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      Comparative three-dimensional finite element analysis of implant-supported fixed complete arch mandibular prostheses in two materials

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          Abstract

          Background:

          The increase of requests for implant-supported prosthesis (ISP) with zirconia as infrastructure has attracted a lot of attention due to its esthetics, biocompatibility, and survival rate similar to metallic infrastructure. The aim of this study was to evaluate the influence of two different framework materials on stress distribution over a bone tissue-simulating material.

          Materials and Methods:

          Two ISP were modeled and divided into two infrastructure materials: titanium (Ti) and zirconia. Then, these bars were attached to a modeled jaw with polyurethane properties to simulate bone tissue. An axial load of 200 N was applied on a standardized area for both systems. Maximum principal stress (MPS) on solids and microstrain (MS) generated through the jaw were analyzed by finite element analysis.

          Results:

          According to MS, both models showed strains on peri-implant region of the penultimate (same side of the load application) and central implants. For MPS, more stress concentration was slightly higher in the left posterior region for Ti's bar. In prosthetic fixation screws, the MPS prevailed strongly in Ti protocol, while for zirconia's bar, the cervical of the penultimate implant was the one that highlighted larger areas of possible damages.

          Conclusions:

          The stress generated in all constituents of the system was not significantly influenced by the framework's material. This allows suggesting that in cases without components, the use of a framework in zirconia has biomechanical behavior similar to that of a Ti bar.

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          Most cited references37

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          Zirconia as a ceramic biomaterial.

          Zirconia ceramics have several advantages over other ceramic materials, due to the transformation toughening mechanisms operating in their microstructure that can give to components made out of them, very interesting mechanical properties. The research on the use of zirconia ceramics as biomaterials started about twenty years ago, and now zirconia (Y-YZP) is in clinical use in THR, but developments are in progress for application in other medical devices. Recent developments have concentrated on the chemistry of precursors, in forming and sintering processes, and on surface finish of components. Today's main applications of zirconia ceramics is in THR ball heads. This review takes into account the main results achieved up to now, and is focused on the role that microstructural characteristics play on the TZP ceramics behaviour in ball heads, namely mechanical properties and their stability, wear of the UHMWPE paired to TZP, and their influence on biocompatibility.
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            Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale.

            Due to lack of the periodontal ligament, osseointegrated implants, unlike natural teeth, react biomechanically in a different fashion to occlusal force. It is therefore believed that dental implants may be more prone to occlusal overloading, which is often regarded as one of the potential causes for peri-implant bone loss and failure of the implant/implant prosthesis. Overloading factors that may negatively influence on implant longevity include large cantilevers, parafunctions, improper occlusal designs, and premature contacts. Hence, it is important to control implant occlusion within physiologic limit and thus provide optimal implant load to ensure a long-term implant success. The purposes of this paper are to discuss the importance of implant occlusion for implant longevity and to provide clinical guidelines of optimal implant occlusion and possible solutions managing complications related to implant occlusion. It must be emphasized that currently there is no evidence-based, implant-specific concept of occlusion. Future studies in this area are needed to clarify the relationship between occlusion and implant success.
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              Influence of forces on peri-implant bone.

              Occlusal forces affect an oral implant and the surrounding bone. According to bone physiology theories, bones carrying mechanical loads adapt their strength to the load applied on it by bone modeling/remodeling. This also applies to bone surrounding an oral implant. The response to an increased mechanical stress below a certain threshold will be a strengthening of the bone by increasing the bone density or apposition of bone. On the other hand, fatigue micro-damage resulting in bone resorption may be the result of mechanical stress beyond this threshold. In the present paper literature dealing with the relationship between forces on oral implants and the surrounding bone is reviewed. Randomized controlled as well as prospective cohorts studies were not found. Although the results are conflicting, animal experimental studies have shown that occlusal load might result in marginal bone loss around oral implants or complete loss of osseointegration. In clinical studies an association between the loading conditions and marginal bone loss around oral implants or complete loss of osseointegration has been stated, but a causative relationship has not been shown.
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                Author and article information

                Journal
                J Indian Prosthodont Soc
                J Indian Prosthodont Soc
                JIPS
                The Journal of the Indian Prosthodontic Society
                Medknow Publications & Media Pvt Ltd (India )
                0972-4052
                1998-4057
                Jul-Sep 2017
                : 17
                : 3
                : 255-260
                Affiliations
                [1]Department of Dental Materials and Prosthodontics, São Paulo University, São Paulo, Brazil
                Author notes
                Address for correspondence: Amanda Maria de Oliveira Dal Piva, Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, SP, Brazil 12.245-000. E-mail: amanda.piva@ 123456ict.unesp.br
                Article
                JIPS-17-255
                10.4103/jips.jips_11_17
                5601488
                28936039
                a346b6e0-e9a7-4af1-a03e-e5c029433dca
                Copyright: © 2017 The Journal of Indian Prosthodontic Society

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 13 January 2017
                : 18 May 2017
                Categories
                Original Article

                biomechanics,dental implants,finite element analysis

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