresses of the periodontal ligament and supporting alveolar bone when abutments with different periodontal supports were splinted and distal-extension removable partial denture was subjected to different loading schemes. The results were as follows : 1. When abutments were splinted, stresses moved from apico-distal to apico-mesial of terminal abutment on a vertical force and from disto-alveolar crest to apex on a distally directed force. But stresses were generally diminished on a mesially directed force. 2. As vertical bone loss was proceeding, most of stresses were transmitted to residual ridge and the rest of stresses were concentrated on apex of distal abutment. But these apical stresses were minimized when abutments were splinted. 3. As mesially inclined bone loss was proceeding, it seemed to be dangerous that many stresses were concentrated on the distal alveolar crest, especially in the distally directed load case. Abutments splinting decreased the alveolar crestal stresses but not enough. 4. For all vertical stresses were effectively decreased on splinting, stresses were concentrated as highly on apico-mesial area of distal abutment in distally directed load cases as the distal inclination of bone level was severe. 5. The directions and magnitudes of abutment movements were decreased with teeth splinting.
Statement of problem: In distal extension removable partial denture, the preservation of health of abutment teeth are very important, but they are always subjected to unfavorable stress. Purpose: The purpose of this study was performed to investigate the effects of abutment splinting and design of direct retainer on the stress distribution of abutments in unilateral distal extension removable partial dentures. Material and method: Abutments were splinted by different method. In group 1, autment teeth were not splinted, in group 2, canine and 1st premolar were splinted, and in group 3, canine, 1st and 2nd premolars were all splinted. Three different types of direct retainer such as Akers clasp, RPI clasp, and wrought wire clasp were designed. Strain was measured with Switch & Balance Unit(SB-10, Measurement Group Instruments Division, Raleigh USA) and Strain Indicator(P-3500, Measurement Group Instruments Division, Raleigh, USA) 15kg of vertical and oblique loads was applied at central fossa of missing 2nd molar area. Results : The strain on lingual side of 2nd premolar was the greatest, and abutment splinting induced decrease of strain on buccolingual side of 2nd premolar. The strain of loaded area was decreased by abutment splinting and there was no statistical difference of strain between Group2 and Group 3, and strain on 2nd premolar in wrought wire clasp was the least. Conclusion: Within the limitations of this study, splinting of two distal abutment teeth is enough for stress distribution widely, and wrought wire clasp was more benefitable than others.
The purpose of this study was to evaluate the stress distribution developed in the supporting structures by mandibular distal extension removable partial dentures with 2 different direct retainer designs and with or without indirect retainer and abutment splinting. The examined direct retainers on the second bicuspid abutment tooth were Akers clasp and RPA clasp, the indirect retainer was located on the mesial fossa of the first bicuspid, and the first and second bicuspid were splinted in case of tooth splinting. Total 8 cases were compared and analyzed with 3-dimensional finite element method. 150N were applied vertically on the artificial teeth of the removable partial denture, and then stress distribution patterns were analyzed and compared. The results were as follows : 1. The forces transmitted to the abutment tooth were primarily from the occlusal rests. 2. The abutment tooth was displaced distally when the force was applied. The compressive stress was observed at the distal root surface of the abutment tooth and the tensile stress, at the mesial root surface. 3. The denture base was displaced posteriorly and inferiorly when the force was applied. At the more distal portion of the denture base, the greater displacement was observed.And the anterior portion of the major connector was displaced superiorly. 4. The occlusal rest placed on the distal part of the abutment tooth tended to tip the tooth more posteriorly than did one on the mesial part of that tooth. 5. Severe superior displacement was observed at the anterior portion of the major connector in case of removable partial dentures without indirect retainer. 6. In case of tooth-splinting, the stress was distributed through all the root surface of both abuments. In case of no tooth-splinting, the stress was concentrated on the distal root surface of the primary abutment.
Purpose: The purpose of this study was to evaluate the color stability of composite resins used for splinting teeth by comparing a self-cure resin cement (Superbond C&B, SB), a flowable composite resin (G-aenial Universal Flo A2, GU), and a composite resin exclusively used for splinting teeth (G-Fix, GF) before and after aging in NaOCl. Methods: Resin samples were fabricated to a size of 2 mm thickness and 8.5 mm diameter and light-cured with an LED light curing unit (G-Light, n = 12). Immediately after fabrication, CIE L*a*b* values of the resin samples were measured with a spectrophotometer (CM-5) as baseline. Then, the resin samples were immersed in 5% NaOCl at $60^{\circ}C$ and the color was measured after 23 hours every day for 4 days. Data were analyzed with one-way ANOVA followed by Duncan post hoc test (p<0.05), and color differences (${\Delta}E$) of resin samples before and after NaOCl aging were also calculated. Results: For SB, there were no changes in L* and a* values but changes were observed in b* values. For GU, there were no changes in L* and b* values but in a* values. For GF, changes were observed in L*, a*, and b* values. All resin samples showed highest ${\Delta}E$ between baseline and the 1st day of NaOCl immersion. ${\Delta}E$ of SB, GU, and GF was 4.6 - 5.8, 4.9 - 7.9, and 9.9 - 16.9, respectively. GF showed highest color change during NaOCl aging. Conclusion: The results of this color quality evaluation showed that the composite resin exclusively used for splinting teeth might be more vulnerable to color change during intraoral service.
Statement of the problem: Under anatomical limitations on maxillary posterior region, a poor crown-to root ratio acting on dental implants can result in undesirable stress in surrounding bone, which in turn can cause bone defects and eventual failure of implants. Purpose: The purpose is to compare stress distribution due to different crown-root ratio and effect of splinting between natural teeth and implants in maxillary molar area under different loads. Material and methods: Analysis of stress arising supporting bone of the natural teeth and the implant was made with 3-dimensional finite element method. The model simulated naturel teeth was made with 2nd premolar and 1st molar in the maxillary molar region (Model T). The model simulated implants placed on same positions with two parallel implants of Straumann Dental Implant cemented abutment (Model I). Each model was designed in different crown-root ratio (0.7:1, 1:1, 1.25:1) and set cement type gold crown to make it non-splinted or splinted. After that, 300 N force was loaded to each model in five ways (Load 1: middle of occlusal table, Load 2: middle of buccal cusp, Load 3: middle of lingual cusp, Load 4: horizontal load to buccal cusp of anterior abutment only, Load 5: horizontal load to middle of buccal cusp of each abutment), and stress distribution was analyzed. Results and conclusion: On all occasions, stress was concentrated at the cervical region of the implant. Under load 1, 2 and 3, stress was not increased even when crown-root ratio increases, but under load 4 and 5, when crown-root ratio increases, stress also increased. There was difference in stress values between natural teeth and implants when crown-root ratio gradually increases; In case of natural teeth, splinting decreased stress under vertical and horizontal loads. In case of implants, splinting decreased stress under vertical loads 1,2 and 3, but increased maximal stress under loads 2 and 3. Under horizontal loads, splinting decreased stress, however the effect of splinting decreased under load 5 than load 4. Furthermore, the stress was increased, when crown-root ratio is 1.25:1. Clinical implications: This limited finite element study suggests that the stress on supporting bone may be increased under non-axial loads and poor crown-root ratio. Under poor crown-root ratio, excessive stress was generated at the cervical region of the implant, and decreased splinting effect for stress distribution, which can be related to clinical failure.
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