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      Mechanical behavior of provisional implant prosthetic abutments

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          Abstract

          Introduction: Implant-supported prostheses have to overcome a major difficulty presented by the morphology and esthetics of peri-implant tissues in the anterior sector. Diverse therapeutic techniques are used for managing the mucosa adjacent to the implant and the most noteworthy is immediate/deferred fixed provisionalization. Objectives: In vitro testing of strength and deformation of implant prosthetic abutments made from different materials (Titanium/PEEK/methacrylate). Material and Methods: Forty Sweden&Martina® implant prosthetic abutments (n=40) were divided into five groups: Group MP: methacrylate provisional abutments with machined titanium base; Group PP: Poly ether ether ketone (PEEK) provisional abutments; Group TP: titanium provisional abutments; Group TAD: titanium anti-rotational definitive abutments; Group TRD: titanium rotational definitive abutments. Their mechanical behavior under static loading was analyzed. Samples were examined under a microscope to determine the type of fracture produced. Results and Conclusions: Definitive anti-rotational titanium abutments and definitive rotational titanium abutments achieved the best mean compression strength, while PEEK resin provisional abutments obtained the lowest. The group that showed the greatest elastic deformation was the group of titanium provisional abutments.

          Key words:Immediate loading, immediate provisionalization, implant prosthetic abutment, definitive implant prosthetic abutment.

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          Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations.

          Daniel Buser, William Martin, U Belser (2003)
          The placement of dental implants in the anterior maxilla is a challenge for clinicians because of patients' exacting esthetic demands and difficult pre-existing anatomy. This article presents anatomic and surgical considerations for these demanding indications for implant therapy. First, potential causes of esthetic implant failures are reviewed, discussing anatomic factors such as horizontal or vertical bone deficiencies and iatrogenic factors such as improper implant selection or the malpositioning of dental implants for an esthetic implant restoration. Furthermore, aspects of preoperative analysis are described in various clinical situations, followed by recommendations for the surgical procedures in single-tooth gaps and in extended edentulous spaces with multiple missing teeth. An ideal implant position in all 3 dimensions is required. These mesiodistal, apicocoronal, and orofacial dimensions are well described, defining "comfort" and "danger" zones for proper implant position in the anterior maxilla. During surgery, the emphasis is on proper implant selection to avoid oversized implants, careful and low-trauma soft tissue handling, and implant placement in a proper position using either a periodontal probe or a prefabricated surgical guide. If missing, the facial bone wall is augmented using a proper surgical technique, such as guided bone regeneration with barrier membranes and appropriate bone grafts and/or bone substitutes. Finally, precise wound closure using a submerged or a semi-submerged healing modality is recommended. Following a healing period of between 6 and 12 weeks, a reopening procedure is recommended with a punch technique to initiate the restorative phase of therapy.
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            Single tooth bite forces in healthy young adults.

            G Serrao, C Dellavia, G Serrao … (2004)
            The assessment of bite forces on healthy single tooth appears essential for a correct quantification of the actual impact of single implant oral rehabilitations. In the present study, a new single tooth strain-gauge bite transducer was used in 52 healthy young adults (36 men, 16 women) with a complete permanent dentition. The influences of tooth position along the dental arch, of side, and of sex, on maximum bite force were assessed by an ANOVA. No significant left-right differences were found. On average, in both sexes the lowest bite force was recorded on the incisors (40-48% of maximum single tooth bite force), the largest force was recorded on the first molar. Bite forces were larger in men than in women (P < 0.002), and increased monotonically along the arch until the first or second permanent molar (P < 0.0001). The present data can be used as reference values for the comparison of dental forces in patients.
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              Implant-abutment interface design affects fatigue and fracture strength of implants.

              Lars Steinebrunner, Stefan Wolfart, Klaus Ludwig … (2008)
              Failures of implant-abutment connections are relatively frequent clinical problems. The aim of this study was to evaluate the influence of long-term dynamic loading on the fracture strength of different implant-abutment connections. Six implant systems were tested: two systems with external connections (Brånemark, Compress) and four systems with internal connections (Frialit-2, Replace-Select, Camlog, Screw-Vent). Fracture strength was tested in two subgroups for each system: one subgroup with (dyn) and the other without prior dynamic loading (contr). Each subgroup consisted of eight specimens with standard implant-abutment combinations for single molar crowns. Dynamic loading was performed in a two-axis chewing simulator with 1,200,000 load cycles at 120 N. Median fracture strengths in Newton (N) and 25th and 75th percentiles [in brackets] were: Brånemark: dyn=729 [0;802]/contr=782 [771;811], Frialit-2: dyn=0 [0;611]/contr=887 [798;941], Replace-Select: dyn=1439 [1403;1465]/contr=1542 [1466;1623], Camlog: dyn=1482 [1394;1544]/contr=1467 [1394;1598], Screw-Vent: dyn=0 [0;526]/contr=780 [762;847] and Compress: dyn=818[0;917]/contr=1008 [983;1028]. In some dyn subgroups, failures of the implant-abutment connection occurred already during dynamic loading: three specimens of the Brånemark and Compress groups and six specimens of the Screw-Vent and the Frialit-2 groups failed during dynamic loading. Statistically significant differences (P< or =0.05) in fracture strength could be found between groups with different connection designs. Implant systems with long internal tube-in-tube connections and cam-slot fixation showed advantages with regard to longevity and fracture strength compared with systems with shorter internal or external connection designs.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Oral Patol Oral Cir Bucal
                Journal ID (iso-abbrev): Med Oral Patol Oral Cir Bucal
                Journal ID (publisher-id): Medicina Oral S.L.
                Title: Medicina Oral, Patología Oral y Cirugía Bucal
                Publisher: Medicina Oral S.L.
                ISSN (Print): 1698-4447
                ISSN (Electronic): 1698-6946
                Publication date (Print): January 2015
                Publication date (Electronic): 17 August 2014
                Volume: 20
                Issue: 1
                Pages: e94-e102
                Affiliations
                [1 ]DDS, PhD. DDS. DDS. DDS, PhD. MD, DDS, PhD. Occlusion and Prosthodontic Teaching Unit, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Spain
                Author notes
                Edificio Clínica Odontológica C/ Gascó Oliag, 1 46021, Valencia, Spain , E-mail: rubenagustinpanadero@ 123456gmail.com

                Conflict of interest statement: The authors have declared that no conflict of interest exist.

                Article
                Publisher ID: 19958
                DOI: 10.4317/medoral.19958
                PMC ID: 4320428
                PubMed ID: 25129253
                SO-VID: 938d59b0-503e-49f6-b801-282f8ca3e770
                Copyright © Copyright: © 2015 Medicina Oral S.L.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 18 May 2014
                Date received : 12 March 2014
                Categories
                Subject: Research
                Subject: Implantology

                ScienceOpen disciplines: Surgery
                Data availability:
                ScienceOpen disciplines: Surgery

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