Download PDF
CC BY 4.0 · Eur J Dent 2024; 18(02): 587-597
DOI: 10.1055/s-0043-1772780
Original Article

Stress Analysis of Endodontically Treated Tooth–Implant Different Connectors Designs in Maxillary Posterior Region: A Finite Element Analysis

Sara Hashemi 
1   Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
,
Kimia Baghaei 
1   Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
,
Amirhossein Fathi
2   Department of Dental Prosthodontics, Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
,
Navid Aghadavoudi
1   Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
,
Seyed Saman Hashemi
3   Private Practice in Isfahan, Iran
,
Ramin Atash
4   Department of Prosthodontics, School of Dentistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
,
Sayed Sobhan Khademi
5   Department of Prosthodontics, School of Dentistry, Islamic Azad University (Khorasgan Branch), Isfahan, Iran
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objectives Using finite element analysis (FEA), this study aimed to determine the effect of nonrigid connectors (NRCs) and their position on the success of tooth and implant-supported fixed prostheses in the maxillary posterior region.

Materials and Methods Three three-dimensional FEA models were designed, presuming maxillary second premolar and first molar to be extracted. Implant (replacing first molar), abutment, bone (spongious and cortical), first premolar (containing dentin, root cement, gutta-percha, and casting post and core), periodontal ligament, and three three-unit cemented porcelain-fused-to-metal prostheses (a rigid one and two nonrigid) were modeled. The NRC was once on the tooth side and once on the implant side. The prostheses were loaded twice. The first molar (180 N) and premolars (120 N) teeth were subjected to progressive vertical and oblique (12-degree) loads, and maximum von Mises stress and strain in teeth and connectors were calculated for each model.

Results The findings of the current study showed evidence that tooth-implant design with an NRC has significantly increased the average stress in the tooth. The average stress in dentin was 769.02 for the mesial connector and 766.95 for the distal connector, and this was only 731.59 for rigid connector. Furthermore, it was observed that rigid connector has considerably minimized the stress within the tooth–implant-supported fixed partial denture. The average stress for the crown and metal frame is 346.22 and 526.41 in rigid connector, while it is 1,172.9 and 2,050.9 for the nonrigid mesial connector.

Conclusion Although distal NRC was more efficient than mesial NRC, using NRC will only reduce the stress applied to cortical bone and is not recommended in the posterior region of the maxilla.

Keywords

finite element - fixed prostheses - implant - maxillary - postcrown - tooth


Publication History

Article published online:
17 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Albrektsson T, Dahl E, Enbom L. et al. Osseointegrated oral implants. A Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. J Periodontol 1988; 59 (05) 287-296
    CrossrefPubMedSearch in Google Scholar
  • 2 Von Stein-Lausnitz M, Nickenig H-J, Wolfart S. et al. Survival rates and complication behaviour of tooth implant-supported, fixed dental prostheses: a systematic review and meta-analysis. J Dent 2019; 88: 103167
    CrossrefPubMedSearch in Google Scholar
  • 3 Gross M, Laufer BZ. Splinting osseointegrated implants and natural teeth in rehabilitation of partially edentulous patients. Part I: laboratory and clinical studies. J Oral Rehabil 1997; 24 (11) 863-870
    CrossrefPubMedSearch in Google Scholar
  • 4 Burak Özcelik T, Ersoy E, Yilmaz B. Biomechanical evaluation of tooth-and implant-supported fixed dental prostheses with various nonrigid connector positions: a finite element analysis. J Prosthodont 2011; 20 (01) 16-28
    CrossrefPubMedSearch in Google Scholar
  • 5 Naert IE, Duyck JA, Hosny MM, Quirynen M, van Steenberghe D. Freestanding and tooth-implant connected prostheses in the treatment of partially edentulous patients Part II: an up to 15-years radiographic evaluation. Clin Oral Implants Res 2001; 12 (03) 245-251
    CrossrefPubMedSearch in Google Scholar
  • 6 Jordan RA, Bodechtel C, Hertrampf K. et al; DMS V Surveillance Investigators' Group. The fifth German oral health study (Fünfte Deutsche Mundgesundheitsstudie, DMS V)–rationale, design, and methods. BMC Oral Health 2014; 14 (01) 161
    CrossrefPubMedSearch in Google Scholar
  • 7 Hämmerle CH, Wagner D, Brägger U. et al. Threshold of tactile sensitivity perceived with dental endosseous implants and natural teeth. Clin Oral Implants Res 1995; 6 (02) 83-90
    CrossrefPubMedSearch in Google Scholar
  • 8 Lin CL, Chang SH, Wang JC. Finite element analysis of biomechanical interactions of a tooth-implant splinting system for various bone qualities. Chang Gung Med J 2006; 29 (02) 143-153
    PubMedSearch in Google Scholar
  • 9 Kay HB. Free-standing versus implant-tooth-interconnected restorations: understanding the prosthodontic perspective. Int J Periodontics Restorative Dent 1993; 13 (01) 47-69
    PubMedSearch in Google Scholar
  • 10 Weinberg LA, Kruger B. Biomechanical considerations when combining tooth-supported and implant-supported prostheses. Oral Surg Oral Med Oral Pathol 1994; 78 (01) 22-27
    CrossrefPubMedSearch in Google Scholar
  • 11 Breeding LC, Dixon DL, Sadler JP, McKay ML. Mechanical considerations for the implant tooth-supported fixed partial denture. J Prosthet Dent 1995; 74 (05) 487-492
    CrossrefPubMedSearch in Google Scholar
  • 12 Cohen SR, Orenstein JH. The use of attachments in combination implant and natural-tooth fixed partial dentures: a technical report. Int J Oral Maxillofac Implants 1994; 9 (02) 230-234
    PubMedSearch in Google Scholar
  • 13 Pjetursson BE, Tan K, Lang NP, Brägger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 2004; 15 (06) 625-642
    CrossrefPubMedSearch in Google Scholar
  • 14 Lang NP, Pjetursson BE, Tan K, Brägger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. II. Combined tooth–implant-supported FPDs. Clin Oral Implants Res 2004; 15 (06) 643-653
    CrossrefPubMedSearch in Google Scholar
  • 15 Ting M, Faulkner RJ, Donatelli DP, Suzuki JB. Tooth-to-implant-supported fixed partial denture: a comprehensive overview of systematic reviews. Implant Dent 2019; 28 (05) 490-499
    CrossrefPubMedSearch in Google Scholar
  • 16 Chee W, Jivraj S. Connecting implants to teeth. Br Dent J 2006; 201 (10) 629-632
    CrossrefPubMedSearch in Google Scholar
  • 17 Garcia LT, Oesterle LJ. Natural tooth intrusion phenomenon with implants: a survey. Int J Oral Maxillofac Implants 1998; 13 (02) 227-231
    PubMedSearch in Google Scholar
  • 18 Ormianer Z, Brosh T, Laufer B-Z, Shifman A. Strains recorded in a combined tooth-implant restoration: an in vivo study. Implant Dent 2005; 14 (01) 58-62
    CrossrefPubMedSearch in Google Scholar
  • 19 Mosharraf R, Molaei P, Fathi A, Isler S. Investigating the effect of nonrigid connectors on the success of tooth-and-implant-supported fixed partial prostheses in maxillary anterior region: a finite element analysis (FEA). Int J Dent 2021; 2021: 5977994
    CrossrefPubMedSearch in Google Scholar
  • 20 Ozçelik T, Ersoy AE. An investigation of tooth/implant-supported fixed prosthesis designs with two different stress analysis methods: an in vitro study. J Prosthodont 2007; 16 (02) 107-116
    CrossrefPubMedSearch in Google Scholar
  • 21 Kumar R, Jhorawat R, Mathur M. et al. Effect of renal transplantation on multiple hormone levels in patients of chronic kidney disease: a single center study. J Dent Implant 2011; 1 (02) 75-79
    Search in Google Scholar
  • 22 Huang YC, Ding SJ, Yuan C, Yan M. Biomechanical analysis of rigid and non-rigid connection with implant abutment designs for tooth-implant supported prosthesis: a finite element analysis. J Dent Sci 2022; 17 (01) 490-499
    CrossrefPubMedSearch in Google Scholar
  • 23 Koosha S, Mirhashemi FS. An investigation of three types of tooth implant supported fixed prosthesis designs with 3D finite element analysis. J Dent (Tehran) 2013; 10 (01) 51-63
    PubMedSearch in Google Scholar
  • 24 Tsaousoglou P, Michalakis K, Kang K, Weber HP, Sculean A. The effect of rigid and non-rigid connections between implants and teeth on biological and technical complications: a systematic review and a meta-analysis. Clin Oral Implants Res 2017; 28 (07) 849-863
    CrossrefPubMedSearch in Google Scholar
  • 25 Wang M, Mehta N. A possible biomechanical role of occlusal cusp-fossa contact relationships. J Oral Rehabil 2013; 40 (01) 69-79
    CrossrefPubMedSearch in Google Scholar
  • 26 Kaur A, N M, N S, Kumari A, Shetty A. A comparative study of intra canal stress pattern in endodontically treated teeth with average sized canal diameter and reinforced wide canals with three different post systems using finite element analysis. J Conserv Dent 2010; 13 (01) 28-33
    CrossrefPubMedSearch in Google Scholar
  • 27 Mosharraf R, Molaei P, Fathi A, Isler S. Investigating the effect of nonrigid connectors on the success of tooth-and-implant-supported fixed partial prostheses in maxillary anterior region: a finite element analysis (FEA). Int J Dent 2021; 2021: 5977994
    CrossrefPubMedSearch in Google Scholar
  • 28 Bechelli AH. The osteointegrated prosthesis–combination of osteointegrated implants and natural teeth in fixed prostheses. J Oral Implantol 1992; 18 (01) 62-65
    PubMedSearch in Google Scholar
  • 29 Rangert B, Gunne J, Sullivan DY. Mechanical aspects of a Brånemark implant connected to a natural tooth: an in vitro study. Int J Oral Maxillofac Implants 1991; 6 (02) 177-186
    PubMedSearch in Google Scholar
  • 30 Mosharraf R, Molaei P, Fathi A, Isler S. Investigating the effect of nonrigid connectors on the success of tooth-and-implant-supported fixed partial prostheses in maxillary anterior region: a finite element analysis (FEA). Int J Dent 2021; 2021: 5977994
    CrossrefPubMedSearch in Google Scholar
  • 31 Lin C-L, Wang J-C, Kuo Y-C. Numerical simulation on the biomechanical interactions of tooth/implant-supported system under various occlusal forces with rigid/non-rigid connections. J Biomech 2006; 39 (03) 453-463
    CrossrefPubMedSearch in Google Scholar
  • 32 Lin CL, Wang JC, Chang WJ. Biomechanical interactions in tooth-implant-supported fixed partial dentures with variations in the number of splinted teeth and connector type: a finite element analysis. Clin Oral Implants Res 2008; 19 (01) 107-117
    CrossrefPubMedSearch in Google Scholar
  • 33 Hamed MT, Mously HA. Stress analysis for different designs of implant-borne and tooth-implant fixed partial dentures in mandibular posterior region. J Contemp Dent Pract 2019; 20 (12) 1375-1379
    CrossrefPubMedSearch in Google Scholar
  • 34 Ciaccio EJ, Biviano AB, Wan EY, Peters NS, Garan H. Development of an automaton model of rotational activity driving atrial fibrillation. Comput Biol Med 2017; 83: 166-181
    CrossrefPubMedSearch in Google Scholar
  • 35 Minatel L, Verri FR, Kudo GAH. et al. Effect of different types of prosthetic platforms on stress-distribution in dental implant-supported prostheses. Mater Sci Eng C 2017; 71: 35-42
    CrossrefPubMedSearch in Google Scholar
  • 36 Melo C, Matsushita Y, Koyano K, Hirowatari H, Suetsugu T. Comparative stress analyses of fixed free-end osseointegrated prostheses using the finite element method. J Oral Implantol 1995; 21 (04) 290-294
    PubMedSearch in Google Scholar
  • 37 Dashti M, Londono J, Ghasemi S, Moghaddasi N. How much can we rely on artificial intelligence chatbots such as the ChatGPT software program to assist with scientific writing?. J Prosthet Dent 2023; S0022-3913 (23) 00371-2
    Search in Google Scholar
  • 38 Londono J, Ghasemi S, Hussain Shah A. et al. Evaluation of deep learning and convolutional neural network algorithms accuracy for detecting and predicting anatomical landmarks on 2D lateral cephalometric images: a systematic review and meta-analysis. Saudi Dent J 2023; 35 (05) 487-497
    CrossrefPubMedSearch in Google Scholar
  • 39 Mauer RG, Shadrav A, Dashti M. Static surgical guides and dynamic navigation in implant surgery. In: Parhiz SA, James JN, Ghasemi S, Amirzade-Iranaq MH. eds. Navigation in Oral and Maxillofacial Surgery: Applications, Advances, and Limitations. Switzerland AG: Springer International Publishing; 2022: 135-150
    Search in Google Scholar
  • 40 Londono J, Ghasmi S, Lawand G, Mirzaei F, Akbari F, Dashti M. Assessment of the golden proportion in natural facial esthetics: A systematic review. J Prosthet Dent 2022; S0022-3913 (22) 00285-2
    Search in Google Scholar
  • 41 Londono J, Ghasemi S, Lawand G, Dashti M. Evaluation of the golden proportion in the natural dentition: a systematic review and meta-analysis. J Prosthet Dent 2023; 129 (05) 696-702
    CrossrefPubMedSearch in Google Scholar