Evaluation of stress distributions in peri-implant and periodontal bone tissues in 3- and 5-unit tooth and implant-supported fixed zirconia restorations by finite elements analysis

ABSTRACT

Objective: In this study, it is aimed to compare the distribution of stress on periodontal and peri-implant bone tissues in 3- and 5-unit-dental and implant-supported zirconia restorations using finite element analysis. Materials and Methods: Stress distribution formed in periodontal and peri-implant bone tissues as a result of chewing forces was analyzed in dental and implant-supported three-dimensional (3D) finite element models of zirconia restoration with 5-unit placed on the numbers of 43, 44, 45, 46, and 47 and with 3-unit placed on the number of 45, 46, and 47. Four different loading conditions were used. 200 N force was applied in 30° from the buccal inclination of number 43, 45, and 47 restorations separately and totally 850 N force was applied in 30° from the buccal inclination of whole restoration. The study was performed through static nonlinear analysis with the 3D finite element analysis method. Results: Stress accumulation in bone tissues in the tooth-supported model was found less than in implant-supported models. Stress accumulation was observed in the cervical portion of the implant in implant-supported models, and stress accumulation was observed surrounding bone of roots in tooth-supported models. The highest stress values were occurred in 5 unit implant-supported model in all loadings. Conclusion: In posterior restorations increased in the number of supported teeth and implant can reduce the destructive forces on periodontal and peri-implant bone tissues and may allow longer period retention of the restorations in the mouth.

 

MissingLinkText

Key words:

Finite element analysis - implant-supported prosthesis - peri-implant and periodontal bone - tooth-supported prosthesis - zirconia restorations

 

 

MissingLinkText

Conflicts of interest

There are no conflicts of interest.

• REFERENCES

• 1 Brånemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969; 3: 81-100
• 2 Moreira W, Hermann C, Pereira JT, Balbinoti JA, Tiossi R. A three-dimensional finite element study on the stress distribution pattern of two prosthetic abutments for external hexagon implants. Eur J Dent 2013; 7: 484-91
• 3 Christensen GJ. Ceramic vs. porcelain-fused-to-metal crowns: Give your patients a choice. J Am Dent Assoc 1994; 125: 311-312, 314
• 4 Malkoc MA, Sevimay M, Yaprak E. The use of zirconium and feldspathic porcelain in the management of the severely worn dentition: A case report. Eur J Dent 2009; 3: 75-80
• 5 Vult von SteyernP, Carlson P, Nilner K. All-ceramic fixed partial dentures designed according to the DC-Zirkon technique. A 2-year clinical study. J Oral Rehabil 2005; 32: 180-7
• 6 Piwowarczyk A, Ottl P, Lauer HC, Kuretzky T. A clinical report and overview of scientific studies and clinical procedures conducted on the 3M ESPE Lava All-Ceramic System. J Prosthodont 2005; 14: 39-45
• 7 Studart AR, Filser F, Kocher P, Lüthy H, Gauckler LJ. Cyclic fatigue in water of veneer-framework composites for all-ceramic dental bridges. Dent Mater 2007; 23: 177-85
• 8 Rismanchian M, Shafiei S, Nourbakhshian F, Davoudi A. Flexural strengths of implant-supported zirconia based bridges in posterior regions. J Adv Prosthodont 2014; 6: 346-50
• 9 Kelly JR, Denry I. Stabilized zirconia as a structural ceramic: An overview. Dent Mater 2008; 24: 289-98
• 10 Kobayashi K, Kuwajima H, Masaki T. Phase change and mechanical properties of ZrO₂-Y₂O₃ solid electrolyte after aging. Solid State Ionics 1981; 3: 489-95
• 11 Sato TM. Transformation of yttria-doped tetragonal ZrO₂ polycrystals by annealing in water. J Am Ceram Soc 1985; 68: 356-9
• 12 Sato T, Shimada M. Crystalline phase-change in yttria-partially stabilized zirconia by low-temperature annealing. J Am Ceram Soc 1984; 67: 212-23
• 13 Cales B, Stefani Y, Lilley E. Long-term in vivo and in vitro aging of a zirconia ceramic used in orthopaedy. J Biomed Mater Res 1994; 28: 619-24
• 14 Luo J, Ball RJ, Stevens R. Gadolinia doped ceria/yttria stabilised zirconia electrolytes for solid oxide fuel cell applications. J Mater Sci 2004; 39: 235-40
• 15 Heuer AH. Transformation toughening in ZrO₂-containing ceramics. J Am Ceram Soc 1987; 70: 689-8
• 16 Reidy DJ, Holmes JD, Morris MA. Preparation of a highly thermally stable titania anatase phase by addition of mixed zirconia and silica dopants. Ceram Int 2006; 32: 235-9
• 17 Kingery WD, Bowen HK, Uhlmann DR. Introduction to Ceramics. 2nd ed.. New York: Wiley and Sons; 1976: 58
• 18 Petrie CS, Williams JL. Comparative evaluation of implant designs: Influence of diameter, length, and taper on strains in the alveolar crest. A three-dimensional finite-element analysis. Clin Oral Implants Res 2005; 16: 486-94
• 19 Bozkaya D, Muftu S, Muftu A. Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite elements analysis. J Prosthet Dent 2004; 92: 523-30
• 20 Chun HJ, Cheong SY, Han JH, Heo SJ, Chung JP, Rhyu IC. et al. Evaluation of design parameters of osseointegrated dental implants using finite element analysis. J Oral Rehabil 2002; 29: 565-74
• 21 Tada S, Stegaroiu R, Kitamura E, Miyakawa O, Kusakari H. Influence of implant design and bone quality on stress/strain distribution in bone around implants: A 3-dimensional finite element analysis. Int J Oral Maxillofac Implants 2003; 18: 357-68
• 22 Wheeler RC. An Atlas of Tooth Form. Toronto: Harcourt, Canada; 1969
• 23 Heravi F, Salari S, Tanbakuchi B, Loh S, Amiri M. Effects of crown-root angle on stress distribution in the maxillary central incisors’ PDL during application of intrusive and retraction forces: A three-dimensional finite element analysis. Prog Orthod 2013; 14: 26
• 24 Covani U, Ricci M, Tonelli P, Barone A. An evaluation of new designs in implant-abutment connections: A finite element method assessment. Implant Dent 2013; 22: 263-7
• 25 Baggi L, Cappelloni I, Di Girolamo M, Maceri F, Vairo G. The influence of implant diameter and length on stress distribution of osseointegrated implants related to crestal bone geometry: A three-dimensional finite element analysis. J Prosthet Dent 2008; 100: 422-31
• 26 Ruse ND. Propagation of erroneous data for the modulus of elasticity of periodontal ligament and gutta percha in FEM/FEA papers: A story of broken links. Dent Mater 2008; 24: 1717-9
• 27 Iplikçioglu H, Akça K. Comparative evaluation of the effect of diameter, length and number of implants supporting three-unit fixed partial prostheses on stress distribution in the bone. J Dent 2002; 30: 41-6
• 28 I-Chiang C, Shyh-Yuan L, Ming-Chang W, Sun CW, Jiang CP. Finite element modelling of implant designs and cortical bone thickness on stress distribution in maxillary type IV bone. Comput Methods Biomech Biomed Engin 2014; 17: 516-26
• 29 Geng JP, Tan KB, Liu GR. Application of finite element analysis in implant dentistry: A review of the literature. J Prosthet Dent 2001; 85: 585-98
• 30 Wiskott HW, Belser UC. Lack of integration of smooth titanium surfaces: A working hypothesis based on strains generated in the surrounding bone. Clin Oral Implants Res 1999; 10: 429-44
• 31 Himmlová L, Dostálová T, Kácovský A, Konvicková S. Influence of implant length and diameter on stress distribution: A finite element analysis. J Prosthet Dent 2004; 91: 20-5
• 32 Koyano K, Esaki D. Occlusion on oral implants: Current clinical guidelines. J Oral Rehabil 2015; 42: 153-61
• 33 Svensson KG, Trulsson M. Impaired force control during food holding and biting in subjects with tooth- or implant-supported fixed prostheses. J Clin Periodontol 2011; 38: 1137-46
• 34 Adams MA. Mechanical testing of the spine. An appraisal of methodology, results, and conclusions. Spine (Phila Pa 1976) 1995; 20: 2151-6
• 35 Arkın H, Xu LX, Holmes KR. Recent developments in modeling heat transfer in blood perfused tissues. Biomed Eng 1994; 41: 97-107
• 36 Ismail YH, Pahountis LN, Fleming JF. Comparison of two-dimensional and three-dimensional finite element analysis of a blade implant. Int J Oral Implantol 1987; 4: 25-31
• 37 Meijer HJ, Starmans FJ, Bosman F, Steen WH. A comparison of three finite element models of an edentulous mandible provided with implants. J Oral Rehabil 1993; 20: 147-57
• 38 Akça K, İplikçioğlu H. Finite element stress analysis of the influence of staggered versus straight placement of dental implants. Int J Oral Maxillofac Implants 2001; 16: 722-30
• 39 Brunski JB, Puleo DA, Nanci A. Biomaterials and biomechanics of oral and maxillofacial implants: Current status and future developments. Int J Oral Maxillofac Implants 2000; 15: 15-46
• 40 Mericske-Stern R, Zarb GA. In vivo measurements of some functional aspects with mandibular fixed prostheses supported by implants. Clin Oral Implants Res 1996; 7: 153-61
• 41 Yamanishi Y, Yamaguchi S, Imazato S, Nakano T, Yatani H. Influences of implant neck design and implant-abutment joint type on peri-implant bone stress and abutment micro movement: Three-dimensional finite element analysis. Dent Mater 2012; 28: 1126-33
• 42 Rangert B, Krogh PH, Langer B, Van Roekel N. Bending overload and implant fracture: A retrospective clinical analysis. Int J Oral Maxillofac Implants 1995; 10: 326-34
• 43 Misch CE. Contemporaray Implant Dentisrty. 3rd ed.. St. Louis: Mosby Elsevier; 2008: p. 337
• 44 Winkler S, Morris HF, Ochi S. Implant survival to 36 months as related to length and diameter. Ann Periodontol 2000; 5: 22-31
• 45 de Baat C, van Loveren C, van der Maarel-Wierink CD, Witter DJ, Creugers NH. Aftercare for durability and profitability of single-unit and multi-unit fixed dental prostheses. Ned Tijdschr Tandheelkd 2013; 120: 411-20
• 46 Ogawa T, Dhaliwal S, Naert I, Mine A, Kronstrom M, Sasaki K. et al. Impact of implant number, distribution and prosthesis material on loading on implants supporting fixed prostheses. J Oral Rehabil 2010; 37: 525-31
• 47 Sahin S, Cehreli MC, Yalçin E. The influence of functional forces on the biomechanics of implant-supported prostheses – A review. J Dent 2002; 30: 271-82
• 48 Duyck J, Van Oosterwyck H, Vander SlotenJ, De Cooman M, Puers R, Naert I. Magnitude and distribution of occlusal forces on oral implants supporting fixed prostheses: An in vivo study. Clin Oral Implants Res 2000; 11: 465-75
• 49 Yan Y, Nunez PL, Hart RT. Finite-element model of the human head: Scalp potentials due to dipole sources. Med Biol Eng Comput 1991; 29: 475-81