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      Biomechanical interactions of endodontically treated tooth implant-supported prosthesis under fatigue test with acoustic emission monitoring

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          Abstract

          Background

          This study investigated the biomechanical interactions in endodontically treated tooth implant-supported prosthesis (TISP) with implant system variations under dynamic cyclic loads monitored using the acoustic emission (AE) technique.

          Methods

          Macrostructure implants using a taper integrated screw-in (TIS; 2-piece implant) and a retaining-screw (RS; 3-piece implant) connected to an abutment were used for this investigation and their corresponding mechanical resistances in conformity with the ISO 14801 standard were evaluated. The endodontically treated TISP samples were constructed containing TIS and RS implants splinted to the second premolar with fatigue tests performed by applying occlusal force onto the premolar simulating the bending moment effect. The numbers of accumulated AE signals in the fatigue tests and failure modes for the sample were recorded to evaluate the mechanical resistance.

          Result

          The maximum load in the static test for RS (3-piece) implant (797N) was significantly higher than that for the TIS (2-piece) implant (559N). Large deformations were found at abutment screws in both RS and TIS implants. Although the numbers of accumulated AE signals for the TIS implant (72511) were higher than those for the RS implant (437), statistical non-significant differences were found between TIS and RS implants. No obvious damage was noted in endodontically treated TISP samples using RS implants but two of the corresponding TIS implants fractured in the abutment screws.

          Conclusions

          Splints with RS (3-piece) implant prosthesis produce better mechanical responses than the TIS (2-piece) implant when connected to an endodontically treated tooth restored with a post core and crown.

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          Most cited references33

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          The adhesion between fiber posts and root canal walls: comparison between microtensile and push-out bond strength measurements.

          Aim of the study was to compare the trimming and non-trimming variants of the microtensile technique with the 'micro' push-out test in the ability to measure accurately the bond strength of fiber posts luted inside root canals. In 15 endodontically treated teeth (Group A), fiber posts were cemented with Excite DSC in combination with Variolink II (Ivoclar-Vivadent). In 15 roots RelyX Unicem (3M-ESPE) was used for fiber post luting (Group B). Within each group, the bond strength of cemented fiber posts was assessed with the trimming and non-trimming microtensile technique, as well as with the push-out test. The great number of premature failures (16.9% in Group A, 27.5% in Group B) and the finding of high standard deviation values make questionable the reliability of the trimming microtensile technique. With the non-trimming microtensile technique, only five sticks were obtained from a total of six roots. The remaining specimens failed prematurely during the cutting phase. With the push-out test no premature failure occurred, the variability of the data distribution was acceptable, and regional differences in bond strength among root levels could be assessed. Relatively low values of bond strength were, in general, recorded for luted fiber posts. In conclusion, when measuring the bond strength of luted fiber posts, the push-out test appears to be more dependable than the microtensile technique.
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            Loss of osseointegration caused by occlusal load of oral implants. A clinical and radiographic study in monkeys.

            F Isidor (1996)
            The breakdown of bone around oral implants following excessive occlusal load or plaque accumulation was evaluated in monkeys. 5 screw type implants of pure titanium (Astra) were inserted in the mandible of 4 monkeys (Macaca Fascicularis). 2 implants were placed in each of the lateral segments and 1 in the frontal area. Each monkey was provided with 2 cemented splints covering the premolars and molars in the right and left side of the maxilla, respectively. 6 months after insertion of the fixtures, a fixed partial prosthesis was mounted on the 2 implants in one of the lateral segments. The prosthesis was in supra-occlusal contact with the antagonizing splint. Each prosthesis was replaced during the course of the experiment. The renewed prosthesis caused a lateral displacement of the mandible during occlusion, and therefore resulted in a lateral rather than axial excessive occlusal load. Implants retaining the prosthesis were brushed 1 x a week and subgingival cleaning was performed 1 x a month. The remaining implants were never cleaned and, additionally, a cotton cord was placed passively around each of these to promote plaque accumulation. 5 out of 8 implants with excessive occlusal load lost osseointegration (mobility and peri-implant radiolucency). The loss of osseointegration was observed 4.5 months to 15.5 months after the occlusal overload was commenced. None of the implants with plaque accumulation lost osseointegration, although an average loss of 1.8 mm in the radiographic bone level was assessed after 18 months.
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              Biomechanical considerations for the restoration of endodontically treated teeth: a systematic review of the literature, Part II (Evaluation of fatigue behavior, interfaces, and in vivo studies).

              The restoration of endodontically treated teeth has long been guided by empirical rather than biomechanical concepts. Part I of this literature review presented up-to-date knowledge about changes in tissue structure and properties following endodontic therapy, as well as the behavior of restored teeth in monotonic mechanical tests or finite element analysis. The aim of the second part is to review current knowledge about the various interfaces of restored, nonvital teeth and their behavior in fatigue and clinical studies. The basic search process included a systematic review of articles contained in the PubMed/Medline database, dating between 1990 and 2005, using single or combined key words to obtain the most comprehensive list of references; a perusal of the references of the references completed the review. Nonvital teeth restored with composite resin or composite resin combined with fiber posts resisted fatigue tests and currently represent the best treatment option. In comparison to rigid metal and/or ceramic posts, when composite resin or composite resin/fiber posts fail, the occurrence of interfacial defects or severe tooth breakdown is less likely. Adhesion into the root, however, remains a challenge because of the unfavorable ovoid canal configuration, as well as critical dentin microstructure in the deepest parts of the canal. Thus, specific combinations of adhesives and cements are recommended. The clinical performance of post-and-core restorations proved satisfactory overall, in particular with a contemporary restorative approach using composite resin and fiber posts. However, the clinical literature does not clearly isolate or identify exact parameters critical to success. This, in turn, emphasizes the importance and relevance of in vitro studies to further improve the quality and long-term stability of prosthetic foundations.
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                Author and article information

                Contributors
                886-2-28267000 , shaofu.h@gmail.com
                lovefox2627@hotmail.com
                cllin2@ym.edu.tw
                Journal
                Biomed Eng Online
                Biomed Eng Online
                BioMedical Engineering OnLine
                BioMed Central (London )
                1475-925X
                24 February 2016
                24 February 2016
                2016
                : 15
                : 23
                Affiliations
                Department of Biomedical Engineering, National Yang-Ming University, 2 No.155, Sec.2, Linong Street, 112, Taipei, Taiwan
                Article
                140
                10.1186/s12938-016-0140-y
                4765056
                26912169
                0ca7d61b-57d9-477b-b567-df48b88c0271
                © Huang et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 8 June 2015
                : 14 February 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004663, Ministry of Science and Technology, Taiwan;
                Award ID: 100-2628-E-010-003-MY3
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Biomedical engineering
                endodontically treated tooth,dental implant,splinting,biomechanics,acoustic emission,fatigue

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