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Dental and Medical Problems 2021The choice between 2 or 3 implants to support a 3-unit implant-supported fixed dental prosthesis (FDP) still generates doubt in clinical practice.
BACKGROUND
The choice between 2 or 3 implants to support a 3-unit implant-supported fixed dental prosthesis (FDP) still generates doubt in clinical practice.
OBJECTIVES
The aim of this study was to evaluate stress distribution in 3-unit implant-supported FDPs according to the implant number and load direction.
MATERIAL AND METHODS
A numerical simulation was performed to analyze stress and strain according to the implant number (2 or 3) and load direction (axial or oblique). A model of a jaw was created by means of the modeling software Rhinoceros, v. 5.0 SR8. External hexagon implants, micro-conical abutments and screws were also modeled. The final geometries were exported to the computer-aided engineering (CAE) software Ansys, v. 17.2, and all materials were considered homogeneous, isotropic and elastic. Different load directions were applied for each model (300 N) at the center of the prosthesis.
RESULTS
The von Mises stress and strain values were obtained for the titanium structures and the bone, respectively. The implant number influenced the prosthesis biomechanics, with higher stress and strain concentrations when 2 implants were simulated. The oblique load also affected the mechanical response, showing higher stress and strain in comparison with the axial load, regardless of the implant number.
CONCLUSIONS
It was concluded that for a 3-unit implant-supported FDP, a greater number of implants associated with axial loads can result in a better mechanical response during chewing.
Topics: Computer Simulation; Dental Implants; Dental Prosthesis, Implant-Supported; Finite Element Analysis; Stress, Mechanical
PubMed: 33687804
DOI: 10.17219/dmp/130847 -
Australian Dental Journal Jun 2011The aim of this study was to review the literature on the restoration of single-tooth implants, and to develop evidence-based conclusions to optimize aesthetic, biologic... (Review)
Review
BACKGROUND
The aim of this study was to review the literature on the restoration of single-tooth implants, and to develop evidence-based conclusions to optimize aesthetic, biologic and patient-related outcomes.
METHODS
An electronic and hand search was conducted using the search terms 'dental implants, single-tooth; dental restoration, temporary; dental impression materials; dental impression technique; dental prosthesis, implant-supported; dental prosthesis design; dental abutments; dental occlusion; maintenance; survival; and survival analysis'. Resultant titles were screened, and full text was obtained where relevant. The authors selected the most appropriate articles, giving preference to systematic reviews and long-term, patient-based outcome data.
RESULTS
Thirty-nine articles were selected and critiqued by the authors.
CONCLUSIONS
There was strong suggestion by several authors that peri-implant soft tissue aesthetics can be sculpted through provisional restoration contour, but there are no clinical outcome studies to define or support this claim. Laboratory studies demonstrate that pick-up type impression copings in conjunction with elastomeric impressions are the most accurate means for transferring implant position to a dental cast. Laboratory and finite-element analysis studies suggest implants with an internal-type connection show improved stress distribution, but supportive clinical data are lacking. The authors of this review favour a screw-retained prosthesis for retrievability. Clinical and histological studies show that gold, titanium and zirconia ceramic abutment materials exhibit excellent biological responses, although there is insufficient data on the clinical service provided by zirconia as an implant-substructure material. The literature does not associate any particular occlusal scheme with superior clinical outcomes. Implant-borne single crowns offer comparable clinical service to tooth-borne fixed dental prostheses. However, single-tooth implant restorations are associated with an increased incidence of biological and technical complications.
Topics: Dental Abutments; Dental Implants, Single-Tooth; Dental Impression Technique; Dental Materials; Dental Occlusion; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration, Temporary; Esthetics, Dental; Humans; Treatment Outcome
PubMed: 21623811
DOI: 10.1111/j.1834-7819.2011.01322.x -
Journal of Dental Research Aug 2011The clinical success of modern dental ceramics depends on an array of factors, ranging from initial physical properties of the material itself, to the fabrication and... (Review)
Review
The clinical success of modern dental ceramics depends on an array of factors, ranging from initial physical properties of the material itself, to the fabrication and clinical procedures that inevitably damage these brittle materials, and the oral environment. Understanding the influence of these factors on clinical performance has engaged the dental, ceramics, and engineering communities alike. The objective of this review is to first summarize clinical, experimental, and analytic results reported in the recent literature. Additionally, it seeks to address how this new information adds insight into predictive test procedures and reveals challenges for future improvements.
Topics: Computer-Aided Design; Dental Porcelain; Dental Prosthesis; Dental Prosthesis Design; Dental Restoration Failure; Dental Stress Analysis; Dental Veneers; Humans; Materials Testing; Surface Properties; Survival Analysis; Yttrium; Zirconium
PubMed: 21224408
DOI: 10.1177/0022034510391795 -
Journal of Periodontology Sep 2014With the increased use of short dental implants (<10 mm), a high crown/implant (C/I) ratio has become a common finding. However, the effect of the C/I ratio on the... (Review)
Review
BACKGROUND
With the increased use of short dental implants (<10 mm), a high crown/implant (C/I) ratio has become a common finding. However, the effect of the C/I ratio on the marginal bone loss (MBL) has not yet been examined extensively. Hence, the aim of the present systematic review is to explore the influence of the C/I ratio on the success rate and MBL of dental implants.
METHODS
Three electronic databases (PubMed, Ovid MEDLINE, and Cochrane Central) and a manual search for human trials with a minimal follow-up of 6 months are used for the present study. A statistical analysis of the influence of the C/I ratio was performed on the peri-implant MBL while considering follow-up period, type of implants, implant connection, and technical and biologic complications.
RESULTS
One hundred ninety-six potential articles were identified on the selected databases. Only 57 articles were selected for full-text evaluation. According to the inclusion criteria, a total of 13 articles were included in this systematic review. A significant negative association between the C/I ratio and the MBL was found (P = 0.012). However, no statistically significant difference was found (P >0.15) for potential effects regarding the observation period, the type of implant connection, or between both methods of evaluating the C/I ratio.
CONCLUSIONS
Within the limitations of the present study, the C/I ratio of implant-supported restorations has an effect on peri-implant marginal bone level. Within the range of 0.6/1 to 2.36/1, the higher the C/I ratio, the less the peri-implant MBL.
Topics: Alveolar Bone Loss; Crowns; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Humans; Peri-Implantitis; Surface Properties; Treatment Outcome
PubMed: 24444399
DOI: 10.1902/jop.2014.130615 -
Journal of Prosthodontic Research Jan 2024This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge. (Review)
Review
PURPOSE
This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge.
STUDY SELECTION
Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined.
RESULTS
One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants.
CONCLUSIONS
Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Patient Satisfaction; Quality of Life; Tooth
PubMed: 37164658
DOI: 10.2186/jpr.JPR_D_22_00252 -
Journal of Indian Prosthodontic Society 2023To evaluate and compare the strain development and distribution of maxillary implant-supported complete fixed dental prosthesis (ISCFDP) with computer-aided...
Comparative evaluation to study the effect of implant support on complete fixed dental prosthesis fabricated with peek framework when implants placed in all-on-4 and all-on-6 situation, by strain gauge analysis and finite element analysis - An study.
AIM
To evaluate and compare the strain development and distribution of maxillary implant-supported complete fixed dental prosthesis (ISCFDP) with computer-aided design-computer-aided manufacturing milled PEEK BIO-HPP superstructure when placed using All-on-4 and All-on-6 situation using a strain gauge and finite element analysis (FEA).
SETTING AND DESIGN
This is an in vitro study to evaluate and compare the stress minimization and strain developed at implant in premolar and in two clinically simulated situation of All-on-4 and All-on -6 ISCFDP.
MATERIALS AND METHODS
The study involved converting a human skull into. stl format to create 3D-printed stereolithography models with a modulus of elasticity closer to bone. Implants were placed in two models (M1 nad M2) in incisor, premolar, and pterygoid regions. A fixed dental prosthesis framework was fabricated on both models, and strain gauge sensors were attached.
STATISTICAL ANALYSIS USED
Descriptive and analytical statistics were done. The normality of data was analyzed by the Shapiro-Wilk test.
RESULTS
The results obtained were tabulated and it showed strain around the neck of ISCFDP under 100N configuration in strain gauge analysis. Stress was found more in the molar region when compared to the premolar region. This design showed that the largest stress around the neck of ISFDP under 100 N load was found more in the premolar region when compared to the molar region due to the reduction of stresses in the pterygoid region in FEA.
CONCLUSION
In the present study, strain gauge analysis at 100 N for loading at the premolar and molar region shows the reduced strain on tilted implants in All-on-6 situation due to stress dissipation to the terminal pterygoid implant using strain gauge.
Topics: Humans; Dental Implants; Finite Element Analysis; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Stress, Mechanical
PubMed: 37861614
DOI: 10.4103/jips.jips_196_23 -
Clinical Oral Implants Research Oct 2003Implant dentistry has become successful with the discovery of the biological properties of titanium. In the original protocol, studies have advocated a 2-stage surgical... (Review)
Review
BACKGROUND
Implant dentistry has become successful with the discovery of the biological properties of titanium. In the original protocol, studies have advocated a 2-stage surgical protocol for load-free and submerged healing to ensure predictable osseointegration. However, the discomfort, inconvenience, and anxiety associated with waiting period remains a challenge to both patients and clinicians. Hence, loading implant right after placement was attempted and has gained popularity among clinicians. Issues/questions related to this approach remain unanswered. Therefore, it is the purpose of this review article to (1). review and analyze critically the current available literature in the field of immediate implant loading and (2). discuss, based on scientific evidence, factors that may influence this treatment modality.
MATERIAL AND METHODS
Literature published over the past 20 years was selected and reviewed. Findings from these studies were discussed and summarized in the tables. The advantages and disadvantages associated with immediate implant loading were analyzed. Factors that may influence the success of immediate implant loading, including patient selection, type of bone quality, required implant length, micro- and macrostructure of the implant, surgical skill, need for achieving primary stability/control of occlusal force, and prosthesis guidelines, were thoroughly reviewed and discussed.
RESULTS AND CONCLUSION
Various studies have demonstrated the feasibility and predictability of this technique. However, most of these articles are based on retrospective data or uncontrolled cases. Randomized, prospective, parallel-armed longitudinal human trials are primarily based on short-term results and long-term follow-ups are still scarce in this field. Nonetheless, from available literature, it may be concluded that anatomic locations, implant designs, and restricted prosthetic guidelines are key to ensure successful outcomes. Future studies, preferably randomized, prospective longitudinal studies, are certainly needed before this approach can be widely used.
Topics: Bite Force; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture, Complete, Immediate; Denture, Partial, Immediate; Humans; Surface Properties
PubMed: 12969355
DOI: 10.1034/j.1600-0501.2003.00950.x -
Journal of Prosthodontic Research Feb 2021This systematic review was performed to compare tooth, implant and prosthesis failures and biological and technical complications in toothimplant vs freestanding implant... (Meta-Analysis)
Meta-Analysis
PURPOSE
This systematic review was performed to compare tooth, implant and prosthesis failures and biological and technical complications in toothimplant vs freestanding implant supported fixed partial prostheses, in order to evaluate the effectiveness and predictability in combining teeth and implants in the same fixed partial prosthesis.
STUDY SELECTION
A comprehensive and systematic literature research was conducted, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, to identify human trials, with a minimum sample size of 10 patients, comparing tooth-implant to freestanding implant supported fixed partial prostheses. Four groups of meta-analyses were performed based on the patients treated with toothimplant vs freestanding implant-supported fixed partial prostheses: abutment failures, biological and mechanical complications, prosthesis failures, and prosthetic (technical) complications.
RESULTS
The search yielded 749 records, after removal of duplicates. Based on the title assessment, the abstracts reading and the full-texts evaluation, 8 articles, published between 1999 and 2013, fulfilled the inclusion criteria and were included in the meta-analysis. The studies included were: 4 controlled clinical trials, 2 prospective and 2 retrospective cohort studies. The meta-analysis revealed no significant difference between tooth-implant and implant-implant supported fixed in the number of abutment (implant or tooth) failures, biological complications, prosthesis lost, and prosthetic complications.
CONCLUSIONS
Within the limitations of the present systematic review, although the freestanding implant supported fixed partial prosthesis remains the first choice, joining teeth and implants to support fixed prosthesis in partially edentulous patients becomes a valid alternative with an acceptable success rate.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Partial, Fixed; Humans; Prospective Studies; Retrospective Studies
PubMed: 32938874
DOI: 10.2186/jpr.JPOR_2019_494 -
Australian Dental Journal Mar 2015Dental implant treatment has established benefits over traditional alternatives. Age-related changes in systemic and oral health in conjunction with social, economic and... (Review)
Review
Dental implant treatment has established benefits over traditional alternatives. Age-related changes in systemic and oral health in conjunction with social, economic and resource considerations often introduce complexities into dental implant treatment of ageing patients. When time, opportunity, discomfort and maintenance costs are coupled with cost-benefit and quality of life predictions, otherwise simple treatment decisions can become more difficult. Implants for different types of prostheses in both arches and the different types of prostheses themselves present a variety of treatment challenges, risks, benefits and maintenance requirements. This narrative review discusses selective literature pertinent to the provision of dental implant treatment in the ageing population.
Topics: Aged; Aged, 80 and over; Cost-Benefit Analysis; Dental Prosthesis; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Mouth, Edentulous; Oral Health; Patient Selection; Prosthesis Failure; Quality of Life; Risk Factors
PubMed: 25762040
DOI: 10.1111/adj.12282 -
Australian Dental Journal Jun 2008The purpose of this review is to explore the concept of immediate loading as it pertains to dental implants and the indications for clinical practice. The definition of... (Review)
Review
The purpose of this review is to explore the concept of immediate loading as it pertains to dental implants and the indications for clinical practice. The definition of immediate loading will be considered together with a review of the relevant literature in an attempt to provide evidence-based guidelines for successful implementation into practice. A search of electronic databases including Medline, PubMed and the Cochrane Database of Systematic Reviews was undertaken using the terms "immediate loading'', "dental implants'', "immediate function'', "early loading'', "oral implants'', "immediate restoration'' and "systematic review''. This was supplemented by handsearching in peer-reviewed journals and cross-referenced with the articles accessed. Emphasis was given to systematic reviews and controlled clinical trials. A definition of immediate loading was suggested pertinent to the realities of logistics in clinical practice with respect to application and time frame. The literature was evaluated and shown to be limited with significant shortcomings. Guidelines and recommendations for clinical protocols were suggested and illustrated by examples of case types with a minimum of 1-3 years follow-up. A list of additional references for further reading was provided. Within the limitations of this review, there is evidence to suggest that immediate loading protocols have demonstrated high implant survival rates and may be cautiously recommended for certain clinical situations. However, more high level evidence studies, preferably randomized controlled trials (RCTs), over a long time frame are required to show a clear benefit over more conventional loading protocols.
Topics: Biomechanical Phenomena; Dental Abutments; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Evidence-Based Medicine; Humans; Randomized Controlled Trials as Topic; Stress, Mechanical
PubMed: 18498588
DOI: 10.1111/j.1834-7819.2008.00044.x