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      Finite Element Analysis of Stress in Anterior Prosthetic Rehabilitation with Zirconia Implants with and without Cantilever

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          Abstract

          Objectives The aim of this study was to evaluate using finite element analysis (FEA), the stress distribution in prostheses (lithium disilicate crowns) on monotype zirconia implants with and without cantilever in the anterior region of the maxilla.

          Materials and Methods From a virtual reconstruction of bone model of the toothed maxilla from a computed tomography, three models (groups) were created: Zr (11–21)—implants placed in the area of 11 and 21 with cantilever; Zr (12–22)—implants placed in the area of 12 and 22 without cantilever; and Zr (11–22)—implants intercalated placed in the area of 11 and 22. In all models, monotype zirconia implant (4.1 × 12.0 mm) was used in single-body configuration. Lithium disilicate crowns were designed on the implants and pontics for all groups. A 150-N load was applied to the prostheses. The materials used were considered isotropic, homogeneous, and linearly elastic. FEA was performed to evaluate the maximum (tensile) and minimum (compressive) principal stresses in the implant, crowns, and bone tissue. Data were analyzed qualitatively and quantitatively.

          Results For all groups, the highest maximum principal stress occurred in the palatal cervical area of the implant, with the high values for the Zr (12–22) group and the low values for the Zr (11–21) group. The maximum principal stress was concentrated in the cervical palatal area of the crown, with the Zr (11–21) group presented the highest values and the Zr (12–22) group showed the lowest values. In the bone tissue all the groups presented similar values of maximum and minimal principal stress, with the palatal (maximum principal) and vestibular (minimum principal) close to the cervical of the implants the area with the highest concentration of stresses.

          Conclusions The position of monotype zirconia implant did not interfere in the bone tissue stress, and the implants placed in the 11–21 present lower stress in implants and higher in the crown. The cantilever does not increase the stress in the implants, crown, and bone tissue.

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          Most cited references31

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          Zirconia dental implants: where are we now, and where are we heading?

          Despite decades of titanium as the gold standard in oral implantology, the search for alternatives has been growing. High esthetic standards and increasing incidence of titanium allergies, along with a rising demand for metal-free reconstructions, have led to the proposal of ceramics as potential surrogates. Following numerous experimental studies, zirconium dioxide (zirconia) has earned its place as a potential substitute for titanium in implantology. Yet, despite zirconia's excellent biocompatibility and tissue integration, low affinity to plaque and favorable biomechanical properties, early failures were significantly higher for zirconia implants than for titanium implants. Technical failure as a result of fracture of the material is also a major concern. So far, zirconia implants have been mainly manufactured as one-piece implant systems because of the material's limitations. Nevertheless, various two-piece systems have been progressively emerging with promising results. Screw-retained abutments are desirable but present a major technical challenge. Innovation and technical advances will undoubtedly lead to further improvement in the reliability and strength of zirconia implants, allowing for novel designs, connections and reconstructions. Additional clinical studies are required to identify all relevant technical and biological factors affecting implant success and patients' satisfaction. However, the evidence for a final verdict is, at present, still incomplete.
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            FEM and Von Mises Analysis on Prosthetic Crowns Structural Elements: Evaluation of Different Applied Materials

            The aim of this paper is to underline the mechanical properties of dental single crown prosthodontics materials in order to differentiate the possibility of using each material for typical clinical condition and masticatory load. Objective of the investigation is to highlight the stress distribution over different common dental crowns by using computer-aided design software and a three-dimensional virtual model. By using engineering systems of analyses like FEM and Von Mises investigations it has been highlighted the strength over simulated lower first premolar crowns made by chrome cobalt alloy, golden alloy, dental resin, and zirconia. The prosthodontics crown models have been created and put on simulated chewing stresses. The three-dimensional models were subjected to axial and oblique forces and both guaranteed expected results over simulated masticatory cycle. Dental resin presented the low value of fracture while high values have been recorded for the metal alloy and zirconia. Clinicians should choose the better prosthetic solution for the teeth they want to restore and replace. Both prosthetic dental crowns offer long-term success if applied following the manufacture guide limitations and suggestions.
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              FEM Investigation of the Stress Distribution over Mandibular Bone Due to Screwed Overdenture Positioned on Dental Implants

              The objective of the present investigation was to evaluate how dental implant positioning can influence the masticatory stress distribution over screwed mandibular prosthodontics restoration and over the surrounding bone tissue. Moreover, the dental implant components and overdenture bar strengths under masticatory cycles have been investigated in order to evaluate possible screw and prosthesis breakage. A “virtual jaw” model and 3D dental implant were reproduced to realise finite element analysis in order to underline the parameters and the mechanical characteristics of the bone and of the dental implants connected to the overdenture bar. The distribution of a nonspecific chewing phase, analysing the overall load on the fixtures of the lower jaw, was performed. The study investigating frontal and horizontal planes and vertical directions of occlusal forces showed how position and perspective of fixtures strongly influenced the stress distribution and the consequent jawbone tissue remodelling. Prostheses elements such as cantilever, passing screws, and dental implants are strictly related to the correct selection of dental implant position. This study suggested a virtual method to guide the surgeon in the choice of implant number, position, diameter, and length, and cantilever length and shape, and to evaluate the prospective stress distribution of chewing strengths for a correct prosthesis rehabilitation.
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                Author and article information

                Journal
                Eur J Dent
                Eur J Dent
                10.1055/s-00042133
                European Journal of Dentistry
                Thieme Medical and Scientific Publishers Pvt. Ltd. (A-12, 2nd Floor, Sector 2, Noida-201301 UP, India )
                1305-7456
                1305-7464
                October 2021
                12 August 2021
                1 October 2021
                : 15
                : 4
                : 669-674
                Affiliations
                [1 ]School of Dentistry, São Leopoldo Mandic, Campinas, São Paulo, Brazil
                [2 ]School of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
                [3 ]School of Dentistry, Santo Amaro University, São Paulo, Brazil
                [4 ]School of Dentistry, Herminio Ometto University Center, Araras, São Paulo, Brazil
                Author notes
                Address for correspondence Rafael Pino Vitti, DDS, MSc, PhD Herminio Ometto University Center Avenue Dr. Maximiliano Baruto, 500, Araras, São Paulo 13607-339Brazil rafapvitti@ 123456gmail.com
                Article
                EJD20121309
                10.1055/s-0041-1727544
                8630963
                34384126
                824eefbf-86cf-40b2-b879-43a7a2ba61f8
                European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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                Categories
                Original Article

                Dentistry
                zirconia implants,cantilever,finite element analysis,rehabilitation
                Dentistry
                zirconia implants, cantilever, finite element analysis, rehabilitation

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