Effect of modifying the screw access channels of zirconia implant abutment on the cement flow pattern and retention of zirconia restorations.

PubMed

Wadhwani, Chandur; Chung, Kwok-Hung

2014-07-01

The effect of managing the screw access channels of zirconia implant abutments in the esthetic zone has not been extensively evaluated. The purpose of this study was to determine the effect of an insert placed within the screw access channel of an anterior zirconia implant abutment on the amount of cement retained within the restoration-abutment system and on the dislodging force. Thirty-six paired zirconia abutments and restorations were fabricated by computer-aided design and computer-aided manufacturing and were divided into 3 groups: open abutment, with the screw access channel unfilled; closed abutment, with the screw access channel sealed; and insert abutment, with a thin, tubular metal insert projection continuous with the screw head and placed into the abutment screw access channel. The restorations were cemented to the abutments with preweighed eugenol-free zinc oxide cement (TempBond NE). Excess cement was removed, and the weight of the cement that remained in the restoration-abutment system was measured. Vertical tensile dislodging forces were recorded at a crosshead speed of 5 mm/min after incubation in a 37°C water bath for 24 hours. The specimens were examined for the cement flow pattern into the screw access channel after dislodgement. Data were analyzed with ANOVA, followed by multiple comparisons by using the Tukey honestly significant difference test (α = .05). The mean (standard deviation) of retentive force values ranged from 108.1 ± 29.9 N to 148.3 ± 21.0 N. The retentive force values differed significantly between the insert abutment and both the open abutment (P < .05) and closed abutment groups (P < .01). Distinct patterns of cement failure were noted. The weight of the cement that remained in the system differed significantly, with both open abutment and insert abutment being greater than closed abutment (P < .05). Modifying the internal configuration of the screw access channel of an esthetic zirconia implant abutment with a metal insert significantly affected both the cement retained within the abutment itself and the retention capabilities of the zirconia restoration cemented with TempBond NE cement. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

In vitro evaluation of reverse torque value of abutment screw and marginal opening in a screw- and cement-retained implant fixed partial denture design.

PubMed

Kim, Seok-Gyu; Park, Jae-Uk; Jeong, Jae-Heon; Bae, Chang; Bae, Tae-Soo; Chee, Winston

2009-01-01

The purpose of this study was to evaluate the clinical efficacy of implant prostheses retained by screws and cement (SCPs) by examining the reverse torque values (RTVs) of the abutment screws and the marginal openings of the implant prostheses. Two implants (3.8 x 13 mm; Camlog Biotechnologies) were embedded in an acrylic resin block 5 mm apart. Eighteen copies of this resin specimen were fabricated and randomly divided into two groups. Two-unit implant prostheses with two different designs-purely cement-retained implant prostheses (group 1) and SCPs (group 2)-were made out of type IV gold alloy and placed on the implants. After tightening to about 30 Ncm, the preloading RTVs of the abutment screws were measured. After retightening the abutment screws or cementing the prostheses, followed by cyclic loading, the postloading RTVs of the abutment screws were examined. Also, the marginal openings of the prostheses in the two groups were measured under a stereomicroscope. These measurements were compared statistically. The postloading RTVs and their differences from the preloading RTVs of the abutment screws demonstrated no significant differences between groups (P > .05). Group 2 prostheses showed significantly smaller marginal openings than group 1 prostheses (P < .05). The forces generated when torquing the abutment screw of the SCP did not cause more loosening of the abutment screws than the purely cement-retained implant prosthesis. The SCP showed better marginal adaptation of the cement-retained part than the purely cement-retained implant prosthesis, possibly as a result of the screw-retained abutment seating the restoration. Within the limitations of this in vitro test, the SCP showed no significant difference in RTV of the abutment screw and a smaller marginal gap compared to a purely cement-retained implant prosthesis.

Preload, Coefficient of Friction, and Thread Friction in an Implant-Abutment-Screw Complex.

PubMed

Wentaschek, Stefan; Tomalla, Sven; Schmidtmann, Irene; Lehmann, Karl Martin

To examine the screw preload, coefficient of friction (COF), and tightening torque needed to overcome the thread friction of an implant-abutment-screw complex. In a customized load frame, 25 new implant-abutment-screw complexes including uncoated titanium alloy screws were torqued and untorqued 10 times each, applying 25 Ncm. Mean preload values decreased significantly from 209.8 N to 129.5 N according to the number of repetitions. The overall COF increased correspondingly. There was no comparable trend for the thread friction component. These results suggest that the application of a used implant-abutment-screw complex may be unfavorable for obtaining optimal screw preload.

Influence of abutment materials on the implant-abutment joint stability in internal conical connection type implant systems

PubMed Central

Jo, Jae-Young; Yang, Dong-Seok; Huh, Jung-Bo; Heo, Jae-Chan; Yun, Mi-Jung

2014-01-01

PURPOSE This study evaluated the influence of abutment materials on the stability of the implant-abutment joint in internal conical connection type implant systems. MATERIALS AND METHODS Internal conical connection type implants, cement-retained abutments, and tungsten carbide-coated abutment screws were used. The abutments were fabricated with commercially pure grade 3 titanium (group T3), commercially pure grade 4 titanium (group T4), or Ti-6Al-4V (group TA) (n=5, each). In order to assess the amount of settlement after abutment fixation, a 30-Ncm tightening torque was applied, then the change in length before and after tightening the abutment screw was measured, and the preload exerted was recorded. The compressive bending strength was measured under the ISO14801 conditions. In order to determine whether there were significant changes in settlement, preload, and compressive bending strength before and after abutment fixation depending on abutment materials, one-way ANOVA and Tukey's HSD post-hoc test was performed. RESULTS Group TA exhibited the smallest mean change in the combined length of the implant and abutment before and after fixation, and no difference was observed between groups T3 and T4 (P>.05). Group TA exhibited the highest preload and compressive bending strength values, followed by T4, then T3 (P<.001). CONCLUSION The abutment material can influence the stability of the interface in internal conical connection type implant systems. The strength of the abutment material was inversely correlated with settlement, and positively correlated with compressive bending strength. Preload was inversely proportional to the frictional coefficient of the abutment material. PMID:25551010

SEM and fractography analysis of screw thread loosening in dental implants.

PubMed

Scarano, A; Quaranta, M; Traini, T; Piattelli, M; Piattelli, A

2007-01-01

Biological and technical failures of implants have already been reported. Mechanical factors are certainly of importance in implant failures, even if their exact nature has not yet been established. The abutment screw fracture or loosening represents a rare, but quite unpleasant failure. The aim of the present research is an analysis and structural examination of screw thread or abutment loosening compared with screw threads or abutment without loosening. The loosening of screw threads was compared to screw thread without loosening of three different implant systems; Branemark (Nobel Biocare, Gothenburg, Sweden), T.B.R. implant systems (Benax, Ancona, Italy) and Restore (Lifecore Biomedical, Chaska, Minnesota, USA). In this study broken screws were excluded. A total of 16 screw thread loosenings were observed (Group I) (4 Branemark, 4 T.B.R and 5 Restore), 10 screw threads without loosening were removed (Group II), and 6 screw threads as received by the manufacturer (unused) (Group III) were used as control (2 Branemark, 2 T.B.R and 2 Restore). The loosened abutment screws were retrieved and analyzed under SEM. Many alterations and deformations were present in concavities and convexities of screw threads in group I. No macroscopic alterations or deformations were observed in groups II and III. A statistical difference of the presence of microcracks were observed between screw threads with an abutment loosening and screw threads without an abutment loosening.

The influence of abutment screw tightening on screw joint configuration.

PubMed

Lang, Lisa A; Wang, Rui-Feng; May, Kenneth B

2002-01-01

Limiting abutment-to-implant hexagonal discrepancies and rotational movement of the abutment around the implant to less than 5 degrees would result in a more stable screw joint. However, the exact relationship after abutment screw tightening is unknown, as is the effect of a counter-torque device in limiting abutment movement during screw tightening. This study examined the orientation of the abutment hexagon to the implant hexagon after tightening of the abutment screw for several abutment systems with and without the use of a counter-torque device. Thirty conical self-tapping implants (3.75 x 10.0 mm) and 10 wide-platform Brånemark System implants (5.0 x 10.0 mm), along with 10 abutment specimens from the CeraOne, Estheticone, Procera, and AuraAdapt systems, were selected for this investigation. The implants were placed in a holding device prior to tightening of the abutments. When the tightening torque recommended for each abutment system was reached with the use of a torque controller, each implant abutment specimen was removed from the holding device and embedded in a hard resin medium. The specimens were sectioned in a horizontal direction at the level of the hexagons and cleansed of debris prior to examination. The hexagon orientations were assessed as the degree and direction of rotation of the abutment hexagon around the implant hexagon. The range of the maximum degrees of rotation for all 4 abutment groups tightened with or without the counter-torque device was slightly more than 3.53 degrees. The absolute degrees of rotation for all 4 abutment groups were less than 1.50 degrees with or without the use of the counter-torque device. The hexagon-to-hexagon orientation measured as rotational fit on all abutment systems was below the 5 degrees suggested as optimal for screw joint stability. The absolute degrees of rotation for all 4 abutment groups were less than 1.50 degrees regardless of whether the counter-torque device was used.

Influence of abutment screw preload on stress distribution in marginal bone.

PubMed

Khraisat, Ameen

2012-01-01

Changes in an implant assembly after abutment connection might possibly cause deformation in the implant/abutment joint and even in the marginal bone. The aim of this study was to evaluate the influence of abutment screw preload through the implant collar on marginal bone stress without external load application. Models of three implant parts made of titanium (implant, abutment, and abutment screw) and cortical bone were built and positioned with computer-aided design software. Meshing and generation of boundary conditions, loads, and interactions were performed. Each part was meshed independently. The sole load applied to the model was a torque of 32 Ncm on the abutment screw about its axis of rotation. The implant collar was deformed axially after the screw was tightened (3 μm). This deformation resulted in 60 MPa of stress in the marginal bone. Moreover, pressure on the marginal bone in a radial direction was observed. It can be concluded that, without any external load application, abutment screw preload exerts stresses on the implant collar and the marginal bone. These findings should help guide the development of new implant/abutment joint designs that exert less stress on the marginal bone.

Mechanical behavior of single-layer ceramized zirconia abutments for dental implant prosthetic rehabilitation

PubMed Central

Jiménez-Melendo, Manuel; Llena-Blasco, Oriol; Bruguera, August; Llena-Blasco, Jaime; Yáñez-Vico, Rosa-María; García-Calderón, Manuel; Vaquero-Aguilar, Cristina; Velázquez-Cayón, Rocío; Gutiérrez-Pérez, José-Luis

2014-01-01

Objectives: This study was undertaken to characterize the mechanical response of bare (as-received) and single-layer ceramized zirconia abutments with both internal and external connections that have been developed to enhanced aesthetic restorations. Material and Methods: Sixteen zirconia implant abutments (ZiReal Post®, Biomet 3i, USA) with internal and external connections have been analyzed. Half of the specimens were coated with a 0.5mm-thick layer of a low-fusing fluroapatite ceramic. Mechanical tests were carried out under static (constant cross-head speed of 1mm/min until fracture) and dynamic (between 100 and 400N at a frequency of 1Hz) loading conditions. The failure location was identified by electron microscopy. The removal torque of the retaining screws after testing was also evaluated. Results: The average fracture strength was above 300N for all the abutments, regardless of connection geometry and coating. In most of the cases (94%), failure occurred by abutment fracture. No significant differences were observed either in fatigue behavior and removal torque between the different abutment groups. Conclusions: Mechanical behavior of Zireal zirconia abutments is independent of the type of internal/external connection and the presence/absence of ceramic coating. This may be clinically valuable in dental rehabilitation to improve the aesthetic outcome of zirconia-based dental implant systems. Key words:Dental implant, zirconia, ceramic structure, mechanical properties. PMID:25674313

Effect of Repeated Screw Joint Closing and Opening Cycles and Cyclic Loading on Abutment Screw Removal Torque and Screw Thread Morphology: Scanning Electron Microscopy Evaluation.

PubMed

Arshad, Mahnaz; Mahgoli, Hosseinali; Payaminia, Leila

To evaluate the effect of repeated screw joint closing and opening cycles and cyclic loading on abutment screw removal torque and screw thread morphology using scanning electron microscopy (SEM). Three groups (n = 10 in each group) of implant-abutment-abutment screw assemblies were created. There were also 10 extra abutment screws as new screws in group 3. The abutment screws were tightened to 12 Ncm with an electronic torque meter; then they were removed and removal torque values were recorded. This sequence was repeated 5 times for group 1 and 15 times for groups 2 and 3. The same screws in groups 1 and 2 and the new screws in group 3 were then tightened to 12 Ncm; this was also followed by screw tightening to 30 Ncm and retightening to 30 Ncm 15 minutes later. Removal torque measurements were performed after screws were subjected to cyclic loading (0.5 × 10⁶ cycles; 1 Hz; 75 N). Moreover, the surface topography of one screw from each group before and after cyclic loading was evaluated with SEM and compared with an unused screw. All groups exhibited reduced removal torque values in comparison to insertion torque in each cycle. However, there was a steady trend of torque loss in each group. A comparison of the last cycle of the groups before loading showed significantly greater torque loss value in the 15th cycle of groups 2 and 3 compared with the fifth cycle of group 1 (P < .05). Nonetheless, torque loss values after loading were not shown to be significantly different from each other. Using a new screw could not significantly increase the value of removal torque. It was concluded that restricting the amount of screw tightening is more important than replacing the screw with a new one when an abutment is definitively placed.

Acrylic resin guide for locating the abutment screw access channel of cement-retained implant prostheses.

PubMed

Ahmed, Ayman; Maroulakos, Georgios; Garaicoa, Jorge

2016-05-01

Abutment screw loosening represents a common and challenging technical complication of cement-retained implant prostheses. This article describes the fabrication of a simple and accurate poly(methyl methacrylate) guide for identifying the location and angulation of the abutment screw access channel of a cement-retained implant prosthesis with a loosened abutment screw. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The applicability of PEEK-based abutment screws.

PubMed

Schwitalla, Andreas Dominik; Abou-Emara, Mohamed; Zimmermann, Tycho; Spintig, Tobias; Beuer, Florian; Lackmann, Justus; Müller, Wolf-Dieter

2016-10-01

The high-performance polymer PEEK (poly-ether-ether-ketone) is more and more being used in the field of dentistry, mainly for removable and fixed prostheses. In cases of screw-retained implant-supported reconstructions of PEEK, an abutment screw made of PEEK might be advantageous over a conventional metal screw due to its similar elasticity. Also in case of abutment screw fracture, a screw of PEEK could be removed more easily. M1.6-abutment screws of four different PEEK compounds were subjected to tensile tests to set their maximum tensile strengths in relation to an equivalent stress of 186MPa, which is aused by a tightening torque of 15Ncm. Two screw types were manufactured via injection molding and contained 15% short carbon fibers (sCF-15) and 40% (sCF-40), respectively. Two screw types were manufactured via milling and contained 20% TiO2 powder (TiO2-20) and >50% parallel orientated, continuous carbon fibers (cCF-50). A conventional abutments screw of Ti6Al4V (Ti; CAMLOG(®) abutment screw, CAMLOG, Wimsheim, Germany) served as control. The maximum tensile strength was 76.08±5.50MPa for TiO2-20, 152.67±15.83MPa for sCF-15, 157.29±20.11MPa for sCF-40 and 191.69±36.33MPa for cCF-50. The maximum tensile strength of the Ti-screws amounted 1196.29±21.4MPa. The results of the TiO2-20 and the Ti screws were significantly different from the results of the other samples, respectively. For the manufacturing of PEEK abutment screws, PEEK reinforced by >50% continuous carbon fibers would be the material of choice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Implant abutment deformation during prosthetic cylinder screw tightening: an in vitro study.

PubMed

Neto, Rafael Tobias Moretti; Moura, Marcio Silva; Souza, Edson Antonio Capello; Rubo, José Henrique

2009-01-01

Nonpassive fit frameworks are believed to lead to implant overload and consequently loss of osseointegration. This is one of the most commonly reported failures of implant prostheses. In an ideal situation of passive fit, when torque is applied to bring the abutment-cylinder interface together some amount of deformation can be expected, and it should be homogeneous along the periphery of the abutment. The aim of this study was to verify the amount of abutment deformation that can be expected when a free-standing cylinder is screwed into place. This could give insight into what should be accepted as passive fit. Strain gauges were bonded to the sides of five standard abutments that had machined palladium-silver cylinders or cobalt-chromium cast cylinders screwed into place. Measurements were taken to verify the deformation at each site. Values of abutment deformation after abutment screw tightening ranged from -127.70 to -590.27 microepsilon. The deformation recorded for palladium-silver prosthetic cylinder tightening ranged from 56.905 to -381.50 microepsilon (mean: 173.298 microepsilon) and from -5.62638 to -383.86 microepsilon (mean: 200.474 microepsilon) for cobalt-chromium cylinders. There was no statistically significant difference among the two groups. Both abutment screw tightening and prosthetic cylinder screw tightening result in abutment deformation, which is compressive most of the time.

Esthetic abutment design for angulated screw channels: A technical report.

PubMed

Sakamoto, Satoshi; Ro, Munehiko; Al Ardah, Aladdin; Goodacre, Charles

2017-11-15

Angulated screw channel system abutments (ASCs) have recently been introduced to address the problem with visible screw access that may compromise esthetics. ASCs allow the screw access to be modified up to 25 degrees relative to the implant axis. However, a widened channel, which may cause thinning of the facial ceramic, is needed at the implant screw head to allow for proper engagement of the screwdriver. This technical report introduces a custom titanium insert design, the Satoshi Sakamoto (SS) abutment. The SS abutment consists of a custom titanium metal insert and zirconia coping in which the access hole is located in an esthetic position with an ASC system. The SS abutment results in a crown with more normal crown dimensions that also provides more space for the soft tissues. This SS abutment design allows clinicians to obtain screw-retained restorations with optimal esthetics and mechanical strength. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluation of the sealing capability of implants to titanium and zirconia abutments against Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum under different screw torque values.

PubMed

Smith, Nicole A; Turkyilmaz, Ilser

2014-09-01

When evaluating long-term implant success, clinicians have always been concerned with the gap at the implant-abutment junction, where bacteria can accumulate and cause marginal bone loss. However, little information regarding bacterial leakage at the implant-abutment junction, or microgap, is available. The purpose of this study was to evaluate sealing at 2 different implant-abutment interfaces under different screw torque values. Twenty sterile zirconia abutments and 20 sterile titanium abutments were screwed into 40 sterile implants and placed in test tubes. The ability of a bacterial mixture of Prevotella intermedia, Porphyromonas gingivalis, and Fusobacterium nucleatum to leak through an implant-titanium abutment seal under 20 and 35 Ncm torque values and an implant-zirconia abutment seal under 20 and 35 Ncm torque values was evaluated daily until leakage was noted. Once a unit demonstrated leakage, a specimen was plated. After 4 days, the number of colonies on each plate was counted with an electronic colony counter. Plating was used to verify whether or not bacterial leakage occurred and when leakage first occurred. The implant-abutment units were removed and rinsed with phosphate buffered saline solution and evaluated with a stereomicroscope. The marginal gap between the implant and the abutment was measured and correlated with the amount of bacterial leakage. The data were analyzed with ANOVA. Bacterial leakage was noted in all specimens, regardless of material or screw torque value. With titanium abutments, changing the screw torque value from 20 to 35 Ncm did not significantly affect the amount of bacterial leakage. However, with zirconia abutments, changing the screw torque value from 20 to 35 Ncm was statistically significant (P<.017). Overall, the marginal gap noted was larger at the zirconia-abutment interface (5.25 ±1.99 μm) than the titanium-abutment interface (12.38 ±3.73 μm), irrespective of the screw torque value. Stereomicroscopy revealed a nonuniform marginal gap in all specimens. The results of this study showed that, over time, bacteria will leak through the implant-abutment microgap at the implant-abutment interface. Implants with a titanium abutment demonstrate a smaller microgap than implants with a zirconia abutment. Tightening the zirconia abutment screw from 20 to 35 Ncm decreases the size of the microgap, which suggests a more intimate fit between the implant and the abutment. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluation of stability of interface between CCM (Co-Cr-Mo) UCLA abutment and external hex implant.

PubMed

Yoon, Ki-Joon; Park, Young-Bum; Choi, Hyunmin; Cho, Youngsung; Lee, Jae-Hoon; Lee, Keun-Woo

2016-12-01

The purpose of this study is to evaluate the stability of interface between Co-Cr-Mo (CCM) UCLA abutment and external hex implant. Sixteen external hex implant fixtures were assigned to two groups (CCM and Gold group) and were embedded in molds using clear acrylic resin. Screw-retained prostheses were constructed using CCM UCLA abutment and Gold UCLA abutment. The external implant fixture and screw-retained prostheses were connected using abutment screws. After the abutments were tightened to 30 Ncm torque, 5 kg thermocyclic functional loading was applied by chewing simulator. A target of 1.0 × 10 6 cycles was applied. After cyclic loading, removal torque values were recorded using a driving torque tester, and the interface between implant fixture and abutment was evaluated by scanning electronic microscope (SEM). The means and standard deviations (SD) between the CCM and Gold groups were analyzed with independent t-test at the significance level of 0.05. Fractures of crowns, abutments, abutment screws, and fixtures and loosening of abutment screws were not observed after thermocyclic loading. There were no statistically significant differences at the recorded removal torque values between CCM and Gold groups ( P >.05). SEM analysis revealed that remarkable wear patterns were observed at the abutment interface only for Gold UCLA abutments. Those patterns were not observed for other specimens. Within the limit of this study, CCM UCLA abutment has no statistically significant difference in the stability of interface with external hex implant, compared with Gold UCLA abutment.

Influence of the implant abutment types and the dynamic loading on initial screw loosening

PubMed Central

Kim, Eun-Sook

2013-01-01

PURPOSE This study examined the effects of the abutment types and dynamic loading on the stability of implant prostheses with three types of implant abutments prepared using different fabrication methods by measuring removal torque both before and after dynamic loading. MATERIALS AND METHODS Three groups of abutments were produced using different types of fabrication methods; stock abutment, gold cast abutment, and CAD/CAM custom abutment. A customized jig was fabricated to apply the load at 30° to the long axis. The implant fixtures were fixed to the jig, and connected to the abutments with a 30 Ncm tightening torque. A sine curved dynamic load was applied for 105 cycles between 25 and 250 N at 14 Hz. Removal torque before loading and after loading were evaluated. The SPSS was used for statistical analysis of the results. A Kruskal-Wallis test was performed to compare screw loosening between the abutment systems. A Wilcoxon signed-rank test was performed to compare screw loosening between before and after loading in each group (α=0.05). RESULTS Removal torque value before loading and after loading was the highest in stock abutment, which was then followed by gold cast abutment and CAD/CAM custom abutment, but there were no significant differences. CONCLUSION The abutment types did not have a significant influence on short term screw loosening. On the other hand, after 105 cycles dynamic loading, CAD/CAM custom abutment affected the initial screw loosening, but stock abutment and gold cast abutment did not. PMID:23509006

Influence of repeated screw tightening on bacterial leakage along the implant-abutment interface.

PubMed

do Nascimento, Cássio; Pedrazzi, Vinícius; Miani, Paola Kirsten; Moreira, Larissa Daher; de Albuquerque, Rubens Ferreira

2009-12-01

Bacterial penetration along the implant-abutment interface as a consequence of abutment screw loosening has been reported in a number of recent studies. The aim of this in vitro study was to investigate the influence of repeated tightening of the abutment screw on leakage of Streptococcus mutans along the interface between implants and pre-machined abutments. Twenty pre-machined abutments with a plastic sleeve were used. The abutment screws were tightened to 32 N cm in group 1 (n=10 - control) and to 32 N cm, loosened and re-tightened with the same torque twice in group 2 (n=10). The assemblies were completely immersed in 5 ml of Tryptic Soy Broth medium inoculated with S. mutans and incubated for 14 days. After this period, contamination of the implant internal threaded chamber was evaluated using the DNA Checkerboard method. Microorganisms were found on the internal surfaces of both groups evaluated. However, bacterial counts in group 2 were significantly higher than that in the control group (P<0.05). These results suggest that bacterial leakage between implants and abutments occurs even under unloaded conditions and at a higher intensity when the abutment screw is tightened and loosened repeatedly.

Removal torque of zirconia abutment screws under dry and wet conditions.

PubMed

Nigro, Frederico; Sendyk, Claudio L; Francischone, Carlos Eduardo; Francischone, Carlos Eduardo

2010-01-01

The aim of this study was to verify whether screw abutment lubrication can generate higher preload values compared to non-lubricated screws, a titanium abutment was screwed onto an implant analog and scanned with the Procera System to generate 20 zirconia abutments. MKIII Brånemark implants were clamped to a precision torque device, and the abutments were distributed in dry and wet groups with 10 specimens each. In the wet groups, the inner threads of the implants were filled with artificial saliva. All abutments were fastened with a Torqtite screw under 32 Ncm. Ten detorque measurements were performed per group pushing the reverse button of the Torque controller soon after screw tightening with values registered. The mean detorque values were calculated and compared by a Student's t test (α=0.05). The wet condition presented significantly higher mean detorque than the dry condition (31.5 ± 1.2 versus 27.5 ± 1.5 Ncm, respectively; p=0.0000024). In conclusion, there was always a loss in the initial torque values when the removal torque was measured under both conditions. The wet condition presented higher mean torque than the dry condition. Better preload values were established in the wet group, suggesting that the abutment screw must be lubricated in saliva to avoid further loosening.

Torque removal evaluation of prosthetic screws after tightening and loosening cycles: an in vitro study.

PubMed

Cardoso, Mayra; Torres, Marcelo Ferreira; Lourenço, Eduardo José Veras; de Moraes Telles, Daniel; Rodrigues, Renata Cristina Silveira; Ribeiro, Ricardo Faria

2012-04-01

The aim of this study was to evaluate the variation in removal torque of implant prosthetic abutment screws after successive tightening and loosening cycles, in addition to evaluating the influence of the hexagon at the abutment base on screw removal torque. Twenty hexagonal abutments were tightened to 20 regular external hex implants with a titanium alloy screw, with an insertion torque of 32 N cm, measured with a digital torque gauge. The implant/abutment/screw assemblies were divided into two groups: (1) abutments without hexagon at the base and (2) abutments with a hexagon at the base. Each assembly received a provisional restoration and was submitted to mechanical loading cycles. After this, the screws were removed and the removal torque was measured. This sequence was repeated 10 times, then the screw was replaced by a new one, and another cycle was performed. Linear regression analysis was performed. Removal torque values tended to decrease as the number of insertion/removal cycles increased, for both groups. Comparisons of the slopes and the intercepts between groups showed no statistical difference. There was no significant difference between the mean values of last five cycles and the 11th cycle. Within the limitations of this in vitro study, it was concluded that (1) repeated insertion/removal cycles promoted gradual reduction in removal torque of screws, (2) replacing the screw with a new one after 10 cycles did not increase resistance to loosening, and (3) removal of the hexagon from the abutment base had no effect on the removal torque of the screws. © 2011 John Wiley & Sons A/S.

The effects of loading on the preload and dimensions of the abutment screw for a 3-unit cantilever-fixed prosthesis design.

PubMed

Setia, Gaurav; Yousef, Hoda; Ehrenberg, David; Luke, Allyn; Weiner, Saul

2013-08-01

The purpose of this study was to use an in vitro model system to compare the effects on the screw torque and screw dimensions within 2 commercially available implant systems from occlusal loading on a cantilevered-fixed partial denture. Cantilevered implant-supported 3-unit prostheses with 2 premolar abutments and 1 premolar pontic (7.3 mm in length) were made on resin casts containing 2 implant analogs for 2 implant systems: BioLok Silhouette Tapered Implant System (Birmingham, AL) and Zimmer Tapered Screw-Vent Implant System (Carlsbad, CA) with 10 samples in each group. Each sample was loaded with either of 2 protocols: (1) a load of 50 N on the cantilevered pontic unit and (2) a loading of 150 N on all 3 units. The outcome measures were (1) changes in residual torque of the abutment screws and (2) changes in screw dimension. The BioLok Silhouette Tapered Implant group demonstrated slight but statistically significant torque loss 18.8% to 28.5% in both abutment screws for both protocols, P ≤ 0.05, without any changes in screw dimension. In the Zimmer Tapered Screw-Vent Implant group, there was a significant elongation of the abutment screws and a markedly significant 44.4%, (P ≤ 0.01) loss in torque in the mesial screw and a 28.5%, (P ≤ 0.05) loss in torque in the distal screw when the cantilever alone was loaded. Differences in screw design influence the maintenance of preload and distortion of the shank. The influence of the interface design, namely an internal hex of 1 mm versus an external hex did not influence the preload. Cantilevered prostheses can cause loss of torque and dimensional changes in abutment screws.

Evaluation of torque maintenance of abutment and cylinder screws with Morse taper implants.

PubMed

Ferreira, Mayara Barbosa; Delben, Juliana Aparecida; Barão, Valentim Adelino Ricardo; Faverani, Leonardo Perez; Dos Santos, Paulo Henrique; Assunção, Wirley Gonçalves

2012-11-01

The screw loosening of implant-supported prostheses is a common mechanical failure and is related to several factors as insertion torque and preload. The aim of this study was to evaluate the torque maintenance of retention screws of tapered abutments and cylinders of Morse taper implants submitted to retightening and detorque measurements. Two groups were obtained (n = 12): group I-tapered abutment connected to the implant with titanium retention screw and group II-cylinder with metallic base connected to tapered abutment with titanium retention screw. The detorque values were measured by an analogic torque gauge after 3 minutes of torque insertion. The detorque was measured 10 times for each retention screw of groups I and II, totalizing 120 detorque measurements in each group. Data were submitted to ANOVA and Fisher exact test (P < 0.05). Both groups presented reduced detorque value (P < 0.05) in comparison to the insertion torque in all measurement periods. There was a statistically significant difference (P < 0.05) between the detorque values of the first measurement and the other measurement periods for the abutment screw. However, there was no statistically significant difference (P > 0.05) for the detorque values of all measurement periods for the cylinder screw. In conclusion, the abutment and cylinder screws exhibited torque loss after insertion, which indicates the need for retightening during function of the implant-supported prostheses.

Evaluation of stability of interface between CCM (Co-Cr-Mo) UCLA abutment and external hex implant

PubMed Central

Yoon, Ki-Joon; Park, Young-Bum; Choi, Hyunmin; Cho, Youngsung; Lee, Jae-Hoon

2016-01-01

PURPOSE The purpose of this study is to evaluate the stability of interface between Co-Cr-Mo (CCM) UCLA abutment and external hex implant. MATERIALS AND METHODS Sixteen external hex implant fixtures were assigned to two groups (CCM and Gold group) and were embedded in molds using clear acrylic resin. Screw-retained prostheses were constructed using CCM UCLA abutment and Gold UCLA abutment. The external implant fixture and screw-retained prostheses were connected using abutment screws. After the abutments were tightened to 30 Ncm torque, 5 kg thermocyclic functional loading was applied by chewing simulator. A target of 1.0 × 106 cycles was applied. After cyclic loading, removal torque values were recorded using a driving torque tester, and the interface between implant fixture and abutment was evaluated by scanning electronic microscope (SEM). The means and standard deviations (SD) between the CCM and Gold groups were analyzed with independent t-test at the significance level of 0.05. RESULTS Fractures of crowns, abutments, abutment screws, and fixtures and loosening of abutment screws were not observed after thermocyclic loading. There were no statistically significant differences at the recorded removal torque values between CCM and Gold groups (P>.05). SEM analysis revealed that remarkable wear patterns were observed at the abutment interface only for Gold UCLA abutments. Those patterns were not observed for other specimens. CONCLUSION Within the limit of this study, CCM UCLA abutment has no statistically significant difference in the stability of interface with external hex implant, compared with Gold UCLA abutment. PMID:28018564

Abutments with reduced diameter for both cement and screw retentions: analysis of failure modes and misfit of abutment-crown-connections after cyclic loading.

PubMed

Moris, Izabela Cristina Maurício; Faria, Adriana Cláudia Lapria; Ribeiro, Ricardo Faria; Rodrigues, Renata Cristina Silveira

2017-04-01

The aim of this study was to analyze failure modes and misfit of abutments with reduced diameter for both cement and screw retentions after cyclic loading. Forty morse-taper abutment/implant sets of titanium were divided into four groups (N = 10): G4.8S-4.8 abutment with screw-retained crown; G4.8C-4.8 abutment with cemented crown; G3.8S-3.8 abutment with screw-retained crown; and G3.8C-3.8 abutment with cemented crown. Copings were waxed on castable cylinders and cast by oxygen gas flame and injected by centrifugation. After, esthetic veneering ceramic was pressed on these copings for obtaining metalloceramic crowns of upper canine. Cemented crowns were cemented on abutments with provisional cement (Temp Bond NE), and screw-retained crowns were tightened to their abutments with torque recommended by manufacturer (10 N cm). The misfit was measured using a stereomicroscope in a 10× magnification before and after cyclic loading (300,000 cycles). Tests were visually monitored, and failures (decementation, screw loosening and fractures) were registered. Misfit was analyzed by mixed linear model while failure modes by chi-square test (α = 0.05). Cyclic loading affected misfit of 3.8C (P ≤ 0.0001), 3.8S (P = 0.0055) and 4.8C (P = 0.0318), but not of 4.8S (P = 0.1243). No differences were noted between 3.8S with 4.8S before (P = 0.1550) and after (P = 0.9861) cyclic loading, but 3.8C was different from 4.8C only after (P = 0.0015) loading. Comparing different types of retentions at the same diameter abutment, significant difference was noted before and after cyclic loading for 3.8 and 4.8 abutments. Analyzing failure modes, retrievable failures were present at 3.8S and 3.8C groups, while irretrievable were only present at 3.8S. The cyclic loading decreased misfit of cemented and screw-retained crowns on reduced diameter abutments, and misfit of cemented crowns is greater than screw-retained ones. Abutments of reduced diameter failed more than conventional. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Stress distribution pattern of screw-retained restorations with segmented vs. non-segmented abutments: A finite element analysis

PubMed Central

Aalaei, Shima; Rajabi Naraki, Zahra; Nematollahi, Fatemeh; Beyabanaki, Elaheh; Shahrokhi Rad, Afsaneh

2017-01-01

Background. Screw-retained restorations are favored in some clinical situations such as limited inter-occlusal spaces. This study was designed to compare stresses developed in the peri-implant bone in two different types of screw-retained restorations (segmented vs. non-segmented abutment) using a finite element model. Methods. An implant, 4.1 mm in diameter and 10 mm in length, was placed in the first molar site of a mandibular model with 1 mm of cortical bone on the buccal and lingual sides. Segmented and non-segmented screw abutments with their crowns were placed on the simulated implant in each model. After loading (100 N, axial and 45° non-axial), von Mises stress was recorded using ANSYS software, version 12.0.1. Results. The maximum stresses in the non-segmented abutment screw were less than those of segmented abutment (87 vs. 100, and 375 vs. 430 MPa under axial and non-axial loading, respectively). The maximum stresses in the peri-implant bone for the model with segmented abutment were less than those of non-segmented ones (21 vs. 24 MPa, and 31 vs. 126 MPa under vertical and angular loading, respectively). In addition, the micro-strain of peri-implant bone for the segmented abutment restoration was less than that of non-segmented abutment. Conclusion. Under axial and non-axial loadings, non-segmented abutment showed less stress concentration in the screw, while there was less stress and strain in the peri-implant bone in the segmented abutment. PMID:29184629

Comparative Evaluation of Fracture Resistance and Mode of Failure of Zirconia and Titanium Abutments with Different Diameters.

PubMed

Shabanpour, Reza; Mousavi, Niloufar; Ghodsi, Safoura; Alikhasi, Marzieh

2015-08-01

The purpose of the current study was to compare the fracture resistance and mode of failure of zirconia and titanium abutments with different diameters. Fourteen groups of abutments including prefabricated zirconia, copy-milled zirconia and titanium abutments of an implant system (XiVE, Dentsply) were prepared in different diameters. An increasing vertical load was applied to each specimen until failure occurred. Fracture resistance was measured in each group using the universal testing machine. Moreover, the failure modes were studied and categorized as abutment screw fracture, connection area fracture, abutment body fracture, abutment body distortion, screw distortion and connection area distortion. Groups were statistically compared using univariate and post-hoc tests. The level of statistical significance was set at 5%. Fabrication method (p = 0.03) and diameter (p < 0.001) had significant effect on the fracture resistance of abutments. Fracture resistance of abutments with 5.5 mm diameter was higher than other diameters (p < 0.001). The observed modes of failure were dependent on the abutment material as well. All of the prefabricated titanium abutments fractured within the abutment screw. Abutment screw distortion, connection area fracture, and abutment body fracture were the common failure type in other groups. Diameter had a significant effect on fracture resistance of implant abutments, as abutments with greater diameters were more resistant to static loads. Copy-milled abutments showed lower fracture resistance as compared to other experimental groups. Although zirconia abutments have received great popularity among clinicians and even patients selecting them for narrow implants should be with caution.

Does Ferrule Effect Affect Implant-Abutment Stability?

PubMed

Mohajerfar, Maryam; Beyabanaki, Elaheh; Geramy, Allahyar; Siadat, Hakimeh; Alikhasi, Marzieh

2016-12-01

This study investigated the influence of placing implant-supported crowns on the torque loss of the abutment screw before and after loading. Twenty implant-abutment assemblies were randomly assigned to two groups. The first group was consisted of abutments with abutment-level finishing line (abutment-level), and in the second group the crown margin was placed on the implant shoulder (implant-level). Initial torque loss was recorded for all specimens. After 500000 cyclic load of 75 N and frequency of 2 Hz, post loading torque loss was recorded. Finite element model of each group was also modeled and screw energy, and stress were analyzed and compared between two groups. ANOVA for repeated measurements showed that the torque loss did not change significantly after cyclic loading (P=0.73). Crown margin also had no significant effect on the torque loss (P=0.56). However, the energy and stress of screw in abutment-level model (4.49 mJ and 22.74 MPa) was higher than implant-level model (3.52 mJ and 20.81 MPa). Although embracing the implant with crown produced less stress and energy in the abutment-implant screw, it did not have any significant influence on the torque loss of the screw. Copyright© 2016 Dennis Barber Ltd

Evaluation of the Effect of Axial Wall Modification and Coping Design on the Retention of Cement-retained Implant-supported Crowns

PubMed Central

Derafshi, Reza; Ahangari, Ahmad Hasan; Torabi, Kianoosh; Farzin, Mitra

2015-01-01

Background and aims. Because of compromised angulations of implants, the abutments are sometimes prepared. The purpose of this study was to investigate the effect of removing one wall of the implant abutment on the retention of cement-retained crowns. Materials and methods. Four prefabricated abutments were attached to analogues and embedded in acrylic resin blocks. The first abutment was left intact. Axial walls were partially removed from the remaining abutments to produce abutments with three walls. The screw access channel for the first and second abutments were completely filled with composite resin. For the third and fourth abutments, only partial filling was done. Wax-up models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The copings of fourth abutment had an extension into the screw access channel. Copings were cemented with Temp Bond. The castings were removed from the abutment using an Instron machine, and the peak removal force was recorded. A one-way ANOVA was used to test for a significant difference followed by the pairwise comparisons. Results. The abutments with opened screw access channel had a significantly higher retention than the two other abutments. The abutment with removed wall and no engagement into the hole by the castings exhibited the highest retention. Conclusion. Preserving the opening of screw access channel significantly increases the retention where one of the axial walls of implant abutments for cement-retained restorations is removed during preparation. PMID:25973152

The influence of implant-abutment connection on the screw loosening and microleakage.

PubMed

Tsuruta, Katsuhiro; Ayukawa, Yasunori; Matsuzaki, Tatsuya; Kihara, Masafumi; Koyano, Kiyoshi

2018-04-09

There are some spaces between abutment and implant body which can be a reservoir of toxic substance, and they can penetrate into subgingival space from microgap at the implant-abutment interface. This penetration may cause periimplantitis which is known to be one of the most important factors associated with late failure. In the present study, three kinds of abutment connection system, external parallel connection (EP), internal parallel connection (IP), and internal conical connection (CC), were studied from the viewpoint of microleakage from the gap between the implant and the abutment and in connection with the loosening of abutment screw. We observed dye leakage from abutment screw hole to outside through microgap under the excessive compressive and tensile load and evaluated the anti-leakage characteristics of these connection systems. During the experiment, one abutment screw for EP and two screws for IP, out of seven samples in each group, were fractured. After the 2000 cycles of compressive tensile loadings, removal torque value (RTV) of abutment screw represented no statistical differences among three groups. Standard deviation was largest in the RTV of EP and smallest in that of CC. The results of microleakage of toluidine blue from implant-abutment connection indicated that microleakage generally increased as loading procedure progressed. The amount of microleakage was almost plateau at 2000 cycles in CC, but still increasing in other two groups. The value of microleakage greatly scattered in EP, but the deviation of that in CC is significantly smaller. At 500 cycles of loading, there were no significant differences in the amount of microleakage among the groups, but at 1000, 1500, and 2000 cycles of loading, the amount of microleakage in CC was significantly smaller than that in IP. Throughout the experiment, the amount of microleakage in EP was largest, but no statistical difference was indicated due to the high standard deviation. Within the limitation of the present study, CC was stable even after the loading in the RTV of abutment screw and it prevented microleakage from the microgap between the implant body and the abutment, among the three tested connections.

Reliability and Failure Modes of a Hybrid Ceramic Abutment Prototype.

PubMed

Silva, Nelson Rfa; Teixeira, Hellen S; Silveira, Lucas M; Bonfante, Estevam A; Coelho, Paulo G; Thompson, Van P

2018-01-01

A ceramic and metal abutment prototype was fatigue tested to determine the probability of survival at various loads. Lithium disilicate CAD-milled abutments (n = 24) were cemented to titanium sleeve inserts and then screw attached to titanium fixtures. The assembly was then embedded at a 30° angle in polymethylmethacrylate. Each (n = 24) was restored with a resin-cemented machined lithium disilicate all-ceramic central incisor crown. Single load (lingual-incisal contact) to failure was determined for three specimens. Fatigue testing (n = 21) was conducted employing the step-stress method with lingual mouth motion loading. Failures were recorded, and reliability calculations were performed using proprietary software. Probability Weibull curves were calculated with 90% confidence bounds. Fracture modes were classified with a stereomicroscope, and representative samples imaged with scanning electron microscopy. Fatigue results indicated that the limiting factor in the current design is the fatigue strength of the abutment screw, where screw fracture often leads to failure of the abutment metal sleeve and/or cracking in the implant fixture. Reliability for completion of a mission at 200 N load for 50K cycles was 0.38 (0.52% to 0.25 90% CI) and for 100K cycles was only 0.12 (0.26 to 0.05)-only 12% predicted to survive. These results are similar to those from previous studies on metal to metal abutment/fixture systems where screw failure is a limitation. No ceramic crown or ceramic abutment initiated fractures occurred, supporting the research hypothesis. The limiting factor in performance was the screw failure in the metal-to-metal connection between the prototyped abutment and the fixture, indicating that this configuration should function clinically with no abutment ceramic complications. The combined ceramic with titanium sleeve abutment prototype performance was limited by the fatigue degradation of the abutment screw. In fatigue, no ceramic crown or ceramic abutment components failed, supporting the research hypothesis with a reliability similar to that of all-metal abutment fixture systems. A lithium disilcate abutment with a Ti alloy sleeve in combination with an all-ceramic crown should be expected to function clinically in a satisfactory manner. © 2016 by the American College of Prosthodontists.

Cone-morse implant connection system significantly reduces bacterial leakage between implant and abutment: an in vitro study.

PubMed

Baj, A; Bolzoni, A; Russillo, A; Lauritano, D; Palmieri, A; Cura, F; Silvestre, F J; Giannì, A B

2017-01-01

Osseointegrated implants are very popular dental treatments today in the world. In osseointegrated implants, the occlusal forces are transmitted from prosthesis through an abutment to a dental implant. The abutment is connected to the implant by mean of a screw. A screw is the most used mean for connecting an implant to an abutment. Frequently the screws break and are lost. There is an alternative to screw retained abutment systems: the cone-morse connection (CMC). The CMC, thanks to the absence of the abutment screw, guarantees no micro-gaps, no micro-movements, and a reduction of bacterial leakage between implant and abutment. As P. gingivalis and T. forsythia penetration might have clinical relevance, it was the purpose of this investigation to evaluate molecular leakage of these two bacteria in a new CMC implants systems (Leone Spa®, Florence, Italy). To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified Escherichia coli across implant-abutment interface was evaluated. Four cone-morse Leone implants (Leone® Spa, Florence, Italy) were immerged in a bacterial culture for 24 h and bacteria amount was then measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 3% for P. gingivalis and 4% for T. forsythia. Cone-morse connection implant system has very low bacterial leakage percentage and is similar to one-piece implants.

Platform-Switching for Cemented Versus Screwed Fixed Dental Prostheses: Reliability and Failure Modes: An In Vitro Study.

PubMed

Anchieta, Rodolfo Brunieira; Machado, Lucas Silveira; Hirata, Ronaldo; Bonfante, Estevam Augusto; Coelho, Paulo G

2016-08-01

The aim of this study was to evaluate the probability of survival of cemented and screwed three-unit implant-supported fixed dental prostheses (ISFDP) using different implant-abutment horizontal matching configurations (regular vs switching platforms). One hundred and sixty-eight implants with internal hexagon connection (4 mm diameter, 10 mm length, Emfils; Colosso Evolution System, Itú, SP, Brazil) were selected for this study according to the horizontal implant-abutment matching configuration (regular or switching) and retention method and divided in four groups (n = 21 per group) as follows: 1) regular platform cemented (IRC); 2) or screw-retained (IRS); 3) switched-platform cemented (ISC); or 4) screw-retained (ISS). Regular and platform-switched abutments (Colosso evolution, 4 mm and 3.3 mm, respectively) were torqued, and 84 three-unit metal bridges were fabricated (first molar pontic). Implants were embedded in polymethyl-methacrylate resin and subjected to step-stress accelerated life testing in water. Weibull distribution was used to determine the probability of survival for a mission of 100,000 cycles at 400 N (90% two-sided confidence intervals). Polarized light and scanning electron microscopes were used for fractographic analysis. The β values of 0.50, 1.19, 1.25, and 1.95 for groups IRC, IRS, ISC, and ISS respectively, indicated that fatigue accelerated the failure for all groups, except IRC. The cement-retained groups presented significantly higher probability of survival (IRC - 98%, ISC - 59%) than screw-retained groups (IRS - 23% and ISS - 0%). Screw-retained FDPs exclusively failed by abutment-screw fractures, whereas cement-retained presented implant/screw/abutment fractures. The probability of survival of cement-retained ISFDP was higher than screw-retained, irrespective of implant-abutment horizontal configuration. © 2015 Wiley Periodicals, Inc.

Removal torque evaluation of three different abutment screws for single implant restorations after mechanical cyclic loading.

PubMed

Paepoemsin, T; Reichart, P A; Chaijareenont, P; Strietzel, F P; Khongkhunthian, P

2016-01-01

The aim of this study was to evaluate the removal torque of three different abutment screws and pull out strength of implant-abutment connection for single implant restorations after mechanical cyclic loading. The study was performed in accordance with ISO 14801:2007. Three implant groups (n=15) were used: group A, PW Plus® with flat head screw; group B, PW Plus® with tapered screw; and group C, Conelog® with flat head screw. All groups had the same implant-abutment connection feature: cone with mandatory index. All screws were tightened with manufacturer's recommended torque. Ten specimens in each group underwent cyclic loading (1×106 cycles, 10 Hz, and 250 N). Then, all specimens were un-tightened, measured for the removal torque, and underwent a tensile test. The force that dislodged abutment from implant fixture was recorded. The data were analysed using independent sample t-test, ANOVA and Tukey HSD test. Before cyclic loading, removal torque in groups A, B and C were significantly different (B> A> C, P<.05). After cyclic loading, removal torque in all groups decreased significantly (P<.05). Group C revealed significantly less removal torque than groups A and B (P<.005). Tensile force in all groups significantly increased after cyclic loading (P<.05), group A had significantly less tensile force than groups B and C (P<.005). Removal torque reduced significantly after cyclic loading. Before cyclic loading, tapered screws maintained more preload than did flat head screws. After cyclic loading, tapered and flat head screws maintained even amounts of preload. The tensile force that dislodged abutment from implant fixture increased immensely after cyclic loading.

Removal torque evaluation of three different abutment screws for single implant restorations after mechanical cyclic loading

PubMed Central

PAEPOEMSIN, T.; REICHART, P. A.; CHAIJAREENONT, P.; STRIETZEL, F. P.; KHONGKHUNTHIAN, P.

2016-01-01

SUMMARY Purpose The aim of this study was to evaluate the removal torque of three different abutment screws and pull out strength of implant-abutment connection for single implant restorations after mechanical cyclic loading. Methods The study was performed in accordance with ISO 14801:2007. Three implant groups (n=15) were used: group A, PW Plus® with flat head screw; group B, PW Plus® with tapered screw; and group C, Conelog® with flat head screw. All groups had the same implant-abutment connection feature: cone with mandatory index. All screws were tightened with manufacturer’s recommended torque. Ten specimens in each group underwent cyclic loading (1×106 cycles, 10 Hz, and 250 N). Then, all specimens were un-tightened, measured for the removal torque, and underwent a tensile test. The force that dislodged abutment from implant fixture was recorded. The data were analysed using independent sample t-test, ANOVA and Tukey HSD test. Results Before cyclic loading, removal torque in groups A, B and C were significantly different (B> A> C, P<.05). After cyclic loading, removal torque in all groups decreased significantly (P<.05). Group C revealed significantly less removal torque than groups A and B (P<.005). Tensile force in all groups significantly increased after cyclic loading (P<.05), group A had significantly less tensile force than groups B and C (P<.005). Conclusions Removal torque reduced significantly after cyclic loading. Before cyclic loading, tapered screws maintained more preload than did flat head screws. After cyclic loading, tapered and flat head screws maintained even amounts of preload. The tensile force that dislodged abutment from implant fixture increased immensely after cyclic loading. PMID:28042450

Effect of cement washout on loosening of abutment screws and vice versa in screw- and cement- retained implant-supported dental prosthesis

PubMed Central

Kim, Seok-Gyu; Son, Mee-Kyoung

2015-01-01

PURPOSE The purpose of this study was to examine the abutment screw stability of screw- and cement-retained implant-supported dental prosthesis (SCP) after simulated cement washout as well as the stability of SCP cements after complete loosening of abutment screws. MATERIALS AND METHODS Thirty-six titanium CAD/CAM-made implant prostheses were fabricated on two implants placed in the resin models. Each prosthesis is a two-unit SCP: one screw-retained and the other cemented. After evaluating the passive fit of each prosthesis, all implant prostheses were randomly divided into 3 groups: screwed and cemented SCP (Control), screwed and noncemented SCP (Group 1), unscrewed and cemented SCP (Group 2). Each prosthesis in Control and Group 1 was screwed and/or cemented, and the preloading reverse torque value (RTV) was evaluated. SCP in Group 2 was screwed and cemented, and then unscrewed (RTV=0) after the cement was set. After cyclic loading was applied, the postloading RTV was measured. RTV loss and decementation ratios were calculated for statistical analysis. RESULTS There was no significant difference in RTV loss ratio between Control and Group 1 (P=.16). No decemented prosthesis was found among Control and Group 2. CONCLUSION Within the limits of this in vitro study, the stabilities of SCP abutment screws and cement were not significantly changed after simulated cement washout or screw loosening. PMID:26140172

Critical bending moment of four implant-abutment interface designs.

PubMed

Lee, Frank K; Tan, Keson B; Nicholls, Jack I

2010-01-01

Critical bending moment (CBM), defined as the bending moment at which the external nonaxial load applied overcomes screw joint preload and causes loss of contact between the mating surfaces of the implant screw joint components, was measured for four different implants and their single-tooth replacement abutments. CBM at the implant-abutment screw joint for four implant-abutment test groups was measured in vitro at 80%, 100%, and 120% of the manufacturers' recommended torque levels. Regular-platform implants with their corresponding single-tooth abutments were used. Microstrain was measured while known loads were applied to the abutment at known distances from the implant-abutment interface. Strain instrumentation was used to record the strain data dynamically to determine the point of gap opening. All torque applications and strain measurements were repeated five times for the five samples in each group. For the Branemark/CeraOne assemblies, the mean CBMs were 72.14 Ncm, 102.21 Ncm, and 119.13 Ncm, respectively, at 80%, 100%, and 120% of the manufacturer's recommended torque. For the Replace/Easy assemblies, mean CBMs were 86.20 Ncm, 109.92 Ncm, and 120.93 Ncm; for the Biomet 3i/STA assemblies, they were 67.97 Ncm, 83.14 Ncm, and 91.81 Ncm; and for the Lifecore/COC assemblies, they were 58.32 Ncm, 76.79 Ncm, and 78.93 Ncm. Two-way analysis of variance revealed significant effects for the test groups and torque levels. Subsequent tests confirmed that significant differences existed between test groups and torque levels. The results appear to confirm the primary role of the compressive preload imparted by the abutment screw in maintaining screw joint integrity. CBM was found to differ among implant systems and torque levels. Torque levels recommended by the manufacturer should be followed to ensure screw joint integrity.

Experimental conical-head abutment screws on the microbial leakage through the implant-abutment interface: an in vitro analysis using target-specific DNA probes.

PubMed

Pita, Murillo S; do Nascimento, Cássio; Dos Santos, Carla G P; Pires, Isabela M; Pedrazzi, Vinícius

2017-07-01

The aim of this in vitro study was to identify and quantify up to 38 microbial species from human saliva penetrating through the implant-abutment interface in two different implant connections, external hexagon and tri-channel internal connection, both with conventional flat-head or experimental conical-head abutment screws. Forty-eight two-part implants with external hexagon (EH; n = 24) or tri-channel internal (TI; n = 24) connections were investigated. Abutments were attached to implants with conventional flat-head or experimental conical-head screws. After saliva incubation, Checkerboard DNA-DNA hybridization was used to identify and quantify up to 38 bacterial colonizing the internal parts of the implants. Kruskal-Wallis test followed by Bonferroni's post-tests for multiple comparisons was used for statistical analysis. Twenty-four of thirty-eight species, including putative periodontal pathogens, were found colonizing the inner surfaces of both EH and TI implants. Peptostreptococcus anaerobios (P = 0.003), Prevotella melaninogenica (P < 0.0001), and Candida dubliniensis (P < 0.0001) presented significant differences between different groups. Means of total microbial count (×10 4 , ±SD) for each group were recorded as follows: G1 (0.27 ± 2.04), G2 (0 ± 0), G3 (1.81 ± 7.50), and G4 (0.35 ± 1.81). Differences in the geometry of implant connections and abutment screws have impacted the microbial leakage through the implant-abutment interface. Implants attached with experimental conical-head abutment screws showed lower counts of microorganisms when compared with conventional flat-head screws. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PRELOAD AND TORQUE REMOVAL EVALUATION OF THREE DIFFERENT ABUTMENT SCREWS FOR SINGLE STANDING IMPLANT RESTORATIONS

PubMed Central

Stüker, Rafael Augusto; Teixeira, Eduardo Rolim; Beck, João Carlos Pinheiro; da Costa, Nilza Pereira

2008-01-01

Several authors still consider the mechanical problems of fracture and component loosening as the main causes of failure of implant-supported restorations. The purpose of this in vitro study was to compare the preload of three types of screw for transmucosal abutment attachment used in single implant-supported prosthesis through strain gauge and removal torque measurements. Three external hex fixtures were used, and each received a transmucosal abutment (Cera One®), which was fixed to the implant with its respective screw: Group A- gold screw, Group B- titanium screw and Group C- surface-treated titanium screw (Ti-Tite®). Ten screws of each type were attached applying a 30.07±0.28 Ncm torque force and maintained in position for 5 minutes. After this, the preload values were measured using strain gauges and a measurement cell. Gold screws presented higher preload values (131.72±8.98 N), followed by surface-treated titanium screws (97.78±4.68 N) and titanium screws (37.03±5.69 N). ANOVA (p<0.05) and Tukey's test (p<0.05) were applied. Statistically significant differences were found among the groups for both preload and removal torque values. In conclusion, gold screws may be indicated to achieve superior longevity of the abutment-implant connection and, consequently, prosthetic restoration due to greater preload values yielded. PMID:19089290

Implant-Abutment Contact Surfaces and Microgap Measurements of Different Implant Connections Under 3-Dimensional X-Ray Microtomography.

PubMed

Scarano, Antonio; Valbonetti, Luca; Degidi, Marco; Pecci, Raffaella; Piattelli, Adriano; de Oliveira, P S; Perrotti, Vittoria

2016-10-01

The presence of a microgap between implant and abutment could produce a bacterial reservoir which could interfere with the long-term health of the periimplant tissues. The aim of this article was to evaluate, by x-ray 3-dimensional microtomography, implant-abutment contact surfaces and microgaps at the implant-abutment interface in different types of implant-abutment connections. A total of 40 implants were used in this in vitro study. Ten implants presented a screw-retained internal hexagon abutment (group I), 10 had a Morse Cone taper internal connection (group II), 10 another type of Morse Cone taper internal connection (group III), and 10 had a screwed trilobed connection (group IV). In both types of Morse Cone internal connections, there was no detectable separation at the implant-abutment in the area of the conical connection, and there was an absolute congruity without any microgaps between abutment and implant. No line was visible separating the implant and the abutment. On the contrary, in the screwed abutment implants, numerous gaps and voids were present. The results of this study support the hypothesis that different types of implant-abutment joints are responsible for the observed differences in bacterial penetration.

A rationale method for evaluating unscrewing torque values of prosthetic screws in dental implants

PubMed Central

SALIBA, Felipe Miguel; CARDOSO, Mayra; TORRES, Marcelo Ferreira; TEIXEIRA, Alexandre Carvalho; LOURENÇO, Eduardo José Veras; TELLES, Daniel de Moraes

2011-01-01

Objectives Previous studies that evaluated the torque needed for removing dental implant screws have not considered the manner of transfer of the occlusal loads in clinical settings. Instead, the torque used for removal was applied directly to the screw, and most of them omitted the possibility that the hexagon could limit the action of the occlusal load in the loosening of the screws. The present study proposes a method for evaluating the screw removal torque in an anti-rotational device independent way, creating an unscrewing load transfer to the entire assembly, not only to the screw. Material and methods Twenty hexagonal abutments without the hexagon in their bases were fixed with a screw to 20 dental implants. They were divided into two groups: Group 1 used titanium screws and Group 2 used titanium screws covered with a solid lubricant. A torque of 32 Ncm was applied to the screw and then a custom-made wrench was used for rotating the abutment counterclockwise, to loosen the screw. A digital torque meter recorded the torque required to loosen the abutment. Results There was a significant difference between the means of Group 1 (38.62±6.43 Ncm) and Group 2 (48.47±5.04 Ncm), with p=0.001. Conclusion This methodology was effective in comparing unscrewing torque values of the implant-abutment junction even with a limited sample size. It confirmed a previously shown significant difference between two types of screws. PMID:21437472

Critical bending moment of implant-abutment screw joint interfaces: effect of torque levels and implant diameter.

PubMed

Tan, Ban Fui; Tan, Keson B; Nicholls, Jack I

2004-01-01

Critical bending moment (CBM), the moment at which the external nonaxial load applied overcomes screw joint preload and causes loss of contact between the mating surfaces of the implant screw joint components, was measured with 2 types of implants and 2 types of abutments. Using 4 test groups of 5 implant-abutment pairs, CBM at the implant-abutment screw joint was measured at 25%, 50%, 75%, and 100% of the manufacturer's recommended torque levels. Regular Platform (RP) Nobel Biocare implants (3.75 mm diameter), Wide Platform (WP) Nobel Biocare implants (5.0 mm diameter), CeraOne abutments, and Multiunit abutments were used. Microstrain was measured as loads were applied to the abutment at various distances from the implant-abutment interface. Strain instrumentation logged the strain data dynamically to determine the point of gap opening. All torque applications and strain measurements were repeated 5 times. For the CeraOne-RP group, the mean CBMs were 17.09 Ncm, 35.35 Ncm, 45.63 Ncm, and 62.64 Ncm at 25%, 50%, 75%, and 100% of the recommended torque level, respectively. For the CeraOne-WP group, mean CBMs were 28.29 Ncm, 62.97 Ncm, 92.20 Ncm, and 127.41 Ncm; for the Multiunit-RP group, 16.08 Ncm, 21.55 Ncm, 34.12 Ncm, and 39.46 Ncm; and for the Multiunit-WP group, 15.90 Ncm, 32.86 Ncm, 43.29 Ncm, and 61.55 Ncm at the 4 different torque levels. Two-way analysis of variance (ANOVA) (P < .001) revealed significant effects for the test groups (F = 2738.2) and torque levels (F = 2969.0). The methodology developed in this study allows confirmation of the gap opening of the screw joint for the test groups and determination of CBM at different torque levels. CBM was found to differ among abutment systems, implant diameters, and torque levels. The torque levels recommended by the manufacturer should followed to ensure screw joint integrity.

Mechanics of the taper integrated screwed-in (TIS) abutments used in dental implants.

PubMed

Bozkaya, Dinçer; Müftü, Sinan

2005-01-01

The tapered implant-abutment interface is becoming more popular due to the mechanical reliability of retention it provides. Consequently, understanding the mechanical properties of the tapered interface with or without a screw at the bottom has been the subject of a considerable amount of studies involving experiments and finite element (FE) analysis. This paper focuses on the tapered implant-abutment interface with a screw integrated at the bottom of the abutment. The tightening and loosening torques are the main factors in determining the reliability and the stability of the attachment. Analytical formulas are developed to predict tightening and loosening torque values by combining the equations related to the tapered interface with screw mechanics equations. This enables the identification of the effects of the parameters such as friction, geometric properties of the screw, the taper angle, and the elastic properties of the materials on the mechanics of the system. In particular, a relation between the tightening torque and the screw pretension is identified. It was shown that the loosening torque is smaller than the tightening torque for typical values of the parameters. Most of the tightening load is carried by the tapered section of the abutment, and in certain combinations of the parameters the pretension in the screw may become zero. The calculations performed to determine the loosening torque as a percentage of tightening torque resulted in the range 85-137%, depending on the values of taper angle and the friction coefficient.

Does Abutment Collar Length Affect Abutment Screw Loosening After Cyclic Loading?

PubMed

Siadat, Hakimeh; Pirmoazen, Salma; Beyabanaki, Elaheh; Alikhasi, Marzieh

2015-07-01

A significant vertical space that is corrected with vertical ridge augmentation may necessitate selection of longer abutments, which would lead to an increased vertical cantilever. This study investigated the influence of different abutment collar heights on single-unit dental implant screw-loosening after cyclic loading. Fifteen implant-abutment assemblies each consisted of an internal hexagonal implant were randomly assigned to 3 groups: Group1, consisting of 5 abutments with 1.5 mm gingival height (GH); Group2, 5 abutments with 3.5 mm GH; and Group3, 5 abutments with 5.5 mm GH. Each specimen was mounted in transparent auto-polymerizing acrylic resin block, and the abutment screw was tightened to 35 Ncm with an electric torque wrench. After 5 minutes, initial torque loss (ITL) was recorded for all specimens. Metal crowns were fabricated with 45° occlusal surface and were placed on the abutments. A cyclic load of 75 N and frequency of 1 Hz were applied perpendicular to the long axis of each specimen. After 500 000 cycles, secondary torque loss (STL) was recorded. One-way ANOVA analysis was used to evaluate the effects of abutment collar height before and after cyclic loading. One-way ANOVA showed that ITL among the groups was not significantly different (P = .52), while STL was significantly different among the groups (P = .008). Post-hoc Tukey HSD tests showed that STL values were significantly different between the abutments with 1.5 mm GH (Group1) and with 5.5 mm GH (Group3) (P = .007). A paired comparison t-test showed that cyclic loading significantly influenced the STL in comparison with the ITL in each group. Within the limitations of this study, it can be concluded that increase in height of the abutment collar could adversely affect the torque loss of the abutment screw.

FEA and microstructure characterization of a one-piece Y-TZP abutment.

PubMed

da Silva, Lucas Hian; Ribeiro, Sebastião; Borges, Alexandre Luís Souto; Cesar, Paulo Francisco; Tango, Rubens Nisie

2014-11-01

The most important drawback of dental implant/abutment assemblies is the need for a fixing screw. This study aimed to develop an esthetic one-piece Y-TZP abutment to suppress the use of the screw. Material characterization was performed using a bar-shaped specimen obtained by slip-casting to validate the method prior to prototype abutment fabrication by the same process. The mechanical behavior of the prototype abutment was verified and compared with a conventional abutment by finite element analysis (FEA). The abutment was evaluated by micro-CT analysis and its density was measured. FEA showed stress concentration at the first thread pitch during installation and in the cervical region during oblique loading for both abutments. However, stress concentration was observed at the base of the screw head and stem in the conventional abutment. The relative density for the fabricated abutment was 95.68%. Micro-CT analysis revealed the presence of elongated cracks with sharp edges over the surface and porosity in the central region. In the light of these findings, the behavior of a one-piece abutment is expected to be better than that of the conventional model. New studies should be conducted to clarify the performance and longevity of this one-piece Y-TZP abutment. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Evaluation of screw loosening on new abutment screws and after successive tightening.

PubMed

Barbosa, Gustavo Seabra; Silva-Neto, João Paulo da; Simamoto-Júnior, Paulo Cezar; Neves, Flávio Domingues das; Mattos, Maria da Gloria Chiarello de; Ribeiro, Ricardo Faria

2011-01-01

This study evaluated the loss of the torque applied after use of new screws and after successive tightening. Four infrastructures (IE), using UCLA castable abutment type, were cast in cobalt-chromium alloy and new abutment screws (G1) were used in a first moment. Subsequently, the same abutment screws were used a second time (G2) and more than two times (G3). The values of the torques applied and detorques were measured with a digital torque wrench to obtain the values of initial tightening loss (%). Data were analyzed by ANOVA and Tukey's test (?=0.05). Significant differences were observed between the G1 (50.71% ± 11.36) and G2 (24.01% ± 3.33) (p=0.000) and between G1 (50.71% ± 11.36) and G3 (25.60% ± 4.64) (p=0.000). There was no significant difference between G2 and G3 (p=0.774). Within the limitations of the study, it may be concluded that the percentage of the initial torque loss is lower when screws that already suffered the application of an initial torque were used, remaining stable after application of successive torques.

Three-Dimensional Finite Element Analysis on Stress Distribution of Internal Implant-Abutment Engagement Features.

PubMed

Cho, Sung-Yong; Huh, Yun-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

To investigate the stress distribution in an implant-abutment complex with a preloaded abutment screw by comparing implant-abutment engagement features using three-dimensional finite element analysis (FEA). For FEA modeling, two implants-one with a single (S) engagement system and the other with a double (D) engagement system-were placed in the human mandibular molar region. Two types of abutments (hexagonal, conical) were connected to the implants. Different implant models (a single implant, two parallel implants, and mesial and tilted distal implants with 1-mm bone loss) were assumed. A static axial force and a 45-degree oblique force of 200 N were applied as the sum of vectors to the top of the prosthetic occlusal surface with a preload of 30 Ncm in the abutment screw. The von Mises stresses at the implant-abutment and abutment-screw interfaces were measured. In the single implant model, the S-conical abutment type exhibited broader stress distribution than the S-hexagonal abutment. In the double engagement system, the stress concentration was high in the lower contact area of the implant-abutment engagement. In the tilted implant model, the stress concentration point was different from that in the parallel implant model because of the difference in the bone level. The double engagement system demonstrated a high stress concentration at the lower contact area of the implant-abutment interface. To decrease the stress concentration, the type of engagement features of the implant-abutment connection should be carefully considered.

The effect of repeated torque in small diameter implants with machined and premachined abutments.

PubMed

Saboury, Abolfazl; Neshandar Asli, Hamid; Vaziri, Shahram

2012-05-01

Detorquing value is an important factor in the amount of preload stresses during abutment screw fastening. This study evaluated the percentage of detorque values in two-piece machined titanium and premachined cast abutments in small diameter implants. Three groups of five samples were evaluated. Group 1 (G1), machined titanium abutments, group 2 (G2), premachined cast straight abutments that cast with gold-palladium, and group 3 (G3), premachined angled cast abutments that cast with the same alloy, were angled before casting. Each abutment was torque to 24 Ncm according to the manufacturer's instructions and detorqued five times. The means of detorquing and torquing values in all groups were recorded. The mean of detorque in each group as a percentage of the toque value was calculated. The data for all groups were compared and calculated using analysis of variance (ANOVA) and t-test. Mean detorque values in G1, G2, and G3 were 88.1 ± 1.69, 93.1 ± 2.68, and 80.9 ± 4.95%, respectively. The ANOVA showed significant differences in mean of applied detorque (p < .001) and torque (p = .06) tightening among different groups. G2 had significantly greater detorque values (p < .05). No significant differences were found between G1 and G2. Surprisingly, abutment screw fracture occurred in three samples of G3. G3 showed significant percentage torque reduction (p < .05) and exhibited abutment screw fracture during evaluation. G2 presented the lowest torque reduction. Screw fracture occurred only in G3. © 2012 Wiley Periodicals, Inc.

The effect of 3 torque delivery systems on gold screw preload at the gold cylinder-abutment screw joint.

PubMed

Tan, Keson B; Nicholls, Jack I

2002-01-01

This study measured the gold screw preload at the gold cylinder-abutment screw joint interface obtained by 3 torque delivery systems. Using a precalibrated, strain-gauged standard abutment as the load cell, 3 torque delivery systems tested were shown to have significant differences in gold screw preload when a gold cylinder was attached. Mean preloads measured were 291.2 N for hand torque drivers set at 10 Ncm, 340.3 N for electronic torque controllers at low setting/10 Ncm, 384.4 N for electronic torque controllers at high setting/10 Ncm; and 140.8 N for hand-tightening with a prosthetic slot screwdriver. Significant differences in screw preload were also found between operators using a hand torque driver. Hand-tightening delivered insufficient preload and cannot be recommended for final gold screw tightening. Different electronic torque controller units set at 10 Ncm induced mean gold screw preloads that ranged from 264.1 N to as high as 501.2 N. Electronic torque controllers should be regularly recalibrated to ensure optimal output.

Effect of abutment screw length and cyclic loading on removal torque in external and internal hex implants.

PubMed

Mohammed, Hnd Hadi; Lee, Jin-Han; Bae, Ji-Myung; Cho, Hye-Won

2016-02-01

The purpose of this study was to evaluate the effects of abutment screw length and cyclic loading on the removal torque (RTV) in external hex (EH) and internal hex (IH) implants. Forty screw-retained single crowns were connected to external and internal hex implants. The prepared titanium abutment screws were classified into 8 groups based on the number of threads (n = 5 per group): EH 12.5, 6.5, 3.5, 2.5 and IH 6.5, 5, 3.5, 2.5 threads. The abutment screws were tightened with 20 Ncm torque twice with 10-minute intervals. After 5 minutes, the initial RTVs of the abutment screws were measured with a digital torque gauge (MGT12). A customized jig was constructed to apply a load along the implant long axis at the central fossa of the maxillary first molar. The post-loading RTVs were measured after 16,000 cycles of mechanical loading with 50 N at a 1-Hz frequency. Statistical analysis included one-way analysis of variance and paired t-tests. The post-loading RTVs were significantly lower than the initial RTVs in the EH 2.5 thread and IH 2.5 thread groups (P<.05). The initial RTVs exhibited no significant differences among the 8 groups, whereas the post-loading RTVs of the EH 6.5 and EH 3.5 thread groups were higher than those of the IH 3.5 thread group (P<.05). Within the limitations of this study, the external hex implants with short screw lengths were more advantageous than internal hex implants with short screw lengths in torque maintenance after cyclic loading.

Effect of abutment screw length and cyclic loading on removal torque in external and internal hex implants

PubMed Central

Mohammed, Hnd Hadi; Lee, Jin-Han; Bae, Ji-Myung

2016-01-01

PURPOSE The purpose of this study was to evaluate the effects of abutment screw length and cyclic loading on the removal torque (RTV) in external hex (EH) and internal hex (IH) implants. MATERIALS AND METHODS Forty screw-retained single crowns were connected to external and internal hex implants. The prepared titanium abutment screws were classified into 8 groups based on the number of threads (n = 5 per group): EH 12.5, 6.5, 3.5, 2.5 and IH 6.5, 5, 3.5, 2.5 threads. The abutment screws were tightened with 20 Ncm torque twice with 10-minute intervals. After 5 minutes, the initial RTVs of the abutment screws were measured with a digital torque gauge (MGT12). A customized jig was constructed to apply a load along the implant long axis at the central fossa of the maxillary first molar. The post-loading RTVs were measured after 16,000 cycles of mechanical loading with 50 N at a 1-Hz frequency. Statistical analysis included one-way analysis of variance and paired t-tests. RESULTS The post-loading RTVs were significantly lower than the initial RTVs in the EH 2.5 thread and IH 2.5 thread groups (P<.05). The initial RTVs exhibited no significant differences among the 8 groups, whereas the post-loading RTVs of the EH 6.5 and EH 3.5 thread groups were higher than those of the IH 3.5 thread group (P<.05). CONCLUSION Within the limitations of this study, the external hex implants with short screw lengths were more advantageous than internal hex implants with short screw lengths in torque maintenance after cyclic loading. PMID:26949489

Influence of abutment type and esthetic veneering on preload maintenance of abutment screw of implant-supported crowns.

PubMed

Delben, Juliana Aparecida; Barão, Valentim Adelino Ricardo; Dos Santos, Paulo Henrique; Assunção, Wirley Gonçalves

2014-02-01

The effect of veneering materials on screw joint stability remains inconclusive. Thus, this study evaluated the preload maintenance of abutment screws of single crowns fabricated with different abutments and veneering materials. Sixty crowns were divided into five groups (n = 12): UCLA abutment in gold alloy with ceramic (group GC) and resin (group GR) veneering, UCLA abutment in titanium with ceramic (group TiC) and resin (group TiR) veneering, and zirconia abutment with ceramic veneering (group ZiC). Abutment screws made of gold were used with a 35 Ncm insertion torque. Detorque measurements were obtained initially and after mechanical cycling. Data were analyzed by ANOVA and Fisher's exact test at a significance level of 5%. For the initial detorque means (in Ncm), group TiC (21.4 ± 1.78) exhibited statistically lower torque maintenance than groups GC (23.9 ± 0.91), GR (24.1 ± 1.34), and TiR (23.2 ± 1.33) (p < 0.05, Fisher's exact test). Group ZiC (21.9 ± 2.68) exhibited significantly lower torque maintenance than groups GC, GR, and TiR (p < 0.05, Fisher's exact test). After mechanical cycling, there was a statistically significant difference between groups TiC (22.1 ± 1.86) and GR (23.8 ± 1.56); between groups ZiC (21.7 ± 2.02) and GR; and also between groups ZiC and TiR (23.6 ± 1.30) (p < 0.05, Fisher's exact test). Detorque reduction occurred regardless of abutment type and veneering material. More irregular surfaces in the hexagon area of the castable abutments were observed. The superiority of any veneering material concerning preload maintenance was not established. © 2013 by the American College of Prosthodontists.

Axial displacement of abutments into implants and implant replicas, with the tapered cone-screw internal connection, as a function of tightening torque.

PubMed

Dailey, Bruno; Jordan, Laurence; Blind, Olivier; Tavernier, Bruno

2009-01-01

The passive fit of a superstructure on implant abutments is essential to success. One source of error when using a tapered cone-screw internal connection may be the difference between the tightening torque level applied to the abutments by the laboratory technician compared to that applied by the treating clinician. The purpose of this study was to measure the axial displacement of tapered cone-screw abutments into implants and their replicas as a function of the tightening torque level. Twenty tapered cone-screw abutments were selected. Two groups were created: 10 abutments were secured into 10 implants, and 10 abutments were secured into 10 corresponding implant replicas. Each abutment was tightened in increasing increments of 5 Ncm, from 0 Ncm to 45 Ncm, with a torque controller. The length of each sample was measured repeatedly with an Electronic Digital Micrometer. The mean axial displacement for the implant group and the replica group was calculated. The data were analyzed by the Mann-Whitney and Spearman tests. For both groups, there was always an axial displacement of the abutment upon each incremental application of torque. The mean axial displacement values varied between 7 and 12 microm for the implant group and between 6 and 21 microm for the replica group at each 5-Ncm increment. From 0 to 45 Ncm, the total mean axial displacement values were 89 microm for the implant group and 122 microm for the replica group. There was a continuous axial displacement of the abutments into implants and implant replicas when the applied torque was raised from 0 to 45 Ncm. Torque applied above the level recommended by the manufacturer increased the difference in displacement between the two groups.

Effect of varying fixture width on stress and strain distribution associated with an implant stack system.

PubMed

Mahon, J M; Norling, B K; Phoenix, R D

2000-01-01

The purpose of this investigation was to evaluate the dissipation of a force applied to an assembled stack of implant components. The stack consisted of a 10-mm threaded implant, a screw-retained abutment and a screw-retained gold crown. The dissipation of force was analyzed in relation to varying the implant diameter with and without a concomitant change in abutment diameter. Two experimental groups were evaluated. The first group consisted of 25 titanium screw-form implants (Implant Innovations, Inc.). These implants measured 10 mm in length and 3.25 mm, 3.75 mm, 4.0 mm, 5.0 mm, and 6.0 mm in diameter. The second group included 15 titanium screw-form implants (Nobel Biocare, Inc.) measuring 10 mm in length and 3.75 mm, 4.0 mm, and 5.0 mm in diameter. All implants were embedded in standardized photoelastic resin blocks. Points of interest were marked on each block using standardized templates to ensure consistency. Implants were restored using system-specific conical abutments and standardized single-unit restorations. A strain gauge was affixed to each abutment, and an eccentric load of 176 N was applied to the restoration. Periimplant stresses were measured using photoelastic analysis. Abutment strain was determined using an electronic strain indicator. Data were collated and compared using ANOVA and the Duncan multiple range statistical tests. When stress was analyzed at points on the resin-implant interface or a fixed distance from the interface, stress tended to decrease from the 5-mm-wide implant to the 6-mm-wide implant. Stress in relation to the 3.25-mm, 3.75-mm, and 4.0-mm implant was not as well defined, indicating the possibility that some deformation of implants was occurring. Increased abutment width resulted in decreased abutment strain. Therefore, using a wider abutment may be helpful in preventing preload reduction in clinical applications. This may reduce the incidence of loosening and fracture of abutment and restoration screws.

Immediate prosthesis over implants retained using abutments with flexible screws: A preliminary study.

PubMed

Peñarrocha-Oltra, David; Serra-Pastor, Blanca; Balaguer-Martí, José-Carlos; Peñarrocha-Diago, Miguel; Agustín-Panadero, Rubén

2017-12-01

Immediate loading protocols for the rehabilitation of edentulous or partially edentulous patients have become very popular, due to the conveniences they afford in comparison with conventional loading techniques. A preliminary study was carried out with 8 patients subjected to dental implant treatment with an immediate loading protocol involving a novel system of abutments with flexible screws. Implant survival was analyzed, together with marginal bone loss and patient and dentist satisfaction. A total of 35 implants were subjected to immediate loading using the abutments with flexible screws. The mean patient and dentist satisfaction score was 9.1 and 8.5, respectively. After 12 months the dental implant survival rate was 95.8%, with a mean marginal bone loss of 0.51 ± 0.12 mm. The novel system of abutments with flexible screws offers a good alternative to conventional immediate loading, since it allows rapid and simple manufacture of a reliable passive fit, fixed interim prosthesis after surgery. Key words: Dental implants, Flexafit®, Immediate loading, Immediate prosthesis.

Impact of Intentional Overload on Joint Stability of Internal Implant-Abutment Connection System with Different Diameter.

PubMed

Lee, Ji-Hye; Lee, Won; Huh, Yoon-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

2017-09-05

To evaluate the axial displacement of the implant-abutment assembly of different implant diameter after static and cyclic loading of overload condition. An internal conical connection system with three diameters (Ø 4.0, 4.5, and 5.0) applying identical abutment dimension and the same abutment screw was evaluated. Axial displacement of abutment and reverse torque loss of abutment screw were evaluated under static and cyclic loading conditions. Static loading test groups were subjected to vertical static loading of 250, 400, 500, 600, 700, and 800 N consecutively. Cyclic loading test groups were subjected to 500 N cyclic loading to evaluate the effect of excessive masticatory loading. After abutment screw tightening for 30 Ncm, axial displacement was measured upon 1, 3, 10, and 1,000,000 cyclic loadings of 500 N. Repeated-measure ANOVA and 2-way ANOVA were used for statistical analysis (α = 0.05). The increasing magnitude of vertical load and thinner wall thickness of implant increased axial displacement of abutment and reverse torque loss of abutment screw (p < 0.05). Implants in the Ø 5.0 diameter group demonstrated significantly low axial displacement, and reverse torque loss after static loading than Ø 4.0 and Ø 4.5 diameter groups (p < 0.05). In the cyclic loading test, all diameter groups of implant showed significant axial displacement after 1 cycle of loading of 500 N (p < 0.05). There was no significant axial displacement after 3, 10, or 1,000,000 cycles of loading (p = 0.603). Implants with Ø 5.0 diameter demonstrated significantly low axial displacement and reverse torque loss after the cyclic and static loading of overload condition. © 2017 by the American College of Prosthodontists.

Load Fatigue Performance Evaluation on Two Internal Tapered Abutment-Implant Connection Implants Under Different Screw Tightening Torques.

PubMed

Jeng, Ming-Dih; Liu, Po-Yi; Kuo, Jia-Hum; Lin, Chun-Li

2017-04-01

This study evaluates the load fatigue performance of different abutment-implant connection implant types-retaining-screw (RS) and taper integrated screwed-in (TIS) types under 3 applied torque levels based on the screw elastic limit. Three torque levels-the recommended torque (25 Ncm), 10% less, and 10% more than the ratio of recommended torque to screw elastic limits of different implants were applied to the implants to perform static and dynamic testing according to the ISO 14801 method. Removal torque loss was calculated for each group after the endurance limitation was reached (passed 5 × 10 6 cycles) in the fatigue test. The static fracture resistance results showed that the fracture resistance in the TIS-type implant significantly increased (P < .05) when the abutment screw was inserted tightly. The dynamic testing results showed that the endurance limitations for the RS-type implant were 229 N, 197 N, and 224 N and those for the TIS-type implant were 322 N, 364 N, and 376 N when the screw insertion torques were applied from low to high. The corresponding significant (P < .05) removal torque losses for the TIS-type implant were 13.2%, 5.3%, and 2.6% but no significant difference was found for the RS-type implant. This study concluded that the static fracture resistance and dynamic endurance limitation of the TIS-type implant (1-piece solid abutment) increased when torque was applied more tightly on the screw. Less torque loss was also found when increasing the screw insertion torque.

In Vitro Evaluation of Manual Torque Values Applied to Implant-Abutment Complex by Different Clinicians and Abutment Screw Loosening.

PubMed

Dincer Kose, Onur; Karataslı, Burcin; Demircan, Sabit; Kose, Taha Emre; Cene, Erhan; Aya, Serhan Aydın; Erdem, Mehmet Ali; Cankaya, Abdulkadir Burak

2017-01-01

Preload is applied to screws manually or using a torque wrench in dental implant systems, and the preload applied must be appropriate for the purpose. The aim of this study was to assess screw loosening and bending/torsional moments applied by clinicians of various specialties following application of manual tightening torque to combinations of implants and abutments. Ten-millimeter implants of 3.7 and 4.1 mm diameters and standard or solid abutments were used. Each group contained five implant-abutment combinations. The control and experimental groups comprised 20 and 160 specimens, respectively. Implants in the experimental group were tightened by dentists of different specialties. Torsional and bending moments during tightening were measured using a strain gauge. Control group and implants with preload values close to the ideal preload were subjected to a dynamic loading test at 150 N, 15 Hz, and 85,000 cycles. The implants that deformed in this test were examined using an optical microscope to assess deformities. Manual tightening did not yield the manufacturer-recommended preload values. Dynamic loading testing suggested early screw loosening/fracture in samples with insufficient preload.

In Vitro Evaluation of Manual Torque Values Applied to Implant-Abutment Complex by Different Clinicians and Abutment Screw Loosening

PubMed Central

Demircan, Sabit; Cene, Erhan; Aya, Serhan Aydın; Erdem, Mehmet Ali; Cankaya, Abdulkadir Burak

2017-01-01

Preload is applied to screws manually or using a torque wrench in dental implant systems, and the preload applied must be appropriate for the purpose. The aim of this study was to assess screw loosening and bending/torsional moments applied by clinicians of various specialties following application of manual tightening torque to combinations of implants and abutments. Ten-millimeter implants of 3.7 and 4.1 mm diameters and standard or solid abutments were used. Each group contained five implant-abutment combinations. The control and experimental groups comprised 20 and 160 specimens, respectively. Implants in the experimental group were tightened by dentists of different specialties. Torsional and bending moments during tightening were measured using a strain gauge. Control group and implants with preload values close to the ideal preload were subjected to a dynamic loading test at 150 N, 15 Hz, and 85,000 cycles. The implants that deformed in this test were examined using an optical microscope to assess deformities. Manual tightening did not yield the manufacturer-recommended preload values. Dynamic loading testing suggested early screw loosening/fracture in samples with insufficient preload. PMID:28473988

The dynamic natures of implant loading.

PubMed

Wang, Rui-Feng; Kang, Byungsik; Lang, Lisa A; Razzoog, Michael E

2009-06-01

A fundamental problem in fully understanding the dynamic nature of implant loading is the confusion that exists regarding the torque load delivered to the implant complex, the initial force transformation/stress/strain developed within the system during the implant complex assembly, and how the clamping forces at the interfaces and the preload stress impact the implant prior to any external loading. The purpose of this study was to create an accurately dimensioned finite element model with spiral threads and threaded bores included in the implant complex, positioned in a bone model, and to determine the magnitude and distribution of the force transformation/stress/strain patterns developed in the modeled implant system and bone and, thus, provide the foundational data for the study of the dynamic loading of dental implants prior to any external loading. An implant (Brånemark Mark III), abutment (CeraOne), abutment screw (Unigrip), and the bone surrounding the implant were modeled using HyperMesh software. The threaded interfaces between screw/implant and implant/bone were designed as a spiral thread helix assigned with specific coefficient of friction values. Assembly simulation using ABAQUS and LS-DYNA was accomplished by applying a 32-Ncm horizontal torque load on the abutment screw (Step 1), then decreasing the torque load to 0 Ncm to simulate the wrench removal (Step 2). The postscript data were collected and reviewed by HyperMesh. A regression analysis was used to depict the relationships between the torque load and the mechanical parameters. During the 32-Ncm tightening sequence, the abutment screw elongated 13.3 mum. The tightening torque generated a 554-N clamping force at the abutment/implant interface and a 522-N preload. The von Mises stress values were 248 MPa in the abutment at the abutment-implant interface, 765 MPa at the top of the screw shaft, 694 MPa at the bottom of the screw shaft, 1365 MPa in the top screw thread, and 21 MPa in the bone at the top of the implant-bone interface. This study also identified various characteristic isosurface stress patterns. The maximum stress magnitude to complete the von Mises stress joint pattern in the present model was 107 MPa during screw tightening, and was reduced to 104 MPa with removal of the wrench. Various specific stress patterns were identified within all elements of the implant complex during the assembly simulation. During the torque moment application, the abutment screw was elongated, and every 1.0-mum elongation of the screw was equivalent to a 47.9-N increase of the preload in the implant complex. The ideal index to determine the preload amount was the contact force at the interface between the screw threads and the threaded screw bore. The isosurface mode identified various characteristic stress patterns developed within the implant complex at the various interfaces during the assembly simulation. These patterns are the (1) spiral and ying-yang pattern of the XY stress, (2) spring, cap, clamping, and preload pattern of the ZZ stress, and (3) bone holding and joint pattern of the von Mises stress.

Surface characteristics of clinically used dental implant screws

NASA Astrophysics Data System (ADS)

Han, Myung-Ju; Choe, Han-Cheol; Chung, Chae-Heon

2005-12-01

Surface alteration of implant screws after function may be associated with mechanicalffailure. This type of metal fatigue appears to be the most common cause of structural failure. The purpose of this study was to evaluate surface alteration of implant screws after function through an examination of used and unused implant screws via scanning electron microscopy (SEM). In this study, abutment screws (Steri-oss, 3i, USA), gold retaining screws (3i, USA), and titanium retaining screws (3i, USA) were retrieved from patients, New, unused abutment, and retaining screws were prepared for a control group. Each of the old, used screws was retrieved with a screwdriver. The retrieved implant complex of a Steri-oss system was also prepared for this study. SEM investigation and energy dispersive spectroscopy (EDS) analysis of the abutment and retaining screws were then performed, as well as SEM investigation of a cross-sectioned sample of the retrieved implant complex in the case of new, unused implant screws, as-manufactured circumferential grooves were regularly examined and screw threads were sharply maintained. Before ultrasonic cleansing of old, used implant screws, there was a large amount of debris accumulation and corrosion products. After ultrasonic cleansing of old, used implant screws, circumferential grooves were examined were found to be randomly deepened and scratching increased. Also, dull screw fhreads were observed. More surface alterations after function were observed in titanium screws than in gold screws. Furthermore, more surface alteration was observed when the screws were retrieved with a driver than without a driver. These surface alterations after function may result in screw instability. Regular cleansing and exchange of screws is therefore recommended. We also recommend the use of gold screws over titanium screws, and careful manipulation of the driver.

Salvaging an angled implant abutment with damaged internal threads: a clinical report.

PubMed

Imam, Ahmad Y; Yilmaz, Burak; Özçelik, Tuncer Burak; McGlumphy, Edwin

2013-05-01

This clinical report describes a technique to fit an existing fixed detachable implant-supported prosthesis to a zygomatic implant abutment with stripped internal threads. The threads of the abutment were retapped and a wide diameter/wide head retaining screw was used to secure the existing prosthesis on the abutment. Care is needed in the retrieval of broken screws so as not to damage the internal threads of the implants, which might lead to irreversible complications. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Comparison of implant component fractures in external and internal type: A 12-year retrospective study.

PubMed

Yi, Yuseung; Koak, Jai-Young; Kim, Seong-Kyun; Lee, Shin-Jae; Heo, Seong-Joo

2018-04-01

The aim of this study was to compare the fracture of implant component behavior of external and internal type of implants to suggest directions for successful implant treatment. Data were collected from the clinical records of all patients who received WARANTEC implants at Seoul National University Dental Hospital from February 2002 to January 2014 for 12 years. Total number of implants was 1,289 and an average of 3.2 implants was installed per patient. Information about abutment connection type, implant locations, platform sizes was collected with presence of implant component fractures and their managements. SPSS statistics software (version 24.0, IBM) was used for the statistical analysis. Overall fracture was significantly more frequent in internal type. The most frequently fractured component was abutment in internal type implants, and screw fracture occurred most frequently in external type. Analyzing by fractured components, screw fracture was the most frequent in the maxillary anterior region and the most abutment fracture occurred in the maxillary posterior region and screw fractures occurred more frequently in NP (narrow platform) and abutment fractures occurred more frequently in RP (regular platform). In external type, screw fracture occurred most frequently, especially in the maxillary anterior region, and in internal type, abutment fracture occurred frequently in the posterior region. placement of an external type implant rather than an internal type is recommended for the posterior region where abutment fractures frequently occur.

Failure modes of Y-TZP abutments with external hex implant-abutment connection determined by fractographic analysis.

PubMed

Basílio, Mariana de Almeida; Delben, Juliana Aparecida; Cesar, Paulo Francisco; Rizkalla, Amin Sami; Santos Junior, Gildo Coelho; Arioli Filho, João Neudenir

2016-07-01

Yttria-stabilized tetragonal zirconia (Y-TZP) was introduced as ceramic implant abutments due to its excellent mechanical properties. However, the damage patterns for Y-TZP abutments are limited in the literature. Fractographic analyses can provide insights as to the failure origin and related mechanisms. The purpose of this study was to analyze fractured Y-TZP abutments to establish fractographic patterns and then possible reasons for failure. Thirty two prefabricated Y-TZP abutments on external hex implants were retrieved from a single-load-to failure test according to the ISO 14801. Fractographic analyses were conducted under polarized-light estereo and scanning electro microscopy. The predominant fracture pattern was abutment fracture at the connecting region. Classic fractographic features such as arrest lines, hackle, and twist hackle established that failure started where Y-TZP abutments were in contact with the retention screw edges. The abutment screw design and the loading point were the reasons for localized stress concentration and fracture patterns. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of the Coronal Wall Thickness of Dental Implants on the Screw Joint Stability in the Internal Implant-Abutment Connection.

PubMed

Lee, Ji-Hye; Huh, Yoon-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

2016-01-01

To evaluate the effect of implant coronal wall thickness on load-bearing capacity and screw joint stability. Experimental implants were customized after investigation of the thinnest coronal wall thickness of commercially available implant systems with a regular platform diameter. Implants with four coronal wall thicknesses (0.2, 0.3, 0.4, and 0.5 mm) were fabricated. Three sets of tests were performed. The first set was a failure test to evaluate load-bearing capacity and elastic limit. The second and third sets were cyclic and static loading tests. After abutment screw tightening of each implant, vertical cyclic loading of 250 N or static loading from 250 to 800 N was applied. Coronal diameter expansion, axial displacement, and removal torque values of the implants were compared. Repeated measures analysis of variance (ANOVA) was used for statistical analysis (α = .05). Implants with 0.2-mm coronal wall thickness demonstrated significantly low load-bearing capacity and elastic limit (both P < .05). These implants also showed significantly large coronal diameter expansion and axial displacement after screw tightening (both P < .05). Greater vertical load and thinner coronal wall thickness significantly increased coronal diameter expansion of the implant, axial displacement of the abutment, and removal torque loss of the abutment screw (all P < .05). Implant coronal wall thickness of 0.2 mm produces significantly inferior load-bearing capacity and screw joint stability.

Immediate prosthesis over implants retained using abutments with flexible screws: A preliminary study

PubMed Central

Peñarrocha-Oltra, David; Serra-Pastor, Blanca; Balaguer-Martí, José-Carlos; Agustín-Panadero, Rubén

2017-01-01

Background Immediate loading protocols for the rehabilitation of edentulous or partially edentulous patients have become very popular, due to the conveniences they afford in comparison with conventional loading techniques. Material and Methods A preliminary study was carried out with 8 patients subjected to dental implant treatment with an immediate loading protocol involving a novel system of abutments with flexible screws. Implant survival was analyzed, together with marginal bone loss and patient and dentist satisfaction. Results A total of 35 implants were subjected to immediate loading using the abutments with flexible screws. The mean patient and dentist satisfaction score was 9.1 and 8.5, respectively. After 12 months the dental implant survival rate was 95.8%, with a mean marginal bone loss of 0.51 ± 0.12 mm. Conclusions The novel system of abutments with flexible screws offers a good alternative to conventional immediate loading, since it allows rapid and simple manufacture of a reliable passive fit, fixed interim prosthesis after surgery. Key words:Dental implants, Flexafit®, Immediate loading, Immediate prosthesis. PMID:29410752

Do Sealing Materials Influence Superstructure Attachment in Implants?

PubMed

Biscoping, Stephanie; Ruttmann, Esther; Rehmann, Peter; Wöstmann, Bernd

This study aimed to evaluate the possible effect of sealing materials on superstructure attachment (ie, tightening/loosening torque and implant-abutment gap) in two different implant systems. A silicone, a chlorhexidine gel, and an industrial lubricant were tested. A 3D microscope was used for assessment of the implant-abutment gap, and the abutment screw was tightened and loosened with a digital torque screwdriver. A total of 20 implants per test group (10 BEGO Semados RI and 10 Nobel Biocare Replace Select Straight) were evaluated. The tested sealing materials did not influence the gap between implant and abutment, but the force necessary for loosening the abutment screws decreased significantly. Sealing materials may be useful against bacteria, but probably influence torque negatively.

A comparison of preload values in gold and titanium dental implant retaining screws.

PubMed

Doolabh, R; Dullabh, H D; Sykes, L M

2014-08-01

This in vitro investigation compared the effect of using either gold or titanium retaining screws on preload in the dental implant- abutment complex. Inadequate preload can result in screw loosening, whilst fracture may occur if preload is excessive. These are the most commonly reported complications in implant-retained prostheses, and result in unscheduled, costly and time-consuming visits for the patient and the clinician. This study investigated changes in preload generation after repeated torque applications to gold and titanium screws. The test set-up consisted of an implant body, a cylindrical transmucosa abutment, and the test samples of gold and of titanium retaining screws. The implant bodies were anchored using a load cell, and the transmucosal abutments were attached using either gold or titanium retaining screws. A torque gauge was used to apply torque of 20Ncm, 32Ncm, and 40Ncm to the retaining screws. The preloads generated in each screw type were compared at each torque setting, and after repeated tightening episodes. In addition, the effect of applying torque beyond the manufacturers' recommendations was also examined. Gold retaining screws were found to achieve consistently higher preload values than titanium retaining screws. Preload values were not significantly different from the first to the tenth torque cycle. Titanium screws showed more consistent preload values, albeit lower than those of the gold screws. However due to possible galling of the internal thread of the implant body by titanium screws, gold screws remain the retaining screw of choice. Based on the findings of this study, gold retaining screws generate better preload than titanium. Torque beyond the manufacturers' recommendations resulted in a more stable implant complex. However, further investigations, with torque applications repeated until screw breakage, are needed to advise on ideal maintenance protocols.

Detorque evaluation of dental abutment screws after immersion in a fluoridated artificial saliva solution.

PubMed

Duarte, Antônio R C; Neto, João P Silva; Souza, Júlio C M; Bonachela, Wellington C

2013-06-01

Implant-abutment connections still present failures in the oral cavity due to the loosening of mechanical integrity by detorque and corrosion of the abutment screws. The objective of this study was to evaluate the detorque of dental abutment screws before and after immersion in fluoridated solutions. Five commercial implant-abutment assemblies were assessed in this investigation: (C) Conexão®, (E) Emfils®, (I) INP®, (S) SIN®, and (T) Titanium Fix®. The implants were embedded in an acrylic resin and then placed in a holding device. The abutments were first connected to the implants and torqued to 20 Ncm using a handheld torque meter. The detorque values of the abutments were evaluated after 10 minutes. After applying a second torque of 20 Ncm, implant-abutment assemblies were withdrawn every 3 hours for 12 hours in a fluoridated solution over a period of 90 days. After that period, detorque of the abutments was examined. Scanning electronic microscopy (SEM) associated to energy dispersive spectroscopy (EDS) was applied to inspect the surfaces of abutments. Detorque values of systems C, E, and I immersed in the fluoridated solution were significantly higher than those of the initial detorque. ANOVA demonstrated no significant differences in detorque values between designs S and T. Signs of localized corrosion could not be detected by SEM although chemical analysis by EDS showed the presence of elements involved in corrosive processes. An increase of detorque values recorded on abutments after immersion in fluoridated artificial saliva solutions was noticed in this study. Regarding chemical analysis, such an increase of detorque can result from a corrosion layer formed between metallic surfaces at static contact in the implant-abutment joint during immersion in the fluoridated solutions. © 2012 by the American College of Prosthodontists.

The effect of photodynamic therapy on pathogenic bacteria around peri-implant sulcus and in the cavity between abutment and implant after healing phase: A prospective clinical study.

PubMed

Zhou, Lin-Yi; Shi, Jun-Yu; Zhu, Yu; Qian, Shu-Jiao; Lai, Hong-Chang; Gu, Ying-Xin

2018-05-14

To compare levels of pathogens from peri-implant sulcus versus abutment screw cavities after photodynamic therapy. Twenty patients were included. Photodynamic therapy (PDT) was applied both in sulcus and cavities after sampling following suprastructures loading, and repeated after 2 weeks. Two samples each containing four paper points were collected for each implant at baseline, 2 weeks, 3 months: (i) peri-implant sulcus and (ii) abutment screw cavities. Seventy-five percent ethanol was applied in another 20 patients as the control group in the same way. qPCR was used to quantify periodontal pathogens: Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus mutans. PDT showed a better bacterial reduction than ethanol. P. g. and F. n. were most frequently detected, while less for S. m. P. gingivalis' proportion from both sites was significantly higher than the other two bacteria (P < 0.05), except for 2 weeks' peri-implant sulcus sample. Bacteria counts from abutment screw cavities were always less than those from peri-implant sulcus and was significantly lower for total bacteria at 3 months (P < 0.05). Total bacterial from abutment screw cavities significantly reduced at 3 months compared to baseline (P < 0.05). PDT appears to be effective in bacterial reduction compared to ethanol and can reduce P. gingivalis with short time intervals, as well as decreasing total bacteria counts within abutment screw cavities in the long run, suggesting PDT an effective way sterilizing inner surface of oral implant suprastrutures. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

The effect of the use of a counter-torque device on the abutment-implant complex.

PubMed

Lang, L A; May, K B; Wang, R F

1999-04-01

Little is known about the condition of the abutment-screw joint before loading, after the development of the preload. This study examined the tightening force transmitted to the implant with and without the use of a counter-torque device during the tightening of the abutment screw. Forty Brânemark implants and 10 CeraOne, Estheticone, Procera, and AurAdapt abutments formed the experimental populations. Samples in each group were further divided into 2 groups, 1 group was tightened with a torque controller without the use of a counter-torque device, whereas the other used the counter-torque device. Samples were positioned in a special holder within the grips of a Tohnichi BTG-6 torque gauge for measuring transmitted forces. There were significant differences (P =. 0001) in the tightening forces transmitted to the implant with and without the use of a counter-torque device when tightening the abutment screws. An average of 91% of the recommended preload tightening torque was transmitted to the implant-bone interface in the absence of a counter-torque device. In all abutment systems, less than 10% of the recommended preload tightening torque was transmitted to the implant when the counter-torque device was used.

In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants.

PubMed

García-Roncero, Herminio; Caballé-Serrano, Jordi; Cano-Batalla, Jordi; Cabratosa-Termes, Josep; Figueras-Álvarez, Oscar

2015-04-01

In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous®; Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30° in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

Fixture-abutment connection surface and micro-gap measurements by 3D micro-tomographic technique analysis.

PubMed

Meleo, Deborah; Baggi, Luigi; Di Girolamo, Michele; Di Carlo, Fabio; Pecci, Raffaella; Bedini, Rossella

2012-01-01

X-ray micro-tomography (micro-CT) is a miniaturized form of conventional computed axial tomography (CAT) able to investigate small radio-opaque objects at a-few-microns high resolution, in a non-destructive, non-invasive, and tri-dimensional way. Compared to traditional optical and electron microscopy techniques, which provide two-dimensional images, this innovative investigation technology enables a sample tri-dimensional analysis without cutting, coating or exposing the object to any particular chemical treatment. X-ray micro-tomography matches ideal 3D microscopy features: the possibility of investigating an object in natural conditions and without any preparation or alteration; non-invasive, non-destructive, and sufficiently magnified 3D reconstruction; reliable measurement of numeric data of the internal structure (morphology, structure and ultra-structure). Hence, this technique has multi-fold applications in a wide range of fields, not only in medical and odontostomatologic areas, but also in biomedical engineering, materials science, biology, electronics, geology, archaeology, oil industry, and semi-conductors industry. This study shows possible applications of micro-CT in dental implantology to analyze 3D micro-features of dental implant to abutment interface. Indeed, implant-abutment misfit is known to increase mechanical stress on connection structures and surrounding bone tissue. This condition may cause not only screw preload loss or screw fracture, but also biological issues in peri-implant tissues.

An Indirect Method to Measure Abutment Screw Preload: A Pilot Study Based on Micro-CT Scanning.

PubMed

Rezende, Carlos Eduardo E; Griggs, Jason Alan; Duan, Yuanyuan; Mushashe, Amanda M; Nolasco, Gisele Maria Correr; Borges, Ana Flávia Sanches; Rubo, José Henrique

2015-01-01

This study aimed to measure the preload in different implant platform geometries based on micro-CT images. External hexagon (EH) implants and Morse Tapered (MT) implants (n=5) were used for the preload measurement. The abutment screws were scanned in micro-CT to obtain their virtual models, which were used to record their initial length. The abutments were screwed on the implant with a 20 Ncm torque and the set composed by implant, abutment screw and abutment were taken to the micro-CT scanner to obtain virtual slices of the specimens. These slices allowed the measurement of screw lengths after torque application and based on the screw elongation. Preload values were calculated using the Hooke's Law. The preloads of both groups were compared by independent t-test. Removal torque of each specimen was recorded. To evaluate the accuracy of the micro-CT technique, three rods with known lengths were scanned and the length of their virtual model was measured and compared with the original length. One rod was scanned four times to evaluate the measuring method variation. There was no difference between groups for preload (EH = 461.6 N and MT = 477.4 N), but the EH group showed higher removal torque values (13.8 ± 4.7 against 8.2 ± 3.6 N cm for MT group). The micro-CT technique showed a variability of 0.053% and repeatability showed an error of 0.23 to 0.28%. Within the limitations of this study, there was no difference between external hexagon and Morse taper for preload. The method using micro-CT may be considered for preload calculation.

Measurements of Repeated Tightening and Loosening Torque of Seven Different Implant/Abutment Connection Designs and Their Modifications: An In Vitro Study.

PubMed

Butkevica, Alena; Nathanson, Dan; Pober, Richard; Strating, Herman

2018-02-01

Repeated tightening and loosening of the abutment screw may alter its mechanical and physical properties affecting the optimal torque and ultimate reliability of an implant/abutment connection. The purpose of this study was to evaluate the effect of repeated tightening and loosening of implant/abutment screws on the loosening torque of implant/abutment connections of commercially available implant systems. Seven different implant/abutment connections and their modifications were tested. The screws of each system were tightened according to the manufacturer's specifications. After 20 minutes the screws were loosened. This procedure was repeated ten times, and the differences between the 1st and 10th cycle were expressed as a percentage change RTq(%) and correlated with initial torque, the number of threads, the length of shank, and thread surface area employing Spearman's analysis. All systems showed significant differences in residual torque (RTq) value (p < 0.05) between the 1st and 10th cycle except groups 6 and 11 (p > 0.05). All connections but group 3 (p = 1.000) showed a significant change from the initial torque (ITq) to the RTq values. The first successive RTq values increased in two connection groups 1 and 2. The remaining connections showed reduced RTq values ranging from -1.2 % (group 5) to -23.5% (group 6). The RTq values declined gradually with every repeated tightening in groups 1, 2, 3, 8, 9, 11, 12. In group 2, after the tenth tightening the RTq was still above the ITq value. Only length of shank demonstrated a correlation with the RTq(%) change over the successive tightening loosening cycles (p < 0.05). Repeated tightening and loosening of implant/abutment screws caused varying torque level changes among the different systems. These observations can probably be attributed to connection design. Limiting the number of tightening/loosening cycles in clinical and laboratory procedures is advisable for most of the implant systems tested. © 2016 by the American College of Prosthodontists.

Prospective assessment of CAD/CAM zirconia abutment and lithium disilicate crown restorations: 2.4 year results.

PubMed

Cooper, Lyndon F; Stanford, Clark; Feine, Jocelyne; McGuire, Michael

2016-07-01

Single-tooth implant restorations are commonly used to replace anterior maxillary teeth. The esthetic, functional, and biologic outcomes are, in part, a function of the abutment and crown. The purpose of this clinical study was to describe the implant, abutment, and crown survival and complication rates for CAD/CAM zirconia abutment and lithium disilicate crown restorations for single-tooth implants. As part of a broader prospective investigation that enrolled and treated 141 participants comparing tissue responses at the conical interface (CI; AstraTech OsseoSpeed), flat-to-flat interface (FI; NobelSpeedy), and platform-switch interface (PS; NanoTite Certain Prevail) of single-tooth implants, computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia abutments (ATLANTIS Abutment) and cemented lithium disilicate (e.max) crowns were used in the restoration of all implants. After 2.4 years in function (3 years after implant placement), the implant, abutment, and crown of 110 participants were evaluated. Technical and biologic complications were recorded. Demographic results were tabulated as percentages with mean values and standard deviations. Abutment survival was calculated with the Kaplan-Meier method. After 2.4 years, no abutments or crowns had been lost. Abutment complications (screw loosening, screw fracture, fracture) were absent for all 3 implant groups. Crown complications were limited to 2 crowns debonding and 1 with excess cement (2.5%). Five biological complications (4.0%) were recorded. The overall complication rate was 6.5%. CAD/CAM zirconia abutments restored with cemented lithium disilicate crowns demonstrated high survival on 3 different implant-abutment interface designs. No abutment or abutment screw fracture occurred. The technical complications observed after 2.4 years were minor and reversible. The use of CAD/CAM zirconia abutments with cemented lithium disilicate crowns is associated with high technical and biologic success at 2.4 years. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

A simple procedure for retrieval of a cement-retained implant-supported crown: a case report.

PubMed

Buzayan, Muaiyed Mahmoud; Mahmood, Wan Adida; Yunus, Norsiah Binti

2014-02-01

Retrieval of cement-retained implant prostheses can be more demanding than retrieval of screw-retained prostheses. This case report describes a simple and predictable procedure to locate the abutment screw access openings of cementretained implant-supported crowns in cases of fractured ceramic veneer. A conventional periapical radiography image was captured using a digital camera, transferred to a computer, and manipulated using Microsoft Word document software to estimate the location of the abutment screw access.

Effect of intentional abutment disconnection on the micro-movements of the implant-abutment assembly: a 3D digital image correlation analysis.

PubMed

Messias, Ana; Rocha, Salomão; Calha, Nuno; Neto, Maria Augusta; Nicolau, Pedro; Guerra, Fernando

2017-01-01

Implant-abutment assembly stability is critical for the success of implant-supported rehabilitation. The intentional removal of the prosthetic components may hamper the achievement of the essential stability due to preload reduction in the screw joint and implant-screw mating surface changes. To evaluate the effect of intentional abutment disconnection and reconnection in the stability of internal locking hex implants and corresponding abutments using the method of 3D digital image correlation. Ten conical shape and internal hexagon connection implants were embedded in acrylic resin and assembled to prosthetic abutments with 30 Ncm torque and assigned to two groups: group 1 - tested for static load-bearing capacity at 30° off-axis for two times and group 2 - underwent intentional disconnection and reconnection between tests. Micro-movements were captured with two high-speed photographic cameras and analyzed with video correlation system in three spacial axes U, V and W. Screw abutment and internal implant thread morphology was observed with a field-emission scanning electron microscopy. After the intentional disconnection of the abutment, group 2 showed generally higher maximum displacements for U and V directions. Under 50N load, mean difference was 24.7 μm (P = 0.008) for U direction and -7.7 μm (P = 0.008) for V direction. No significant differences were found for maximum and minimum displacements in the W direction. Mean displacement of the speckle surface presented was statistically different in the two groups (P = 0.016). SEM revealed non-homogenous screw surfaces with scoring on group 2 plus striations and debris in the implant threads. Micro-movements were higher for the group submitted to intentional disconnection and reconnection of the abutment, particularly under average bite forces. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparison of the compressive strength of 3 different implant design systems.

PubMed

Pedroza, Jose E; Torrealba, Ysidora; Elias, Augusto; Psoter, Walter

2007-01-01

The aims of this study were twofold: to compare the static compressive strength at the implant-abutment interface of 3 design systems and to describe the implant abutment connection failure mode. A stainless steel holding device was designed to align the implants at 30 degrees with respect to the y-axis. Sixty-nine specimens were used, 23 for each system. A computer-controlled universal testing machine (MTS 810) applied static compression loading by a unidirectional vertical piston until failure. Specimens were evaluated macroscopically for longitudinal displacement, abutment looseness, and screw and implant fracture. Data were analyzed by analysis of variance (ANOVA). The mean compressive strength for the Unipost system was 392.5 psi (SD +/-40.9), for the Spline system 342.8 psi (SD+/-25.8), and for the Screw-Vent system 269.1 psi (SD+/-30.7). The Unipost implant-abutment connection demonstrated a statistically significant superior mechanical stability (P < or = .009) compared with the Spline implant system. The Spline implant system showed a statistically significant higher compressive strength than the Screw-Vent implant system (P < or =.009). Regarding failure mode, the Unipost system consistently broke at the same site, while the other systems failed at different points of the connection. The Unipost system demonstrated excellent fracture resistance to compressive forces; this resistance may be attributed primarily to the diameter of the abutment screw and the 2.5 mm counter bore, representing the same and a unique piece of the implant. The Unipost implant system demonstrated a statistically significant superior compressive strength value compared with the Spline and Screw-Vent systems, at a 30 degrees angulation.

Effects of Repeated Screw Tightening on Implant Abutment Interfaces in Terms of Bacterial and Yeast Leakage in Vitro: One-Time Abutment Versus the Multiscrewing Technique.

PubMed

Calcaterra, Roberta; Di Girolamo, Michele; Mirisola, Concetta; Baggi, Luigi

2016-01-01

Screw loosening can damage the interfaces of implant components, resulting in susceptibility to contamination of the internal parts by microorganisms. The aim of this study was to investigate the impact of abutment screw retightening on the leakage of two different types of bacteria, Streptococcus sanguinis and Fusobacterium nucleatum, and of the yeast Candida albicans. Two types of implant-abutment systems with tube-in-tube interfaces were tested. Groups A and B each used a different type of system that consisted of 20 different pieces that were assembled according to the manufacturer's torque recommendations; four samples in each group were closed just one time, four samples three times, four samples five times, four samples seven times, and four samples nine times. The implants of groups A and B were contaminated with 0.1 μL of microbial solution just before being assembled for the last time to minimize the possibility of contamination. Results showed a direct correlation between the number of colony-forming units grown in the plates and the closing/opening cycles of the implant-abutment systems. Within the limitations of this study, the results indicate the possibility that repeated closing/opening cycles of the implant-abutment unit may influence bacterial/yeast leakage, most likely as a consequence of decreased precision of the coupling between the abutment and the internal part of the dental implant. These findings suggest that a one-time abutment technique may avoid microbiologic leakage in cases of implant-abutment systems with tube-in-tube interfaces.

In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants

PubMed Central

2015-01-01

PURPOSE In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous®; Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30° in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants. PMID:25932315

[Dynamic analysis of the rigid fixed bridge and related tissue after intrusion of abutment with micro screw implant].

PubMed

Zhu, Lin; Xu, Pei-cheng; Lu, Liu-lei

2013-08-01

To study the variety of mechanical behavior of fixed bridge after abutments being intruded by micro screw implant and to provide theoretical principles for clinical practice of teeth preparation after intrusion of abutments under dynamic loads. Two-dimensional images of maxilla, teeth and supporting tissues of healthy people were scanned by spiral CT and were synthesized by Mimics10.01, Ansys13.0, etc. The three-dimensional finite element mathematical model of rigid fixed bridge repairing on double end of maxillary molar was developed. Under the condition of 10% simulative abutment alveolar absorption, vertical and oblique dynamic forces were applied in a circle of mastication(0.875 s) to build mathematical model after the abutment had been intruded for 0.5, 1.0, 1.5 and 2.0 mm. Stress variety of prosthesis, teeth, periodontal ligaments and supporting tissues were compared before and after intrusion of abutments. Stress variety of the prosthesis occurred, which had close relationship with the structure of prosthesis and teeth, the areas of periodontal ligaments increased, stress on the whole decreased along with the increase of the length of intrusion. With time accumulating, the stress value in prosthesis, teeth, periodontal ligaments and supporting tissues increased gradually and loads in oblique direction induced peak value stress in a masticatory cycle. Some residual stress left after unloading. By preparing the fixed bridge after abutment intrusion by micro screw implant, the service life of abutment and fixed bridge prosthesis can be reduced. The abutment and its related tissue have time-dependent mechanical behaviors during one mastication. The influence of oblique force on stress was greater than vertical force. There is some residual stress left after one mastication period. With the increase of the intrusion on abutment, residual stress reduced.

The fracture strength by a torsion test at the implant-abutment interface.

PubMed

Watanabe, Fumihiko; Hiroyasu, Kazuhiko; Ueda, Kazuhiko

2015-12-01

Fractured connections between implants and implant abutments or abutment screws are frequently encountered in a clinical setting. The purpose of this study was to investigate fracture strength using a torsion test at the interface between the implant and the abutment. Thirty screw-type implant with diameters of 3.3, 3.8, 4.3, 5.0, and 6.0 mm were submitted to a torsion test. Implants of each size were connected to abutments with abutment screws tightened to 20 N · cm. Mechanical stress was applied with a rotational speed of 3.6 °/min until fracture occurred, and maximum torque (fracture torque) and torsional yield strength were measured. The mean values were calculated and then compared using Tukey's test. The abutments were then removed, and the implant-abutment interfaces were examined using a scanning electron microscope (SEM). No significant differences in mean fracture torque were found among 3.3, 3.8, and 4.3 mm-diameter implants, but significant differences were found between these sizes and 5.0 and 6.0 mm-diameter implants (p < 0.01). Concerning mean torsional yield strength, significant differences were found between 3.3, 3.8, and 4.3 mm-diameter and 5.0 and 6.0 mm-diameter implants (p < 0.01). Observations under the SEM showed that all the projections of the abutment corresponding to the internal notches of the implant body had been destroyed. Smaller diameter implants demonstrated lower fracture torque and torsional yield strength than implants with larger diameters. In internal tube-in-tube connections, three abutment projections corresponding to rotation-prevention notches were destroyed in each implant.

Three-Dimensional Finite Element Analysis of the Stress Distribution at the Internal Implant-Abutment Connection.

PubMed

Cho, Sung-Yong; Huh, Yoon-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

2016-01-01

This study investigated stress distribution in four different implant-abutment interface conditions in the internal tapered connection implant system. Four different implant diameters (3.5 mm, 4.0 mm, 4.5 mm, and 5.0 mm) and two abutment types (hexagonal and conical) were simulated. Four unique implant-abutment interface conditions were assumed based on wall thickness, mating surface length, distance to the vertical stop, and abutment shape. Axial and oblique loading was applied during abutment screw preload, and the Von Mises stresses were measured at the implant-abutment and abutment-screw interfaces. The implant-abutment interface stress decreased as the wall thickness increased. As the mating surface increased, the stress distribution trended downward, and when the distance to the implant vertical stop was 0 μm, the Von Mises stress was extremely high at the vertical stop. Despite their different shapes, the abutments showed similar stress distributions. However, the maximum Von Mises stress was higher in the conical connection than in the hexagonal connection, particularly at the contralateral side to loading. To decrease the stress distribution at the implant-abutment interface, the implant wall thickness, mating surface contact length, distance to the vertical stop, and abutment shape should be carefully considered.

Strain analysis of 9 different abutments for cement-retained crowns on an internal hexagonal implant.

PubMed

Salaita, Louai G; Yilmaz, Burak; Seidt, Jeremy D; Clelland, Nancy L; Chien, Hua-Hong; McGlumphy, Edwin A

2017-08-01

Many aftermarket abutments for cement-retained crowns are available for the tapered screw-vent implant. Aftermarket abutments vary widely, from stock to custom abutments and in materials such as zirconia, titanium, or a combination of the two. How these aftermarket abutments perform under occlusal loads with regard to strain distribution is not clear. The purpose of this in vitro study was to measure and compare the different strains placed upon the bone around implants by 9 different abutments for cement-retained crowns on an implant with an internal hexagonal platform. Nine 4.1×11.5-mm tapered screw-vent implants were placed into a 305×51×8-mm resin block for strain measurements. Five abutment specimens of each of the 9 different abutments (N=45) were evaluated with 1 of the 9 implants. Monolithic zirconia crowns were then fabricated for each of the 9 different abutments, the crowns were cyclically loaded (maximum force 225 N) at 30 degrees, twice at a frequency of 2 Hz, and the strain was measured and recorded. The strain to the resin block was determined using a 3-dimensional digital image correlation (3D DIC) technique. Commercial image correlation software was used to analyze the strain around the implants. Data for maximal and minimal principal strains were compared using analysis of variance with a Tukey-Kramer post hoc test (α=.05). Strain measurements showed no significant differences among any of the abutments for minimal (compression) principal strains (P>.05). For maximal (tensile) principal strains, the zirconia abutment showed the highest, and the patient-specific abutment showed the second-highest strain around the implant, with the zirconia being significantly greater than all abutments, with the exception of the patient-specific abutment, and the patient-specific abutment being significantly greater than the straight contoured abutment in titanium and also zirconia (P<.05). The name brand patient specific titanium and Atlantis zirconia abutments conferred the most tensile strain to the implants. When selecting an abutment for a cement-retained crown on a tapered screw-vent implant, practitioners should consider the abutment material and the manufacturer of the abutment because not all abutments that fit in an individual implant transmit the strains in the same way. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Accuracy of fit of implant-supported bars fabricated on definitive casts made by different dental stones

PubMed Central

Kioleoglou, Ioannis; Pissiotis, Argirios

2018-01-01

Background The purpose of this study was to evaluate the accuracy of fitting of an implant supported screw-retained bar made on definitive casts produced by 4 different dental stone products. Material and Methods The dental stones tested were QuickRock (Protechno), FujiRock (GC), Jade Stone (Whip Mix) and Moldasynt (Heraeus). Three external hexagon implants were placed in a polyoxymethylene block. Definitive impressions were made using monophase high viscosity polyvinylsiloxane in combination with custom trays. Then, definitive models from the different types of dental stones were fabricated. Three castable cylinders with a machined non-enganging base were cast and connected with a very small quantity of PMMA to a cast bar, which was used to verify the marginal discrepancies between the abutments and the prosthetic platforms of the implants. For that purpose special software and a camera mounted on an optical microscope were used. The gap was measured by taking 10 measurements on each abutment, after the Sheffield test was applied. Twelve definitive casts were fabricated for each gypsum product and 40 measurements were performed for each cast. Mean, minimum, and maximum values were calculated. The Shapiro-Wilk test of normality was performed. Mann-Whitney test (P<.06) was used for the statistical analysis of the measurements. Results The non-parametric Kruskal-Wallis test revealed a statistically significant effect of the stone factor on the marginal discrepancy for all Sheffield test combinations: 1. Abutment 2 when screw was fastened on abutment 1 (χ2=3, df=35.33, P<0.01), 2. Abutment 3 when the screw was fastened on abutment 1 (χ2=3, df=37.74, P<0.01), 3. Abutment 1 when the screw was fastened on abutment 3 (χ2=3, df=39.79, P<0.01), 4. Abutment 2 when the screw was fastened on abutment 3 (χ2=3, df=37.26, P<0.01). Conclusions A significant correlation exists between marginal discrepancy and different dental gypsum products used for the fabrication of definitive casts for implant supported bars. The smallest marginal discrepancy was noted on implant supported bars fabricated on definitive casts made by Type III mounting stone. The biggest marginal discrepancy was noted on implant supported bars fabricated on definitive casts made by Type V dental stone. The marginal discrepancies presented on implant supported bars fabricated on definitive casts made by two types of Type IV dental stone were not significantly different. Key words:Dental implant, passive fit, dental stones, marginal discrepancy. PMID:29721227

Bacterial plaque colonization around dental implant surfaces.

PubMed

Covani, Ugo; Marconcini, Simone; Crespi, Roberto; Barone, Antonio

2006-09-01

To examine the distribution of bacteria into the internal and external surfaces of failed implants using histologic analysis. There were 10 failed pure titanium and 5 failed hydroxyapatite-coated titanium implants consecutively removed various years after their placement. Criteria for fixture removal were peri-implant radiolucency and clinical mobility. The mobile fixtures were retrieved with the patients under local anesthesia. Fixtures were removed maintaining the abutments with the aim to observe the bacterial infiltration at the level of abutment/implant interface and on the implant surface. A thin radiolucent space was always present around all the failed implants. The abutments screws were tightly secured in all clinical cases. The bacterial cells were composed of cocci and filaments, which were adherent to the implant surface with an orientation perpendicular to the long axis of the implant. All the specimens included in this study showed bacteria at the level of implant/abutment interface. Histologic analysis at the level of abutment/implant interface in 2-stage implants identified heavy bacterial colonization. These findings appear to support those studies showing bacteria penetration at the level of the micro-gap, which can legitimate the hypothesis that the micro-gap at the bone level could present a risk for bone loss caused by bacterial colonization.

Load fatigue performance of four implant-abutment interface designs: effect of torque level and implant system.

PubMed

Quek, H C; Tan, Keson B; Nicholls, Jack I

2008-01-01

Biomechanical load-fatigue performance data on single-tooth implant systems with different implant-abutment interface designs is lacking in the literature. This study evaluated the load fatigue performance of 4 implant-abutment interface designs (Brånemark-CeraOne; 3i Osseotite-STA abutment; Replace Select-Easy abutment; and Lifecore Stage-1-COC abutment system). The number of load cycles to fatigue failure of 4 implant-abutment designs was tested with a custom rotational load fatigue machine. The effect of increasing and decreasing the tightening torque by 20% respectively on the load fatigue performance was also investigated. Three different tightening torque levels (recommended torque, -20% recommended torque, +20% recommended torque) were applied to the 4 implant systems. There were 12 test groups with 5 samples in each group. The rotational load fatigue machine subjected specimens to a sinusoidally applied 35 Ncm bending moment at a test frequency of 14 Hz. The number of cycles to failure was recorded. A cutoff of 5 x 10(6) cycles was applied as an upper limit. There were 2 implant failures and 1 abutment screw failure in the Brånemark group. Five abutment screw failures and 4 implant failures was recorded for the 3i system. The Replace Select system had 1 implant failure. Five cone screw failures were noted for the Lifecore system. Analysis of variance revealed no statistically significant difference in load cycles to failure for the 4 different implant-abutment systems torqued at recommended torque level. A statistically significant difference was found between the -20% torque group and the +20% torque group (P < .05) for the 3i system. Load fatigue performance and failure location is system specific and related to the design characteristics of the implant-abutment combination. It appeared that if the implant-abutment interface was maintained, load fatigue failure would occur at the weakest point of the implant. It is important to use the torque level recommended by the manufacturer.

Dynamic nature of abutment screw retightening: finite element study of the effect of retightening on the settling effect.

PubMed

Bulaqi, Haddad Arabi; Mousavi Mashhadi, Mahmoud; Safari, Hamed; Samandari, Mohammad Mahdi; Geramipanah, Farideh

2015-05-01

A fundamental problem in fully understanding the dynamic nature of screw loosening is lack of recognition of the entire process of screw tightening and retightening. The purpose of this study was to explain the dynamic nature of abutment screw retightening by using finite element methods to investigate the effect of the coefficient of friction and retightening on the settling effect. Precise computer models were designed of a Straumann dental implant, a directly attached crown, an abutment screw, and the bone surrounding the implant. All threaded interfaces were designed with a spiral thread helix with a specific coefficient of static and kinetic friction, and the surfaces were characterized as fine, regular, and rough. Abaqus software was used for dynamic simulation, which involved applying rotational displacement to the abutment screw and torque controlling during the steps of tightening, relaxation, retightening, and second relaxation and at different coefficients of friction. The obtained torque and preload values were compared to the predicted values. When surfaces changed from fine to rough, the remaining torque and preload decreased, and the settling effect increased. Upon retightening, the remaining torque and preload increased, and the settling effect also decreased. The reduction of the coefficient of friction contributes to increases in the preload and decreases in the settling effect. Retightening reduced the settling effect and had an insignificant effect on the preload. At high coefficients of friction, the retightening effect was intensified. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Biomechanical evaluation of different abutment-implant connections - A nonlinear finite element analysis

NASA Astrophysics Data System (ADS)

Ishak, Muhammad Ikman; Shafi, Aisyah Ahmad; Rosli, M. U.; Khor, C. Y.; Zakaria, M. S.; Rahim, Wan Mohd Faizal Wan Abd; Jamalludin, Mohd Riduan

2017-09-01

The success of dental implant surgery is majorly dependent on the stability of prosthesis to anchor to implant body as well as the integration of implant body to bone. The attachment between dental implant body and abutment plays a vital role in attributing to the stability of dental implant system. A good connection between implant body cavity to abutment may minimize the complications of abutment loosening and implant fractures as widely reported in clinical findings. The aim of this paper is to investigate the effect of different abutment-implant connections on stress dispersion within the abutment and implant bodies as well as displacement of implant body via three-dimensional (3-D) finite element analysis (FEA). A 3-D model of mandible was reconstructed from computed tomography (CT) image datasets using an image-processing software with the selected region of interest was the left side covering the second premolar, first molar and second molar regions. The bone was modelled as compact (cortical) and porous (cancellous) structures. Besides, three implant bodies and three generic models of abutment with different types of connections - tapered interference fit (TIF), tapered integrated screwed-in (TIS) and screw retention (SR) were created using computer-aided design (CAD) software and all models were then analysed via 3D FEA software. Occlusal forces of 114.6 N, 17.2 N and 23.4 N were applied in the axial, lingual and mesio-distal directions, respectively, on the top surface of first molar crown. All planes of the mandibular bone model were rigidly fixed. The result exhibited that abutment with TIS connection produced the most favourable stress and displacement outcomes as compared to other attachment types. This is due to the existence of integrated screw at the bottom portion of tapered abutment which increases the motion resistance.

Efficacy of Sealing Agents on Preload Maintenance of Screw-Retained Implant-Supported Prostheses.

PubMed

Seloto, Camila Berbel; Strazzi Sahyon, Henrico Badaoui; Dos Santos, Paulo Henrique; Delben, Juliana Aparecida; Assunção, Wirley Gonçalves

The aim of this study was to evaluate the effect of sealing agents on preload maintenance of screw joints. A total of four groups (n = 10 in each group) of abutment/implant systems, including external hexagon implants and antirotational UCLA abutments with a metallic collar in cobalt-chromium alloy, were assessed. In the control group (CG), no sealing agent was used at the abutment screw/implant interface. In the other groups, three different sealing agents were used at the abutment screw/implant interface: anaerobic sealing agent for medium torque (ASMT), anaerobic sealing agent for high torque (ASHT), and cyanoacrylate-based bonding agent (CYAB). All abutments were attached to the implants at 32 ± 1 N.cm. After 48 ± 2 hours of initial tightening, loosing torque (detorque) was measured using a digital torque wrench. Data were analyzed using Shapiro-Wilk, Wilcoxon, and Kruskal-Wallis tests, at 5% level of significance. In the CG and ASMT groups, detorque was lower than the insertion torque (24.6 ± 1.5 N.cm and 24.3 ± 1.1 N.cm, respectively). In the ASHT and CYAB groups, mean detorque increased in comparison to the insertion torque (51.0 ± 7.4 N.cm and 47.7 ± 15.1 N.cm, respectively). The ASHT was more efficient than the other sealing agents, increasing the remaining preload (detorque value) 58.88%. Although the cyanoacrylate-based bonding agent also generated high detorque values, the high standard deviation suggested its lower reliability.

Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures

PubMed Central

2015-01-01

PURPOSE To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants. MATERIALS AND METHODS This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. RESULTS The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). CONCLUSION The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture. PMID:26813443

Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures.

PubMed

Shim, Hye Won; Yang, Byoung-Eun

2015-12-01

To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants. This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.

Heat generation during removal of an abutment screw fragment from dental implants.

PubMed

Arias, Sergio R; Rueggeberg, Frederick A; Mettenburg, Donald; Sharawy, Mohamed; Looney, Stephen; Elsayed, Ranya; Elsalanty, Mohammed E

2018-04-01

Little information is available on the effect of drilling speed on surrounding bone during the removal of an abutment screw fragment. The purpose of this in vitro study was to compare, in vitro, the peak temperature increase during the removal of fractured abutment screws from implants placed in a porcine mandible, using drilling speeds of 600 or 2000 rpm. Twenty 4.3×13-mm dental implants were placed in 10 dissected porcine mandibles: 2 implants per mandible, 1 on each side. Localized defects were created in 20 surface-treated abutment screws, which were then tightened into each implant until a reproducible fracture occurred in each screw. The fractured screws were removed with a handpiece removal kit and irrigated with room-temperature water at either 600 or 2000 rpm. The temperature rise at the implant surface was measured at 3 levels with 3 type-K thermocouples. Repeated measure ANOVA was performed with the Tukey-Kramer post hoc test for mean pair-wise comparisons (α=.05 for all tests). Mean peak temperatures were significantly higher at 2000 rpm than at 600 rpm in the mid-body (P<.001) and crestal (P=.003) regions but not in the apical (P=.225) implant locations. No significant differences in mean peak temperatures were found among the 3 locations using 600 rpm (P=.179). In the 2000-rpm group, mean peak temperature in the mid-body area was consistently higher than that in the apical (P<.001) area, and more instances of temperature rise above 56°C and 60°C were observed. In 1 implant from this group, the estimated peak temperature exceeded the bone damage threshold value (50°C for 30 seconds). A drilling speed of 2000 rpm during the removal of abutment screw fragments caused overheating of the outer surface of the implant which may damage the surrounding bone; a speed of 600 rpm appears to be safe. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Comparative Analysis of Screw Loosening With Prefabricated Abutments and Customized CAD/CAM Abutments.

PubMed

Paek, Janghyun; Woo, Yi-Hyung; Kim, Hyeong-Seob; Pae, Ahran; Noh, Kwantae; Lee, Hyeonjong; Kwon, Kung-Rock

2016-12-01

The aim of this study was to determine the stability of computer-aided design and manufacturing (CAD/CAM) and prefabricated abutment by measuring removal torque before and after cyclic loading. Three types of fixture and 2 types of abutments were used. Removable torque was measured after cyclic loading for 5000 cycles between 25 and 250 N for each group. The same procedure was performed twice. First, removal torque values (Newton centimeter) were measured for stock versus custom abutments as follows: group 1: 27.17 versus 26.67, group 2: 26.27 versus 26.33, and group 3: 37.33 versus 36.67. Second removal torque values (Newton centimeter) were also measured: group 1: 23 versus 23.5, group 2: 22.5 versus 22.33, and group 3: 32.67 versus 32.5. There was no significant difference between the stock and custom abutments in either the first or second removal torque values and also no significant difference among initial tightening torque, first or second removal torque (P > 0.05). With precise control of CAD/CAM abutments, good screw joint stability can be achieved.

Custom-made laser-welded titanium implant prosthetic abutment.

PubMed

Iglesia-Puig, Miguel A

2005-10-01

A technique to create an individually modified implant prosthetic abutment is described. An overcasting is waxed onto a machined titanium abutment, cast in titanium, and joined to it with laser welding. With the proposed technique, a custom-made titanium implant prosthetic abutment is created with adequate volume and contour of metal to support a screw-retained, metal-ceramic implant-supported crown.

Influence of Different Screw Torque Levels on the Biomechanical Behavior of Tapered Prosthetic Abutments.

PubMed

Herbst, Paulo Eduardo; de Carvalho, Eduardo Bortolas; Salatti, Rafael C; Valgas, Laiz; Tiossi, Rodrigo

To study the force used for tightening tapered one-piece prosthetic abutments and their influence on the removal torque value and stress level of the prosthetic abutment after cyclic loading. Fourteen implants and prosthetic abutments were divided into two groups (n = 7): G1, 20 Ncm; and G2, 32 Ncm (manufacturer recommended). A 20-mm T-shaped horizontal bar was adapted to the abutments. A 12-Hz cyclic loading was applied to the specimens in an electrodynamic testing system with the maximum number of cycles set to 10 6 . Specimens were inclined by 15 degrees from the vertical axis, and a 5-mm off-center vertical load was applied to generate a combination of bending and torquing moments on the tapered connections. Progressive loads (from 164.85 to 362.85 N) were applied when the previous sample survived 10 6 cycles. The paired t test compared the screw removal torque with the initial tightening torque for each group (α = .05). A finite element analysis (FEA) of the mechanical testing analyzed the regions of stress concentration. No specimens failed after 10 6 cyclic loadings. The mean screw removal torque for both groups was similar to the initial abutment torque value applied for each group (G1, 20.36 ± 8.73 Ncm; and G2, 35.61 ± 6.99 Ncm) (P > .05). FEA showed similar stress behavior for both groups in the study despite the different simulated screw preloads (G1: 200 N; G2: 320 N). The coronal region of the implant body presented the highest strain values in both groups. Tightening tapered one-piece prosthetic abutments at 20 and 32 Ncm maintains a stable connection after cyclic loading. The stresses generated by the different tightening forces during cyclic loading are highest at the coronal level of the connection.

Development of a new quantitative gas permeability method for dental implant-abutment connection tightness assessment

PubMed Central

2011-01-01

Background Most dental implant systems are presently made of two pieces: the implant itself and the abutment. The connection tightness between those two pieces is a key point to prevent bacterial proliferation, tissue inflammation and bone loss. The leak has been previously estimated by microbial, color tracer and endotoxin percolation. Methods A new nitrogen flow technique was developed for implant-abutment connection leakage measurement, adapted from a recent, sensitive, reproducible and quantitative method used to assess endodontic sealing. Results The results show very significant differences between various sealing and screwing conditions. The remaining flow was lower after key screwing compared to hand screwing (p = 0.03) and remained different from the negative test (p = 0.0004). The method reproducibility was very good, with a coefficient of variation of 1.29%. Conclusions Therefore, the presented new gas flow method appears to be a simple and robust method to compare different implant systems. It allows successive measures without disconnecting the abutment from the implant and should in particular be used to assess the behavior of the connection before and after mechanical stress. PMID:21492459

The Influence of Torque Tightening on the Position Stability of the Abutment in Conical Implant-Abutment Connections.

PubMed

Hogg, Wiebke Semper; Zulauf, Kris; Mehrhof, Jürgen; Nelson, Katja

2015-01-01

The influence of repeated system-specific torque tightening on the position stability of the abutment after de- and reassembly of the implant components was evaluated in six dental implant systems with a conical implant-abutment connection. An established experimental setup was used in this study. Rotation, vertical displacement, and canting moments of the abutment were observed; they depended on the implant system (P = .001, P < .001, P = .006, respectively). Repeated torque tightening of the abutment screw does not eliminate changes in position of the abutment.

Fracture Resistance and Mode of Failure of Ceramic versus Titanium Implant Abutments and Single Implant-Supported Restorations.

PubMed

Sghaireen, Mohd G

2015-06-01

The material of choice for implant-supported restorations is affected by esthetic requirements and type of abutment. This study compares the fracture resistance of different types of implant abutments and implant-supported restorations and their mode of failure. Forty-five Oraltronics Pitt-Easy implants (Oraltronics Dental Implant Technology GmbH, Bremen, Germany) (4 mm diameter, 10 mm length) were embedded in clear autopolymerizing acrylic resin. The implants were randomly divided into three groups, A, B and C, of 15 implants each. In group A, titanium abutments and metal-ceramic crowns were used. In group B, zirconia ceramic abutments and In-Ceram Alumina crowns were used. In group C, zirconia ceramic abutments and IPS Empress Esthetic crowns were used. Specimens were tested to failure by applying load at 130° from horizontal plane using an Instron Universal Testing Machine. Subsequently, the mode of failure of each specimen was identified. Fracture resistance was significantly different between groups (p < .05). The highest fracture loads were associated with metal-ceramic crowns supported by titanium abutments (p = .000). IPS Empress crowns supported by zirconia abutments had the lowest fracture loads (p = .000). Fracture modes of metal-ceramic crowns supported by titanium abutments included screw fracture and screw bending. Fracture of both crown and abutment was the dominant mode of failure of In-Ceram/IPS Empress crowns supported by zirconia abutments. Metal-ceramic crowns supported by titanium abutments were more resistant to fracture than In-Ceram crowns supported by zirconia abutments, which in turn were more resistant to fracture than IPS Empress crowns supported by zirconia abutments. In addition, failure modes of restorations supported by zirconia abutments were more catastrophic than those for restorations supported by titanium abutments. © 2013 Wiley Periodicals, Inc.

The influence of abutment angulation on screw loosening of implants in the anterior maxilla.

PubMed

Ha, Chun-Yeo; Lim, Yung-Jun; Kim, Myung-Joo; Choi, Jung-Han

2011-01-01

This study compared the removal torque values (RTVs) of different abutments (straight, angled, and gold premachined UCLA-type) in external- and internal-hex implants after dynamic cyclic loading with the clinical situation of the anterior maxilla simulated. An ideal cast of a maxilla with a missing right central incisor was fabricated in dental stone, and an implant analog was embedded in this model at a 15-degree angle labial to the long axis of the left central incisor. Thirty external-hex and 30 internal-hex implants were used. A total of 10 straight abutments, 10 angled abutments, and 10 gold premachined UCLA-type abutments of each system and 60 abutment screws were tested. Initial RTVs were measured after each assembly was tightened to 30 Ncm. Straight abutments and angled abutments were prepared and gold-premachined UCLA-type abutments were waxed and cast with low-fusing gold alloy for the central incisor. RTVs were then measured again. After each assembly was tightened, a metal crown was temporarily cemented. After cyclic loading of 20 to 200 N was applied 1 million times, RTVs were measured for a third time. Statistical analysis (alpha = .05) was performed to evaluate the results. The angled abutment group showed significantly higher RTVs than the straight abutment and gold premachined UCLA-type abutment groups in external-hex implants. However, no significant difference in RTVs was found among abutments in internal-hex implants. The time of analysis of RTV was found to significantly influence mean RTVs. Mean RTVs of external- and internal-hex implants showed significant differences. Within the limitations of this study, there were significant differences in RTVs among different abutment groups in external-hex implants. There were no significant differences in RTVs among different abutment groups in internal-hex implants.

Variation in the total lengths of abutment/implant assemblies generated with a function of applied tightening torque in external and internal implant-abutment connection.

PubMed

Kim, Ki-Seong; Lim, Young-Jun; Kim, Myung-Joo; Kwon, Ho-Beom; Yang, Jae-Ho; Lee, Jai-Bong; Yim, Soon-Ho

2011-08-01

Settling (embedment relaxation), which is the main cause for screw loosening, is developed by microroughness between implant and abutment metal surface. The objective of this study was to evaluate and compare the relationship between the level of applied torque and the settling of abutments into implants in external and internal implant-abutment connection. Five different implant-abutment connections were used (Ext, External butt joint + two-piece abutment; Int-H2, Internal hexagon + two-piece abutment; Int-H1, Internal hexagon + one-piece abutment; Int-O2, Internal octagon + two-piece abutment; Int-O1, Internal octagon + one-piece abutment). All abutments of each group were assembled and tightened with corresponding implants by a digital torque gauge. The total lengths of implant-abutment samples were measured at each torque (5, 10, 30 N cm and repeated 30 N cm with 10-min interval) by an electronic digital micrometer. The settling values were calculated by changes between the total lengths of implant-abutment samples. All groups developed settling with repeated tightening. The Int-H2 group showed markedly higher settling for all instances of tightening torque and the Ext group was the lowest. Statistically significant differences were found in settling values between the groups and statistically significant increases were observed within each group at different tightening torques (P<0.05). After the second tightening of 30 N cm, repeated tightening showed almost constant settling values. Results from the present study suggested that to minimize the settling effect, abutment screws should be retightened at least twice at 30 N cm torque at a 10-min interval in all laboratory and clinical procedures. © 2010 John Wiley & Sons A/S.

Probabilistic analysis of preload in the abutment screw of a dental implant complex.

PubMed

Guda, Teja; Ross, Thomas A; Lang, Lisa A; Millwater, Harry R

2008-09-01

Screw loosening is a problem for a percentage of implants. A probabilistic analysis to determine the cumulative probability distribution of the preload, the probability of obtaining an optimal preload, and the probabilistic sensitivities identifying important variables is lacking. The purpose of this study was to examine the inherent variability of material properties, surface interactions, and applied torque in an implant system to determine the probability of obtaining desired preload values and to identify the significant variables that affect the preload. Using software programs, an abutment screw was subjected to a tightening torque and the preload was determined from finite element (FE) analysis. The FE model was integrated with probabilistic analysis software. Two probabilistic analysis methods (advanced mean value and Monte Carlo sampling) were applied to determine the cumulative distribution function (CDF) of preload. The coefficient of friction, elastic moduli, Poisson's ratios, and applied torque were modeled as random variables and defined by probability distributions. Separate probability distributions were determined for the coefficient of friction in well-lubricated and dry environments. The probabilistic analyses were performed and the cumulative distribution of preload was determined for each environment. A distinct difference was seen between the preload probability distributions generated in a dry environment (normal distribution, mean (SD): 347 (61.9) N) compared to a well-lubricated environment (normal distribution, mean (SD): 616 (92.2) N). The probability of obtaining a preload value within the target range was approximately 54% for the well-lubricated environment and only 0.02% for the dry environment. The preload is predominately affected by the applied torque and coefficient of friction between the screw threads and implant bore at lower and middle values of the preload CDF, and by the applied torque and the elastic modulus of the abutment screw at high values of the preload CDF. Lubrication at the threaded surfaces between the abutment screw and implant bore affects the preload developed in the implant complex. For the well-lubricated surfaces, only approximately 50% of implants will have preload values within the generally accepted range. This probability can be improved by applying a higher torque than normally recommended or a more closely controlled torque than typically achieved. It is also suggested that materials with higher elastic moduli be used in the manufacture of the abutment screw to achieve a higher preload.

Can the Hydroxyapatite-Coated Skin-Penetrating Abutment for Bone Conduction Hearing Implants Integrate with the Surrounding Skin?

PubMed

van Hoof, Marc; Wigren, Stina; Duimel, Hans; Savelkoul, Paul H M; Flynn, Mark; Stokroos, Robert Jan

2015-01-01

Percutaneous implants, such as bone conduction hearing implants, suffer from complications that include inflammation of the surrounding skin. A sealed skin-abutment interface can prevent the ingress of bacteria, which should reduce the occurrence of peri-abutment dermatitis. It was hypothesized that a hydroxyapatite (HA)-coated abutment in conjunction with soft tissue preservation surgery should enable integration with the adjacent skin. Previous research has confirmed that integration is never achieved with as-machined titanium abutments. Here, we investigate, in vivo, if skin integration is achievable in patients using a HA-coated abutment. One titanium abutment (control) and one HA-coated abutment (case) together with the surrounding skin were surgically retrieved from two patients who had a medical indication for this procedure. Histological sections of the skin were investigated using light microscopy. The abutment was qualitatively analyzed using scanning electron microscopy. The titanium abutment only had a partial and thin layer of attached amorphous biological material. The HA-coated abutment was almost fully covered by a pronounced thick layer of organized skin, composed of different interconnected structural layers. Proof-of-principle evidence that the HA-coated abutment can achieve integration with the surrounding skin was presented for the first time.

An in vivo assessment of the effects of using different implant abutment occluding materials on implant microleakage and the peri-implant microbiome

NASA Astrophysics Data System (ADS)

Rubino, Caroline

Microleakage may be a factor in the progression of peri-implant pathology. Microleakage in implant dentistry refers to the passage of bacteria, fluids, molecules or ions between the abutment-implant interface to and from the surrounding periodontal tissues. This creates a zone of inflammation and reservoir of bacteria at the implant-abutment interface. Bone loss typically occurs within the first year of abutment connection and then stabilizes. It has not yet been definitively proven that the occurrence of microleakage cannot contribute to future bone loss or impede the treatment of peri-implant disease. Therefore, strategies to reduce or eliminate microleakage are sought out. Recent evidence demonstrates that the type of implant abutment channel occluding material can affect the amount of microleakage in an in vitro study environment. Thus, we hypothesize that different abutment screw channel occluding materials will affect the amount of observed microleakage, vis-a-vis the correlation between the microflora found on the abutment screw channel occluding material those found in the peri-implant sulcus. Additional objectives include confirming the presence of microleakage in vivo and assessing any impact that different abutment screw channel occluding materials may have on the peri-implant microbiome. Finally, the present study provides an opportunity to further characterize the peri-implant microbiome. Eight fully edentulous patients restored with at dental implants supporting screw-retained fixed hybrid prostheses were included in the study. At the initial appointment (T1), the prostheses were removed and the implants and prostheses were cleaned. The prostheses were then inserted with polytetrafluoroethylene tape (PTFE, TeflonRTM), cotton, polyvinyl siloxane (PVS), or synthetic foam as the implant abutment channel occluding material and sealed over with composite resin. About six months later (T2), the prostheses were removed and the materials collected. Paper points were used to sample the peri-implant sulcus bacteria. All samples were then submitted to DNA purification, polymerase chain reaction (PCR), and sequencing protocols to assess relative numbers of bacterial species. Periodontal parameters were collected at both time points. Overall, our findings support several conclusions. Different implant abutment channel occluding materials appear to have no effect on the amount of observed microleakage and the peri-implant microbiome. Evidence for microleakage was found in the present study, corroborating existing in vivo evidence. Finally, we gained several insights regarding the peri implant microbiome. Of note, the peri-implant microbiome is well described by the classical periodontal microbial complexes, but a large portion consists of bacteria not previously classified into the microbial complexes.

Accuracy of electronic implant torque controllers following time in clinical service.

PubMed

Mitrani, R; Nicholls, J I; Phillips, K M; Ma, T

2001-01-01

Tightening of the screws in implant-supported restorations has been reported to be problematic, in that if the applied torque is too low, screw loosening occurs. If the torque is too high, then screw fracture can take place. Thus, accuracy of the torque driver is of the utmost importance. This study evaluated 4 new electronic torque drivers (controls) and 10 test electronic torque drivers, which had been in clinical service for a minimum of 5 years. Torque values of the test drivers were measured and were compared with the control values using a 1-way analysis of variance. Torque delivery accuracy was measured using a technique that simulated the clinical situation. In vivo, the torque driver turns the screw until the selected tightening torque is reached. In this laboratory experiment, an implant, along with an attached abutment and abutment gold screw, was held firmly in a Tohnichi torque gauge. Calibration accuracy for the Tohnichi is +/- 3% of the scale value. During torque measurement, the gold screw turned a minimum of 180 degrees before contact was made between the screw and abutment. Three torque values (10, 20, and 32 N-cm) were evaluated, at both high- and low-speed settings. The recorded torque measurements indicated that the 10 test electronic torque drivers maintained a torque delivery accuracy equivalent to the 4 new (unused) units. Judging from the torque output values obtained from the 10 test units, the clinical use of the electronic torque driver suggests that accuracy did not change significantly over the 5-year period of clinical service.

Effect of Cyclic Loading on Micromotion at the Implant-Abutment Interface.

PubMed

Karl, Matthias; Taylor, Thomas D

2016-01-01

Cyclic loading may cause settling of abutments mounted on dental implants, potentially affecting screw joint stability and implant-abutment micromotion. It was the goal of this in vitro study to compare micromotion of implant-abutment assemblies before and after masticatory simulation. Six groups of abutments (n = 5) for a specific tissue-level implant system with an internal octagon were subject to micromotion measurements. The implant-abutment assemblies were loaded in a universal testing machine, and an apparatus and extensometers were used to record displacement. This was done twice, in the condition in which they were received from the abutment manufacturer and after simulated loading (100,000 cycles; 100 N). Statistical analysis was based on analysis of variance, two-sample t tests (Welch tests), and Pearson product moment correlation (α = .05). The mean values for micromotion ranged from 33.15 to 63.41 μm and from 30.03 to 42.40 μm before and after load cycling. The general trend toward reduced micromotion following load cycling was statistically significant only for CAD/CAM zirconia abutments (P = .036) and for one type of clone abutment (P = .012), with no significant correlation between values measured before and after cyclic loading (Pearson product moment correlation; P = .104). While significant differences in micromotion were found prior to load cycling, no significant difference among any of the abutment types tested could be observed afterward (P > .05 in all cases). A quantifiable settling effect at the implant-abutment interface seems to result from cyclic loading, leading to a decrease in micromotion. This effect seems to be more pronounced in low-quality abutments. For the implant system tested in this study, retightening of abutment screws is recommended after an initial period of clinical use.

Clinical Performance of One-Piece, Screw-Retained Implant Crowns Based on Hand-Veneered CAD/CAM Zirconia Abutments After a Mean Follow-up Period of 2.3 Years.

PubMed

Schnider, Nicole; Forrer, Fiona Alena; Brägger, Urs; Hicklin, Stefan Paul

The aim of this study was to evaluate the clinical performance of one-piece, screw-retained implant crowns based on hand-veneered computer-aided design/computer-aided manufacture (CAD/CAM) zirconium dioxide abutments with a crossfit connection at least 1 year after insertion of the crown. Consecutive patients who had received at least one Straumann bone level implant and one-piece, screw-retained implant crowns fabricated with CARES zirconium dioxide abutments were reexamined. Patient satisfaction, occlusal and peri-implant parameters, mechanical and biologic complications, radiologic parameters, and esthetics were recorded. A total of 50 implant crowns in the anterior and premolar region were examined in 41 patients. The follow-up period of the definitive reconstructions ranged from 1.1 to 3.8 years. No technical and no biologic complications had occurred. At the reexamination, 100% of the implants and reconstructions were in situ. Radiographic evaluation revealed a mean distance from the implant shoulder to the first visible bone-to-implant contact of 0.06 mm at the follow-up examination. Screw-retained crowns based on veneered CAD/CAM zirconium dioxide abutments with a crossfit connection seem to be a promising way to replace missing teeth in the anterior and premolar region. In the short term, neither failures of components nor complications were noted, and the clinical and radiographic data revealed stable hard and soft tissue conditions.

In vitro effect of chlorhexidine gel on torque and detorque values of implant abutment screw.

PubMed

Asli, Hamid Neshandar; Saberi, Bardia Vadiati; Fatemi, Arezoo Sadat

2017-01-01

Use of chlorhexidine (CHX) gel to eliminate the malodor of implant cavity may decrease the friction coefficient and effective preload and result in abutment screw loosening. This study aimed to assess the effect of CHX gel on the preload, torque, and detorque values. This in vitro experimental study was conducted on three groups of five implants. Group A (G1) was the control group and no material was applied to the implant cavity. In Group B (G2), implant cavity was filled with saliva before abutment screw tightening. In Group C (G3), implant cavity was first filled with saliva and then with CHX gel. The abutments were torqued to 24 N/cm2 according to the manufacturer's instructions and were then loosened. These processes were repeated five times. The ratio of the mean percentage of detorque to torque values was measured in all groups. The collected data were analyzed using ANOVA and post hoc Tukey's test. No significant difference was noted between G1 and G2. Group G2 had significantly higher detorque value (p < 0.05). ANOVA detected a significant difference in the mean torque (p < 0.05) and detorque (p < 0.001) values among the three groups. G3 showed maximum difference between torque and detorque values; the minimum difference was noted in G2. Application of CHX gel (to decrease the malodor of the implant cavity) decreases the detorque and preload values and increases the risk of screw loosening.

Experimental research on the relationship between fit accuracy and fracture resistance of zirconia abutments.

PubMed

Sui, Xinxin; Wei, Huasha; Wang, Dashan; Han, Yan; Deng, Jing; Wang, Yongliang; Wang, Junjun; Yang, Jianjun

2014-10-01

The purpose of the study was to investigate the correlation between fit accuracy and fracture resistance of zirconia abutments, as well as its feasibility for clinical applications. Twenty self-made zirconia abutments were tested with 30 Osstem GSII implants. First, 10 Osstem GSII implants were cut into two parts along the long axis and assembled with the zirconia abutments. The microgaps between the implants and the zirconia abutments were measured under a scanning electron microscope. Second, the zirconia abutments were assembled with 20 un-cut implants and photographed before and after being fixed with a central screw of 30-Ncm torque. The dental films were measured by Digora for Windows 2.6 software. Then the fracture resistance of zirconia abutments was measured using the universal testing machine at 90°. All results were analyzed using SPSS13.0 software. The average internal-hexagon microgaps between the implants and zirconia abutments were 19.38±1.34μm. The average Morse taper microgap in the implant-abutment interface was 17.55±1.68μm. The dental film showed that the Morse taper gap in the implant-abutment interface disappeared after being fixed with a central screw of 30-Ncm torque, and the average moving distance of the zirconia abutments to the implants was 0.19±0.02mm. The average fracture resistance of zirconia abutments was 282.93±17.28N. The internal-hexagon microgap between the implants and zirconia abutments was negatively related to the fracture resistance of the abutments (r1=-0.97, p<0.01). The Morse taper microgap in the implant-abutment interface was negatively related to the fracture resistance of the abutments (r2=-0.84, p<0.01). The microgap between implant and abutment was negatively related to the fracture resistance of the abutment, while the internal-hexagon microgap has better correlation than the Morse taper microgap. The closure of microgap is helpful to improve the fracture resistance of zirconia abutments. The fracture resistance of zirconia abutments can satisfy the clinical application. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bone Loss at Implant with Titanium Abutments Coated by Soda Lime Glass Containing Silver Nanoparticles: A Histological Study in the Dog

PubMed Central

Martinez, Arturo; Guitián, Francisco; López-Píriz, Roberto; Bartolomé, José F.; Cabal, Belén; Esteban-Tejeda, Leticia; Torrecillas, Ramón; Moya, José S.

2014-01-01

The aim of the present study was to evaluate bone loss at implants connected to abutments coated with a soda-lime glass containing silver nanoparticles, subjected to experimental peri-implantitis. Also the aging and erosion of the coating in mouth was studied. Five beagle dogs were used in the experiments. Three implants were placed in each mandible quadrant: in 2 of them, Glass/n-Ag coated abutments were connected to implant platform, 1 was covered with a Ti-mechanized abutment. Experimental peri-implantitis was induced in all implants after the submarginal placement of cotton ligatures, and three months after animals were euthanatized. Thickness and morphology of coating was studied in abutment cross-sections by SEM. Histology and histo-morphometric studies were carried on in undecalfied ground slides. After the induced peri-implantitis: 1.The abutment coating shown losing of thickness and cracking. 2. The histometry showed a significant less bone loss in the implants with glass/n-Ag coated abutments. A more symmetric cone of bone resorption was observed in the coated group. There were no significant differences in the peri-implantitis histological characteristics between both groups of implants. Within the limits of this in-vivo study, it could be affirmed that abutments coated with biocide soda-lime-glass-silver nanoparticles can reduce bone loss in experimental peri-implantitis. This achievement makes this coating a suggestive material to control peri-implantitis development and progression. PMID:24466292

Machined and plastic copings in three-element prostheses with different types of implantabutment joints: a strain gauge comparative analysis

PubMed Central

NISHIOKA, Renato Sussumu; NISHIOKA, Lea Nogueira Braulino de Melo; ABREU, Celina Wanderley; de VASCONCELLOS, Luis Gustavo Oliveira; BALDUCCI, Ivan

2010-01-01

Objective Using strain gauge (SG) analysis, the aim of this in vitro study was quantify the strain development during the fixation of three-unit screw implant-supported fixed partial dentures, varying the types of implant-abutment joints and the type of prosthetic coping. The hypotheses were that the type of hexagonal connection would generate different microstrains and the type of copings would produce similar microstrains after prosthetic screws had been tightened onto microunit abutments. Materials and methods Three dental implants with external (EH) and internal (IH) hexagonal configurations were inserted into two polyurethane blocks. Microunit abutments were screwed onto their respective implant groups, applying a torque of 20 Ncm. Machined Co-Cr copings (M) and plastic prosthetic copings (P) were screwed onto the abutments, which received standard wax patterns. The wax patterns were cast in Co-Cr alloy (n=5), forming four groups: G1) EH/M; G2) EH/P; G3) IH/M and G4) IH/P. Four SGs were bonded onto the surface of the block tangentially to the implants, SG 1 mesially to implant 1, SG 2 and SG 3 mesially and distally to implant 2, respectively, and SG 4 distally to implant 3. The superstructure’s occlusal screws were tightened onto microunit abutments with 10 Ncm torque using a manual torque driver. The magnitude of microstrain on each SG was recorded in units of microstrain (µε). The data were analyzed statistically by ANOVA and Tukey’s test (p<0.05). Results Microstrain values of each group were: G1= 338.1±223.0 µε; G2= 363.9±190.9 µε; G3= 415.1±53.5 µε; G4= 363.9±190.9 µε. No statistically significant difference was found between EH and IH, regardless of the type of copings (p>0.05). The hypotheses were partially accepted. Conclusions It was concluded that the type of hexagonal connection and coping presented similar mechanical behavior under tightening conditions. PMID:20856998

A finite element analysis of novel vented dental abutment geometries for cement‐retained crown restorations

PubMed Central

Rodriguez, Lucas C.; Saba, Juliana N.; Meyer, Clark A.; Chung, Kwok‐Hung; Wadhwani, Chandur

2016-01-01

Abstract Recent literature indicates that the long‐term success of dental implants is, in part, attributed to how dental crowns are attached to their associated implants. The commonly utilized method for crown attachment – cementation, has been criticized because of recent links between residual cement and peri‐implant disease. Residual cement extrusion from crown‐abutment margins post‐crown seating is a growing concern. This study aimed at (1) identifying key abutment features, which would improve dental cement flow characteristics, and (2) understanding how these features would impact the mechanical stability of the abutment under functional loads. Computational fluid dynamic modeling was used to evaluate cement flow in novel abutment geometries. These models were then evaluated using 3D‐printed surrogate models. Finite element analysis also provided an understanding of how the mechanical stability of these abutments was altered after key features were incorporated into the geometry. The findings demonstrated that the key features involved in improved venting of the abutment during crown seating were (1) addition of vents, (2) diameter of the vents, (3) location of the vents, (4) addition of a plastic screw insert, and (5) thickness of the abutment wall. This study culminated in a novel design for a vented abutment consisting of 8 vents located radially around the abutment neck‐margin plus a plastic insert to guide the cement during seating and provide retrievability to the abutment system.Venting of the dental abutment has been shown to decrease the risk of undetected residual dental cement post‐cement‐retained crown seating. This article will utilize a finite element analysis approach toward optimizing dental abutment designs for improved dental cement venting. Features investigated include (1) addition of vents, (2) diameter of vents, (3) location of vents, (4) addition of plastic screw insert, and (5) thickness of abutment wall. PMID:29744160

A finite element analysis of novel vented dental abutment geometries for cement-retained crown restorations.

PubMed

Rodriguez, Lucas C; Saba, Juliana N; Meyer, Clark A; Chung, Kwok-Hung; Wadhwani, Chandur; Rodrigues, Danieli C

2016-11-01

Recent literature indicates that the long-term success of dental implants is, in part, attributed to how dental crowns are attached to their associated implants. The commonly utilized method for crown attachment - cementation, has been criticized because of recent links between residual cement and peri-implant disease. Residual cement extrusion from crown-abutment margins post-crown seating is a growing concern. This study aimed at (1) identifying key abutment features, which would improve dental cement flow characteristics, and (2) understanding how these features would impact the mechanical stability of the abutment under functional loads. Computational fluid dynamic modeling was used to evaluate cement flow in novel abutment geometries. These models were then evaluated using 3D-printed surrogate models. Finite element analysis also provided an understanding of how the mechanical stability of these abutments was altered after key features were incorporated into the geometry. The findings demonstrated that the key features involved in improved venting of the abutment during crown seating were (1) addition of vents, (2) diameter of the vents, (3) location of the vents, (4) addition of a plastic screw insert, and (5) thickness of the abutment wall. This study culminated in a novel design for a vented abutment consisting of 8 vents located radially around the abutment neck-margin plus a plastic insert to guide the cement during seating and provide retrievability to the abutment system.Venting of the dental abutment has been shown to decrease the risk of undetected residual dental cement post-cement-retained crown seating. This article will utilize a finite element analysis approach toward optimizing dental abutment designs for improved dental cement venting. Features investigated include (1) addition of vents, (2) diameter of vents, (3) location of vents, (4) addition of plastic screw insert, and (5) thickness of abutment wall.

Stresses in Implant-Supported Fixed Complete Dentures with Different Screw-Tightening Sequences and Torque Application Modes.

PubMed

Barcellos, Leonardo H; Palmeiro, Marina Lobato; Naconecy, Marcos M; Geremia, Tomás; Cervieri, André; Shinkai, Rosemary S

2018-05-17

To compare the effects of different screw-tightening sequences and torque applications on stresses in implant-supported fixed complete dentures supported by five abutments. Strain gauges fixed to the abutments were used to test the sequences 2-4-3-1-5; 1-2-3-4-5; 3-2-4-1-5; and 2-5-4-1-3 with direct 10-Ncm torque or progressive torque (5 + 10 Ncm). Data were analyzed using analysis of variance and standardized effect size. No effects of tightening sequence or torque application were found except for the sequence 3-2-4-1-5 and some small to moderate effect sizes. Screw-tightening sequences and torque application modes have only a marginal effect on residual stresses.

Comparison of fracture resistance of pressable metal ceramic custom implant abutment with a commercially fabricated CAD/CAM zirconia implant abutment.

PubMed

Protopapadaki, Maria; Monaco, Edward A; Kim, Hyeong-Il; Davis, Elaine L

2013-11-01

The predictable nature of the hot pressing ceramic technique has several applications, but no study was identified that evaluated its application to the fabrication of custom implant abutments. The purpose of this study was to compare the fracture resistance of an experimentally designed pressable metal ceramic custom implant abutment (PR) with that of a duplicate zirconia abutment (ZR). Two groups of narrow platform (NP) (Nobel Replace) implant abutment specimens were fabricated (n=10). The experimental abutment (PR) had a metal substructure cast with ceramic alloy (Lodestar) and veneered with leucite pressable glass ceramic (InLine PoM). Each PR abutment was individually scanned and 10 duplicate CAD/CAM ZR abutments were fabricated for the control group. Ceramic crowns (n=20) with the average dimensions of a human lateral incisor were pressed with lithium disilicate glass ceramic (IPS e.max Press) and bonded on the abutments with a resin luting agent (Multilink Automix). The specimens were subjected to thermocycling, cyclic loading, and finally static loading to failure with a computer-controlled Universal Testing Machine. An independent t test (1 sided) determined whether the mean values of the fracture load differed significantly (α=.05) between the 2 groups. No specimen failed during cyclic loading. Upon static loading, the mean (SD) load to failure was significantly higher for the PR group (525.89 [143.547] N) than for the ZR group (413.70 [35.515] N) for internal connection narrow platform bone-level implants (P=.025). Failure was initiated at the screw and internal connection level for both groups. It is possible to fabricate PR abutments that are stronger than ZR abutments for Nobel Biocare internal connection NP bone-level implants. The screw and the internal connection are the weak links for both groups. Copyright © 2013 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Are sectioning and soldering of short-span implant-supported prostheses necessary procedures?

PubMed

Bianchini, Marco A; Souza, João G O; Souza, Dircilene C; Magini, Ricardo S; Benfatti, Cesar A M; Cardoso, Antonio C

2011-01-01

The aim of this study was to evaluate the fit between dental abutments and the metal framework of a 3-unit fixed prosthesis screwed to two implants to determine whether sectioning and soldering of the framework are in fact necessary procedures. The study was based on a model of a metal framework of a 3-unit prosthesis screwed to two implants. A total of 18 metal frameworks were constructed and divided into 3 groups: (1) NS group - each framework was cast in one piece and not sectioned; (2) CS group - the components of each sectioned framework were joined by conventional soldering; and (3) LW group - the components of each sectioned framework were joined by laser welding. The control group consisted of six silver-palladium alloy copings that were not cast together. Two analyses were mperformed: in the first analysis, the framework was screwed only to the first abutment, and in the second analysis, the framework was screwed to both abutments. The prosthetic fit was assessed at a single point using a measuring microscope (Measurescope, Nikon, Japan) and the marginal gap was measured in micrometers. Statistical analysis was performed using analysis of variance (ANOVA), Scheffe's test, Student's t-test, and Mann-Whitney U test. The NS group had larger marginal gaps than the other groups (p<0.01), while the CS and LW groups had a similar degree of misfit with no significant difference between them. The results revealed that, in the case of short-span 3-unit fixed prostheses, the framework should be sectioned and soldered or welded to prevent or reduce marginal gaps between the metal framework and dental abutments.

Implant-abutment connections on single crowns: a systematic review.

PubMed

Ceruso, F M; Barnaba, P; Mazzoleni, S; Ottria, L; Gargari, M; Zuccon, A; Bruno, G; DI Fiore, A

2017-01-01

Different implant-abutment connections have been developed in the effort of reducing mechanical and biological failure. The most frequent complications are screw loosening, abutment or implant fracture and marginal bone loss due to overload and bacterial micro-leakage. Ideal connection should work as a one-piece implant avoiding the formation of a micro-gap at the implant-abutment interface. Different in vitro and in vivo researches have been published to compare the implant-abutment connections actually available: external hexagon, internal hexagon and conical finding different amount of micro-gap, micro-leakage and marginal bone loss. The aim of this article is to describe, according to the most recent literature, different kind of fixture-abutment connections and their clinical and mechanical advantages or disadvantages.

Effect of the coefficient of friction and tightening speed on the preload induced at the dental implant complex with the finite element method.

PubMed

Bulaqi, Haddad Arabi; Mousavi Mashhadi, Mahmoud; Geramipanah, Farideh; Safari, Hamed; Paknejad, Mojgan

2015-05-01

To prevent screw loosening, a clear understanding of the factors influencing secure preload is necessary. The purpose of this study was to investigate the effect of coefficient of friction and tightening speed on screw tightening based on energy distribution method with exact geometric modeling and finite element analysis. To simulate the proper boundary conditions of the screw tightening process, the supporting bone of an implant was considered. The exact geometry of the implant complex, including the Straumann dental implant, direct crown attachment, and abutment screw were modeled with Solidworks software. Abutment screw/implant and implant/bone interfaces were designed as spiral thread helixes. The screw-tightening process was simulated with Abaqus software, and to achieve the target torque, an angular displacement was applied to the abutment screw head at different coefficients of friction and tightening speeds. The values of torque, preload, energy distribution, elastic energy, and efficiency were obtained at the target torque of 35 Ncm. Additionally, the torque distribution ratio and preload simulated values were compared to theoretically predicted values. Upon reducing the coefficient of friction and enhancing the tightening speed, the angle of turn increased at the target torque. As the angle of turn increased, the elastic energy and preload also increased. Additionally, by increasing the coefficient of friction, the frictional dissipation energy increased but the efficiency decreased, whereas the increase in tightening speed insignificantly affected efficiency. The results of this study indicate that the coefficient of friction is the most influential factor on efficiency. Increasing the tightening speed lowered the response rate to the frictional resistance, thus diminishing the coefficient of friction and slightly increasing the preload. Increasing the tightening speed has the same result as reducing the coefficient of friction. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Thoracic Aortic Stent-Graft Placement for Safe Removal of a Malpositioned Pedicle Screw

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu Hongtao; Shin, Ji Hoon, E-mail: jhshin@amc.seoul.kr; Hwang, Jae-Yeon

2010-10-15

We describe a case of percutaneous placement of a thoracic aortic stent-graft for safe removal of a malpositioned pedicle screw in a 52-year-old man. The patient had undergone posterior thoracic spinal instrumentation for pyogenic spondylitis and spinal deformity 8 months previously. Follow-up CT images showed a malpositioned pedicle screw which was abutting the thoracic aorta at the T5 level. After percutaneous stent-graft placement, the malpositioned pedicle screw was safely and successfully removed.

Microbiological and biochemical effectiveness of an antiseptic gel on the bacterial contamination of the inner space of dental implants: a 3-month human longitudinal study.

PubMed

D'Ercole, S; Tetè, S; Catamo, G; Sammartino, G; Femminella, B; Tripodi, D; Spoto, G; Paolantonio, M

2009-01-01

Microbial penetration inside the implants internal cavity produces a bacterial reservoir that is associated with an area of inflamed connective tissue facing the fixture-abutment junction. The aim of this clinical trial is to evaluate the effectiveness of a 1 percent chlorhexidine gel on the internal bacterial contamination of implants with screw-retained abutments and on the level of AST secreted in peri-implant crevicular fluid. Twenty-five patients (aged 29 to 58 years) each received one implant. Three months after the end of the restorative treatment, and immediately after a clinical and radiographic examination and the abutment removal, microbiological samples were obtained from the internal part of each fixture and biochemical samples were collected by peri-implant sulci. The patients were then divided into two groups: the control (CG; n=10) and test (TG; n=15) groups. The CG had the abutment screwed into place and the crown cemented without any further intervention. In contrast, before the abutment placement and screw tightening, the TG had the internal part of the fixture filled with a 1 percent chlorhexidine gel. Three months later, the same clinical, microbiological and biochemical procedures were repeated in both groups. Total bacterial count, specific pathogens and AST activity were detected. The clinical parameters remained stable throughout the study. From baseline to the 3-month examination, the total bacterial counts underwent a significant reduction only in the TG. In contrast, the AST activity showed a significant increase in the CG. The administration of a 1% chlorhexidine gel appears to be an effective method for the reduction of bacterial colonization of the implant cavity and for safeguarding the health status of peri-implant tissue over a 3-month administration period.

Two Different Percutaneous Bone-Anchored Hearing Aid Abutment Systems: Comparative Clinical Study.

PubMed

Polat, Beldan; İşeri, Mete; Orhan, Kadir Serkan; Yılmazer, Ayça Başkadem; Enver, Necati; Ceylan, Didem; Kara, Ahmet; Güldiken, Yahya; Çomoğlu, Şenol

2016-04-01

To compare two different percutaneous bone-anchored hearing aid (BAHA) abutment systems regarding operation time, scar healing, quality of life, implant stability, audiologic results, and complications. The study involves a prospective multi-center clinical evaluation. Thirty-two consecutive patients who had undergone BAHA surgery from January 2011 to January 2013 in two tertiary centers were included in the study. The Glasgow Inventory Benefit Score was used to assess the patients at least 6 months after surgery. The operation time and complications were recorded. Implant stability quotient (ISQ) values were recorded using resonance frequency analysis. Holger's classification was used to evaluate skin reactions. The mean length of the operation was 39.2±4 min for standard abutment and 18.3±5.7 min for hydroxyapatite-coated abutment. ISQ scores were significantly better for standard abutment in all tests. The mean total Glasgow Inventory Benefit Score was 39.3±19 for the standard abutment and 46.3±24.5 for the hydroxyapatite-coated abutment groups, but there was no statistical significance between the two groups. There was no difference in audiological improvement between the two groups after surgery. Hydroxyapatite-coated abutment provided a shorter operation time that was significantly different from standard abutment. There were no significant differences between standard abutment and hydroxyapatite-coated abutment regarding audiologic improvement, quality of life, loading time, and complications.

Diamondlike carbon coating as a galvanic corrosion barrier between dental implant abutments and nickel-chromium superstructures.

PubMed

Ozkomur, Ahmet; Erbil, Mehmet; Akova, Tolga

2013-01-01

The objectives of this study were to evaluate the galvanic corrosion behavior between titanium and nickel-chromium (Ni-Cr) alloy, to investigate the effect of diamondlike carbon (DLC) coating over titanium on galvanic corrosion behavior between titanium and Ni-Cr alloy, and to evaluate the effect of DLC coating over titanium abutments on the fit and integrity of prosthetic assemblies by scanning electron microcopy (SEM). Five Ni-Cr and 10 titanium disks with a diameter of 5 mm and thickness of 3 mm were prepared. DLC coating was applied to five titanium disks. Electrode samples were prepared, and open circuit potential measurements, galvanic current measurements over platinum electrodes, and potentiodynamic polarization tests were carried out. For the SEM evaluation, 20 Ni-Cr alloy and 10 gold alloy superstructures were cast and prepared over 30 abutments. DLC coating was applied to 10 of the abutments. Following the fixation of prosthetic assemblies, the samples were embedded in acrylic resin and cross sectioned longitudinally. Internal fit evaluations were carried out through examination of the SEM images. Titanium showed more noble and electrochemically stable properties than Ni-Cr alloy. DLC coating over the cathode electrode served as an insulating film layer over the surface and prevented galvanic coupling. Results of the SEM evaluations indicated that the DLC-coated and titanium abutments showed no statistically significant difference in fit. Hence, no adverse effects on the adaptation of prosthetic components were found with the application of DLC coating over abutment surfaces. DLC coating might serve as a galvanic corrosion barrier between titanium abutments and Ni-Cr superstructures.

Evaluation of Titanium-Coated Pedicle Screws: In Vivo Porcine Lumbar Spine Model.

PubMed

Kim, Do-Yeon; Kim, Jung-Ryul; Jang, Kyu Yun; Kim, Min Gu; Lee, Kwang-Bok

2016-07-01

Many studies have addressed the problem of loosening pedicle screws in spinal surgery, which is a serious concern. Titanium coating of medical implants (arthroplasty) is common, but few studies involving in vivo spine models have been reported. We evaluated the radiological, mechanical, and histological characteristics of titanium-coated pedicle screws compared with uncoated or hydroxyapatite-coated pedicle screws. Three different types of pedicle screws, i.e., uncoated, hydroxyapatite-coated, and titanium-coated, were implanted into the lumbar 3-4-5 levels of 9 mature miniature pigs. Radiological evaluation of loosening of pedicle screws was performed. Peak torsional extraction torque was tested in the 42 screws from 7 miniature pigs at 12 weeks postoperatively. The implant-bone interface of the remaining 12 pedicle screws from 2 miniature pigs in each group was assessed by micro-computed tomography and histologic studies. The incidence of loosening at 12 weeks postoperatively was not significantly different between the titanium-coated pedicle screw group and the other groups. The titanium-coated pedicle screw group exhibited the greatest mean extraction torsional peak torque at 12 weeks postoperatively (P < 0.05). Quantitative micro-computed tomography data were greatest in the titanium-coated pedicle screw group (P < 0.05). Histologic findings showed osteointegration with densely packed new bone formation at the screw coating-bone interface in the titanium-coated pedicle screw group. Fixation strength was greatest in the titanium-coated pedicle screw group. Osteointegration at the interface between the titanium-coated implant and bone produced prominent and firm bonding. The titanium-coated pedicle screw is a promising device for application in spinal surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

CORROSION RESISTANT JACKETED METAL BODY

DOEpatents

Brugmann, E.W.

1958-08-26

S>Metal jacketed metallic bodies of the type used as feel elements fer nuclear reactors are presented. The fuel element is comprised of a plurality of jacketed cylindrical bodies joined in end to end abutting relationship. The abutting ends of the internal fissionable bodies are provided with a mating screw and thread means for joining the two together. The jacket material is of a corrosion resistant metal and overlaps the abutting ends of the internal bodies, thereby effectively sealing these bodies from contact with exteral reactive gases and liquids.

THE INFLUENCE OF SCREW TYPE, ALLOY AND CYLINDER POSITION ON THE MARGINAL FIT OF IMPLANT FRAMEWORKS BEFORE AND AFTER LASER WELDING

PubMed Central

Castilio, Daniela; Pedreira, Ana Paula Ribeiro do Vale; Rossetti, Paulo Henrique Orlato; Rossetti, Leylha Maria Nunes; Bonachela, Wellington Cardoso

2006-01-01

Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. Objectives: To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. Methods: After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected prosthetic components. Five specimens were one-piece cast in titanium and five in cobalt-chromium alloy. On each specimen, tests were conducted with hexagonal titanium and slotted gold screws separately, performing a total of thirty tested screws. Measurements at the interfaces were performed using an optical microscope with 5 μm accuracy. After sectioning, specimens were laser welded and new measurements were obtained. Data were submitted to a four-way ANOVA and Tukey's multiple comparisons test (α =0.05). Results: Slotted and hexagonal screws did not present significant differences regarding to the fit of cylinders cast in titanium, either in one-piece casting framework or after laser welding. When slotted and hexagonal screws were tested on the cobalt-chromium specimens, statistically significant differences were found for the one-piece casting condition, with the slotted screws presenting better fit (24.13μm) than the hexagonal screws (27.93 μm). Besides, no statistically significant differences were found after laser welding. Conclusions: 1) The use of different metal alloys do exert influence on the marginal fit, 2) The slotted and hexagonal screws play the exclusive role of fixing the prosthesis, and did not improve the fit of cylinders, and 3) cylinder position did not affect marginal fit values. PMID:19089035

Long-term outcome of cemented versus screw-retained implant-supported partial restorations.

PubMed

Nissan, Joseph; Narobai, Demitri; Gross, Ora; Ghelfan, Oded; Chaushu, Gavriel

2011-01-01

The present study was designed to compare the long-term outcome and complications of cemented versus screw-retained implant restorations in partially edentulous patients. Consecutive patients with bilateral partial posterior edentulism comprised the study group. Implants were placed, and cemented or screw-retained restorations were randomly assigned to the patients in a split-mouth design. Follow-up (up to 15 years) examinations were performed every 6 months in the first year and every 12 months in subsequent years. The following parameters were evaluated and recorded at each recall appointment: ceramic fracture, abutment screw loosening, metal frame fracture, Gingival Index, and marginal bone loss. Thirty-eight patients were treated with 221 implants to support partial prostheses. No implants during the follow-up period (mean follow-up, 66 ± 47 months for screw-retained restorations [range, 18 to 180 months] and 61 ± 40 months for cemented restorations [range, 18 to 159 months]). Ceramic fracture occurred significantly more frequently (P < .001) in screw-retained (38% ± 0.3%) than in cemented (4% ± 0.1%) restorations. Abutment screw loosening occurred statistically significantly more often (P = .001) in screw-retained (32% ± 0.3%) than in cement-retained (9% ± 0.2%) restorations. There were no metal frame fractures in either type of restoration. The mean Gingival Index scores were statistically significantly higher (P < .001) for screw-retained (0.48 ± 0.5) than for cemented (0.09 ± 0.3) restorations. The mean marginal bone loss was statistically significantly higher (P < .001) for screw-retained (1.4 ± 0.6 mm) than for cemented (0.69 ± 0.5 mm) restorations. The long-term outcome of cemented implant-supported restorations was superior to that of screw-retained restorations, both clinically and biologically.

The influence of screw type, alloy and cylinder position on the marginal fit of implant frameworks before and after laser welding.

PubMed

Castilio, Daniela; Pedreira, Ana Paula Ribeiro do Vale; Rossetti, Paulo Henrique Orlato; Rossetti, Leylha Maria Nunes; Bonachela, Wellington Cardoso

2006-04-01

Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected prosthetic components. Five specimens were one-piece cast in titanium and five in cobalt-chromium alloy. On each specimen, tests were conducted with hexagonal titanium and slotted gold screws separately, performing a total of thirty tested screws. Measurements at the interfaces were performed using an optical microscope with 5mm accuracy. After sectioning, specimens were laser welded and new measurements were obtained. Data were submitted to a four-way ANOVA and Tukey's multiple comparisons test (alpha=0.05). Slotted and hexagonal screws did not present significant differences regarding to the fit of cylinders cast in titanium, either in one-piece casting framework or after laser welding. When slotted and hexagonal screws were tested on the cobalt-chromium specimens, statistically significant differences were found for the one-piece casting condition, with the slotted screws presenting better fit (24.13 microm) than the hexagonal screws (27.93 microm). Besides, no statistically significant differences were found after laser welding. 1) The use of different metal alloys do exert influence on the marginal fit, 2) The slotted and hexagonal screws play the exclusive role of fixing the prosthesis, and did not improve the fit of cylinders, and 3) cylinder position did not affect marginal fit values.

Effect of increased crown height on stress distribution in short dental implant components and their surrounding bone: A finite element analysis.

PubMed

Bulaqi, Haddad Arabi; Mousavi Mashhadi, Mahmoud; Safari, Hamed; Samandari, Mohammad Mahdi; Geramipanah, Farideh

2015-06-01

Implants in posterior regions of the jaw require short dental implants with long crown heights, leading to increased crown-to-implant ratios and mechanical stress. This can lead to fracture and screw loosening. The purpose of this study was to investigate the dynamic nature and behavior of prosthetic components and preimplant bone and evaluate the effect of increased crown height space (CHS) and crown-to-implant ratio on stress concentrations under external oblique forces. The severely resorbed bone of a posterior mandible site was modeled with Mimics and Catia software. A second mandibular premolar tooth was modeled with CHS values of 8.8, 11.2, 13.6, and 16 mm. A Straumann implant (4.1×8 mm), a directly attached crown, and an abutment screw were modeled with geometric data and designed by using SolidWorks software. Abaqus software was used for the dynamic simulation of screw tightening and the application of an external load to the buccal cusp at a 75.8-degree angle with the occlusal plane. The distribution of screw load and member load at each step was compared, and the stress values were calculated within the dental implant complex and surrounding bone. During tightening, the magnitude and distribution of the preload and clamp load were uniform and equal at the cross section of all CHSs. Under an external load, the screw load decreased and member load increased. An increase in the CHS caused the corresponding distribution to become more nonuniform and increased the maximum compressive and tensile stresses in the preimplant bone. Additionally, the von Mises stress decreased at the abutment screw and increased at the abutment and fixture. Under nonaxial forces, increased CHS does not influence the decrease in screw load or increase in member load. However, it contributes to screw loosening and fatigue fracture by skewing the stress distribution to the transverse section of the implant. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Effects of a cementing technique in addition to luting agent on the uniaxial retention force of a single-tooth implant-supported restoration: an in vitro study.

PubMed

Santosa, Robert E; Martin, William; Morton, Dean

2010-01-01

Excess residual cement around the implant margin has been shown to be detrimental to the peri-implant tissue. This in vitro study examines the retentive strengths of two different cementing techniques and two different luting agents on a machined titanium abutment and solid screw implants. The amount of reduction of excess cement weight between the two cementation techniques was assessed. Forty gold castings were fabricated for 4.1 mm in diameter and 10 mm in length solid-screw dental implants paired with 5.5-mm machined titanium abutments. Twenty implants received a provisional cement, and 20 implants received a definitive cement. Each group was further divided into two groups. In the control group, cement was applied and the castings seated over the implant-abutment assembly. The excess cement was then removed. In the study group, a "practice abutment" was used to express excess cement prior to cementation. The weight of the implant-casting assembly was measured and the residual weight of cement was calculated. The samples were then stored for 24 hours at 100% humidity prior to tensile strength testing. Statistical analysis revealed significant differences in tensile strength across the groups. Further Tukey tests showed no significant difference in tensile strength between the practice abutment technique and the conventional technique for both definitive and provisional cements. There was a significant reduction in residual cement weight, irrespective of the type of cement, when the practice abutment was used prior to cementation. Cementation of implant restorations on a machined abutment using the practice abutment technique and definitive cement may provide similar uniaxial retention force and significantly reduced residual cement weight compared to the conventional technique of cement removal.

The influence of different screw tightening forces on the vertical misfit of implant-supported frameworks.

PubMed

Vasconcellos, Diego Klee de; Bottino, Marco Antonio; Nishioka, Renato Sussumu; Valandro, Luiz Felipe; Costa, Elza Maria Valadares da

2005-06-01

The present in vitro study was designed to compare the differences in the vertical misfit of implant-supported frameworks using three different forces for tightening the bridge locking screws: fastening by hand until first resistance, and using torque drivers with 10 and 20Ncm. The investigation was conducted based on the results given by 9 six-unit nickel-chromium (2 abutments/ 4 pontics) screw-retained implant-supported frameworks. The structures were exposed to simulated porcelain firings. The marginal misfit measurements were made using a traveling measuring microscope at selected screw tightening forces: fastening by hand until first resistance, and using torque drivers with 10 and 20Ncm. The results were submitted to one-way ANOVA with repeated measures on one factor, and post hoc pairwise comparisons using Tukey test (5%). The mean marginal misfit of the frameworks, fastening the screws by hand until first resistance, was 41.56µm (SD±12.45µm). The use of torque driver devices caused a significant reduction in marginal opening (p<0.05). With the lowest torque available (10Ncm), the mean marginal discrepancy at the abutment-framework interface was reduced an average of 52% to a mean marginal opening of 19.71µm (SD±2.97µm). After the use of the 20Ncm torque driver, the mean marginal discrepancy of the frameworks was reduced an average of 69% to a mean marginal opening of 12.82µm (SD±4.0µm). Comparing the use of torque drivers with 10 and 20 Ncm torque, the means are not significantly different from one another. The seating force has an important effect on the vertical misfit measurements, once it may considerably narrow the vertical misfit gaps at the abutment-framework interface, thus leading to a misjudgment of the real marginal situation.

The Evaluation of Unscrewing Torque Values of Implant-Abutment Connections: An In Vitro Study.

PubMed

Bruna, Ezio; Fabianelli, Andrea; Mastriforti, Giacomo; Papacchini, Federica

This study investigated the stability of titanium screws in implant-abutment connections by measuring the force necessary to induce unscrewing. A total of 60 implant-abutment couplings were assigned to two groups (n = 30 each). The sequence 10-20-32 Ncm was tested in Group 1; the sequence 10-20-32-32-32 Ncm was tested in Group 2. The force necessary to unscrew each abutment-implant sample was recorded and statistically analyzed. The significance level was set at P < .05. Significant differences were found between the two sequences. Group 2 required higher forces than Group 1 to unscrew. The stability of the implant-abutment joint may be improved by tightening with the sequence 10-20-32-32-32 Ncm.

Salivary bacterial leakage into implant-abutment connections: preliminary results of an in vitro study.

PubMed

Mencio, F; Papi, P; Di Carlo, S; Pompa, G

2016-06-01

The occurrence of bacterial leakage in the internal surface of implants, through implant-abutment interface (IAI), is one of the parameters for analyzing the fabrication quality of the connections. The aim of this in vitro study is to evaluate two different types of implant-abutment connections: the screwed connection (Group 1) and the cemented connection (Group 2), analyzing the permeability of the IAI to bacterial colonization, using human saliva as culture medium. A total of twelve implants were tested, six in each experimental group. Five healthy patients were enrolled in this study. Two milliliters of non-stimulated saliva were collected from each subject and mixed in a test tube. After 14 days of incubation of the bacteria sample in the implant fixtures, a PCR-Real Time analysis was performed. Fisher's exact test was used to compare the proportions of implant-abutment assembled structures detected with bacterial leakage. Differences in the bacterial counts of the two groups were compared using the Mann-Whitney U test. A p value < 0.05 was considered significant. The results showed a decreased stability with the screwed implant-abutment connections compared to the cemented implant-abutment connections. A mean total bacterial count of 1.2E+07 (± 0.25E+07) for Group 1 and of 7.2E+04 (± 14.4E+04) for Group 2 was found, with a high level of significance, p = .0001. Within the limitations of this study it can be concluded that bacterial species from human saliva may penetrate along the implant-abutment interface in both connections, however the cemented connection implants showed the lowest amount of bacterial colonization.

Evaluation in a Dog Model of Three Antimicrobial Glassy Coatings: Prevention of Bone Loss around Implants and Microbial Assessments.

PubMed

López-Píriz, Roberto; Solá-Linares, Eva; Rodriguez-Portugal, Mercedes; Malpica, Beatriz; Díaz-Güemes, Idoia; Enciso, Silvia; Esteban-Tejeda, Leticia; Cabal, Belén; Granizo, Juan José; Moya, José Serafín; Torrecillas, Ramón

2015-01-01

The aim of the present study is to evaluate, in a ligature-induced peri-implantitis model, the efficacy of three antimicrobial glassy coatings in the prevention of biofilm formation, intrasulcular bacterial growth and the resulting peri-implant bone loss. Mandibular premolars were bilaterally extracted from five beagle dogs. Four dental implants were inserted on each hemiarch. Eight weeks after, one control zirconia abutment and three with different bactericidal coatings (G1n-Ag, ZnO35, G3) were connected. After a plaque control period, bacterial accumulation was allowed and biofilm formation on abutments was observed by Scanning Electron Microscopy (SEM). Peri-implantitis was induced by cotton ligatures. Microbial samples and peri-implant crestal bone levels of all implant sites were obtained before, during and after the breakdown period. During experimental induce peri-implantitis: colony forming units counts from intrasulcular microbial samples at implants with G1n-Ag coated abutment remained close to the basal inoculum; G3 and ZnO35 coatings showed similar low counts; and anaerobic bacterias counts at control abutments exhibited a logarithmic increase by more than 2. Bone loss during passive breakdown period was no statistically significant. Additional bone loss occurred during ligature-induce breakdown: 0.71 (SD 0.48) at G3 coating, 0.57 (SD 0.36) at ZnO35 coating, 0.74 (SD 0.47) at G1n-Ag coating, and 1.29 (SD 0.45) at control abutments; and statistically significant differences (p<0.001) were found. The lowest bone loss at the end of the experiment was exhibited by implants dressing G3 coated abutments (mean 2.1; SD 0.42). Antimicrobial glassy coatings could be a useful tool to ward off, diminish or delay peri-implantitis progression.

Biomechanical interactions of endodontically treated tooth implant-supported prosthesis under fatigue test with acoustic emission monitoring.

PubMed

Huang, Shao-Fu; Chen, Wan-Rung; Lin, Chun-Li

2016-02-24

This study investigated the biomechanical interactions in endodontically treated tooth implant-supported prosthesis (TISP) with implant system variations under dynamic cyclic loads monitored using the acoustic emission (AE) technique. Macrostructure implants using a taper integrated screw-in (TIS; 2-piece implant) and a retaining-screw (RS; 3-piece implant) connected to an abutment were used for this investigation and their corresponding mechanical resistances in conformity with the ISO 14801 standard were evaluated. The endodontically treated TISP samples were constructed containing TIS and RS implants splinted to the second premolar with fatigue tests performed by applying occlusal force onto the premolar simulating the bending moment effect. The numbers of accumulated AE signals in the fatigue tests and failure modes for the sample were recorded to evaluate the mechanical resistance. The maximum load in the static test for RS (3-piece) implant (797N) was significantly higher than that for the TIS (2-piece) implant (559N). Large deformations were found at abutment screws in both RS and TIS implants. Although the numbers of accumulated AE signals for the TIS implant (72511) were higher than those for the RS implant (437), statistical non-significant differences were found between TIS and RS implants. No obvious damage was noted in endodontically treated TISP samples using RS implants but two of the corresponding TIS implants fractured in the abutment screws. Splints with RS (3-piece) implant prosthesis produce better mechanical responses than the TIS (2-piece) implant when connected to an endodontically treated tooth restored with a post core and crown.

Peri-Implant Strain in an In Vitro Model.

PubMed

Hussaini, Souheil; Vaidyanathan, Tritala K; Wadkar, Abhinav P; Quran, Firas A Al; Ehrenberg, David; Weiner, Saul

2015-10-01

An in vitro experimental model was designed and tested to determine the influence that peri-implant strain may have on the overall crestal bone. Strain gages were attached to polymethylmethacrylate (PMMA) models containing a screw-type root form implant at sites 1 mm from the resin-implant interface. Three different types of crown superstructures (cemented, 1-screw [UCLA] and 2-screw abutment types) were tested. Loading (1 Hz, 200 N load) was performed using a MTS Mechanical Test System. The strain gage data were stored and organized in a computer for statistical treatment. Strains for all abutment types did not exceed the physiological range for modeling and remodeling of cancellous bone, 200-2500 με (microstrain). For approximately one-quarter of the trials, the strain values were less than 200 με the zone for bone atrophy. The mean microstrain obtained was 517.7 με. In conclusion, the peri-implant strain in this in vitro model did not exceed the physiologic range of bone remodeling under axial occlusal loading.

Self-Inflicted Drywall Screws in the Sagittal Sinus.

PubMed

Guppy, Kern H; Ochi, Calvin

2018-02-01

A 30-year-old right-handed man with a history of schizophrenia presented with 2 self-inflicted drywall screws in the skull. The patient was sleepy but easily arousable; blood tests showed he had taken methamphetamines. Computed tomography and computed tomography angiography of the head showed the frontal screw abutted left of the superior sagittal sinus, and the posterior screw went through the superior sagittal sinus with no extravasation of contrast material at either site. Both screws were removed with exposure of the sagittal sinus using U-shaped craniectomies. There was no bleeding on the removal of the screws. It appears the posterior screw entered between the leaflets of the sagittal sinus dura mater. The patient had returned to work without any sequelae 1 month after injury. Copyright © 2017 Elsevier Inc. All rights reserved.

Mechanical design, analysis, and laboratory testing of a dental implant with axial flexibility similar to natural tooth with periodontal ligament.

PubMed

Pektaş, Ömer; Tönük, Ergin

2014-11-01

At the interface between the jawbone and the roots of natural teeth, a thin, elastic, shock-absorbing tissue, called the periodontal ligament, forms a cushion which provides certain flexibility under mechanical loading. The dental restorations supported by implants, however, involve comparatively rigid connections to the jawbone. This causes overloading of the implant while bearing functional loading together with neighboring natural teeth, which leads to high stresses within the implant system and in the jawbone. A dental implant, with resilient components in the upper structure (abutment) in order to mimic the mechanical behavior of the periodontal ligament in the axial direction, was designed, analyzed in silico, and produced for mechanical testing. The aims of the design were avoiding high levels of stress, loosening of the abutment connection screw, and soft tissue irritations. The finite element analysis of the designed implant revealed that the elastic abutment yielded a similar axial mobility with the natural tooth while keeping stress in the implant at safe levels. The in vitro mechanical testing of the prototype resulted in similar axial mobility predicted by the analysis and as that of a typical natural tooth. The abutment screw did not loosen under repeated loading and there was no static or fatigue failure. © IMechE 2014.

In vitro performance and fracture resistance of CAD/CAM-fabricated implant supported molar crowns.

PubMed

Rosentritt, Martin; Hahnel, Sebastian; Engelhardt, Frank; Behr, Michael; Preis, Verena

2017-05-01

The aim of this study is to investigate the performance and fracture resistance of different CAD/CAM ceramic and composite materials as implant- or tooth-supported single crowns with respect to the clinical procedure (screwed/bonded restoration). One hundred twenty crowns were fabricated on implants or human molar teeth simulating (a) chairside procedure ([CHAIR] implant crown bonded to abutment), (b) labside procedure ([LAB] abutment and implant crown bonded in laboratory, screwed chairside), and (c) reference ([TOOTH] crowns luted on human teeth). Four materials were investigated: ZLS (zirconia-reinforced lithium silicate ceramic; Celtra Duo, Degudent: polished (P)/crystallized (C)), RB (resin-based composite; Cerasmart, GC), and RIC (resin-infiltrated ceramic; Enamic, Vita-Zahnfabrik). LiS (lithiumdisilicate; Emax CAD, Ivoclar-Vivadent) served as reference. Combined thermal cycling and mechanical loading (TCML) was performed simulating a 5-year clinical situation. Fracture force was determined. Data were statistically analyzed (Kolmogorov-Smirnov test, one-way ANOVA; post hoc Bonferroni, α = 0.05). One crown of ZLS_C[LAB] (1,200,000 cycles) and RB[CHAIR] (890 cycles) failed during TCML. Fracture values varied between 977.7 N(RB) and 3070.4 N(LiS)[CHAIR], 1130.6 N(RB) and 2998.1 N(LiS)[LAB], and 1802.4 N(ZLS) and 2664.3 N(LiS)[TOOTH]. Significantly (p < 0.003) different forces were found between the materials in all three groups. ZLS_C, RIC, and RB showed significantly (p < 0.014) different values for the individual groups. Partly ceramic and resin-based materials performed differently on implant or tooth abutments. The insertion of a screw channel reduced the stability for individual crown materials. Insertion of the screw channel should be performed carefully. All restorations were in a range where clinical application seems not restricted, but insertion of a screw channel might reduce stability of individual materials.

A simplified method to reduce prosthetic misfit for a screw-retained, implant-supported complete denture using a luting technique and laser welding.

PubMed

Longoni, Salvatore; Sartori, Matteo; Davide, Roberto

2004-06-01

An important aim of implant-supported prostheses is to achieve a passive fit of the framework with the abutments to limit the amount of stress transfer to the bone-implant interface. An efficient and standardized technique is proposed. A definitive screw-retained, implant-supported complete denture was fabricated for an immediately loaded provisional screw-retained implant-supported complete denture. Precise fit was achieved by the use of industrial titanium components and the passivity, by an intraoral luting sequence and laser welding.

Evaluation in a Dog Model of Three Antimicrobial Glassy Coatings: Prevention of Bone Loss around Implants and Microbial Assessments

PubMed Central

López-Píriz, Roberto; Solá-Linares, Eva; Rodriguez-Portugal, Mercedes; Malpica, Beatriz; Díaz-Güemes, Idoia; Enciso, Silvia; Esteban-Tejeda, Leticia; Cabal, Belén; Granizo, Juan José; Moya, José Serafín; Torrecillas, Ramón

2015-01-01

Objectives The aim of the present study is to evaluate, in a ligature-induced peri-implantitis model, the efficacy of three antimicrobial glassy coatings in the prevention of biofilm formation, intrasulcular bacterial growth and the resulting peri-implant bone loss. Methods Mandibular premolars were bilaterally extracted from five beagle dogs. Four dental implants were inserted on each hemiarch. Eight weeks after, one control zirconia abutment and three with different bactericidal coatings (G1n-Ag, ZnO35, G3) were connected. After a plaque control period, bacterial accumulation was allowed and biofilm formation on abutments was observed by Scanning Electron Microscopy (SEM). Peri-implantitis was induced by cotton ligatures. Microbial samples and peri-implant crestal bone levels of all implant sites were obtained before, during and after the breakdown period. Results During experimental induce peri-implantitis: colony forming units counts from intrasulcular microbial samples at implants with G1n-Ag coated abutment remained close to the basal inoculum; G3 and ZnO35 coatings showed similar low counts; and anaerobic bacterias counts at control abutments exhibited a logarithmic increase by more than 2. Bone loss during passive breakdown period was no statistically significant. Additional bone loss occurred during ligature-induce breakdown: 0.71 (SD 0.48) at G3 coating, 0.57 (SD 0.36) at ZnO35 coating, 0.74 (SD 0.47) at G1n-Ag coating, and 1.29 (SD 0.45) at control abutments; and statistically significant differences (p<0.001) were found. The lowest bone loss at the end of the experiment was exhibited by implants dressing G3 coated abutments (mean 2.1; SD 0.42). Significance Antimicrobial glassy coatings could be a useful tool to ward off, diminish or delay peri-implantitis progression. PMID:26489088

[Tensile strength of bone fixation of hydroxyapatite coated Schanz screws of the Heidelberg External Fixation System (HEFS)--comparative torque measurements in clinical use and in cadaver tibia].

PubMed

Placzek, R; Deuretzbacher, G; Meiss, A L

2002-12-01

It is claimed in the literature that hydroxyapatite(HA)-coated screws of external fixators have superior fixation strength in bone, which is postulated to lead to a substantial decrease in loosening and infection rates. We report on a study of the maximum torque values developed while inserting and removing 30 HA-coated Schanz screws of 8 Heidelberg external fixation systems applied to the tibia to correct leg length differences and axial deformities. The infection rate was determined in accordance with defined criteria, and was found to be about 20% for the HA-coated screws. Screws without infection showed an extraction torque above insertion torque, screws with infection an extraction torque below. A significant correlation (p = 0.05) was seen between infection and decrease in fixation strength (quotient: loosening torque/tightening torque). To exclude the impact of such biological processes as osteointegration and bone remodelling, the clinical results were compared with the torques measured for coated and uncoated Schanz screws in a human cadaveric tibia. A significantly higher fixation strength in bone was found for HA-coated screws in comparison with uncoated screws (p = 0.002). These data warrant a clinical study directly comparing HA-coated and uncoated Schanz screws.

Effect of framework soldering on the deformation of implant abutments after framework seating: a study with strain gauges.

PubMed

Mendes, Stella de N C; Edwards Rezende, Carlos E; Moretti Neto, Rafael T; Capello Sousa, Edson A; Henrique Rubo, José

2013-04-01

Passive fit has been considered an important requirement for the longevity of implant-supported prostheses. Among the different steps of prostheses construction, casting is a feature that can influence the precision of fit and consequently the uniformity of possible deformation among abutments upon the framework connection. This study aimed at evaluating the deformation of abutments after the connection of frameworks either cast in one piece or after soldering. A master model was used to simulate a human mandible with 5 implants. Ten frameworks were fabricated on cast models and divided into 2 groups. Strain gauges were attached to the mesial and distal sides of the abutments to capture their deformation after the framework's screw retentions were tightened to the abutments. The mean values of deformation were submitted to a 3-way analysis of variance that revealed significant differences between procedures and the abutment side. The results showed that none of the frameworks presented a complete passive fit. The soldering procedure led to a better although uneven distribution of compression strains on the abutments.

A comparative study of gold UCLA-type and CAD/CAM titanium implant abutments

PubMed Central

Park, Ji-Man; Lee, Jai-Bong; Heo, Seong-Joo

2014-01-01

PURPOSE The aim of this study was to evaluate the interface accuracy of computer-assisted designed and manufactured (CAD/CAM) titanium abutments and implant fixture compared to gold-cast UCLA abutments. MATERIALS AND METHODS An external connection implant system (Mark III, n=10) and an internal connection implant system (Replace Select, n=10) were used, 5 of each group were connected to milled titanium abutment and the rest were connected to the gold-cast UCLA abutments. The implant fixture and abutment were tightened to torque of 35 Ncm using a digital torque gauge, and initial detorque values were measured 10 minutes after tightening. To mimic the mastication, a cyclic loading was applied at 14 Hz for one million cycles, with the stress amplitude range being within 0 N to 100 N. After the cyclic loading, detorque values were measured again. The fixture-abutment gaps were measured under a microscope and recorded with an accuracy of ±0.1 µm at 50 points. RESULTS Initial detorque values of milled abutment were significantly higher than those of cast abutment (P<.05). Detorque values after one million dynamic cyclic loadings were not significantly different (P>.05). After cyclic loading, detorque values of cast abutment increased, but those of milled abutment decreased (P<.05). There was no significant difference of gap dimension between the milled abutment group and the cast abutment group after cyclic loading. CONCLUSION In conclusion, CAD/CAM milled titanium abutment can be fabricated with sufficient accuracy to permit screw joint stability between abutment and fixture comparable to that of the traditional gold cast UCLA abutment. PMID:24605206

Bioactive ceramic coating of cancellous screws improves the osseointegration in the cancellous bone.

PubMed

Lee, Jae Hyup; Nam, Hwa; Ryu, Hyun-Seung; Seo, Jun-Hyuk; Chang, Bong-Soon; Lee, Choon-Ki

2011-05-01

A number of methods for coating implants with bioactive ceramics have been reported to improve osseointegration in bone, but the effects of bioactive ceramic coatings on the osseointegration of cancellous screws are not known. Accordingly, biomechanical and histomorphometric analyses of the bone-screw interface of uncoated cancellous screws and cancellous screws coated with four different bioactive ceramics were performed. After coating titanium alloy cancellous screws with calcium pyrophosphate (CPP), CaO-SiO(2)-B(2)O(3) glass-ceramics (CSG), apatite-wollastonite 1:3 glass-ceramics (W3G), and CaO-SiO(2)-P(2)O(5)-B(2)O(3) glass-ceramics (BGS-7) using an enameling method, the coated and the uncoated screws were inserted into the proximal tibia and distal femur metaphysis of seven male mongrel dogs. The torque values of the screws were measured at the time of insertion and at removal after 8 weeks. The bone-screw contact ratio was analyzed by histomorphometry. There was no significant difference in the insertion torque between the uncoated and coated screws. The torque values of the CPP and BGS-7 groups measured at removal after 8 weeks were significantly higher than those of the uncoated group. Moreover, the values of the CPP and BGS-7 groups were significantly higher than the insertion torques. The fraction of bone-screw interface measured from the undecalcified histological slide showed that the CPP, W3G, and BGS-7 groups had significantly higher torque values in the cortical bone area than the uncoated group, and the CPP and BGS-7 groups had significantly higher torque values in the cancellous bone area than the uncoated group. In conclusion, a cancellous screw coated with CPP and BGS-7 ceramic bonds directly to cancellous bone to improve the bone-implant osseointegration. This may broaden the indications for cancellous screws by clarifying their contribution to improving osseointegration, even in the cancellous bone area.

Method for partially coating laser diode facets

NASA Technical Reports Server (NTRS)

Dholakia, Anil R. (Inventor)

1990-01-01

Bars of integral laser diode devices cleaved from a wafer are placed with their p regions abutting and n regions abutting. A thin BeCu mask having alternate openings and strips of the same width as the end facets is used to mask the n region interfaces so that multiple bars can be partially coated over their exposed p regions with a reflective or partial reflective coating. The partial coating permits identification of the emitting facet from the fully coated back facet during a later device mounting procedure.

Zygomatic Implants: The Impact of Zygoma Bone Support on Biomechanics.

PubMed

Romeed, Shihab; Malik, Raheel; Dunne, Stephen

2012-03-20

Abstract Maxillectomy and severely resorbed maxilla are challenging to restore with provision of removable prostheses. Dental implants are essential to restore aesthetics and function and subsequently quality of life in such group of patients. Zygomatic implants reduce the complications associated with bone grafting procedures and simplify the rehabilitation of atrophic maxilla and maxillectomy. The purpose of this study was to compare, by means of three-dimensional finite element analysis, the impact of different zygomatic bone support (10, 15, and 20mm) on the biomechanics of zygomatic implants. Results indicated maximum stresses within the fixture were increased by three times, when bone support decreased from 20 to 10mm, and concentrated at fixture/bone interface. However, stresses within the abutment screw and abutment itself were not significantly different regardless of the bone support level. Supporting bone at 10mm suffered double the stresses of 15 and 20mm. Fixture's deflection was decreased by two to three times when bone level support increased to 15mm and 20mm respectively. It was concluded that zygomatic bone support should not be less than 15mm and abutment screw is not at risk of fracture regardless of the zygomatic bone support.

Zygomatic implants: the impact of zygoma bone support on biomechanics.

PubMed

Romeed, Shihab A; Malik, Raheel; Dunne, Stephen M

2014-06-01

Maxillectomy and severely resorbed maxilla are challenging to restore with provision of removable prostheses. Dental implants are essential to restore esthetics and function and subsequently quality of life in such group of patients. Zygomatic implants reduce the complications associated with bone grafting procedures and simplify the rehabilitation of atrophic maxilla and maxillectomy. The purpose of this study was to compare, by means of 3-dimensional finite element analysis, the impact of different zygomatic bone support (10, 15, and 20 mm) on the biomechanics of zygomatic implants. Results indicated that maximum stresses within the fixture were increased by 3 times when bone support decreased from 20 to 10 mm and were concentrated at the fixture/bone interface. However, stresses within the abutment screw and the abutment itself were not significantly different regardless of the bone support level. Supporting bone at 10 mm sustained double the stresses of 15 and 20 mm. Fixture's deflection was decreased by 2 to 3 times when bone support level increased to 15 mm and 20 mm, respectively. It was concluded that zygomatic bone support should not be less than 15 mm, and abutment screw is not at risk of fracture regardless of the zygomatic bone support.

Fit Analysis of Different Framework Fabrication Techniques for Implant-Supported Partial Prostheses.

PubMed

Spazzin, Aloísio Oro; Bacchi, Atais; Trevisani, Alexandre; Farina, Ana Paula; Dos Santos, Mateus Bertolini

2016-01-01

This study evaluated the vertical misfit of implant-supported frameworks made using different techniques to obtain passive fit. Thirty three-unit fixed partial dentures were fabricated in cobalt-chromium alloy (n = 10) using three fabrication methods: one-piece casting, framework cemented on prepared abutments, and laser welding. The vertical misfit between the frameworks and the abutments was evaluated with an optical microscope using the single-screw test. Data were analyzed using one-way analysis of variance and Tukey test (α = .05). The one-piece casted frameworks presented significantly higher vertical misfit values than those found for framework cemented on prepared abutments and laser welding techniques (P < .001 and P < .003, respectively). Laser welding and framework cemented on prepared abutments are effective techniques to improve the adaptation of three-unit implant-supported prostheses. These techniques presented similar fit.

Sinking and fit of abutment of locking taper implant system

PubMed Central

Moon, Seung-Jin; Kim, Hee-Jung; Son, Mee-Kyoung

2009-01-01

STATEMENT OF PROBLEM Unlike screw-retention type, fixture-abutment retention in Locking taper connection depends on frictional force so it has possibility of abutment to sink. PURPOSE In this study, Bicon® Implant System, one of the conical internal connection implant system, was used with applying loading force to the abutments connected to the fixture. Then the amount of sinking was measured. MATERIAL AND METHODS 10 Bicon® implant fixtures were used. First, the abutment was connected to the fixture with finger force. Then it was tapped with a mallet for 3 times and loads of 20 kg corresponding to masticatory force using loading application instrument were applied successively. The abutment state, slightly connected to the fixture without pressure was considered as a reference length, and every new abutment length was measured after each load's step was added. The amount of abutment sinking (mm) was gained by subtracting the length of abutment-fixture under each loading condition from reference length. RESULTS It was evident, that the amount of abutment sinking in Bicon® Implant System increased as loads were added. When loads of 20 kg were applied more than 5 - 7 times, sinking stopped at 0.45 ± 0.09 mm. CONCLUSION Even though locking taper connection type implant shows good adaption to occlusal force, it has potential for abutment sinking as loads are given. When locking taper connection type implant is used, satisfactory loads are recommended for precise abutment location. PMID:21165262

Influence of implant location on the clinical outcomes of implant abutments: a systematic review and meta-analysis

PubMed Central

ElHoussiney, Amr G; Zhang, He; Song, Jinlin; Ji, Ping; Wang, Lu; Yang, Sheng

2018-01-01

Purpose To compare the failure events and incidence of complications of different abutment materials in anterior and posterior regions. Failure was defined as complete loss of the abutment requiring replacement by a new abutment. Materials and methods Electronic searches using PubMed/Medline and Google Scholar complemented with manual searches were performed with specific search terms. Searches were restricted to publications in English between January 2006 and March 2016. Results A total of 863 and 1,264 implants were inserted in the anterior and posterior regions, respectively, in a total of 1,529 patients. No titanium abutments failed in anterior or posterior regions. On the other hand, 1.6% of zirconia abutments failed in the anterior region and 1.5% failed in the posterior region. Technical complications occurred mostly in the posterior region and mostly involved zirconia abutment. Meta-analysis was possible only for zirconia-abutment failure, due to considerable heterogeneity of studies and outcome variables. No significant difference in failure rate was found between anterior and posterior zirconia abutments (risk ratio 1.53, 95% CI 0.49–4.77; P=0.47). Conclusion This systematic review and meta-analysis showed similar outcomes of different abutment materials when used in anterior and posterior regions in terms of failure events and biological and aesthetic complications. The only significant finding was the increased incidence of technical complications in the posterior region, mostly involving zirconia abutments. Abutment-screw loosening was the most common technical complication. PMID:29520162

Scanning Electron Microscopy Analysis of the Adaptation of Single-Unit Screw-Retained Computer-Aided Design/Computer-Aided Manufacture Abutments After Mechanical Cycling.

PubMed

Markarian, Roberto Adrian; Galles, Deborah Pedroso; Gomes França, Fabiana Mantovani

To measure the microgap between dental implants and custom abutments fabricated using different computer-aided design/computer-aided manufacture (CAD/CAM) methods before and after mechanical cycling. CAD software (Dental System, 3Shape) was used to design a custom abutment for a single-unit, screw-retained crown compatible with a 4.1-mm external hexagon dental implant. The resulting stereolithography file was sent for manufacturing using four CAD/CAM methods (n = 40): milling and sintering of zirconium dioxide (ZO group), cobalt-chromium (Co-Cr) sintered via selective laser melting (SLM group), fully sintered machined Co-Cr alloy (MM group), and machined and sintered agglutinated Co-Cr alloy powder (AM group). Prefabricated titanium abutments (TI group) were used as controls. Each abutment was placed on a dental implant measuring 4.1× 11 mm (SA411, SIN) inserted into an aluminum block. Measurements were taken using scanning electron microscopy (SEM) (×4,000) on four regions of the implant-abutment interface (IAI) and at a relative distance of 90 degrees from each other. The specimens were mechanically aged (1 million cycles, 2 Hz, 100 N, 37°C) and the IAI width was measured again using the same approach. Data were analyzed using two-way analysis of variance, followed by the Tukey test. After mechanical cycling, the best adaptation results were obtained from the TI (2.29 ± 1.13 μm), AM (3.58 ± 1.80 μm), and MM (1.89 ± 0.98 μm) groups. A significantly worse adaptation outcome was observed for the SLM (18.40 ± 20.78 μm) and ZO (10.42 ± 0.80 μm) groups. Mechanical cycling had a marked effect only on the AM specimens, which significantly increased the microgap at the IAI. Custom abutments fabricated using fully sintered machined Co-Cr alloy and machined and sintered agglutinated Co-Cr alloy powder demonstrated the best adaptation results at the IAI, similar to those obtained with commercial prefabricated titanium abutments after mechanical cycling. The adaptation of custom abutments made by means of SLM or milling and sintering of zirconium dioxide were worse both before and after mechanical cycling.

Wear resistance of thick diamond like carbon coatings against polymeric materials used in single screw plasticizing technology

NASA Astrophysics Data System (ADS)

Zitzenbacher, G.; Liu, K.; Forsich, C.; Heim, D.

2015-05-01

Wear on the screw and barrel surface accompany polymer single screw plasticizing technology from the beginning. In general, wear on screws can be reduced by using nitrided steel surfaces, fused armour alloys on the screw flights and coatings. However, DLC-coatings (Diamond Like Carbon) comprise a number of interesting properties such as a high hardness, a low coefficient of friction and an excellent corrosion resistance due to their amorphous structure. The wear resistance of about 50 µm thick DLC-coatings against polyamide 6.6, polybutylene terephthalate and polypropylene is investigated in this paper. The tribology in the solids conveying zone of a single screw extruder until the beginning of melting is evaluated using a pin on disc tribometer and a so called screw tribometer. The polymeric pins are pressed against coated metal samples using the pin on disc tribometer and the tests are carried out at a defined normal force and sliding velocity. The screw tribometer is used to perform tribological experiments between polymer pellets and rotating coated metal shafts simulating the extruder screw. Long term experiments were performed to evaluate the wear resistance of the DLC-coating. A reduction of the coefficient of friction can be observed after a frictional distance of about 20 kilometers using glass fibre reinforced polymeric materials. This reduction is independent on the polymer and accompanied by a black layer on the wear surface of the polymeric pins. The DLC-coated metal samples show an up to 16 µm deep wear track after the 100 kilometer test period against the glass fiber filled materials only.

Fracture loads and failure modes of customized and non-customized zirconia abutments.

PubMed

Moris, Izabela Cristina Maurício; Chen, Yung-Chung; Faria, Adriana Cláudia Lapria; Ribeiro, Ricardo Faria; Fok, Alex Sui-Lun; Rodrigues, Renata Cristina Silveira

2018-05-05

This study aimed to evaluate the fracture load and pattern of customized and non-customized zirconia abutments with Morse-taper connection. 18 implants were divided into 3 groups according to the abutments used: Zr - with non-customized zirconia abutments; Zrc - with customized zirconia abutments; and Ti - with titanium abutments. To test their load capacity, a universal test machine with a 500-kgf load cell and a 0.5-mm/min speed were used. After, one implant-abutment assembly from each group was analyzed by Scanning Electron Microscopy (SEM). For fractographic analysis, the specimens were transversely sectioned above the threads of the abutment screw in order to examine their fracture surfaces using SEM. A significant difference was noted between the groups (Zr=573.7±11.66N, Zrc=768.0±8.72N and Ti=659.1±7.70N). Also, the zirconia abutments fractured while the titanium abutments deformed plastically. Zrc presented fracture loads significantly higher than Zr (p=0.009). All the zirconia abutments fractured below the implant platform, starting from the area of contact between the abutment and implant and propagating to the internal surface of the abutment. All the zirconia abutments presented complete cleavage in the mechanical test. Fractography detected differences in the position and pattern of fracture between the two groups with zirconia abutments, probably because of the different diameters in the transmucosal region. Customization of zirconia abutments did not affect their fracture loads, which were comparable to that of titanium and much higher than the maximum physiological limit for the anterior region of the maxilla. Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

Influence of the implant-abutment connection design and diameter on the screw joint stability.

PubMed

Shin, Hyon-Mo; Huh, Jung-Bo; Yun, Mi-Jeong; Jeon, Young-Chan; Chang, Brian Myung; Jeong, Chang-Mo

2014-04-01

This study was conducted to evaluate the influence of the implant-abutment connection design and diameter on the screw joint stability. Regular and wide-diameter implant systems with three different joint connection designs: an external butt joint, a one-stage internal cone, and a two-stage internal cone were divided into seven groups (n=5, in each group). The initial removal torque values of the abutment screw were measured with a digital torque gauge. The postload removal torque values were measured after 100,000 cycles of a 150 N and a 10 Hz cyclic load had been applied. Subsequently, the rates of the initial and postload removal torque losses were calculated to evaluate the effect of the joint connection design and diameter on the screw joint stability. Each group was compared using Kruskal-Wallis test and Mann-Whitney U test as post-hoc test (α=0.05). THE POSTLOAD REMOVAL TORQUE VALUE WAS HIGH IN THE FOLLOWING ORDER WITH REGARD TO MAGNITUDE: two-stage internal cone, one-stage internal cone, and external butt joint systems. In the regular-diameter group, the external butt joint and one-stage internal cone systems showed lower postload removal torque loss rates than the two-stage internal cone system. In the wide-diameter group, the external butt joint system showed a lower loss rate than the one-stage internal cone and two-stage internal cone systems. In the two-stage internal cone system, the wide-diameter group showed a significantly lower loss rate than the regular-diameter group (P<.05). The results of this study showed that the external butt joint was more advantageous than the internal cone in terms of the postload removal torque loss. For the difference in the implant diameter, a wide diameter was more advantageous in terms of the torque loss rate.

Influence of the implant-abutment connection design and diameter on the screw joint stability

PubMed Central

Shin, Hyon-Mo; Huh, Jung-Bo; Yun, Mi-Jeong; Jeon, Young-Chan; Chang, Brian Myung

2014-01-01

PURPOSE This study was conducted to evaluate the influence of the implant-abutment connection design and diameter on the screw joint stability. MATERIALS AND METHODS Regular and wide-diameter implant systems with three different joint connection designs: an external butt joint, a one-stage internal cone, and a two-stage internal cone were divided into seven groups (n=5, in each group). The initial removal torque values of the abutment screw were measured with a digital torque gauge. The postload removal torque values were measured after 100,000 cycles of a 150 N and a 10 Hz cyclic load had been applied. Subsequently, the rates of the initial and postload removal torque losses were calculated to evaluate the effect of the joint connection design and diameter on the screw joint stability. Each group was compared using Kruskal-Wallis test and Mann-Whitney U test as post-hoc test (α=0.05). RESULTS The postload removal torque value was high in the following order with regard to magnitude: two-stage internal cone, one-stage internal cone, and external butt joint systems. In the regular-diameter group, the external butt joint and one-stage internal cone systems showed lower postload removal torque loss rates than the two-stage internal cone system. In the wide-diameter group, the external butt joint system showed a lower loss rate than the one-stage internal cone and two-stage internal cone systems. In the two-stage internal cone system, the wide-diameter group showed a significantly lower loss rate than the regular-diameter group (P<.05). CONCLUSION The results of this study showed that the external butt joint was more advantageous than the internal cone in terms of the postload removal torque loss. For the difference in the implant diameter, a wide diameter was more advantageous in terms of the torque loss rate. PMID:24843398

Three-Dimensional Displacement of Nine Different Abutments for an Implant with an Internal Hexagon Platform.

PubMed

Gilbert, Andy B; Yilmaz, Burak; Seidt, Jeremy D; McGlumphy, Edwin A; Clelland, Nancy L; Chien, Hua-Hong

2015-01-01

Clinicians need to know whether there are any differences among the many abutment options available for restoring a particular implant. This study aims to compare nine abutments for one implant system for positional changes between hand tightening and torqueing. Nine Tapered Screw-Vent (TSV) implants were placed into a resin block. Five specimens of nine different abutments (n = 45) were tried in one of the nine implants. Initially, the abutments were torqued to 20 Ncm to represent hand tightening. Abutments were tightened to 30 Ncm using a torque driver as recommended by the manufacturer for final seating. Images were recorded in 12-second intervals for approximately 10 minutes after the torque was applied. The spatial relationship of the abutments to the resin block was determined using three-dimensional digital image correlation. Commercial image correlation software was used to analyze the displacements. Mean displacements for the nine different abutments were calculated in all three dimensions and for overall displacement in space. A t test with a step-down Bonferroni correction was used for a pairwise comparison of each abutment's mean displacements to the other abutments to determine statistical differences (α = .05). The Atlantis titanium, Inclusive titanium, and Legacy zirconia abutments showed mean displacements that were statistically significantly higher than other abutments in the horizontal direction. The overall three-dimensional displacement of the Atlantis titanium abutment after an applied 30-Ncm torque was significantly higher than that of six of the other eight abutments (P < .0144). Within the limitations of this in vitro study, the Zimmer PSA demonstrated less displacement between hand tightening and torqueing than the Atlantis titanium or Inclusive titanium abutments when used to restore a TSV implant.

Effects of orthopedic implants with a polycaprolactone polymer coating containing bone morphogenetic protein-2 on osseointegration in bones of sheep.

PubMed

Niehaus, Andrew J; Anderson, David E; Samii, Valerie F; Weisbrode, Steven E; Johnson, Jed K; Noon, Mike S; Tomasko, David L; Lannutti, John J

2009-11-01

To determine elution characteristics of bone morphogenetic protein (BMP)-2 from a polycaprolactone coating applied to orthopedic implants and determine effects of this coating on osseointegration. 6 sheep. An in vitro study was conducted to determine BMP-2 elution from polycaprolactone-coated implants. An in vivo study was conducted to determine the effects on osseointegration when the polycaprolactone with BMP-2 coating was applied to bone screws. Osseointegration was assessed via radiography, measurement of peak removal torque and bone mineral density, and histomorphometric analysis. Physiologic response was assessed by measuring serum bone-specific alkaline phosphatase activity and uptake of bone markers. Mean +/- SD elution on day 1 of the in vitro study was 263 +/- 152 pg/d, which then maintained a plateau at 59.8 +/- 29.1 pg/d. Mean peak removal torque for screws coated with polycalprolactone and BMP-2 (0.91 +/- 0.65 dN x m) and screws coated with polycaprolactone alone (0.97 +/- 1.30 dN.m) did not differ significantly from that for the control screws (2.34 +/- 1.62 dN x m). Mean bone mineral densities were 0.535 +/- 0.060 g/cm(2), 0.596 +/- 0.093 g/cm(2), and 0.524 +/- 0.142 g/cm(2) for the polycaprolactone-BMP-2-coated, polycaprolactone-coated, and control screws, respectively, and did not differ significantly among groups. Histologically, bone was in closer apposition to the implant with the control screws than with either of the coated screws. BMP-2 within the polycaprolactone coating did not stimulate osteogenesis. The polycaprolactone coating appeared to cause a barrier effect that prevented formation of new bone. A longer period or use of another carrier polymer may result in increased osseointegration.

Radiological, histological, and hematological evaluation of hydroxyapatite-coated resorbable magnesium alloy screws placed in rabbit tibia.

PubMed

Lim, Ho-Kyung; Byun, Soo-Hwan; Lee, Jin-Yong; Lee, Jung-Woo; Kim, Sae-Mi; Lee, Sung-Mi; Kim, Hyoun-Ee; Lee, Jong-Ho

2017-08-01

Titanium (Ti) screw has excellent mechanical property, and osseointegration capacity. However, they require surgery for removal. In contrast, polymer screws are resorbable, but they have poor mechanical properties. In this research, magnesium alloy screws (WE43: Mg-Y-Nd-Zr) that have advantages of titanium and polymer were manufactured. In addition, to increase biocompatibility and control degradation rate, the Mg alloy was coated with hydroxyapatite (HA). Torsion test and corrosion test were performed in vitro. For clinical, radiological and histological evaluation, on the eight rabbits, two HA-coated screws were installed in left tibia, and two noncoated screws were installed in right tibia. Each four rabbits were sacrificed 6 and 12 weeks postoperatively. For hematological evaluation, the same type of screws were installed on both legs. Complete blood count (CBC), Mg 2+ concentrate were sampled from the ear central artery on the operation day for a control point, and at 1, 2, 4, 6, 8, and 12 weeks. Mg alloy screws have no differences of biocompatibility according to the HA coating. However, resorption of screw was slower in case of the HA coating. The hematological problem related releasing of Mg was not found. The results suggest that Mg alloy screws have feasibility for clinical application. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1636-1644, 2017. © 2016 Wiley Periodicals, Inc.

Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: a comparative in vitro study.

PubMed

Stimmelmayr, Michael; Edelhoff, Daniel; Güth, Jan-Frederik; Erdelt, Kurt; Happe, Arndt; Beuer, Florian

2012-12-01

The purpose of this study was to determine and measure the wear of the interface between titanium implants and one-piece zirconia abutments in comparison to titanium abutments. 6 implants were secured into epoxy resin blocks. The implant interface of these implants and 6 corresponding abutments (group Zr: three one-piece zirconia abutments; group Ti: three titanium abutments) were examined by a microscope and scanning electron micrograph (SEM). Also the implants and the abutments were scanned by 3D-Micro Computer Tomography (CT). The abutments were connected to the implants and cyclically loaded with 1,200,000 cycles at 100N in a two-axis fatigue testing machine. Afterwards, all specimens were unscrewed and the implants and abutments again were scanned by microscope, SEM and CT. The microscope and SEM images were compared, the CT data were superimposed and the wear was calculated by inspection software. The statistical analysis was carried out with an unpaired t-test. Abutment fracture or screw loosening was not observed during cyclical loading. Comparing the microscope and SEM images more wear was observed on the implants connected to zirconia abutments. The maximum wear on the implant shoulder calculated by the inspection software was 10.2μm for group Zr, and 0.7μm for group Ti. The influence of the abutment material on the measured wear was statistically significant (p≤0.001; Levene-test). Titanium implants showed higher wear at the implant interface following cyclic loading when connected to one-piece zirconia implant abutments compared to titanium abutments. The clinical relevance is not clear; hence damage of the internal implant connection could result in prosthetic failures up to the need of implant removal. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

A three-dimensional finite element study on the stress distribution pattern of two prosthetic abutments for external hexagon implants.

PubMed

Moreira, Wagner; Hermann, Caio; Pereira, Jucélio Tomás; Balbinoti, Jean Anacleto; Tiossi, Rodrigo

2013-10-01

The purpose of this study was to evaluate the mechanical behavior of two different straight prosthetic abutments (one- and two-piece) for external hex butt-joint connection implants using three-dimensional finite element analysis (3D-FEA). Two 3D-FEA models were designed, one for the two-piece prosthetic abutment (2 mm in height, two-piece mini-conical abutment, Neodent) and another one for the one-piece abutment (2 mm in height, Slim Fit one-piece mini-conical abutment, Neodent), with their corresponding screws and implants (Titamax Ti, 3.75 diameter by 13 mm in length, Neodent). The model simulated the single restoration of a lower premolar using data from a computerized tomography of a mandible. The preload (20 N) after torque application for installation of the abutment and an occlusal loading were simulated. The occlusal load was simulated using average physiological bite force and direction (114.6 N in the axial direction, 17.1 N in the lingual direction and 23.4 N toward the mesial at an angle of 75° to the occlusal plan). The regions with the highest von Mises stress results were at the bottom of the initial two threads of both prosthetic abutments that were tested. The one-piece prosthetic abutment presented a more homogeneous behavior of stress distribution when compared with the two-piece abutment. Under the simulated chewing loads, the von Mises stresses for both tested prosthetic-abutments were within the tensile strength values of the materials analyzed which thus supports the clinical use of both prosthetic abutments.

In vivo degradation of a new concept of magnesium-based rivet-screws in the minipig mandibular bone.

PubMed

Schaller, Benoit; Saulacic, Nikola; Beck, Stefan; Imwinkelried, Thomas; Goh, Bee Tin; Nakahara, Ken; Hofstetter, Willy; Iizuka, Tateyuki

2016-12-01

Self-tapping of magnesium screws in hard bone may be a challenge due to the limited torsional strength of magnesium alloys in comparison with titanium. To avoid screw failure upon implantation, the new concept of a rivet-screw was applied to a WE43 magnesium alloy. Hollow cylinders with threads on the outside were expanded inside drill holes of minipig mandibles. During the expansion with a hexagonal mandrel, the threads engaged the surrounding bone and the inside of the screw transformed into a hexagonal screw drive to allow further screwing in or out of the implant. The in vivo degradation of the magnesium implants and the performance of the used coating were studied in a human standard-sized animal model. Four magnesium alloy rivet-screws were implanted in each mandible of 12 minipigs. Six animals received the plasmaelectrolytically coated magnesium alloy implants; another six received the uncoated magnesium alloy rivet-screws. Two further animals received one titanium rivet-screw each as control. In vivo radiologic examination was performed at one, four, and eight weeks. Euthanasia was performed for one group of seven animals (three animals with coated, three with uncoated magnesium alloy implants and one with titanium implant) at 12weeks and for the remaining seven animals at 24weeks. After euthanasia, micro-computed tomography and histological examination with histomorphometry were performed. Significantly less void formation as well as higher bone volume density (BV/TV) and bone-implant contact area (BIC) were measured around the coated implants compared to the uncoated ones. The surface coating was effective in delaying degradation despite plastic deformation. The results showed potential for further development of magnesium hollow coated screws for bone fixation. Copyright © 2016 Elsevier B.V. All rights reserved.

Height parallelism of implants in the treatment of the edentulous mandible with ball-retained overdentures: a technical note.

PubMed

Iglesia-Puig, Miguel A

2008-01-01

The objective of this report is to present a device to achieve equal platform height in the vertical axis to allow the spherical abutments to work correctly in mandibular overdentures retained with 2 implants. The device is fabricated over plastic castable abutments, with a plate perpendicular to the implant platforms and located at the top of the platform height. Once implants are inserted, the device is screwed to an implant and allows evaluation of the height of the platforms.

Effect of Abutment Modification and Cement Type on Retention of Cement-Retained Implant Supported Crowns

PubMed Central

Farzin, Mitra; Torabi, Kianoosh; Ahangari, Ahmad Hasan; Derafshi, Reza

2014-01-01

Objective: Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations; but compromised abutment preparation may affect the retention of implant-retained crowns.The purpose of this study was to investigate the effect of abutment design and type of luting agent on the retentive strength of cement-retained implant restorations. Materials and Method: Two prefabricated abutments were attached to their corresponding analogs and embedded in an acrylic resin block. The first abutment (control group) was left intact without any modifications. The screw access channel for the first abutment was completely filled with composite resin. In the second abutment, (test group) the axial wall was partially removed to form an abutment with 3 walls. Wax models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The prepared copings were cemented on the abutments by Temp Bond luting agent under standardized conditions (n=20). The assemblies were stored in 100% humidity for one day at 37°C prior to testing. The cast crown was removed from the abutment using an Instron machine, and the peak removal force was recorded. Coping/abutment specimens were cleaned after testing, and the testing procedure was repeated for Dycal luting agent (n=20). Data were analyzed with two- way ANOVA (α=0.05). Results: There was no significant difference in the mean transformed retention (Ln-R) between intact abutments (4.90±0.37) and the abutments with 3 walls (4.83±0.25) using Dycal luting agent. However, in TempBond group, the mean transformed retention (Ln-R) was significantly lower in the intact abutment (3.9±0.23) compared to the abutment with 3 walls (4.13±0.33, P=0.027). Conclusion: The retention of cement-retained implant restoration can be improved by the type of temporary cement used. The retention of cast crowns cemented to implant abutments with TempBond is influenced by the wall removal. PMID:25628660

Comparison of Customized Abutments Made from Titanium and a Machinable Precious Alloy.

PubMed

Lee, Jee-Ho; Park, Ji-Man; Park, Eun-Jin; Koak, Jai-Young; Kim, Seong-Kyun; Heo, Seong-Joo

2016-01-01

To investigate the clinical usefulness, a customized abutment produced with the Pd-Ag-In alloy was compared with a customized abutment produced with the conventional titanium alloy for discoloration and mechanical accuracy. Discoloration and resistance to corrosion of the Pd-Ag-In alloy were evaluated using chemical solutions. Marginal adaptation of internal-type implants and abutments was compared using 10 titanium abutments and 10 Pd-Ag-In abutments using a surface measuring system. A detorque test was performed on 12 implant-abutment complexes of each control and experimental group to investigate screw joint stability. Cyclic loading simulating a human's mastication movement for 1 year was applied after 30 Ncm initial tightening, and the removal torque was measured using a digital torque gauge. The noninferiority test was conducted to compare the Pd-Ag-In alloy with a titanium abutment with a 10% margin. The Pd-Ag-In alloy had a warm yellow color and displayed stable resistance to discoloration and corrosion, resulting in an advantageous esthetic property. When compared to the titanium alloy, it did not show noninferiority with respect to the gap between the implant and the abutment; the gap was approximately 13.3 μm on average, which was not significantly different from those observed in previous studies. After long-term use, it displayed statistically significant noninferiority in the removal torque value compared to the titanium group. The Pd-Ag-In alloy-based customized abutment had good mechanical properties of the implant-abutment complex as well as a superior esthetic property, and can provide favorable outcomes in anterior implant restoration.

In Vitro Microbiological Analysis of Bacterial Seal in Hybrid Zirconia Abutment Tapered Connection.

PubMed

Harlos, Maurício Marcelo; Bezerra da Silva, Thiago; Peruzzo, Daiane C; Napimoga, Marcelo H; Joly, Julio Cesar; Martinez, Elizabeth F

2017-04-01

The aim of this study was to evaluate the bacterial seal at the implant-hybrid zirconia abutment interface and Morse taper-type connections through in vitro microbiological analysis. Sixteen implants and their respective abutments were divided into 3 groups: test (10 sets), positive control (3 sets), and negative control (3 sets). In the test group, 10 implants were contaminated with Escherichia coli using a sterile inoculating loop to the inner portion of the implants, followed by torque application to the abutment (30 N·cm). The positive controls were also contaminated, but no torque was applied to the abutment screw. The negative control consisted of uncontaminated sets. All specimens were immersed in test tubes containing 5 mL brain heart infusion (BHI) broth, maintained in a microbiological incubator for 14 days at 37°C under aerobic conditions, and monitored every 24 hours for evidence of bacterial growth. During the 14 days of incubation, no significant increase in the number of cloudy culture media was observed in the test group (P = 0.448). No significant difference in broth turbidity ratio was observed (P > 0.05). Hybrid zirconia abutments can create an effective seal at the tapered abutment-implant interface with a 30-N·cm installation torque.

Displacement comparison of CAD-CAM titanium and zirconia abutments to implants with different conical connections.

PubMed

Yilmaz, Burak; Hashemzadeh, Shervin; Seidt, Jeremy D; Clelland, Nancy L

2018-04-01

To compare the displacements of CAD-CAM zirconia and titanium abutments into different internal connection systems after torquing. OsseoSpeed EV and OsseoSpeed TX implants (n=10) were placed in resin blocks. Zirconia and titanium abutments (n=5) were first hand tightened and then tightened to the recommended torque (20Ncm for TX and 25Ncm for EV). Displacements of abutments between screw tightening by hand and torque driver was measured using three-dimensional digital image correlation (3D DIC) technique. Displacements were measured in U (front/back), V (into/outward), W (right/left) directions and 3-dimensionally (3D). ANOVA with restricted maximum likelihood estimation method was used to analyze the data. Bonferroni-corrected t tests was used to determine the statistical differences (α=0.05). 3D displacement of zirconia and titanium abutments was significantly greater in OsseoSpeed EV implant (P<0.001). Displacement of zirconia and titanium abutments was not significantly different within implant systems, 3D (P≥0.386) and in each direction (P≥0.382). In U and V directions, zirconia and titanium abutments displaced significantly more towards negative in OsseoSpeed EV implant (P<0.019). Within the OsseoSpeed TX system, abutments displaced significantly more in V direction compared to the U and W (P≤0.005), and within the Osseospeed EV system, abutment displacements were significantly different amongst directions and displacements in V were the greatest (P<0.001). Abutments displaced more in the implant that required higher torque values to tighten the abutment. The amount of displacement in both systems was clinically small. Abutment material did not affect the magnitude of displacement. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Investigating the micromorphological differences of the implant-abutment junction and their clinical implications: a pilot study.

PubMed

Mattheos, Nikos; Li, Xiaona; Zampelis, Antonios; Ma, Li; Janda, Martin

2016-11-01

The aim of this pilot study was to investigate the morphological micro-features of three commercially available implant-abutment joints, using compatible and original prosthetic components. Furthermore, possible correlations between the micromorphology and potential functional complications were investigated with the use of finite element analysis. Three abutments (one original and two compatibles) were torqued on original Straumann RN implants, as according to each of the manufacturer's instructions. The implant-abutment units were sliced in the microtome and photographed under different magnifications (10×-500×) through a scanning electron microscope. Finite element analysis models were reconstructed for each of the implant-abutment units using the precise measurements from the SEM. Differences in stress, strain and deformation for the three different abutments were then calculated using ANSYS Workbench v13. Major dimensional differences were identified between all studied contact areas of the three units. The tight contact in the implant shoulder was similar in all three units, but engagement of the internal connection and, in particular, the anti-rotation elements was seriously compromised in the compatible abutments. One compatible abutment demonstrated compromised engagement of the abutment screw as well. Equivalent stress and strain in the FEA were much higher for the compatible abutments. An evaluation of the sequence of preload application revealed differences in the pattern of deformation between the original and compatible abutments, which can have serious clinical implications. Compatible abutments can present critical morphological differences from the original ones. The differences in the cross-sectional geometry result in large differences in the overall contact areas, both in terms of quality and quantity which could have serious implications for the long-term stability of the prosthesis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Incidence of undetected cement on CAD/CAM monolithic zirconia crowns and customized CAD/CAM implant abutments. A prospective case series.

PubMed

Wasiluk, Grzegorz; Chomik, Ewa; Gehrke, Peter; Pietruska, Małgorzata; Skurska, Anna; Pietruski, Jan

2017-07-01

The aim of this study was to assess the frequency of cement residues after cementation of CAD/CAM monolithic zirconia crowns on customized CAD/CAM titanium abutments. Sixty premolars and molars were restored on Astra Tech Osseospeed TX ™ implants using single monolithic zirconia crowns fixed on two types of custom-made abutments: Atlantis ™ titanium or Atlantis ™ Gold Hue. Occlusal openings providing access to the abutment screws were designed for retrievability of the crown/abutment connection. After fixation with glass ionomer cement, the crown/abutment units were unscrewed to evaluate the presence of residual cement. Dichotomous assessment of the presence or absence of cement at the crown/abutment unit and peri-implant tissues was performed. Clinically undetected cement excess was visible on 44 of 60 restorations (73.3%). There was no interdependency between residual cement presence and implant location or diameter. However, a dependency between the presence of residual cement and the aspect of the abutment/crown connection could be noted. The majority of the residues were observed on the distal (17.9%) and mesial (15%) aspects. While on the palatal/lingual aspect, the cement was visible in 8.8%; only 3.4% of all surfaces displayed cement residues. Within the limitations of the study, it can be concluded that the use of customized CAD/CAM abutments do not guarantee avoidance of subgingival cement residues after crown cementation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The bacterial sealing capacity of morse taper implant-abutment systems in vitro.

PubMed

Ranieri, Rogerio; Ferreira, Andreia; Souza, Emmanuel; Arcoverde, Joao; Dametto, Fabio; Gade-Neto, Cicero; Seabra, Flavio; Sarmento, Carlos

2015-05-01

The use of Morse taper systems in dental implantology has been associated widely with a more precise adaptation between implants and their respective abutments. This may lead to an increase in the stability of the implant system and may also prevent microbial invasion through the implant-abutment interface. The aim of this study was to investigate in vitro the ability of four commercially available Morse taper system units to impede bacterial penetration through their implant-abutment interfaces. Abutments were screwed onto the implants, and the units were subsequently immersed in Streptococcus sanguinis bacterial broth (1 × 10(8) colony forming units/mL) for 48 hours. The units were examined by scanning electron microscopy (SEM) under three conditions: 1) with the implant-abutment components assembled as units to investigate for both the existence of microgaps and the presence of bacteria; 2) with the implants and abutments separated for examination of internal surfaces; and 3) with the implant-abutment components again assembled as units to measure any microgaps detected. The mean size of the microgaps in each unit was determined by measuring, under SEM, their width in four equidistant points. Microgaps were detected in all units with no significant differences in dimension (Kruskal-Wallis test, P >0.05). Within all units, the presence of bacteria was also observed. The seals provided by the interfaces of the commercially available Morse taper implant-abutment units tested were not sufficiently small to shield the implant from bacterial penetration.

Influence of Diamondlike Carbon Coating of Screws on Axial Tightening Force and Stress Distribution on Overdenture Bar Frameworks with Different Fit Levels and Materials.

PubMed

dos Santos, Mateus Bertolini Fernandes; Bacchi, Atais; Consani, Rafael Leonardo Xediek; Correr-Sobrinho, Lourenço

2015-01-01

The aim of this study was to evaluate the axial tightening force applied by conventional and diamondlike carbon (DLC)-coated screws and to verify, through three-dimensional finite element analysis (FEA), the stress distribution caused by different framework materials and prosthetic screws in overdenture frameworks with different misfit levels. The axial tightening force applied by the screw was evaluated by means of a titanium matrix connected to a load cell. Conventional titanium or DLC-coated screws were tightened with a digital torque wrench, and the load values were recorded. The values were applied in an FEA to a bar-clip attachment system connected to two 4.0 × 11-mm external-hexagon titanium implants placed in an anterior edentulous arch. DLC-coated and conventional screws were modeled with their respective axial forces obtained on the experimental evaluation for three bar framework materials (titanium, nickel-chromium, and cobalt-chromium) and three levels of misfit (100, 150, and 200 μm). Von Mises stresses for prosthetic components and maximum principal stress and microstrains (maximum principal strains) for bone tissue were measured. The mean force applied by the conventional screw was 25.55 N (± 1.78); the prosthetic screw coated with a DLC layer applied a mean force of 31.44 N (± 2.11), a statistically significant difference. In the FEA, the DLC screw led to higher stresses on the framework; however, the prosthetic screw suffered lower stress. No influence of screw type was seen in the bone tissue. Titanium frameworks reduced the stress transmitted to the bone tissue and the bar framework but had no influence on the screws. Higher misfit values resulted in an increased stress/strain in bone tissue and bar framework, which was not the case for retention screws.

Comparative analysis of different joining techniques to improve the passive fit of cobalt-chromium superstructures.

PubMed

Barbi, Francisco C L; Camarini, Edevaldo T; Silva, Rafael S; Endo, Eliana H; Pereira, Jefferson R

2012-12-01

The influence of different joining techniques on passive fit at the interface structure/abutment of cobalt-chromium (Co-Cr) superstructures has not yet been clearly established. The purpose of this study was to compare 3 different techniques of joining Co-Cr superstructures by measuring the resulting marginal misfit in a simulated prosthetic assembly. A specially designed metal model was used for casting, sectioning, joining, and measuring marginal misfit. Forty-five cast bar-type superstructures were fabricated in a Co-Cr alloy and randomly assigned by drawing lots to 3 groups (n=15) according to the joining method used: conventional gas-torch brazing (G-TB), laser welding (LW), and tungsten inert gas welding (TIG). Joined specimens were assembled onto abutment analogs in the metal model with the 1-screw method. The resulting marginal misfit was measured with scanning electron microscopy (SEM) at 3 different points: distal (D), central (C), and mesial (M) along the buccal aspect of both abutments: A (tightened) and B (without screw). The Levene test was used to evaluate variance homogeneity and then the Welsch ANOVA for heteroscedastic data (α=.05). Significant differences were found on abutment A between groups G-TB and LW (P=.013) measured mesially and between groups G-TB and TIG (P=.037) measured centrally. On abutment B, significant differences were found between groups G-TB and LW (P<.001) and groups LW and TIG (P<.001) measured mesially; groups G-TB and TIG (P=.007) measured distally; and groups G-TB and TIG (P=.001) and LW and TIG (P=.007) measured centrally. The method used for joining Co-Cr prosthetic structures had an influence on the level of resulting passive fit. Structures joined by the tungsten inert gas method produced better mean results than did the brazing or laser method. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Microleakage of the prosthetic abutment/implant interface with internal and external connection: in vitro study.

PubMed

Larrucea Verdugo, Carlos; Jaramillo Núñez, Guido; Acevedo Avila, Ariel; Larrucea San Martín, Carlo

2014-09-01

This study determined the degree of marginal microleakage of the abutment-implant interface on platforms with Morse taper connection and external connection. For this in vitro study, 42 implants, 21 with external connection and 21 with Morse taper connection, were used, immersed in acrylic resin cylinders. Each implant was joined by a prosthetic abutment screw tightened at different degrees, forming the six study groups: (1) External connection, manual tightening (2) External connection, 20 Newton (N) tightening (3) External connection, 30 N tightening (4) Morse taper connection, manual tightening (5) Morse taper connection, 20 N tightening (6) orse taper connection, 30 N tightening. All samples were subjected to load cycling and thermocycling. Then, they were submerged in a solution of 0.2% methylene blue for 24 h. Finally, the microleakage was measured via 20× optical microscopy in each study group, average was obtained, and Mann-Whitney test was applied. Statistically significant differences (P < 0.001) were found between the levels of microleakage presented in the Morse taper connection implants (1.48) and external connection implants (2.8) in all three types of tightening. Microleakage levels decreases when increasing torque is applied to the screws. Morse taper connection implants showed lower levels of microleakage than external connection implants; also, it was observed that microleakage decreases in the way torque increases. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Using a guide template with a handpiece sleeve to locate the abutment screw position of a cement-retained implant restoration.

PubMed

Kang, Hye-Won; Lee, Du-Hyeong

2015-09-01

The existing techniques for drilling a screw access hole in cement-retained restorations are limited by inaccurate drill guidance and ineffective cooling of the drilling area. An approach for fabricating a guide template to provide screw retrievability using computer-aided design and computer-aided manufacturing (CAD/CAM) is described. A handpiece sleeve was made by 3-dimensional printing and incorporating it into a vacuum-formed template. The handpiece sleeve not only guides the head of the handpiece accurately but also enables the cooling water to reach the area of drilling directly. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Non-linear 3D evaluation of different oral implant-abutment connections.

PubMed

Streckbein, P; Streckbein, R G; Wilbrand, J F; Malik, C Y; Schaaf, H; Howaldt, H P; Flach, M

2012-12-01

Micro-gaps and osseous overload in the implant-abutment connection are the most common causes of peri-implant bone resorption and implant failure. These undesirable events can be visualized on standardized three-dimensional finite element models and by radiographic methods. The present study investigated the influence of 7 available implant systems (Ankylos, Astra, Bego, Brånemark, Camlog, Straumann, and Xive) with different implant-abutment connections on bone overload and the appearance of micro-gaps in vitro. The individual geometries of the implants were transferred to three-dimensional finite element models. In a non-linear analysis considering the pre-loading of the occlusion screw, friction between the implant and abutment, the influence of the cone angle on bone strain, and the appearance of micro-gaps were determined. Increased bone strains were correlated with small (< 15°) cone angles. Conical implant-abutment connections efficiently avoided micro-gaps but had a negative effect on peri-implant bone strain. Bone strain was reduced in implants with greater wall thickness (Ankylos) or a smaller cone angle (Bego). The results of our in silico study provide a solid basis for the reduction of peri-implant bone strain and micro-gaps in the implant-abutment connection to improve long-term stability.

Dynamic fatigue performance of implant-abutment assemblies with different tightening torque values.

PubMed

Xia, Dandan; Lin, Hong; Yuan, Shenpo; Bai, Wei; Zheng, Gang

2014-01-01

Implant-abutment assemblies are usually subject to long-term cyclic loading. To evaluate the dynamic fatigue performance of implant-abutment assemblies with different tightening torque values, thirty implant-abutment assemblies (Zimmer Dental, Carlsbad, CA, USA) were randomly assigned to three tightening groups (24 Ncm; 30 Ncm; 36 Ncm), each consisted of 10 implants. Five specimens from each group were unscrewed, and their reverse torque values recorded. The remaining specimens were subjected to a load between 30 N~300 N at a loading frequency of 15 Hz for 5 × 10(6) cycles. After fatigue tests, residual reverse torque values were recorded if available. In the 24 Ncm tightening group, all the implants fractured at the first outer thread of the implant after fatigue loading, with fatigue crack propagation at the fractured surface showed by SEM observation. For the 30 Ncm and 36 Ncm tightening groups, a statistical significant difference (p<0.05) between the unloaded and loaded groups was revealed. Compared with the unloaded specimens, the specimens went through fatigue loading had decreased reverse torque values. It was demonstrated that insufficient torque will lead to poor fatigue performance of dental implant-abutment assemblies and abutment screws should be tightened to the torque recommended by the manufacturer. It was also concluded that fatigue loading would lead to preload loss.

Evaluation of Heat Transfer to the Implant-Bone Interface During Removal of Metal Copings Cemented onto Titanium Abutments.

PubMed

Cakan, Umut; Cakan, Murat; Delilbasi, Cagri

2016-01-01

The aim of this investigation was to measure the temperature increase due to heat transferred to the implant-bone interface when the abutment screw channel is accessed or a metal-ceramic crown is sectioned buccally with diamond or tungsten carbide bur using an air rotor, with or without irrigation. Cobalt-chromium copings were cemented onto straight titanium abutments. The temperature changes during removal of the copings were recorded over a period of 1 minute. The sectioning of coping with diamond bur and without water irrigation generated the highest temperature change at the cervical part of the implant. Both crown removal methods resulted in an increase in temperature at the implant-bone interface. However, this temperature change did not exceed 47°C, the potentially damaging threshold for bone reported in the literature.

Stability of Uncemented Cups - Long-Term Effect of Screws, Pegs and HA Coating: A 14-Year RSA Follow-Up of Total Hip Arthroplasty.

PubMed

Otten, Volker T C; Crnalic, Sead; Röhrl, Stephan M; Nivbrant, Bo; Nilsson, Kjell G

2016-01-01

Screws, pegs and hydroxyapatite-coating are used to enhance the primary stability of uncemented cups. We present a 14-year follow-up of 48 hips randomized to four groups: press-fit only, press-fit plus screws, press-fit plus pegs and hydroxyapatite-coated cups. Radiostereometric migration measurements showed equally good stability regardless cup augmentation. The mean wear rate was high, 0.21 mm/year, with no differences between the groups. Seven hips had radiographical osteolysis but only in hips with augmented cups. Cups without screw-holes compared with cups with screw-holes resulted in better clinical outcome at the 14-year follow-up. Thus, augmentation of uncemented cups with screws, pegs, or hydroxyapatite did not appear to improve the long-term stability compared with press-fit only. Copyright © 2016 Elsevier Inc. All rights reserved.

A prospective, split-mouth study comparing tilted implants with angulated connection versus conventional implants with angulated abutment.

PubMed

Van Weehaeghe, Manú; De Bruyn, Hugo; Vandeweghe, Stefan

2017-12-01

An angulation of the implant connection could overcome the problems related to angulated abutments. This study compares conventional implants with angulated abutment to tilted implants with an angulated connection. Twenty patients were treated in the edentulous mandible. In the posterior jaw locations, one conventional tilted implant with angulated abutment and one angulated implant without abutment were placed. In the anterior jaw, two conventional implants were placed, one with and one without abutment. Implants were immediately loaded and 3 months later, the final bridge (PFM or monolithic zirconia) was placed. After a follow-up of 48 months, 17 patients were available for clinical examination. The mean overall marginal bone loss (MBL) was 1.26 mm. No significant differences in implant survival, MBL, periodontal indices, patients' satisfaction, or complications was found between implants restored on abutment or implant level, between the posteriorly located angulated implant nor angulated abutment, and between both anterior implants with or without abutment. The posterior implants demonstrated less MBL compared to the anterior implants (P < .001). There was no significant difference in MBL between the implants restored with zirconia or PFM bridges (P = .294). Overall mean pocket depth was 2.83 mm. More plaque was found in the PFM group compared to the full-zirconia group, at the bridge (P = .042) and the implants (P = .029). There was no difference between both materials in pocket depth (P = .635) or bleeding (P = .821). One zirconia bridge fractured, two angulated abutment were replaced and four loose bridge screws connected to the angulated abutments had to be tightened. Patients were overall satisfied (4.74/5). An implant with angulated connection may results in a stronger connection but does not affect the marginal bone loss. No difference in MBL was seen between implants restored on abutment or implant level. Zirconia seems to reduce the amount of plaque. © 2017 Wiley Periodicals, Inc.

Dental implants as strategic supplementary abutments for implant-tooth-supported telescopic crown-retained maxillary dentures: a retrospective follow-up study for up to 9 years.

PubMed

Krennmair, Gerald; Krainhöfner, Martin; Waldenberger, Otmar; Piehslinger, Eva

2007-01-01

The aim of this retrospective study was to present the results of implants and natural teeth used as combined abutments to support maxillary telescopic prostheses. Between 1997 and 2004, 22 patients with residual maxillary teeth underwent prosthodontic rehabilitation with supplementary implant placement of implant-tooth-supported telescopic prostheses. A total of 60 supplementary implants (mean: 2.9 implants; SD: 1.6; range: 1 to 5 per patient) were placed in strategic position and connected with 48 natural abutment teeth (mean: 2.2 teeth; SD: 0.9; range: 1 to 4 per patient) using telescopic crowns. The follow-up registration included implant and natural tooth survival rates and peri-implant and periodontal parameters, along with prosthodontic maintenance. Natural tooth abutments were additionally followed to compare their periodontal parameters at baseline to the follow-up examination. After a mean of 38 months (12 to 108 months) no implants or natural tooth abutments were lost (survival rate: 100%). There was no fracture, endodontic treatment, loss, or intrusion of natural teeth used for telescopic abutments. Implant abutments showed high stability and excellent periimplant soft tissue conditions. Natural tooth abutments used for double crowns also showed uneventful progress. A low rate of prosthodontic maintenance was seen, with implant screw abutment loosening as the most severe complication (3 of 60 implants; 5%). On the basis of this retrospective clinical review, the following conclusions were drawn: (1) successful function over a prolonged period and a minor complication rate of implant-tooth-supported telescopic maxillary dentures may be anticipated, and (2) the great variety of treatment modalities offered by tooth-implant support for telescopic prostheses appears to be useful as a treatment option for the maxilla in elderly patients.

Proposal for monitoring concrete painting as a preventive maintenance tool (Abutments and pier caps).

DOT National Transportation Integrated Search

2017-07-01

One of the growing number of preventive bridge maintenance activities conducted by the Kentucky Transportation Cabinet (KYTC) is washing and applying thin film protective coatings to bridge abutments and piers. Previous work conducted by Kentucky Tra...

Loss of mechanical properties in vivo and bone-implant interface strength of AZ31B magnesium alloy screws with Si-containing coating.

PubMed

Tan, Lili; Wang, Qiang; Lin, Xiao; Wan, Peng; Zhang, Guangdao; Zhang, Qiang; Yang, Ke

2014-05-01

In this study the loss of mechanical properties and the interface strength of coated AZ31B magnesium alloy (a magnesium-aluminum alloy) screws with surrounding host tissues were investigated and compared with non-coated AZ31B, degradable polymer and biostable titanium alloy screws in a rabbit animal model after 1, 4, 12 and 21weeks of implantation. The interface strength was evaluated in terms of the extraction torque required to back out the screws. The loss of mechanical properties over time was indicated by one-point bending load loss of the screws after these were extracted at different times. AZ31B samples with a silicon-containing coating had a decreased degradation rate and improved biological properties. The extraction torque of Ti6Al4V, poly-l-lactide (PLLA) and coated AZ31B increased significantly from 1week to 4weeks post-implantation, indicating a rapid osteosynthesis process over 3weeks. The extraction torque of coated AZ31B increased with implantation time, and was higher than that of PLLA after 4weeks of implantation, equalling that of Ti6Al4V at 12weeks and was higher at 21weeks. The bending loads of non-coated AZ31B and PLLA screws degraded sharply after implantation, and that of coated AZ31B degraded more slowly. The biodegradation mechanism, the coating to control the degradation rate and the bioactivity of magnesium alloys influencing the mechanical properties loss over time and bone-implant interface strength are discussed in this study and it is concluded that a suitable degradation rate will result in an improvement in the mechanical performance of magnesium alloys, making them more suitable for clinical application. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Soft tissues stability of cad-cam and stock abutments in anterior regions: 2-year prospective multicentric cohort study.

PubMed

Lops, Diego; Bressan, Eriberto; Parpaiola, Andrea; Sbricoli, Luca; Cecchinato, Denis; Romeo, Eugenio

2015-12-01

Aim of this study was to verify if the type of implant abutment manufacturing, stock or cad-cam, could influence the maintenance of stable gingival margins around single restorations in anterior areas. After 16 weeks of healing, implants (Osseospeed, Astra Tech Dental Implant) were positioned. Depending on the different fixture inclination and the thickness of buccal peri-implant soft tissue, abutment selection resulted in four groups: Group 1 (patients with zirconia ZirDesign(®) stock abutments), Group 2 (titanium stock TiDesign(®) abutments), Group 3 (zirconia cad-cam abutments), and Group 4 (titanium cad-cam abutments). The following parameters were assessed: buccal gingival margin modification (BGM). The modification of the implant gingival margin was followed at 1 and 2 years of follow-up. A computerized analysis was performed for measurements. Differences between soft tissue margin at baseline and after 2 years measured the gingival margin recession. A general linear model was used to evaluate each group in relation to gingival recession after two years. Tukey's post hoc test was used to compare the mean REC indexes of each group of abutments. Seventy-two healthy patients (39 males and 33 females; mean age of 46 years) scheduled for single gap rehabilitation in anterior areas were enrolled. A 100% of implant survival rate was observed after 24 months of function. One failure occurred due to fracture of a Zirconia cad-cam abutment. Moreover, two abutment screw unscrewing were observed. Both for zirconia and titanium stock abutments (Group 1 and 2), the mean recession of implant buccal soft tissue was of 0.3 mm (SD of 0.3 and 0.4 mm, respectively). Soft tissue mean recession of zirconia and titanium cad-cam abutments (Group 3 and 4) was of 0.1 and -0.3 mm, respectively (SD of 0.3 and 0.4 mm, respectively). REC values of cad-cam titanium abutments (Group 4) were significantly lower than that of Group 1 (-0.57 mm), Group 2 (-0.61 mm), and Group 3 (-0.40 mm), respectively (Table 4). In the anterior area, the use of cad-cam abutments is related to a better soft tissue stability. Such a relationship is significant if cad-cam titanium abutments are compared to both titanium and zirconia stock abutments. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Degradation behaviour of LAE442-based plate-screw-systems in an in vitro bone model.

PubMed

Wolters, Leonie; Besdo, Silke; Angrisani, Nina; Wriggers, Peter; Hering, Britta; Seitz, Jan-Marten; Reifenrath, Janin

2015-04-01

The use of absorbable implant materials for fixation after bone fracture helps to avoid a second surgery for implant removal and the risks and costs involved. Magnesium (Mg) is well known as a potential metallic material for degradable implants. The aim of the present in vitro study was to evaluate if degradable LAE442-based magnesium plate-screw-systems are suitable candidates for osteosynthesis implants in load-bearing bones. The corrosion behaviour was tested concerning the influence of different surface treatments, coatings and screw torques. Steel plates and screws of the same size served as control. Plates without special treatment screwed on up to a specified torque of 15cNm or 7cNm, NaOH treated plates (15cNm), magnesium fluoride coated plates (15cNm) and steel plates as control (15cNm) were examined in pH-buffered, temperature-controlled SBF solution for two weeks. The experimental results indicate that the LAE442 plates and screws coated with magnesium fluoride revealed a lower hydrogen evolution in SBF solution as well as a lower weight loss and volume decrease in μ-computed tomography (μCT). The nanoindentation and SEM/EDX measurements at several plate areas showed no significant differences. Summarized, the different screw torques did not affect the corrosion behaviour differently. Also the NaOH treatment seemed to have no essential influence on the degradation kinetics. The plates coated with magnesium fluoride showed a decreased corrosion rate. Hence, it is recommended to consider this coating for the next in vivo study. Copyright © 2015 Elsevier B.V. All rights reserved.

Analysis of plastic deformation in cortical bone after insertion of coated and non-coated self-tapping orthopaedic screws.

PubMed

Koistinen, A P; Korhonen, H; Kiviranta, I; Kröger, H; Lappalainen, R

2011-07-01

Insertion of internal fracture fixation devices, such as screws, mechanically weakens the bone. Diamond-like carbon has outstanding tribology properties which may decrease the amount of damage in tissue. The purpose of this study was to investigate methods for quantification of cortical bone damage after orthopaedic bone screw insertion and to evaluate the effect of surface modification on tissue damage. In total, 48 stainless steel screws were inserted into cadaver bones. Half of the screws were coated with a smooth amorphous diamond coating. Geometrical data of the bones was determined by peripheral quantitative computed tomography. Thin sections of the bone samples were prepared after screw insertion, and histomorphometric evaluation of damage was performed on images obtained using light microscopy. Micro-computed tomography and scanning electron microscopy were also used to examine tissue damage. A positive correlation was found between tissue damage and the geometric properties of the bone. The age of the cadaver significantly affected the bone mineral density, as well as the damage perimeter and diameter of the screw hole. However, the expected positive effect of surface modification was probably obscured by large variations in the results and, thus, statistically significant differences were not found in this study. This can be explained by natural variability in bone tissue, which also made automated image analysis difficult.

Connective Tissue Characteristics around Healing Abutments of Different Geometries: New Methodological Technique under Circularly Polarized Light.

PubMed

Delgado-Ruiz, Rafael Arcesio; Calvo-Guirado, Jose Luis; Abboud, Marcus; Ramirez-Fernandez, Maria Piedad; Maté-Sánchez de Val, José Eduardo; Negri, Bruno; Gomez-Moreno, Gerardo; Markovic, Aleksa

2015-08-01

To describe contact, thickness, density, and orientation of connective tissue fibers around healing abutments of different geometries by means of a new method using coordinates. Following the bilateral extraction of mandibular premolars (P2, P3, and P4) from six fox hound dogs and a 2-month healing period, 36 titanium implants were inserted, onto which two groups of healing abutments of different geometry were screwed: Group A (concave abutments) and Group B (wider healing abutment). After 3 months the animals were sacrificed and samples extracted containing each implant and surrounding soft and hard tissues. Histological analysis was performed without decalcifying the samples by means of circularly polarized light under optical microscope and a system of vertical and horizontal coordinates across all the connective tissue in an area delimited by the implant/abutment, epithelium, and bone tissue. In no case had the connective tissue formed a connection to the healing abutment/implant in the internal zone; a space of 35 ± 10 μm separated the connective tissue fibers from the healing abutment surface. The total thickness of connective tissue in the horizontal direction was significantly greater in the medial zone in Group B than in Group A (p < .05). The orientation of the fibers varied according to the coordinate area so that internal coordinates showed a higher percentage of parallel fibers in Group A (p < .05) and a higher percentage of oblique fibers in Group B (p < .05); medial coordinates showed more oblique fibers (p < .05); and the area of external coordinates showed the highest percentage of perpendicular fibers (p < .05). The fiber density was higher in the basal and medial areas (p < .05). Abutment geometry influences the orientation of collagen fibers; therefore, an abutment with a profile wider than the implant platform favors oblique and perpendicular orientation of collagen fibers and greater connective tissue thickness. © 2013 Wiley Periodicals, Inc.

Effect of cyclic load on vertical misfit of prefabricated and cast implant single abutment

PubMed Central

DE JESUS TAVAREZ, Rudys Rodolfo; BONACHELA, Wellington Cardoso; XIBLE, Anuar Antônio

2011-01-01

Objective The purpose of this in vitro study was to evaluate misfit alterations at the implant/abutment interface of external and internal connection implant systems when subjected to cyclic loading. Material and Methods Standard metal crowns were fabricated for 5 groups (n=10) of implant/abutment assemblies: Group 1, external hexagon implant and UCLA cast-on premachined abutment; Group 2, internal hexagon implant and premachined abutment; Group 3, internal octagon implant and prefabricated abutment; Group 4, external hexagon implant and UCLA cast-on premachined abutment; and Group 5, external hexagon implant and Ceraone abutment. For groups 1, 2, 3 and 5, the crowns were cemented on the abutments and in group 4 crowns were screwed directly on the implant. The specimens were subjected to 500,000 cycles at 19.1 Hz of frequency and non-axial load of 133 N in a MTS 810 machine. The vertical misfit (μm) at the implant/abutment interface was evaluated before (B) and after (A) application of the cyclic loading. Data were analyzed statistically by using two-away ANOVA and Tukey’s post-hoc test (p<0.05). Results Before loading values showed no difference among groups 2 (4.33±3.13), 3 (4.79±3.43) and 5 (3.86±4.60); between groups 1 (12.88±6.43) and 4 (9.67±3.08), and among groups 2, 3 and 4. However, groups 1 and 4 were significantly different from groups 2, 3 and 5. After loading values of groups 1 (17.28±8.77) and 4 (17.78±10.99) were significantly different from those of groups 2 (4.83±4.50), 3 (8.07±4.31) and 5 (3.81±4.84). There was a significant increase in misfit values of groups 1, 3 and 4 after cyclic loading, but not for groups 2 and 5. Conclusion The cyclic loading and type of implant/abutment connection may develop a role on the vertical misfit at the implant/abutment interface. PMID:21437464

An In Vitro Evaluation of the Loosening of Different Interchangeable Abutments in Internal-Connection-Type Implants.

PubMed

Park, Ji-Man; Baek, Chang-Hyun; Heo, Seong-Joo; Kim, Seong-Kyun; Koak, Jai-Young; Kim, Shin-Koo; Belser, Urs C

The aim of this study was to compare the loosening of interchangeable one-piece abutments connected to internal-connection-type implants after cyclic loading. Four implant abutment groups (n = 7 in each group) with Straumann tissue-level implants were assessed: Straumann solid abutment (group S), Southern Implants solid abutment (group SI), Implant Direct straight abutment (group ID), and Blue Sky Bio regular platform abutment (group BSB). The implant was firmly held in a special jig to ensure fixation. Abutment screws were tightened to manufacturers' recommended torque with a digital torque gauge. The hemispherical loading members were fabricated for the load cell of a universal testing machine to evenly distribute the force on the specimens and to fulfill the ISO 14801:2007 standard. A cyclic loading of 25 N at 30 degrees to the implant's long axis was applied for a duty of a half million cycles. Tightening torques were measured prior to the loading. Removal torques were measured after cyclic loading. The data were analyzed with one-way analysis of variance (ANOVA), and the significance level was set at P < .05. The mean removal torques after cyclic loading were 34.0 ± 1.1 Ncm (group S), 25.0 ± 1.5 Ncm (group SI), 23.9 ± 2.1 Ncm (group ID), and 27.9 ± 1.3 Ncm (group BSB). Removal torques of each group were statistically different in the order of group S > group BSB > groups SI and ID (P < .05). The mean reduction rates were -2.9% ± 3.2% (group S), -21.9% ± 4.8% (group SI), -20.2% ± 7.2% (group ID), and -6.9% ± 4.3% (group BSB) after a half million cycles, respectively. Reduction rates of groups S and BSB were statistically lower than those of groups SI and ID (P < .01). The standard deviation of group S was lower than group BSB. The removal torque of the original Straumann abutment was significantly higher than those of the copy abutments. The reduction rate of the groups S and BSB abutments was lower than those of the other copy abutments.

Comparison of 3D displacements of screw-retained zirconia implant crowns into implants with different internal connections with respect to screw tightening.

PubMed

Rebeeah, Hanadi A; Yilmaz, Burak; Seidt, Jeremy D; McGlumphy, Edwin; Clelland, Nancy; Brantley, William

2018-01-01

Internal conical implant-abutment connections without horizontal platforms may lead to crown displacement during screw tightening and torque application. This displacement may affect the proximal contacts and occlusion of the definitive prosthesis. The purpose of this in vitro study was to evaluate the displacement of custom screw-retained zirconia single crowns into a recently introduced internal conical seal implant-abutment connection in 3D during hand and torque driver screw tightening. Stereolithic acrylic resin models were printed using computed tomography data from a patient missing the maxillary right central incisor. Two different internal connection implant systems (both ∼11.5 mm) were placed in the edentulous site in each model using a surgical guide. Five screw-retained single zirconia computer-aided design and computer-aided manufacturing (CAD-CAM) crowns were fabricated for each system. A pair of high-resolution digital cameras was used to record the relationship of the crown to the model. The crowns were tightened according to the manufacturers' specifications using a torque driver, and the cameras recorded their relative position again. Three-dimensional image correlation was used to measure and compare crown positions, first hand tightened and then torque driven. The displacement test was repeated 3 times for each crown. Commercial image correlation software was used to extract the data and compare the amount of displacement vertically, mesiodistally, and buccolingually. Repeated-measures ANOVA calculated the relative displacements for all 5 specimens for each implant for both crown screw hand tightening and after applied torque. A Student t test with Bonferroni correction was used for pairwise comparison of interest to determine statistical differences between the 2 implants (α=.05). The mean vertical displacements were statistically higher than the mean displacements in the mesiodistal and buccolingual directions for both implants (P<.001). Mean displacements in all directions were statistically significant between iterations for both implants (P<.001). No statistically significant differences were found for displacements between implants at different directions and at different iterations (P>.05). Within the limitations of this in vitro study, screw-retained zirconia crowns tended to displace in all 3 directions, with the highest mean displacement in the vertical direction at iteration 1. However, the amount of displacement of crowns between the 2 different implants was statistically insignificant for all directions and iterations. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

PubMed Central

Kim, Ha-Young; Shin, Sang-Wan

2014-01-01

PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction. PMID:25352954

Effects of artificial aging conditions on yttria-stabilized zirconia implant abutments.

PubMed

Basílio, Mariana de Almeida; Cardoso, Kátia Vieira; Antonio, Selma Gutierrez; Rizkalla, Amin Sami; Santos Junior, Gildo Coelho; Arioli Filho, João Neudenir

2016-08-01

Most ceramic abutments are fabricated from yttria-stabilized tetragonal zirconia (Y-TZP). However, Y-TZP undergoes hydrothermal degradation, a process that is not well understood. The purpose of this in vitro study was to assess the effects of artificial aging conditions on the fracture load, phase stability, and surface microstructure of a Y-TZP abutment. Thirty-two prefabricated Y-TZP abutments were screwed and tightened down to external hexagon implants and divided into 4 groups (n = 8): C, control; MC, mechanical cycling (1×10(6) cycles; 10 Hz); AUT, autoclaving (134°C; 5 hours; 0.2 MPa); and TC, thermal cycling (10(4) cycles; 5°/55°C). A single-load-to-fracture test was performed at a crosshead speed of 0.5 mm/min to assess the assembly's resistance to fracture (ISO Norm 14801). X-ray diffraction (XRD) analysis was applied to observe and quantify the tetragonal-monoclinic (t-m) phase transformation. Representative abutments were examined with high-resolution scanning electron microscopy (SEM) to observe the surface characteristics of the abutments. Load-to-fracture test results (N) were compared by ANOVA and Tukey test (α=.05). XRD measurements revealed the monoclinic phase in some abutments after each aging condition. All the aging conditions reduced the fracture load significantly (P<.001). Mechanical cycling reduced the fracture load more than autoclaving (P=.034). No differences were found in the process of surface degradation among the groups; however, the SEM detected grinding-induced surface flaws and microcracks. The resistance to fracture and the phase stability of Y-TZP implant abutments were susceptible to hydrothermal and mechanical conditions. The surface microstructure of Y-TZP abutments did not change after aging conditions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Influence of finish line in the distribution of stress trough an all ceramic implant-supported crown.

PubMed Central

SANNINO, G.; GLORIA, F.; OTTRIA, L.; BARLATTANI, A.

2010-01-01

SUMMARY Porpose. The aim of this study was to evaluate, by finite element analysis (FEA), the influence of finish line on stress distribution and resistance to the loads of a ZrO2 crown and porcelain in implant-supported. Material and methods. The object of this analysis consisted of a fxture, an abutment, a passing screw, a layer of cement, a framework crown, a feldspatic porcelain veneering. The abutment’s marginal design was used in 3 different types of preparation: feather edge, slight chamfer and 50°, each of them was of 1 mm depth over the entire circumference. The ZrO2Y-TZP coping was 0.6 mm thick. Two material matching for the abutment and the framework was used for the simulations: ZrO2 framework and ZrO2 abutment, ZrO2 framework and T abutment. A 600 N axial force distributed over the entire surface of the crown was applied. The numerical simulations with finite elements were used to verify the different distribution of equivalent von Mises stress for three different geometries of abutment and framework. Results Slight chamfer on the matching ZrO2 - ZrO2 is the geometry with minimum equivalent stress of von Mises. Even for T abutment and ZrO2 framework slight chamfer is the best configuration to minimize the localized stress. Geometry that has the highest average stress is one with abutment at 50°, we see a downward trend for all three configurations using only zirconium for both components. Conclusions Finite element analysis. performed for the manifacturing of implant-supported crown, gives exact geometric guide lines about the choice of chamfer preparation, while the analysis of other marginal geometries suggests a possible improved behavior of the mating between ZrO2 abutment and ZrO2 coping. for three different geometries of the abutment and the coping. PMID:23285359

In vitro and in vivo corrosion, mechanical properties and biocompatibility evaluation of MgF2-coated Mg-Zn-Zr alloy as cancellous screws.

PubMed

Li, Zhen; Shizhao, Sun; Chen, Minfang; Fahlman, Bradley Dean; Debao Liu; Bi, Hongwei

2017-06-01

Magnesium (Mg) and its alloys as biodegradable materials have received much attention in the orthopedics applications; however, the corrosion behavior of these metals in vivo remains challenging. In this work, a dense and nanoscale magnesium fluoride (MgF 2 ) coating was deposited on the surface of Mg-Zn-Zr (MZZ) alloy cancellous screw. The MZZ cancellous screw with MgF 2 coating maintained an integrated shape and high yield tensile stress after 30days immersion in SBF, comparing with the bare screw. Hydrogen releasing rate of the MZZ samples was suppressed at a lower level at the initial stage, which is in favour of the adhesion of the cells. And in vivo experiments indicated that MgF 2 -coated MZZ screws presented advantages in cytocompatibility, osteoconductivity and osteogenesis of cancellous bone in rabbits. Corrosion rate in vivo perfusion environment increased very slowly with time in long-term study, which was an opposite trend in vitro static immersion test. Moreover, maximum corrosion rate (CR max ), a critical calculation method of corrosion rate was introduced to predict fracture regions of the sample. The MZZ alloy with MgF 2 coating possesses a great potential for clinical applications for internal fracture fixation repair. Copyright © 2017 Elsevier B.V. All rights reserved.

77 FR 64505 - Archon Energy 1, Inc.; Notice of Preliminary Permit Application Accepted for Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

.... The proposed project would consist of the following: (1) A new gated water intake structure and canal adjacent to the north abutment of the existing dam; (2) a 70-foot by 55-foot by 35-foot turbine structure enclosing five 400-kilowatt Archimedes-screw-type turbines, each 13 feet in diameter and 45 feet in length...

Microleakage of different sealing materials in access holes of internal connection implant systems.

PubMed

Park, Sung-Do; Lee, Yoon; Kim, Yu-Lee; Yu, Sang-Hui; Bae, Ji-Myung; Cho, Hye-Won

2012-09-01

Current implant systems cannot completely prevent microleakage from the access holes of screw-retained implant prostheses, which may constitute risks to the clinical success of the implants. The purpose of this study was to evaluate the levels of microleakage through the access holes of screw-retained implant prostheses sealed with different materials. An implant with an internal hexagonal configuration was connected to a temporary abutment with an acrylic resin crown. The apical 6.5 mm of the access hole was filled with 1 of the following materials: cotton pellet, silicone sealing material, vinyl polysiloxane, or gutta-percha. The remaining coronal 3 mm was sealed with composite resin. Cyclic loading with 21 N at 1 Hz was applied 16,000 times to the specimens in 0.5% basic fuchsin solution according to the long axis of the tooth. Basic fuchsin dye which penetrated into the internal wall of the abutment through the access hole was dissolved with methyl alcohol. Then the absorbance was measured by a spectrophotometer at 540 nm to evaluate the degree of microleakage. The results were statistically analyzed with 1-way ANOVA and the Tukey HSD test. From greatest to least, the levels of microleakage were in the following order: cotton pellet, silicone sealing material, vinyl polysiloxane, and gutta-percha. The microleakage associated with gutta-percha was not significantly different from that of vinyl polysiloxane. When sealing the access holes of screw-retained implant prostheses, gutta-percha or vinyl polysiloxane would help reduce microleakage. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Displacement of screw-retained single crowns into implants with conical internal connections.

PubMed

Yilmaz, Burak; Seidt, Jeremy D; McGlumphy, Edwin A; Clelland, Nancy L

2013-01-01

Internal conical implant-abutment connections without platforms may lead to axial displacement of crowns during screw tightening. This displacement may affect proximal contacts, incisal edge position, or occlusion. This study aimed to measure the displacement of screw-retained single crowns into an implant in three dimensions during screw tightening by hand or via torque driver. A stereolithic acrylic resin cast was created using computed tomography data from a patient missing the maxillary right central incisor. A 4.0- × 11-mm implant was placed in the edentulous site. Five porcelain-fused-to-metal single crowns were made using "cast-to" abutments. Crowns were tried on the stereolithic model, representing the patient, and hand tightened. The spatial relationship of crowns to the model after hand tightening was determined using three-dimensional digital image correlation (3D DIC), an optical measurement technique. The crowns were then tightened using a torque driver to 20 Ncm and the relative crown positions were again recorded. Testing was repeated three times for each crown, and displacement of the crowns was compared between the hand-tightened and torqued states. Commercial image correlation software was used to analyze the data. Mean vertical and horizontal crown displacement values were calculated after torqueing. The interproximal contacts were evaluated before and after torquing using an 8-μm aluminum foil shim. There were vertical and horizontal differences in crown positions between hand tightening and torqueing. Although these were small in magnitude, detectable displacements occurred in both apical and facial directions. After hand tightening, the 8-μm shim could be dragged without tearing. However, after torque tightening, the interproximal contacts were too tight and the 8-μm shim could not be dragged without tearing. Differences between hand tightening and torque tightening should be taken into consideration during laboratory and clinical adjustments to prevent esthetic and functional complications.

In vivo bioactivity of titanium and fluorinated apatite coatings for orthopaedic implants: a vibrational study

NASA Astrophysics Data System (ADS)

Taddei, Paola; Tinti, Anna; Reggiani, Matteo; Monti, Patrizia; Fagnano, Concezio

2003-06-01

The bone integration of implants is a complex process which depends on chemical composition and surface morphology. To accelerate osteointegration, metal implants are coated with porous metal or apatites which have been reported to increase mineralisation, improving prosthesis fixation. To study the influence of composition and morphology on the in vivo bioactivity, titanium screws coated by Plasma Flame Spraying (PFS) with titanium or fluorinated apatite (K690) were implanted in sheep tibia and femur for 10 weeks and studied by micro-Raman and IR spectroscopy. The same techniques, together with thermogravimetry, were used for characterising the pre-coating K690 powder. Contrary to the manufacturer report, the K690 pre-coating revealed to be composed of a partially fluorinated apatite containing impurities of Ca(OH) 2 and CaCO 3. By effect of PFS, the impurities were decomposed and the crystallinity degree of the coating was found to decrease. The vibrational spectra recorded on the implanted screws revealed the presence of newly formed bone; for the K690-coated screws at least, a high level of osteointegration was evidenced.

Tolerance measurements on internal- and external-hexagon implants.

PubMed

Braian, Michael; De Bruyn, Hugo; Fransson, Håkan; Christersson, Cecilia; Wennerberg, Ann

2014-01-01

To measure the horizontal machining tolerances of the interface between internal- and external-hexagon implants and analogs with corresponding components after delivery from the manufacturer. These values may be a valuable tool for evaluating increasing misfit caused by fabrication, processing, and wear. Seven implants and seven analogs with external- and internal-hexagon connections (Biomet 3i) with corresponding prefabricated gold cylinders and gold screws, prefabricated cylindric plastic cylinders, and laboratory screws were studied. One set of components from the external and internal groups was measured manually and digitally. Measurements from the test subjects were compared with identical measurements from the virtual model to obtain threshold values. The virtual model was then used to obtain optimally oriented cuts. The horizontal machining tolerances for castable plastic abutments on external implants were 12 ± 89 μm, and for internal implants they were 86 ± 47 μm. Tolerance measurements on prefabricated gold abutments for external implants were 44 ± 9 μm, and for internal implants they were 58 ± 28 μm. The groups with metallic components showed the smallest tolerance at < 50 μm for the external group and < 90 μm for the internal group. The prefabricated plastic cylinder groups ranged from < 100 μm for external and < 130 μm for internal connection.

The Accuracy of New and Aged Mechanical Torque Devices Employed in Five Dental Implant Systems.

PubMed

Erdem, Mehmet Ali; Karatasli, Burcin; Dinçer Kose, Onur; Kose, Taha Emre; Çene, Erhan; Aydın Aya, Serhan; Cankaya, Abdulkadir Burak

2017-01-01

Friction-style and spring-style torque wrenches are used to tighten implant abutments and prosthetic screws. The mechanical stability of these torque wrenches is crucial for the implant-abutment connection. The purposes of this study were to assess the performance of five brands (Straumann, Zimmer, Implant KA, Bredent, and Biohorizons) of wrench and to evaluate possible changes in applied torque values of aged wrenches. Five new and aged wrenches that had been used approximately 250 times in a 1-year period were tested. The torque applied by friction- and spring-style wrenches was measured with a specially designed strain gauge indicator. Descriptive statistics, the one-sample t -test, and the independent-samples t -test were used to analyze values obtained from all torque wrenches. The accuracy of new and aged torque devices of all brands except Bredent differed significantly from the target values, but the mean values for aged and new wrenches did not differ significantly from each other ( p > 0.05). Values for the spring- and friction-type torque wrenches deviated from the target values by 11.6% and 10.2%, respectively. The accuracy of aged torque wrenches is adequate for prosthetic screw tightening, but that of new torque wrenches is unsatisfactory and must be examined carefully before delivery.

Dynamic locking screw improves fixation strength in osteoporotic bone: an in vitro study on an artificial bone model.

PubMed

Pohlemann, Tim; Gueorguiev, Boyko; Agarwal, Yash; Wahl, Dieter; Sprecher, Christoph; Schwieger, Karsten; Lenz, Mark

2015-04-01

The novel dynamic locking screw (DLS) was developed to improve bone healing with locked-plate osteosynthesis by equalising construct stiffness at both cortices. Due to a theoretical damping effect, this modulated stiffness could be beneficial for fracture fixation in osteoporotic bone. Therefore, the mechanical behaviour of the DLS at the screw-bone interface was investigated in an artificial osteoporotic bone model and compared with conventional locking screws (LHS). Osteoporotic surrogate bones were plated with either a DLS or a LHS construct consisting of two screws and cyclically axially loaded (8,500 cycles, amplitude 420 N, increase 2 mN/cycle). Construct stiffness, relative movement, axial screw migration, proximal (P) and distal (D) screw pullout force and loosening at the bone interface were determined and statistically evaluated. DLS constructs exhibited a higher screw pullout force of P 85 N [standard deviation (SD) 21] and D 93 N (SD 12) compared with LHS (P 62 N, SD 28, p = 0.1; D 57 N, SD 25, p < 0.01) and a significantly lower axial migration over cycles compared with LHS (p = 0.01). DLS constructs showed significantly lower axial construct stiffness (403 N/mm, SD 21, p < 0.01) and a significantly higher relative movement (1.1 mm, SD 0.05, p < 0.01) compared with LHS (529 N/mm, SD 27; 0.8 mm, SD 0.04). Based on the model data, the DLS principle might also improve in vivo plate fixation in osteoporotic bone, providing enhanced residual holding strength and reducing screw cutout. The influence of pin-sleeve abutment still needs to be investigated.

Comparison of the fracture resistance of dental implants with different abutment taper angles.

PubMed

Wang, Kun; Geng, Jianping; Jones, David; Xu, Wei

2016-06-01

To investigate the effects of abutment taper angles on the fracture strength of dental implants with TIS (taper integrated screwed-in) connection. Thirty prototype cylindrical titanium alloy 5.0mm-diameter dental implants with different TIS-connection designs were divided into six groups and tested for their fracture strength, using a universal testing machine. These groups consisted of combinations of 3.5 and 4.0 mm abutment diameter, each with taper angles of 6°, 8° or 10°. 3-Dimensional finite element analysis (FEA) was also used to analyze stress states at implant-abutment connection areas. In general, the mechanical tests found an increasing trend of implant fracture forces as the taper angle enlarged. When the abutment diameter was 3.5 mm, the mean fracture forces for 8° and 10° taper groups were 1638.9 N ± 20.3 and 1577.1 N ± 103.2, respectively, both larger than that for the 6° taper group of 1475.0 N ± 24.4, with the largest increasing rate of 11.1%. Furthermore, the difference between 8° and 6° taper groups was significant, based on Tamhane's multiple comparison test (P<0.05). In 4.0 mm-diameter abutment groups, as the taper angle was enlarged from 6° to 8° and 10°, the mean fracture value was increased from 1066.7 N ± 56.1 to 1241.4 N ± 6.4 and 1419.3 N ± 20.0, with the largest increasing rate of 33.1%, and the differences among the three groups were significant (P<0.05). The FEA results showed that stress values varied in implants with different abutment taper angles and supported the findings of the static tests. In conclusion, increases of the abutment taper angle could significantly increase implant fracture resistance in most cases established in the study, which is due to the increased implant wall thickness in the connection part resulting from the taper angle enlargement. The increasing effects were notable when a thin implant wall was present to accommodate wide abutments. Copyright © 2016 Elsevier B.V. All rights reserved.

Implant-level prostheses in the edentulous maxilla: a comparison with conventional abutment-level prostheses after 5 years of use.

PubMed

Hjalmarsson, Lars; Smedberg, Jan-Ivan; Pettersson, Mattias; Jemt, Torsten

2011-01-01

Long-term comparisons of frameworks at the implant or abutment level are not available, and knowledge of the clinical function of cobalt-chromium (Co-Cr) alloy frameworks is limited. Primarily, the aim of this study was to compare the 5-year clinical performance of frameworks with or without abutment connections to implants. Secondly, the outcomes of prostheses made from Co-Cr alloy with porcelain veneers to those made of commercially pure titanium (CP Ti) with acrylic veneers were compared. The test groups comprised patients treated with screw-retained fixed prostheses made at the implant level according to the Cresco method in either dental porcelain-veneered Co-Cr alloy (n = 15) or acrylic-veneered CP Ti (n = 25). A control group of 40 randomly selected patients were provided with prostheses made at the standard abutment level in CP Ti with acrylic veneers. For all patients, clinical and radiologic 5-year data were retrospectively collected and evaluated. Five-year implant cumulative survival rates (CSRs) were 98.6% and 97.6% for test and control groups, respectively (P > .05). No major differences in bone level were demonstrated between the groups after 5 years (P > .05). Significantly more complications occurred in the test groups compared to the control group (P < .01), with the most common complications being mucositis and fracture of veneers. After 5 years, the clinical outcomes of implant-level prostheses made of porcelain-veneered Co-Cr or acrylic-veneered CP Ti seem comparable to acrylic-veneered titanium prostheses made at the standard abutment level regarding implant CSR and bone levels. However, more complications were registered in implant-level prostheses compared to the standard abutment-level prostheses.

Fracture resistance of implant- supported monolithic crowns cemented to zirconia hybrid-abutments: zirconia-based crowns vs. lithium disilicate crowns

PubMed Central

Nawafleh, Noor; Öchsner, Andreas; George, Roy

2018-01-01

PURPOSE The aim of this in vitro study was to investigate the fracture resistance under chewing simulation of implant-supported posterior restorations (crowns cemented to hybrid-abutments) made of different all-ceramic materials. MATERIALS AND METHODS Monolithic zirconia (MZr) and monolithic lithium disilicate (MLD) crowns for mandibular first molar were fabricated using computer-aided design/computer-aided manufacturing technology and then cemented to zirconia hybrid-abutments (Ti-based). Each group was divided into two subgroups (n=10): (A) control group, crowns were subjected to single load to fracture; (B) test group, crowns underwent chewing simulation using multiple loads for 1.2 million cycles at 1.2 Hz with simultaneous thermocycling between 5℃ and 55℃. Data was statistically analyzed with one-way ANOVA and a Post-Hoc test. RESULTS All tested crowns survived chewing simulation resulting in 100% survival rate. However, wear facets were observed on all the crowns at the occlusal contact point. Fracture load of monolithic lithium disilicate crowns was statistically significantly lower than that of monolithic zirconia crowns. Also, fracture load was significantly reduced in both of the all-ceramic materials after exposure to chewing simulation and thermocycling. Crowns of all test groups exhibited cohesive fracture within the monolithic crown structure only, and no abutment fractures or screw loosening were observed. CONCLUSION When supported by implants, monolithic zirconia restorations cemented to hybrid abutments withstand masticatory forces. Also, fatigue loading accompanied by simultaneous thermocycling significantly reduces the strength of both of the all-ceramic materials. Moreover, further research is needed to define potentials, limits, and long-term serviceability of the materials and hybrid abutments. PMID:29503716

Influence of space size of abutment screw access channel on the amount of extruded excess cement and marginal accuracy of cement-retained single implant restorations.

PubMed

Al Amri, Mohammad D; Al-Johany, Sulieman S; Al-Qarni, Mohammed N; Al-Bakri, Ahmed S; Al-Maflehi, Nassr S; Abualsaud, Haythem S

2018-02-01

The detrimental effect of extruded excess cement on peri-implant tissue has been well documented. Although several techniques have been proposed to reduce this effect by decreasing the amount of extruded cement, how the space size of the abutment screw access channel (SAC) affects the amount of extruded cement and marginal accuracy is unclear. The purpose of this in vitro study was to evaluate the effect of the size of the unfilled space of the abutment SAC on the amount of extruded excess cement and the marginal accuracy of zirconia copings. Twelve implant replicas and corresponding standard abutments were attached and embedded in acrylic resin blocks. Computer-aided design and computer-aided manufacturing (CAD-CAM) zirconia copings with a uniform 30-μm cement space were fabricated by 1 dental technician using the standard method. The copings were temporarily cemented 3 times at different sizes of the left space of the SAC as follows: the nonspaced group (NS), in which the entire SAC was completely filled, the 1-mm-spaced group (1MMS), and the 2-mm-spaced group (2MMS). Abutments and crowns were ultrasonically cleaned, steam cleaned, and air-dried. The excess cement was collected and weighed. To measure the marginal accuracy, 20 measurements were made every 18 degrees along the coping margin at ×300 magnification and compared with the pre-cementation readings. One-way ANOVA was calculated to determine whether the amount of extruded excess cement differed among the 3 groups, and the Tukey test was applied for multiple comparisons (α=.05). The mean weights (mg) of extruded excess cement were NS (33.53 ±1.5), 1MMS (22.97 ±5.4), and 2MMS (15.17 ±5.9). Multiple comparisons showed significant differences in the amount of extruded excess cement among the 3 test groups (P<.001). The mean marginal discrepancy (μm) of the pre-cemented group (29.5 ±8.2) was significantly different (P<.01) from that of the NS (72.3 ±13.7), the 1MMS (70.1 ±19), and the 2MMS group (70.1 ±18.8). No significant differences were found in marginal accuracy among the 3 test groups (P=.942). Within the limitations of this in vitro study, leaving a 2-mm space in the SAC reduced the amount of extruded excess cement by 55% in comparison with the nonspaced abutments. However, no effect was found on the marginal accuracy of zirconia copings. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Influence of Abutment Color and Mucosal Thickness on Soft Tissue Color.

PubMed

Ferrari, Marco; Carrabba, Michele; Vichi, Alessandro; Goracci, Cecilia; Cagidiaco, Maria Crysanti

Zirconia (ZrO₂) and titanium nitride (TiN) implant abutments were introduced mainly for esthetic purposes, as titanium's gray color can be visible through mucosal tissues. This study was aimed at assessing whether ZrO₂ and TiN abutments could achieve better esthetics in comparison with titanium (Ti) abutments, regarding the appearance of soft tissues. Ninety patients were included in the study. Each patient was provided with an implant (OsseoSpeed, Dentsply Implant System). A two-stage surgical technique was performed. Six months later, surgical reentry was performed. After 1 week, provisional restorations were screwed onto the implants. After 8 weeks, implant-level impressions were taken and soft tissue thickness was recorded, ranking thin (≤ 2 mm) or thick (≥ 2 mm). Patients were randomly allocated to three experimental groups, based on abutment type: (1) Ti, (2) TiN, and (3) ZrO₂. After 15 weeks, the final restorations were delivered. The mucosal area referring to each abutment was measured for color using a clinical spectrophotometer (Easyshade, VITA); color measurements of the contralateral areas referring to natural teeth were performed at the same time. The data were collected using the Commission Internationale de l'Eclairage (CIE) L*a*b* color system, and ΔE was calculated between peri-implant and contralateral soft tissues. A critical threshold of ΔE = 3.7 was selected. The chi-square test was used to identify statistically significant differences in ΔE between thin and thick mucosal tissues and among the abutment types. Three patients were lost at follow-up. No statistically significant differences were noticed as to the abutment type (P = .966). Statistically significant differences in ΔE were recorded between thick and thin peri-implant soft tissues (P < .001). Only 2 out of 64 patients with thick soft tissues showed a ΔE higher than 3.7: 1 in the TiN group and 1 in the ZrO₂ group. All the patients with thin soft tissues reported color changes that exceeded the critical threshold. The different abutment materials showed comparable results in terms of influence on soft tissue color. Regarding peri-implant soft tissue thickness, the influence of the tested abutments on soft tissue color became clinically relevant for values ≤ 2 mm.

Pre-load on oral implants after screw tightening fixed full prostheses: an in vivo study.

PubMed

Duyck, J; Van Oosterwyck, H; Vander Sloten, J; De Cooman, M; Puers, R; Naert, I

2001-03-01

The fit of implant supported fixed prostheses is said to be of clinical concern because of the rigid fixation of an oral implant in its surrounding bone. The influence of the torque sequence of the set screws during fixation of implant supported fixed full prostheses on the final pre-load was investigated in vitro. No significant effect of the torque sequence of the set screws on the final pre-load was observed. The main objective of this study was to quantify and qualify the pre-load in vivo on implants supporting a fixed full prosthesis. This was performed when the prostheses were supported by all five or six implants and was repeated when the prostheses were supported by only four and three implants. A total of 13 patients with a fixed full implant supported prosthesis were selected. The existing abutments were changed for strain gauged abutments. After tightening the set screws with a torque of 10 N cm, the pre-load conditions were registered. The average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 323 N (43 N), 346 N (59 N), 307 N (60 N) 21 N cm (3 N cm) and 21 N cm (2 N cm), 23 N cm (5 N cm), respectively. In addition, the pre-load was registered after fixation of a machined gold cylinder, as delivered by the manufacturer, on each of the supporting implants, representing the 'optimal fit' situation. The corresponding average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 426 N (36 N), 405 N (40 N), 413 N (46 N) and 8 N cm (1 N cm), 8 N cm (1 N cm), 8 N cm (1 N cm), respectively. The induced axial forces after tightening the prostheses were significantly lower then after tightening the gold cylinder in case of five or six supporting implants (P < 0.02). The induced bending moments after tightening the prostheses were statistically significantly higher (P < 0.0001) then after tightening the gold cylinder in all test conditions (five or six, four or three supporting implants). This study underlines the static load present after screw tightening implant supported fixed full prostheses.

The role of welding techniques in the biomechanical behavior of implant-supported prostheses.

PubMed

Rodrigues, Sabrina Alessandra; Presotto, Anna Gabriella Camacho; Barão, Valentim Adelino Ricardo; Consani, Rafael Leonardo Xediek; Nóbilo, Mauro Antônio Arruda; Mesquita, Marcelo Ferraz

2017-09-01

This in vitro study investigated the role of welding techniques of implant-supported prostheses in the 2D and 3D marginal misfits of prosthetic frameworks, strain induced on the mini abutment, and detorque of prosthetic screws. The correlations between the analyzed variables were also investigated. Frameworks were cast in commercially pure titanium (cp-Ti). A marginal misfit of 200μm was simulated in the working models (control group) (n=20). The 2D marginal misfit was analyzed according to the single-screw test protocol using a precision optical microscope. The 3D marginal misfit was performed by X-ray microtomography. Strain gauge analysis was performed to investigate the strain induced on the mini abutment. A digital torque meter was used for analysis of the detorque and the mean value was calculated for each framework. Afterwards, the frameworks were divided into two experimental groups (n=10): Laser (L) and TIG (T). The welding techniques were performed according to the following parameters: L (390V/9ms); T (36A/60ms). The L and T groups were reevaluated according to the marginal misfit, strain, and detorque. The results were submitted to one-way ANOVA followed by Tukey's HSD test and Person correlation analysis (α=0.05). Welding techniques statistically reduced the 2D and 3D marginal misfits of prosthetic frameworks (p<0.001), the strain induced on the mini abutment replicas (p=0.006), and improved the screw torque maintenance (p<0.001). Similar behavior was noted between L and T groups for all dependent variables (p>0.05). Positive correlations were observed between 2D and 3D marginal misfit reading methods (r=0.943, p<0.0001) and between misfit and strain (2D r=0.844, p<0.0001 and 3D r=0.864, p<0.0001). Negative correlation was observed between misfit and detorque (2D r=-0.823, p=0.003 and 3D r=-0.811, p=0.005). In conclusion, the welding techniques improved the biomechanical behavior of the implant-supported system. TIG can be an acceptable and affordable technique to reduce the misfit of 3-unit Ti frameworks. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of technique and impression material on the vertical misfit of a screw-retained, three-unit implant bridge: An in vitro study

PubMed Central

Haghi, Hamidreza Rajati; Shiehzadeh, Masoud; Nakhaei, Mohammadreza; Ahrary, Fatemeh; Sabzevari, Saeid

2017-01-01

Introduction: A dental impression is a negative imprint of an oral structure that can be used to produce a positive cast of a patient's teeth as a permanent record. The accuracy of the impression affects the accuracy of the cast, and a precise impression is needed in order to create prosthesis with optimal fitting. Minimization of misfit is an important aim in prosthesis science and dental implants. The aim of this study was to evaluate the effects of the materials and techniques used to take an impression on the vertical misfit of implant-supported, screw-retained, three-unit bridges. Materials and Methods: The principal model used was an acrylic block with two ITI implants. A 1.5-mm abutment was attached to fixtures with torque of 25 N.cm. A base-metal framework was built on the abutment in the acrylic block. The abutments of the acrylic model were unscrewed and fixture-level impressions were made. The impression techniques included open/closed-tray techniques and the impression materials were polyether and polyvinyl siloxane. Forty acrylic custom trays were built for each impression. The marginal gap in the framework at three points (buccal, lingual, and distal) was measured using an optical microscope with ×250. Results: It is demonstrated that in all 360 evaluated samples, the mean vertical misfit in polyether samples of molar and premolar teeth was significantly lower than in polyvinyl siloxane (P < 0.001 and P = 0.017, respectively) in all three locations of the molar and lingual premolar examined (buccal, lingual, and distal), the mean vertical misfit of the polyether samples was significantly lower than those of polyvinyl siloxane (P < 0.01). On the other hand, although the mean vertical misfit using the open-tray technique in the molar teeth was significantly lower than with the closed-tray method (P = 0.002), no statistical difference was seen between the open-tray and closed-tray technique in general (P = 0.87). Conclusion: Within the limitations of this study, the following conclusions can be drawn: The impression method had no effect on marginal discrepancy of 3-unit screw retained fixed partial dentures. A higher marginal accuracy was obtained using polyether impression material compared to polyvinyl siloxane. PMID:28216844

Oral mucosa tissue response to titanium cover screws.

PubMed

Olmedo, Daniel G; Paparella, María L; Spielberg, Martín; Brandizzi, Daniel; Guglielmotti, María B; Cabrini, Rómulo L

2012-08-01

Titanium is the most widely used metal in dental implantology. The release of particles from metal structures into the biologic milieu may be the result of electrochemical processes (corrosion) and/or mechanical disruption during insertion, abutment connection, or removal of failing implants. The aim of the present study is to evaluate tissue response of human oral mucosa adjacent to titanium cover screws. One hundred fifty-three biopsies of the supra-implant oral mucosa adjacent to the cover screw of submerged dental implants were analyzed. Histologic studies were performed to analyze epithelial and connective tissue as well as the presence of metal particles, which were identified using microchemical analysis. Langerhans cells, macrophages, and T lymphocytes were studied using immunohistochemical techniques. The surface of the cover screws was evaluated by scanning electron microscopy (SEM). Forty-one percent of mucosa biopsies exhibited metal particles in different layers of the section thickness. Particle number and size varied greatly among specimens. Immunohistochemical study confirmed the presence of macrophages and T lymphocytes associated with the metal particles. Microchemical analysis revealed the presence of titanium in the particles. On SEM analysis, the surface of the screws exhibited depressions and irregularities. The biologic effects seen in the mucosa in contact with the cover screws might be associated with the presence of titanium or other elements, such as aluminum or vanadium. The potential long-term biologic effects of particles on soft tissues adjacent to metallic devices should be further investigated because these effects might affect the clinical outcome of the implant.

Resistance of three implant-abutment interfaces to fatigue testing

PubMed Central

RIBEIRO, Cleide Gisele; MAIA, Maria Luiza Cabral; SCHERRER, Susanne S.; CARDOSO, Antonio Carlos; WISKOTT, H. W. Anselm

2011-01-01

The design and retentive properties of implant-abutment connectors affect the mechanical resistance of implants. A number of studies have been carried out to compare the efficacy of connecting mechanisms between abutment and fixture. Objectives The aims of this study were: 1) to compare 3 implant-abutment interfaces (external hexagon, internal hexagon and cone-in-cone) regarding the fatigue resistance of the prosthetic screw, 2) to evaluate the corresponding mode of failure, and 3) to compare the results of this study with data obtained in previous studies on Nobel Biocare and Straumann connectors. Materials and Methods In order to duplicate the alternating and multivectorial intraoral loading pattern, the specimens were submitted to the rotating cantilever beam test. The implants, abutments and restoration analogs were spun around their longitudinal axes while a perpendicular force was applied to the external end. The objective was to determine the force level at which 50% of the specimens survived 106 load cycles. The mean force levels at which 50% failed and the corresponding 95% confidence intervals were determined using the staircase procedure. Results The external hexagon interface presented better than the cone-in-cone and internal hexagon interfaces. There was no significant difference between the cone-in-cone and internal hex interfaces. Conclusion Although internal connections present a more favorable design, this study did not show any advantage in terms of strength. The external hexagon connector used in this study yielded similar results to those obtained in a previous study with Nobel Biocare and Straumann systems. However, the internal connections (cone-in-cone and internal hexagon) were mechanically inferior compared to previous results. PMID:21710094

Stress Distribution in Single Dental Implant System: Three-Dimensional Finite Element Analysis Based on an In Vitro Experimental Model.

PubMed

Rezende, Carlos Eduardo Edwards; Chase-Diaz, Melody; Costa, Max Doria; Albarracin, Max Laurent; Paschoeto, Gabriela; Sousa, Edson Antonio Capello; Rubo, José Henrique; Borges, Ana Flávia Sanches

2015-10-01

This study aimed to analyze the stress distribution in single implant system and to evaluate the compatibility of an in vitro model with finite element (FE) model. The in vitro model consisted of Brånemark implant; multiunit set abutment of 5 mm height; metal-ceramic screw-retained crown, and polyurethane simulating the bone. Deformations were recorded in the peri-implant region in the mesial and distal aspects, after an axial 300 N load application at the center of the occlusal aspect of the crown, using strain gauges. This in vitro model was scanned with micro CT to design a three-dimensional FE model and the strains in the peri-implant bone region were registered to check the compatibility between both models. The FE model was used to evaluate stress distribution in different parts of the system. The values obtained from the in vitro model (20-587 με) and the finite element analysis (81-588 με) showed agreement among them. The highest stresses because of axial and oblique load, respectively were 5.83 and 40 MPa for the cortical bone, 55 and 1200 MPa for the implant, and 80 and 470 MPa for the abutment screw. The FE method proved to be effective for evaluating the deformation around single implant. Oblique loads lead to higher stress concentrations.

The Accuracy of New and Aged Mechanical Torque Devices Employed in Five Dental Implant Systems

PubMed Central

Karatasli, Burcin; Dinçer Kose, Onur; Kose, Taha Emre; Çene, Erhan; Aydın Aya, Serhan

2017-01-01

Purpose Friction-style and spring-style torque wrenches are used to tighten implant abutments and prosthetic screws. The mechanical stability of these torque wrenches is crucial for the implant–abutment connection. The purposes of this study were to assess the performance of five brands (Straumann, Zimmer, Implant KA, Bredent, and Biohorizons) of wrench and to evaluate possible changes in applied torque values of aged wrenches. Materials and Methods Five new and aged wrenches that had been used approximately 250 times in a 1-year period were tested. The torque applied by friction- and spring-style wrenches was measured with a specially designed strain gauge indicator. Descriptive statistics, the one-sample t-test, and the independent-samples t-test were used to analyze values obtained from all torque wrenches. Results The accuracy of new and aged torque devices of all brands except Bredent differed significantly from the target values, but the mean values for aged and new wrenches did not differ significantly from each other (p > 0.05). Values for the spring- and friction-type torque wrenches deviated from the target values by 11.6% and 10.2%, respectively. Conclusion The accuracy of aged torque wrenches is adequate for prosthetic screw tightening, but that of new torque wrenches is unsatisfactory and must be examined carefully before delivery. PMID:29238725

Marginal discrepancy of CAD-CAM complete-arch fixed implant-supported frameworks.

PubMed

Yilmaz, Burak; Kale, Ediz; Johnston, William M

2018-02-21

Computer-aided design and computer-aided manufacturing (CAD-CAM) high-density polymers (HDPs) have recently been marketed for the fabrication of long-term interim implant-supported fixed prostheses. However, information regarding the precision of fit of CAD-CAM HDP implant-supported complete-arch screw-retained prostheses is scarce. The purpose of this in vitro study was to evaluate the marginal discrepancy of CAD-CAM HDP complete-arch implant-supported screw-retained fixed prosthesis frameworks and compare them with conventional titanium (Ti) and zirconia (Zir) frameworks. A screw-retained complete-arch acrylic resin prototype with multiunit abutments was fabricated on a typodont model with 2 straight implants in the anterior region and 2 implants with a 30-degree distal tilt in the posterior region. A 3-dimensional (3D) laboratory laser scanner was used to digitize the typodont model with scan bodies and the resin prototype to generate a virtual 3D CAD framework. A CAM milling unit was used to fabricate 5 frameworks from HDP, Ti, and Zir blocks. The 1-screw test was performed by tightening the prosthetic screw in the maxillary left first molar abutment (terminal location) when the frameworks were on the typodont model, and the marginal discrepancy of frameworks was evaluated using an industrial computed tomographic scanner and a 3D volumetric software. The 3D marginal discrepancy at the abutment-framework interface of the maxillary left canine (L1), right canine (L2), and right first molar (L3) sites was measured. The mean values for 3D marginal discrepancy were calculated for each location in a group with 95% confidence limits. The results were analyzed by repeated-measures 2-way ANOVA using the restricted maximum likelihood estimation and the Satterthwaite degrees of freedom methods, which do not require normality and homoscedasticity in the data. The between-subjects factor was material, the within-subjects factor was location, and the interaction was included in the model. Tukey tests were applied to resolve any statistically significant source of variation (overall α=.05). The 3D marginal discrepancy measurement was possible only for L2 and L3 because the L1 values were too small to detect. The mean discrepancy values at L2 were 60 μm for HDP, 74 μm for Ti, and 84 μm for Zir. At the L3 location, the mean discrepancy values were 55 μm for HDP, 102 μm for Ti, and 94 μm for Zir. The ANOVA did not find a statistically significant overall effect for implant location (P=.072) or a statistically significant interaction of location and material (P=.078), but it did find a statistically significant overall effect of material (P=.019). Statistical differences were found overall between HDP and the other 2 materials (P≤.037). When the tested materials were used with the CAD-CAM system, the 3D marginal discrepancy of CAD-CAM HDP frameworks was smaller than that of titanium or zirconia frameworks. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Effect of feldspathic porcelain layering on the marginal fit of zirconia and titanium complete-arch fixed implant-supported frameworks.

PubMed

Yilmaz, Burak; Alshahrani, Faris A; Kale, Ediz; Johnston, William M

2018-02-06

Veneering with porcelain may adversely affect the marginal fit of long-span computer-aided design and computer-aided manufacturing (CAD-CAM) implant-supported fixed prostheses. Moreover, data regarding the precision of fit of CAD-CAM-fabricated implant-supported complete zirconia fixed dental prostheses (FDPs) before and after porcelain layering are limited. The purpose of this in vitro study was to evaluate the effect of porcelain layering on the marginal fit of CAD-CAM-fabricated complete-arch implant-supported, screw-retained FDPs with presintered zirconia frameworks compared with titanium. An autopolymerizing acrylic resin-fixed complete denture framework prototype was fabricated on an edentulous typodont master model (all-on-4 concept; Nobel Biocare) with 2 straight in the anterior and 2 distally tilted internal-hexagon dental implants in the posterior with multiunit abutments bilaterally in canine and first molar locations. A 3-dimensional (3D) laser scanner (S600 ARTI; Zirkonzahn) was used to digitize the prototype and the master model by using scan bodies to generate a virtual 3D CAD framework. Five presintered zirconia (ICE Zirkon Translucent - 95H16; Zirkonzahn) and 5 titanium (Titan 5 - 95H14; Zirkonzahn) frameworks were fabricated using the CAM milling unit (M1 Wet Heavy Metal Milling Unit; Zirkonzahn).The 1-screw test was applied by fixing the frameworks at the location of the maxillary left first molar abutment, and an industrial computed tomography (CT) scanner (XT H 225 - Basic Configuration; Nikon) was used to scan the framework-model complex to evaluate the passive fit of the frameworks on the master model. The scanned data were transported in standard tessellation language (STL) from Volume Graphics analysis software to PolyWorks analysis software by using the maximum-fit algorithm to fit scanned planes in order to mimic the mating surfaces in the best way. 3D virtual assessment of the marginal fit was performed at the abutment-framework interface at the maxillary right canine (gap 3) and right first molar (gap 4) abutments without prosthetic screws. The facial or buccal aspects of the teeth on frameworks were layered with corresponding porcelain (Initial Dental Ceramic System; GC) and CT-scanned again using the same protocol. Marginal fit measurements were made for 4 groups: titanium (Ti) (control), porcelain-layered titanium (Ti-P) (control), zirconia (Zr), and porcelain-layered zirconia (Zr-P). 3D discrepancy mean values were computed and calculated, and the results were analyzed with a repeated measures 3-way ANOVA using the maximum likelihood estimation method and Bonferroni adjustments for selected pairwise comparison t-tests (α=.05). The 3D fit was measured at gap 3 and gap 4. Statistically significant differences in mean 3D discrepancies were observed between Zr-P (175 μm) and Zr (89 μm) and between Zr-P and Ti-P (71 μm) (P<.001). Porcelain layering had a significant effect on the marginal fit of CAD-CAM-fabricated complete-arch implant-supported, screw-retained FDPs with partially sintered zirconia frameworks. 3D marginal discrepancy mean values for all groups were within clinically acceptable limits (<120 μm), except for the layered zirconia framework. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Tightening of healing abutments: influence of torque on bacterial proliferation risk, an in vitro investigation.

PubMed

Bousquet, Philippe; Bennasar, Isabelle Calas; Tramini, Paul; Jacquemot, Maxime; Cuisinier, Frédéric

2014-12-01

Gap at the implant-healing abutment junction can increase the risk of bacterial proliferation. In this study, we determined the leakage at the microgap, and we evaluated hand screwing among clinicians. The torques tested with nitrogen gas flow were 10, 15, 20, and 30 N cm, and 54 clinicians were asked to torque down a healing abutment as for a surgical procedure. There were no significant differences between 10 and 15 N cm, with a total lack of tightness. For 20 and 30 N cm, there was a notable decrease in leakage. The torque achieved by hand was <10 N cm for 61.7% of the clinicians, between 10 and 15 N cm for 29.1%, between 15 and 20 N cm for 8.0%, and between 20 and 25 N cm for 1.2%. There was a significant difference related to the strength of tightening. Under the conditions of our experiment, the gap of connection was reduced with a torque of ≥20 N cm. Only a small portion of the clinicians could obtain these values by hand. Therefore, a dynamometrical manual wrench should be used to minimize the gap during the osseointegration period.

Osteosynthesis of partial rib osteotomy in a miniature pig model using human standard-sized magnesium plate/screw systems: Effect of cyclic deformation on implant integrity and bone healing.

PubMed

Schaller, Benoit; Saulacic, Nikola; Beck, Stefan; Imwinkelried, Thomas; Liu, Edwin Wei Yang; Nakahara, Ken; Hofstetter, Willy; Iizuka, Tateyuki

2017-06-01

Magnesium alloys are candidates for resorbable material in bone fixation. However, the degradation and performance of osteosynthesis plate/screw systems in vivo, under cyclic deformation, is unknown. We evaluated the outcomes of human standard-sized magnesium plate/screw systems with or without plasma-electrolytic surface modifications in a miniature pig rib model. Of a total of 14 minipigs, six were implanted with coated magnesium WE43 six-hole plates/screws, six received magnesium uncoated plates/screws, and two received titanium osteosynthesis systems. The performance of the plate/screw fixation system on partially osteotomized 7th ribs was compared with that on intact 9th ribs. Radiological examinations were performed in vivo at 1, 4 and 8 weeks and after euthanasia at 12 and 24 weeks. After euthanasia the bone blocks were analyzed by computed tomography (CT), microfocus computed tomography (micro-CT), histology and histomorphometry. Follow-up post-surgery showed no trouble with wound healing. In vivo radiological examinations showed higher amounts of gas formation above the uncoated magnesium plates fixed on the partially osteotomized and intact ribs. CT scans showed no broken plates or implant displacement. The micro-CT examination demonstrated better surrounding bone properties around the coated than the uncoated magnesium implants 12 weeks after surgery. No negative influence of magnesium degradation on bone healing was observed with histological examinations. Plastic deformation during surgery and cyclic deformation did not affect the integrity of the used magnesium plates. This study showed promising results for the further development of coated magnesium plate/screw systems for bone fixation. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The effect of different screw-tightening techniques on the strain generated on an internal-connection implant superstructure. Part 2: Models created with a splinted impression technique.

PubMed

Choi, Jung-Han

2011-01-01

This study aimed to evaluate the effect of different screw-tightening sequences, torques, and methods on the strains generated on an internal-connection implant (Astra Tech) superstructure with good fit. An edentulous mandibular master model and a metal framework directly connected to four parallel implants with a passive fit to each other were fabricated. Six stone casts were made from a dental stone master model by a splinted impression technique to represent a well-fitting situation with the metal framework. Strains generated by four screw-tightening sequences (1-2-3-4, 4-3-2-1, 2-4-3-1, and 2-3-1-4), two torques (10 and 20 Ncm), and two methods (one-step and two-step) were evaluated. In the two-step method, screws were tightened to the initial torque (10 Ncm) in a predetermined screw-tightening sequence and then to the final torque (20 Ncm) in the same sequence. Strains were recorded twice by three strain gauges attached to the framework (superior face midway between abutments). Deformation data were analyzed using multiple analysis of variance at a .05 level of statistical significance. In all stone casts, strains were produced by connection of the superstructure, regardless of screw-tightening sequence, torque, and method. No statistically significant differences in superstructure strains were found based on screw-tightening sequences (range, -409.8 to -413.8 μm/m), torques (-409.7 and -399.1 μm/m), or methods (-399.1 and -410.3 μm/m). Within the limitations of this in vitro study, screw-tightening sequence, torque, and method were not critical factors for the strain generated on a well-fitting internal-connection implant superstructure by the splinted impression technique. Further studies are needed to evaluate the effect of screw-tightening techniques on the preload stress in various different clinical situations.

The Biocompatibility of Degradable Magnesium Interference Screws: An Experimental Study with Sheep

PubMed Central

Thormann, Ulrich; Alt, Volker; Heimann, Lydia; Gasquere, Cyrille; Heiss, Christian; Szalay, Gabor; Franke, Jörg; Schnettler, Reinhard; Lips, Katrin Susanne

2015-01-01

Screws for ligament reconstruction are nowadays mostly made of poly-L-lactide (PLLA). However, magnesium-based biomaterials are gathering increased interest in this research field because of their good mechanical property and osteoanabolic influence on bone metabolism. The aim of this pilot study was to evaluate the biocompatibility of an interference screw for ligament reconstruction made of magnesium alloy W4 by diecasting and milling and using different PEO-coatings with calcium phosphates. PLLA and titanium screws were used as control samples. The screws were implanted in the femur condyle of the hind leg of a merino sheep. The observation period was six and twelve weeks and one year. Histomorphometric, immunohistochemical, immunofluorescence, and molecular biological evaluation were conducted. Further TEM analysis was done. In all magnesium screws a clinically relevant gas formation in the vicinity of the biomaterial was observed. Except for the PLLA and titanium control samples, no screw was fully integrated in the surrounding bone tissue. Regarding the fabrication process, milling seems to produce less gas liberation and has a better influence on bone metabolism than diecasting. Coating by PEO with calcium phosphates could not reduce the initial gas liberation but rather reduced the bone metabolism in the vicinity of the biomaterial. PMID:25717474

Effect of cyclic loading and retightening on reverse torque value in external and internal implants.

PubMed

Cho, Woong-Rae; Huh, Yoon-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

2015-08-01

The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading.

Reliability of retrievable cemented implant-supported prostheses.

PubMed

Nissan, Joseph; Snir, David; Rosner, Ofir; Kolerman, Roni; Chaushu, Liat; Chaushu, Gavriel

2016-05-01

One of the disadvantages of a cemented implant restoration is the potential difficulty of retrieving it. The restoration may be destroyed during removal. The purpose of this retrospective clinical study was to assess the long-term survival rates of cemented posterior metal ceramic implant-supported prostheses (ISPs) with a metal screw access hole. During a 12-year period, 274 cemented ISPs with an abutment screw access hole in the metal framework were assessed and served as the study group, and 119 conventional cemented ISPs (without access hole) served as the control group. Participants were followed every 6 months in the first year and once a year subsequently. Ceramic fracture, screw loosening, and refabrication were the prosthetic outcome parameters evaluated at the recall. The Pearson Chi square and Fisher exact test were used to compare the outcome parameters between the control and study groups. A total of 1005 implants and 393 ISPs were evaluated. Ceramic fracture occurred in 6.6% of the ISPs (6.2% test and 7.6% control). Screw loosening occurred in 3.28% of the test group and 3.36% of the control group. Refabrication of ISPs was done in 2.79% of all restorations, (1.45% test and 6.72% control [P=.012]). Within the limits of this study, preparing cemented ISPs with a screw access hole in the metal framework improves ISP survival rates over time and lowers the cost of maintenance without increasing the risk for porcelain fracture or screw loosening. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Group D. Initiator paper. Implants--peri-implant (hard and soft tissue) interactions in health and disease: the impact of explosion of implant manufacturers.

PubMed

Ivanovski, Saso

2015-01-01

1. The best-documented implants have a threaded solid screw-type design and are manufactured from commercially pure (grade IV) titanium. There is good evidence to support implants ≥ 6 mm in length, and ≥ 3 mm in diameter. 2. Integrity of the seal between the abutment and the implant is important for several reasons, including minimization of mechanical and biological complications and maintaining marginal bone levels. Although the ideal design features of the implant-abutment connection have not been determined, an internal connection, micro-grooves at the implant collar, and horizontal offset of the implant-abutment junction (platform switch) appear to impart favorable properties. 3. Implants with moderately rough implant surfaces provide advantages over machined surfaces in terms of the speed and extent of osseointegration. While the favorable performances of both minimally and moderately rough surfaces are supported by long-term data, moderately rough surfaces provide superior outcomes in compromised sites, such as the posterior maxilla. 4. Although plaque is critical in the progression of peri-implantitis, the disease has a multi-factorial aetiology, and may be influenced by poor integrity of the abutment/implant connection. Iatrogenic factors, such as the introduction of a foreign body. (e.g., cement) below the mucosal margin, can be important contributors. 5. Clinicians should exercise caution when using a particular implant system, ensuring that the implant design is appropriate and supported by scientific evidence. Central to this is access to and participation in quality education on the impact that implant characteristics can have on clinical outcomes. Caution should be exercised in utilizing non-genuine restorative componentry that may lead to a poor implant-abutment fit and subsequent technical and biological complications.

The effects of simulated bone loss on the implant-abutment assembly and likelihood of fracture: an in vitro study.

PubMed

Manzoor, Behzad; Suleiman, Mahmood; Palmer, Richard M

2013-01-01

The crestal bone level around a dental implant may influence its strength characteristics by offering protection against mechanical failures. Therefore, the present study investigated the effect of simulated bone loss on modes, loads, and cycles to failure in an in vitro model. Different amounts of bone loss were simulated: 0, 1.5, 3.0, and 4.5 mm from the implant head. Forty narrow-diameter (3.0-mm) implant-abutment assemblies were tested using compressive bending and cyclic fatigue testing. Weibull and accelerated life testing analysis were used to assess reliability and functional life. Statistical analyses were performed using the Fisher-Exact test and the Spearman ranked correlation. Compressive bending tests showed that the level of bone loss influenced the load-bearing capacity of implant-abutment assemblies. Fatigue testing showed that the modes, loads, and cycles to failure had a statistically significant relationship with the level of bone loss. All 16 samples with bone loss of 3.0 mm or more experienced horizontal implant body fractures. In contrast, 14 of 16 samples with 0 and 1.5 mm of bone loss showed abutment and screw fractures. Weibull and accelerated life testing analysis indicated a two-group distribution: the 0- and 1.5-mm bone loss samples had better functional life and reliability than the 3.0- and 4.5-mm samples. Progressive bone loss had a significant effect on modes, loads, and cycles to failure. In addition, bone loss influenced the functional life and reliability of the implant-abutment assemblies. Maintaining crestal bone levels is important in ensuring biomechanical sustainability and predictable long-term function of dental implant assemblies.

Stability of prototype two-piece zirconia and titanium implants after artificial aging: an in vitro pilot study.

PubMed

Kohal, Ralf-Joachim; Finke, Hans Christian; Klaus, Gerold

2009-12-01

Zirconia oral implants are a new topic in implant dentistry. So far, no data are available on the biomechanical behavior of two-piece zirconia implants. Therefore, the purpose of this pilot investigation was to test in vitro the fracture strength of two-piece cylindrical zirconia implants after aging in a chewing simulator. This laboratory in vitro investigation comprised three different treatment groups. Each group consisted of 16 specimens. In group 1, two-piece zirconia implants were restored with zirconia crowns (zirconia copings veneered with Triceram; Esprident, Ispringen, Germany), and in group 2 zirconia implants received Empress 2 single crowns (Ivoclar Vivadent AG, Schaan, Liechtenstein). The implants, including the abutments, in the two zirconia groups were identical. In group 3, similar titanium implants were reconstructed with porcelain-fused-to-metal crowns. Eight samples of each group were submitted to artificial aging with a long-term load test in the artificial mouth (chewing simulator). Subsequently, all not artificially aged samples and all artificially aged samples that survived the long-term loading of each group were submitted to a fracture strength test in a universal testing machine. For the pairwise comparisons in the different test groups with or without artificial loading and between the different groups at a given artificial loading condition, the Wilcoxon rank-sum test for independent samples was used. The significance level was set at 5%. One sample of group 1 (veneer fracture), none of group 2, and six samples of group 3 (implant abutment screw fractures) failed while exposed to the artificial mouth. The values for the fracture strength after artificial loading with 1.2 million cycles for group 1 were between 45 and 377 N (mean: 275.7 N), in group 2 between 240 and 314 N (mean: 280.7 N), and in the titanium group between 45 and 582 N (mean: 165.7 N). The fracture strength results without artificial load for group 1 amounted to between 270 and 393 N (mean: 325.1 N), for group 2 between 235 and 321 N (mean: 281.8 N), and between 474 and 765 N (mean: 595.2 N) for the titanium group. The failure mode during the fracture testing in the zirconia implant groups was a fracture of the implant head and a bending/fracture of the abutment screw in the titanium group. Within the limits of this pilot investigation, the biomechanical stability of all tested prototype implant groups seems to be - compared with the possibly exerted occlusal forces - borderline for clinical use. A high number of failures occurred already during the artificial loading in the titanium group at the abutment screw level. The zirconia implant groups showed irreparable implant head fractures at relatively low fracture loads. Therefore, the clinical use of the presented prototype implants has to be questioned.

An investigation of heat transfer to the implant-bone interface when drilling through a zirconia crown attached to a titanium or zirconia abutment.

PubMed

Mason, Amy G; Sutton, Alan; Turkyilmaz, Ilser

2014-11-01

Thermal injury to the implant-bone interface may lead to bone necrosis and loss of osseointegration. This is a concern during manipulation of the implant throughout the restorative phase of treatment. The risk of heat transfer to the implant-bone interface during abutment preparation or prosthesis removal should be considered. The purpose of the study was to examine the amount of heat transferred to the implant-bone interface when a zirconia crown is drilled to access the screw channel or section a crown with a high-speed dental handpiece. Of the 64 ceramic-veneered zirconia crowns fabricated, 32 had a coping thickness of 0.5 mm and 32 had a coping thickness of 1.0 mm. The crowns were cemented on either titanium stock abutments or zirconia stock abutments. Each group was further subdivided to evaluate heat transfer when the screw channel was accessed or the crown was sectioned with a high-speed handpiece with or without irrigation. Temperature change was recorded for each specimen at the cervical and apical aspect of the implant with thermocouples and a logging thermometer. ANOVA was used to assess the statistical significance in temperature change between the test combinations, and nonparametric Mann-Whitney U tests were used to evaluate the findings. The use of irrigation during both crown removal processes yielded an average temperature increase of 3.59 ±0.35°C. Crown removal in the absence of irrigation yielded an average temperature increase of 18.76 ±3.09°C. When all parameter combinations in the presence of irrigation were evaluated, the maximum temperature change was below the threshold of thermal injury to bone. The maximum temperature change was above the threshold for thermal injury at the coronal aspect of the implant and below the threshold at the apical aspect in the absence of irrigation. Within the limitations of this investigation, the use of irrigation with a high-speed dental handpiece to remove a ceramic-veneered zirconia crown results in a temperature increase at the implant-bone interface insufficient to cause irreversible damage. Conversely, a lack of irrigation may yield a temperature increase capable of producing irreversible damage at the coronal aspect of the implant. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The effect of different screw-tightening techniques on the stress generated on an internal-connection implant superstructure.

PubMed

Choi, Jung-Han; Lim, Young-Jun; Kim, Chang-Whe; Kim, Myung-Joo

2009-01-01

This study evaluated the effect of different screw-tightening sequences, forces, and methods on the stresses generated on a well-fitting internal-connection implant (Astra Tech) superstructure. A metal framework directly connected to four parallel implants was fabricated on a fully edentulous mandibular resin model. Six stone casts with four implant replicas were made from a pickup impression of the superstructure to represent a "well-fitting" situation. Stresses generated by four screw-tightening sequences (1-2-3-4, 4-3-2-1, 2-4-3-1, and 2-3-1-4), two forces (10 and 20 Ncm), and two methods (one-step and two-step) were evaluated. In the two-step method, screws were tightened to the initial torque (10 Ncm) in a predetermined screw-tightening sequence and then to the final torque (20 Ncm) in the same sequence. Stresses were recorded twice by three strain gauges attached to the framework (superior face midway between abutments). Deformation data were analyzed using multiple analysis of variance at a .05 level of statistical significance. In all stone casts, stresses were produced by the superstructure connection, regardless of screw-tightening sequence, force, and method. No statistically significant differences for superstructure preload stresses were found based on screw-tightening sequences (-180.0 to -181.6 microm/m) or forces (-163.4 and -169.2 microm/m) (P > .05). However, different screw-tightening methods induced different stresses on the superstructure. The two-step screw-tightening method (-180.1 microm/m) produced significantly higher stress than the one-step method (-169.2 microm/m) (P = .0457). Within the limitations of this in vitro study, screw-tightening sequence and force were not critical factors in the stress generated on a well-fitting internal-connection implant superstructure. The stress caused by the two-step method was greater than that produced using the one-step method. Further studies are needed to evaluate the effect of screw-tightening techniques on preload stress in various different clinical situations.

Magnetic Resonance Imaging Studies of Process Rheology

DTIC Science & Technology

1990-08-14

a Twin - screw Extruder ................ 7 2.1.2 NMR Flow Imaging Studies ................................... 7U 2.2 Theoretical Modeling ...run at high production rates, mixed in a 50.8 mm fully intermeshing, co - rotating twin - screw off-line techniques of quality control may lead to very...Imaging Studies of............... A -1 Mixing in a Twin - Screw Extruder " B. "Stokesian Dynamics Simulation of Polyether-coated

Biomechanical Comparison of External Fixation and Compression Screws for Transverse Tarsal Joint Arthrodesis.

PubMed

Latt, L Daniel; Glisson, Richard R; Adams, Samuel B; Schuh, Reinhard; Narron, John A; Easley, Mark E

2015-10-01

Transverse tarsal joint arthrodesis is commonly performed in the operative treatment of hindfoot arthritis and acquired flatfoot deformity. While fixation is typically achieved using screws, failure to obtain and maintain joint compression sometimes occurs, potentially leading to nonunion. External fixation is an alternate method of achieving arthrodesis site compression and has the advantage of allowing postoperative compression adjustment when necessary. However, its performance relative to standard screw fixation has not been quantified in this application. We hypothesized that external fixation could provide transverse tarsal joint compression exceeding that possible with screw fixation. Transverse tarsal joint fixation was performed sequentially, first with a circular external fixator and then with compression screws, on 9 fresh-frozen cadaveric legs. The external fixator was attached in abutting rings fixed to the tibia and the hindfoot and a third anterior ring parallel to the hindfoot ring using transverse wires and half-pins in the tibial diaphysis, calcaneus, and metatarsals. Screw fixation comprised two 4.3 mm headless compression screws traversing the talonavicular joint and 1 across the calcaneocuboid joint. Compressive forces generated during incremental fixator foot ring displacement to 20 mm and incremental screw tightening were measured using a custom-fabricated instrumented miniature external fixator spanning the transverse tarsal joint. The maximum compressive force generated by the external fixator averaged 186% of that produced by the screws (range, 104%-391%). Fixator compression surpassed that obtainable with screws at 12 mm of ring displacement and decreased when the tibial ring was detached. No correlation was found between bone density and the compressive force achievable by either fusion method. The compression across the transverse tarsal joint that can be obtained with a circular external fixator including a tibial ring exceeds that which can be obtained with 3 headless compression screws. Screw and external fixator performance did not correlate with bone mineral density. This study supports the use of external fixation as an alternative method of generating compression to help stimulate fusion across the transverse tarsal joints. The findings provide biomechanical evidence to support the use of external fixation as a viable option in transverse tarsal joint fusion cases in which screw fixation has failed or is anticipated to be inadequate due to suboptimal bone quality. © The Author(s) 2015.

Assessment of cold welding properties of the internal conical interface of two commercially available implant systems.

PubMed

Norton, M R

1999-02-01

The cone-screw abutment has been shown to diminish micromovement by reducing the burden of component loosening and fracture. However, anecdotal concern for cold welding of cone-screw joints in implant design has been identified as a potential source for lack of retrievability. This comparative study evaluated the loosening torque, as a percentage of tightening torque, for the ITI Straumann and Astra Tech (3.5 and 4.0 mm diameters) implant systems, which use an 8-degree and 11-degree internal cone, respectively. Implants and abutments from each system were mounted in a torque device, and a range of tightening torques was applied. Loosening torques were then measured, and the influence of conus angle, interfacial surface area, saliva contamination, and time delay to loosening were all assessed. The loosening torque only exceeded tightening torque at the highest levels, just before component failure, when plastic deformation was expected. For all clinically relevant levels of torque, both in a dry environment and with components bathed in artificial saliva at 37 degrees C, loosening torque was always seen to be 80% to 90% of tightening torque, demonstrating that cold welding does not occur. There was a high correlation between loosening and tightening torque for all systems tested, but no statistical difference when comparing wet versus dry or comparing individual data for each system. It can be concluded that for clinically relevant levels of tightening torque, no problems are anticipated with respect to retrievability.

Improving the fit of implant prosthetics: an in vitro study.

PubMed

Yannikakis, Stavros; Prombonas, Anthony

2013-01-01

Accurate and passive fit between a prosthesis and its supporting implants has been considered a prerequisite for successful long-term osseointegration. The objective of this in vitro study was to evaluate the strain development during tightening of a five-unit screw-retained superstructure constructed using five different methods. Five-unit screw-retained fixed partial prostheses (n = 25) were fabricated on three implants embedded in an epoxy resin block using five different methods: (1) cobalt-chromium (Co-Cr), plastic cylinders, one-piece cast; (2) Co-Cr, plastic cylinders, framework sectioned, preceramic laser-welding soldering; (3) gold-platinum (Au-Pt), gold cylinders, one-piece cast; (4) Au-Pt, gold cylinders, framework sectioned, preceramic laser-welding soldering; (5) Co-Cr, one-piece cast, and cementation to "passive abutments" (Southern Implants) after final finishing and polishing. Strain gauges (SG) were attached to the fixed partial prosthesis (FPP) and to the resin block to measure the stress created during screw tightening. The combination of Co-Cr alloy and plastic cylinders in a one-piece cast showed such an inadequate fit among the fabricated methods that this group was excluded from the remainder of the experiment. Specimens of Au-Pt cast on gold cylinders in one piece showed higher strain development than the other groups used in this study, with strains ranging from 223.1 to 2,198.1 Μm/m. Sectioning and soldering significantly improved the overall fit. FPPs of Co-Cr in a one-piece cast cemented to "passive abutments" produced the best level of fit, with the least strain development in the prosthesis and the resin block (59 to 204.6 Μm/m). Absolute fit of superstructures on implants is not possible using conventional laboratory procedures. Cementing FPPs onto prefabricated cylinders directly onto the implants significantly reduces strain development compared to the other fabrication methods.

Evaluation of the success rate of cone beam computed tomography in determining the location and direction of screw access holes in cement-retained implant-supported prostheses: An in vitro study.

PubMed

Neshandar Asli, Hamid; Dalili Kajan, Zahra; Gholizade, Fatemeh

2018-02-21

Cement-retained implant-supported restorations have advantages over screw-retained restorations but are difficult to retrieve. Identifying the approximate location of the screw access hole (SAH) may reduce damage to the prosthesis. The purpose of this in vitro study was to evaluate the ability of cone beam computed tomography (CBCT) imaging to determine the location and direction of SAHs in cement-retained implant prostheses. Five clear acrylic resin casts were made based on a mandibular model. Several implant osteotomies (n=30) were created on the models with surgical burs, and crowns were made using the standard laboratory method with a transfer coping and the closed tray impression technique. CBCT images from the acrylic resin casts were evaluated by a maxillofacial radiologist who was blind to the locations and angles of the osteotomies. The locations of the access holes were determined on multiplanar reconstruction images and transferred to the clinical crown surface as defined points. Based on cross-sectional images, the predicted angle of the access hole was provided to a prosthodontist who was requested to pierce the crown at the proposed location in the specified direction. If the location and/or direction of the access hole were found, the process was considered successful, as the crown could then be removed from the implant abutment through the SAH. The success rate in the detection of the location and direction of the SAH was calculated, and chi-square and Fisher exact tests were applied for data analysis (α=.05). According to the results of this study, the success rate of CBCT to define the location of SAHs was 83.3% and 80% to determine the direction. No significant differences were found among the different dental groups in determination of the location (P=.79) or the direction (P=.53) of the SAHs. Most of the failures in determining the location and direction of the access hole in the buccolingual and mesiodistal directions were in the buccal and mesial locations of the SAH. The success rate of using CBCT to determine the location of SAHs in straight abutments was 100%. A significant difference was found between angled and straight abutments (P=.042). Using CBCT could help determine the direction and location of SAHs in clinical situations. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Comparative Microstrain Study of Internal Hexagon and Plateau Design of Short Implants Under Vertical Loading.

PubMed

Nishioka, Renato Sussumu; Rodrigues, Vinicius Anéas; De Santis, Leandro Ruivo; Nishioka, Gabriela Nogueira De Melo; Santos, Vivian Mayumi Miyazaki; Souza, Francisley Ávila

2016-02-01

To quantify microstrain development during axial loading using strain gauge analysis for short implants, varying the type of fixture-abutment joint and thread design. An internal hexagon implant (4 × 8 mm) and a plateau design implant (4 × 8 mm) were embedded on the center of 10 polyurethane blocks with dimensions of 190 × 30 × 12 mm. The respective abutments were screwed onto the implants. Four strain gauges (SGs) were bonded onto the surface of each block, and 4 vertical SGs were bonded onto the side of each block. Axial load of 30 kgf was applied for 10 seconds in the center of each implant. The data were analyzed statistically by analysis of variance for repeated measures and Tukey test (P < 0.05). The interaction between implant and region factors have been statistically significant (P = 0.0259). Tukey test revealed a difference on plateau's horizontal region. The cervical region presented higher microstrain values, when compared with the medium and apical regions of the implants. Within the purpose of the study, the type of fixture-abutment joint is a relevant factor to affect the amount of stress/strain in bone simulation. The microstrain development was concentrated on the cervical region of the implant.

Mixed zirconia calcium phosphate coatings for dental implants: tailoring coating stability and bioactivity potential.

PubMed

Pardun, Karoline; Treccani, Laura; Volkmann, Eike; Streckbein, Philipp; Heiss, Christian; Li Destri, Giovanni; Marletta, Giovanni; Rezwan, Kurosch

2015-03-01

Enhanced coating stability and adhesion are essential for long-term success of orthopedic and dental implants. In this study, the effect of coating composition on mechanical, physico-chemical and biological properties of coated zirconia specimens is investigated. Zirconia discs and dental screw implants are coated using the wet powder spraying (WPS) technique. The coatings are obtained by mixing yttria-stabilized zirconia (TZ) and hydroxyapatite (HA) in various ratios while a pure HA coating served as reference material. Scanning electron microscopy (SEM) and optical profilometer analysis confirm a similar coating morphology and roughness for all studied coatings, whereas the coating stability can be tailored with composition and is probed by insertion and dissections experiments in bovine bone with coated zirconia screw implants. An increasing content of calcium phosphate (CP) resulted in a decrease of mechanical and chemical stability, while the bioactivity increased in simulated body fluid (SBF). In vitro experiments with human osteoblast cells (HOB) revealed that the cells grew well on all samples but are affected by dissolution behavior of the studied coatings. This work demonstrates the overall good mechanical strength, the excellent interfacial bonding and the bioactivity potential of coatings with higher TZ contents, which provide a highly interesting coating for dental implants. Copyright © 2014 Elsevier B.V. All rights reserved.

Enhancement of osteogenesis and biodegradation control by brushite coating on Mg-Nd-Zn-Zr alloy for mandibular bone repair.

PubMed

Guan, Xingmin; Xiong, Meiping; Zeng, Feiyue; Xu, Bin; Yang, Lingdi; Guo, Han; Niu, Jialin; Zhang, Jian; Chen, Chenxin; Pei, Jia; Huang, Hua; Yuan, Guangyin

2014-12-10

To diminish incongruity between bone regeneration and biodegradation of implant magnesium alloy applied for mandibular bone repair, a brushite coating was deposited on a matrix of a Mg-Nd-Zn-Zr (hereafter, denoted as JDBM) alloy to control the degradation rate of the implant and enhance osteogenesis of the mandible bone. Both in vitro and in vivo evaluations were carried out in the present work. Viability and adhesion assays of rabbit bone marrow mesenchyal stem cells (rBM-MSCs) were applied to determine the biocompatibility of a brushite-coated JDBM alloy. Osteogenic gene expression was characterized by quantitative real-time polymerase chain reaction (RT-PCR). Brushite-coated JDBM screws were implanted into mandible bones of rabbits for 1, 4, and 7 months, respectively, using 316L stainless steel screws as a control group. In vivo biodegradation rate was determined by synchrotron radiation X-ray microtomography, and osteogenesis was observed and evaluated using Van Gieson's picric acid-fuchsin. Both the naked JDBM and brushite-coated JDBM samples revealed adequate biosafety and biocompatibility as bone repair substitutes. In vitro results showed that brushite-coated JDBM considerably induced osteogenic differentiation of rBM-MSCs. And in vivo experiments indicated that brushite-coated JDBM screws presented advantages in osteoconductivity and osteogenesis of mandible bone of rabbits. Degradation rate was suppressed at a lower level at the initial stage of implantation when new bone tissue formed. Brushite, which can enhance oeteogenesis and partly control the degradation rate of an implant, is an appropriate coating for JDBM alloys used for mandibular repair. The Mg-Nd-Zn-Zr alloy with brushite coating possesses great potential for clinical applications for mandibular repair.

Effect of cyclic loading and retightening on reverse torque value in external and internal implants

PubMed Central

Cho, Woong-Rae; Huh, Yoon-Hyuk; Park, Chan-Jin

2015-01-01

PURPOSE The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. MATERIALS AND METHODS Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. RESULTS Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. CONCLUSION Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading. PMID:26330975

Comparative study of torque resistance and microgaps between a combined Octatorx-cone connection and an internal hexagon implant-abutment connection.

PubMed

Khongkhunthian, Pathawee; Khongkhunthian, Sakornratana; Weerawatprachya, Winai; Pongpat, Kanuengnit; Aunmeungtong, Weerapan

2015-05-01

Although the implant-abutment connection may prevent crestal bone loss around dental implants, its failure often leads to treatment failure. Microgap and micromovement of the implant-abutment connection could be causes of bone resorption around dental implant neck. The purpose of this study was to compare torque resistance and microgaps between a new cone and index connection (Octatorx) and an internal hexagon implant-abutment connection (Internal hex). Twenty Octatorx and 20 internal hexagon connections were attached with retaining screws at 30 Ncm. In a torsion resistance test, 10 of each type of connection were attached to a universal testing machine. Torque resistance with 90 degrees per minute rotation speed was recorded. For microgap measurement, each of 10 connections was embedded in clear acrylic resin. The blocks were cut longitudinally. Twenty specimens of each connection were evaluated. Twelve measurements of microgaps (6 on each side of specimen) were recorded under scanning electron microscopy. The average torsion resistance of Octatorx (203.6 ±17.4 Ncm) was significantly greater than that of the internal hexagon (146.4 ±16.1 Ncm, P<.05). For the microgap, there was a significant difference (P=.001) between the median values of Octatorx (1.19 μm) and the internal hexagon (3.80 μm). In this study, the new connection, Octatorx, had a smaller microgap and greater torque resistance than the internal hexagon connection. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Comparative Analysis of Potential Auxiliary Icebreaking Devices/Systems for Great Lakes. Volume I.

DTIC Science & Technology

1981-06-01

Archimedes Screw Vehicle Mechanical Impact Device Water Hull Lubrication Systems Low Friction Hull Coatings Stem Knives Bow Ramp A harbor tug with...direct mounting on ships but rather on bow attachments or specialized material handling concepts. Archimedes Screw Vehicle (Figure A-il) The Archimedes ...or pull ships through ice and water. The Archimedes screw works better in a soft pliable terrain than in water or on a hard material such as sheet

Intended and Achieved Torque of Implant Abutment's Screw using Manual Wrenches in Simulated Clinical Setting.

PubMed

Al-Otaibi, Hanan N

2016-11-01

To measure the difference between the intended torque and the achieved torque by the operator using the spring-style mechanical torque-limiting device (MTLD). Inexperienced and experienced clinicians used one spring-type MTLD to torque two abutment screws of each anterior and posterior implants, which were attached to two digital torque meters through a jaw model. The jaw model was part of a preclinical bench manikin attached to a dental chair. The intended torque value was 35 N cm (recommended by manufacturer) and the technique of torquing was observed for all the participants (instantaneous and repeated). The mean torque value was calculated for each subject for the anterior and posterior implants independently; t-test was used to compare between the intended and achieved torque values and to compare between the experienced and inexperienced clinicians (p ≤ 0.05). Thirty-seven clinicians participated, with an overall mean torque value of 34.30 N cm. The mean torque value of the achieved torque (34.30 ± 4.13 N cm) was statistically significantly less than the intended torque (p = 0.041). The male clinicians produced more statistically significantly accurate torque value (34.54 ± 3.78 N cm) than the female clinicians (p = 0.034), and the experienced clinicians produced more accurate torque values (34.9 ± 5.13 N cm) than the inexperienced clinicians (p = 0.048). Within the limitation of this study, the use of MTLDs did not always produce consistent torque values and the technique by which the operators use the MTLD might affect the torque value.

Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A Randomized, Multicenter Clinical Trial.

PubMed

Wittneben, J G; Gavric, J; Belser, U C; Bornstein, M M; Joda, T; Chappuis, V; Sailer, I; Brägger, U

2017-02-01

Patients' esthetic expectations are increasing, and the options of the prosthetic pathways are currently evolving. The objective of this randomized multicenter clinical trial was to assess and compare the esthetic outcome and clinical performance of anterior maxillary all-ceramic implant crowns (ICs) based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with hand buildup technique. The null hypothesis was that there is no statistically significant difference between the 2 groups. Forty implants were inserted in sites 14 to 24 (FDI) in 40 patients in 2 centers, the Universities of Bern and Geneva, Switzerland. After final impression, 20 patients were randomized into group A, restored with a 1-piece screw-retained single crown made of a prefabricated zirconia abutment with pressed ceramic as the veneering material using the cut-back technique, or group B using an individualized CAD/CAM zirconia abutment (CARES abutment; Institut Straumann AG) with a hand buildup technique. At baseline, 6 mo, and 1 y clinical, esthetic and radiographic parameters were assessed. Group A exhibited 1 dropout patient and 1 failure, resulting in a survival rate of 94.7% after 1 y, in comparison to 100% for group B. No other complications occurred. Clinical parameters presented stable and healthy peri-implant soft tissues. Overall, no or only minimal crestal bone changes were observed with a mean DIB (distance from the implant shoulder to the first bone-to-implant contact) of -0.15 mm (group A) and 0.12 mm (group B) at 1 y. There were no significant differences at baseline, 6 mo, and 1 y for DIB values between the 2 groups. Pink esthetic score (PES) and white esthetic score (WES) values at all 3 examinations indicated stability over time for both groups and pleasing esthetic outcomes. Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of single ICs in the anterior maxilla ( ClinicalTrials.gov NCT02905838).

Retrospective evaluation of complete-arch fixed partial dentures connecting teeth and implant abutments in patients with normal and reduced periodontal support.

PubMed

Cordaro, Luca; Ercoli, Carlo; Rossini, Carlo; Torsello, Ferruccio; Feng, Changyong

2005-10-01

The clinical outcome of complete-arch fixed prostheses supported by implants and natural tooth abutments in patients with normal or reduced periodontal support has been reported by few studies, with controversial results. The purpose of this study was to report on the implant success rate, prosthetic complications, and the occurrence of tooth intrusion, when complete-arch fixed prostheses, supported by a combination of implants and teeth, were fabricated for patients with normal and reduced periodontal support. Nineteen patients with residual teeth that served as abutments were consecutively treated with combined tooth- and implant-supported complete-arch fixed prostheses and were retrospectively evaluated after a period varying from 24 to 94 months. Nine patients showed reduced periodontal support as a result of periodontal disease and treatment (RPS group), and 10 patients had normal periodontal support of the abutment teeth (more than 2/3 of periodontal support [NPS group]). Ninety implants and 72 tooth abutments were used to support 19 fixed partial dentures. Screw- and cement-retained metal-ceramic and metal-resin prostheses were fabricated with rigid and nonrigid connectors. Implant survival and success rates, occurrence of caries and tooth intrusion, and prosthetic complications were recorded. The number of teeth, implants, prosthetic units, fixed partial dentures, and nonrigid connectors were compared with a t test to assess differences between the 2 groups, while data for the occurrence of intrusions and prosthetic complications were compared with the Fisher exact test (alpha=.05). One of the 90 implants was lost (99% survival rate) over 24 to 94 months, while 3 implants showed more than 2 mm of crestal bone loss (96% success rate) over the same period. No caries were detected, but 5.6% (4/72) of the abutment teeth exhibited intrusion. Intrusion of abutment teeth was noted in 3 patients who had normal periodontal support (13% of teeth in NPS group) of the abutment teeth and was associated with nonrigid connectors. No intrusion of teeth was noted in the patients exhibiting reduced periodontal support regardless of the type of connector or when a rigid connector was used for either group. The number of intruded teeth was significantly greater in patients with intact periodontal support (P=.03). Complete-arch fixed prosthesis supported by implant and tooth abutments may be associated with intrusion of teeth with intact periodontal support when nonrigid connectors are used to join the implant- and tooth-supported sections of the prostheses. However, fixed partial dentures supported by implants and teeth with reduced periodontal support were not associated with tooth intrusion, regardless of the type of connectors used.

The Effect of Tissue Entrapment on Screw Loosening at the Implant/Abutment Interface of External- and Internal-Connection Implants: An In Vitro Study.

PubMed

Zeno, Helios A; Buitrago, Renan L; Sternberger, Sidney S; Patt, Marisa E; Tovar, Nick; Coelho, Paulo; Kurtz, Kenneth S; Tuminelli, Frank J

2016-04-01

To compare the removal of torque values of machined implant abutment connections (internal and external) with and without soft tissue entrapment using an in vitro model. Thirty external- and 30 internal-connection implants were embedded in urethane dimethacrylate. Porcine tissue was prepared and measured to thicknesses of 0.5 and 1.0 mm. Six groups (n = 10) were studied: External- and internal-connection implants with no tissue (control), 0.5, and 1.0 mm of tissue were entrapped at the implant/abutment interface. Abutments were inserted to 20 Ncm for all six groups. Insertion torque values were recorded using a digital torque gauge. All groups were then immersed in 1 M NaOH for 48 hours to dissolve tissue. Subsequent reverse torque measurements were recorded. Mean and standard deviation were determined for each group, and one-way ANOVA and Bonferroni test were used for statistical analysis. All 60 specimens achieved a 20-Ncm insertion torque, despite tissue entrapment. Reverse torque measurements for external connection displayed a statistically significant difference (p < 0.05) between all groups with mean reverse torque values for the control (13.71 ± 1.4 Ncm), 0.5 mm (7.83 ± 2.4 Ncm), and 1.0 mm tissue entrapment (2.29 ± 1.4 Ncm) groups. Some statistically significant differences (p < 0.05) were found between internal-connection groups. In all specimens, tissue did not completely dissolve after 48 hours. External-connection implants were significantly affected by tissue entrapment; the thicker the tissue, the lower the reverse torque values noted. Internal-connection implants were less affected by tissue entrapment. © 2015 by the American College of Prosthodontists.

Efficiency considerations for the purely tapered interference fit (TIF) abutments used in dental implants.

PubMed

Bozkaya, Dinçer; Müftü, Sinan

2004-08-01

A tapered interference fit provides a mechanically reliable retention mechanism for the implant-abutment interface in a dental implant. Understanding the mechanical properties of the tapered interface with or without a screw at the bottom has been the subject of a considerable amount of studies involving experiments and finite element (FE) analysis. In this paper, approximate closed-form formulas are developed to analyze the mechanics of a tapered interference fit. In particular, the insertion force, the efficiency, defined as the ratio of the pull-out force to insertion force, and the critical insertion depth, which causes the onset of plastic deformation, are analyzed. It is shown that the insertion force is a function of the taper angle, the contact length, the inner and outer radii of the implant, the static and the kinetic coefficients of friction, and the elastic modulii of the implant/abutment materials. The efficiency of the tapered interference fit, which is defined as the ratio of the pull-out force to insertion force, is found to be greater than one, for taper angles that are less than 6 deg when the friction coefficient is 0.3. A safe range of insertion forces has been shown to exist. The lower end of this range depends on the maximum pull-out force that may occur due to occlusion in the multiple tooth restorations and the efficiency of the system; and the upper end of this range depends on the plastic deformation of the abutment and the implant due to interference fit. It has been shown that using a small taper angle and a long contact length widens the safe range of insertion forces.

Evaluation of marginal fit of single implant-supported metal-ceramic crowns prepared by using presintered metal blocks.

PubMed

Pasali, Baris; Sarac, Duygu; Kaleli, Necati; Sarac, Yakup Sinasi

2018-02-01

Recently, presintered metal blocks for nonprecious and precious metal implant-supported restorations have gained popularity in computer-aided design and computer-aided manufacturing (CAD-CAM) systems. However, few studies have evaluated the marginal discrepancy of implant-supported restorations made with these new alloy systems. The purpose of this in vitro study was to compare the milling-sintering method with the lost-wax and milling methods in terms of the marginal fit of implant-supported metal-ceramic restorations. Thirty implant abutments screwed to implant analogs were embedded into acrylic resin to investigate marginal fit and then divided according to fabrication methods into the following 3 groups (n=10): lost-wax (LW; control group), milling (M), and milling-sintering (MS). Porcelain material was applied to all specimens after completion of the fabrication process. Subsequently, all specimens were cemented to implant abutments for the measurement of marginal discrepancies. Twelve marginal discrepancy measurements were recorded on each implant abutment by using a stereomicroscope. The arithmetic mean of these 12 measurements was considered the mean marginal discrepancy value of each abutment. Data were statistically analyzed by using 1-way ANOVA and Tukey honest significant difference tests (α=.05). The lowest mean marginal discrepancy values (81 ±2 μm) were observed in the M group, which was significantly different (P<.001) from the other methods. The highest mean marginal discrepancy values (99 ±2 μm) were observed in the MS group. The results revealed that restorations prepared by the milling-sintering method provided clinically acceptable results (<120 μm); however, this new technique was not found to be as precise as the milling method in terms of marginal fit. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Implant-supported titanium prostheses following augmentation procedures: a clinical report.

PubMed

Knabe, C; Hoffmeister, B

2003-03-01

This report describes a novel technique for fabricating retrievable implant-supported titanium (Ti) prostheses in patients requiring a comprehensive treatment plan involving the combined efforts of maxillofacial surgery and implant prosthodontics. Following bone graft reconstructive surgery and implant placement prosthetic treatment was initiated by inserting ITI-Octa abutments. An impression was made, and a framework was fabricated by fusing Ti-cast frameworks to prefabricated titanium copings by laser-welding. This was followed by veneering or fabrication of a removable denture with Ti metal re-enforcement. Favourable clinical results have been achieved using these screw-retained Ti implant-supported restorations for patients treated with reconstructive bone graft-surgery, with clinical observation periods ranging from three to four years. The present observations suggest that these screw-retained implant-supported Ti prostheses may be a meaningful contribution to implant prosthodontics, facilitating retrievable restorations of optimum biocompatibility, good marginal precision and with a good esthetic result. However, controlled clinical studies are needed to establish the long-term serviceability of these Ti restorations.

Clinical and Radiographic Assessment of Three-Implant-Supported Fixed-Prosthesis Rehabilitation of the Edentulous Mandible: Immediate Versus Delayed Loading.

PubMed

Primo, Bruno Tochetto; Mezzari, Leonardo Marcos; da Fontoura Frasca, Luís Carlos; Linderman, Raquel; Rivaldo, Elken Gomes

To evaluate and compare the clinical and radiographic outcomes of mandibular rehabilitation with fixed prostheses on three implants with immediate versus delayed loading. The sample comprised 21 patients who underwent treatment with immediate loading and 23 who received delayed loading. All had worn their prostheses for at least 18 months. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs. Clinical examination of the technical conditions of the prosthetic device assessed the condition of the acrylic resin base, dental occlusion, metal framework, presence of cover screws, screw fixation of the prosthesis and abutments, length of cantilever (effort) and resistance arms, presence of plaque on prosthetic abutments, and hygiene of the prosthesis. One implant failed in each group, resulting in a 95.23% treatment success rate with immediate loading and 95.65% with delayed loading (no statistically significant between-group difference). In the immediate-loading group, the mean bone loss was 1.96 ± 0.73 mm around central implants and 1.64 ± 0.84 mm at distal implants. In the delayed-loading group, the mean bone loss was 1.85 ± 0.67 mm around central implants and 1.70 ± 0.77 mm at distal implants. According to Student t test, there was no significant within-group difference in bone loss and no difference between the immediate-loading and delayed-loading groups. The only prosthesis-related complications that differed significantly between groups were "condition of the acrylic base," "occlusion," and "presence of right cover screw." There was no statistically significant association of lever arm ratio with peri-implant bone loss or bone loss on the mesial surfaces compared to the distal surfaces of the distal implants. The three-implant-supported fixed prosthesis protocol tested in this study proved to be a viable therapeutic strategy for mandibular edentulous patients with maxillary complete dentures, regardless of whether loading was immediate or delayed, with no difference in peri-implant bone loss.

In vitro comparative analysis of the fit of gold alloy or commercially pure titanium implant-supported prostheses before and after electroerosion.

PubMed

Sartori, Ivete Aparecida de Mattias; Ribeiro, Ricardo Faria; Francischone, Carlos Eduardo; de Mattos, Maria da Gloria Chiarello

2004-08-01

For implant-supported prostheses, passive fit is critical for the success of rehabilitation, especially when alternative materials are used. The purpose of this study was to compare interfacial fit of implant-supported prostheses cast in titanium to those cast in gold alloy. Five 3-unit fixed partial dentures were fabricated in gold alloy (Degudent U) as 1-piece castings, and 5 others were similarly cast in commercially pure titanium (Grade 1). The interfacial gaps between the prostheses and the abutments were evaluated with an optical microscope, before and after electroerosion. Readings were made with both screws tightened (10 N.cm torque), and with only 1 side tightened, so as to also evaluate the passive fit of the prostheses. Data were compared statistically by 2-way analysis of variance and the post hoc Tukey multiple range test (alpha=.05). Before electroerosion, the interfacial gaps for the 1-piece prostheses were significantly smaller (P<.001) in the gold alloy group when the screws were tightened (Au=12.6 +/- 3.0 microm, compared to Ti=30.1 +/- 6.4 microm). When the side opposite the tightened side was analyzed, there was no significant difference between the gold alloy and titanium groups (Au=69.2 +/- 24.9 microm and Ti=94.2 +/- 39.6 microm). The electroerosion procedure significantly (P<.001) reduced the gaps at the interfaces for both groups under all conditions. Comparison between groups after electroerosion did not present significant differences when the side opposite the tightened side was analyzed, but the gold alloy group showed better fit when the tightened side was analyzed (12.8 +/- 1.4 microm for gold alloy; 29.6 +/- 4.4 microm for titanium) and when both screws were tightened (5.4 +/- 2.3 microm for gold alloy; 16.1 +/- 5.5 microm for titanium). Cast titanium prostheses, despite showing larger interfacial gaps between the prosthesis and abutment than those obtained with gold alloy, had improved fit after being subjected to electroerosion.

Management of major vascular injury during pedicle screw instrumentation of thoracolumbar spine.

PubMed

Mirza, Aleem K; Alvi, Mohammed Ali; Naylor, Ryan M; Kerezoudis, Panagiotis; Krauss, William E; Clarke, Michelle J; Shepherd, Daniel L; Nassr, Ahmad; DeMartino, Randall R; Bydon, Mohamad

2017-12-01

Vascular injury is a rare complication of spinal instrumentation. Presentation can vary from immediate hemorrhage to pseudoaneurysm formation. In the literature, surgical approach to repair has varied based on anatomy, acuity of diagnosis, infection, and available technology. In this manuscript, we aim to describe our institutional experience with vascular injuries in thoraco-lumbar spine surgery. We report our institutional experience of three cases of vascular injury secondary to pedicle screw misplacement and their management, as well as a review of the literature. The first case had a history of previous instrumentation and presented with back pain and fever. The patient was taken for instrumentation exploration via a posterior approach. Aortic violation was discovered at T6 intraoperatively during instrumentation removal and the patient underwent emergent endovascular repair. The second case presented with chronic back pain after multiple prior posterior fusions and CT angiogram showing screw perforation on the aorta at T10. The patient underwent elective endovascular repair with synchronous removal of the instrumentation. The third case presented with radicular leg pain 6 months after L4-S1 posterior lumbar interbody fusion, with CT scan demonstrating the left S1 screw abutting the L5 nerve root and common iliac vein. The patient underwent elective instrumentation revision with intraoperative venography. Major vascular injury is a known complication of spinal surgery, especially if it involves instrumentation with pedicle screws. Treatment approach has evolved with the advancement of endovascular technology; however, open surgery remains an option when anatomy or infection is prohibitive. In the elective setting, preoperative planning with attention to surgical approach, positioning, and contingencies, should occur in a multidisciplinary fashion. Repair with an aortic stent-graft cuff may minimize unnecessary coverage of the descending thoracic aorta and intercostal arteries. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessment of the stress transmitted to dental implants connected to screw-retained bars using different casting techniques.

PubMed

Haselhuhn, Klaus; Marotti, Juliana; Tortamano, Pedro; Weiss, Claudia; Suleiman, Lubna; Wolfart, Stefan

2014-12-01

Passive fit of the prosthetic superstructure is important to avoid complications; however, evaluation of passive fit is not possible using conventional procedures. Thus, the aim of this study was to check and locate mechanical stress in bar restorations fabricated using two casting techniques. Fifteen patients received four implants in the interforaminal region of the mandible, and a bar was fabricated using either the cast-on abutment or lost-wax casting technique. The fit accuracy was checked according to the Sheffield's test criteria. Measurements were recorded on the master model with a gap-free, passive fit using foil strain gauges both before and after tightening the prosthetic screws. Data acquisition and processing was analyzed with computer software and submitted to statistical analysis (ANOVA). The greatest axial distortion was at position 42 with the cast-on abutment technique, with a mean distortion of 450 μm/m. The lowest axial distortion occurred at position 44 with the lost-wax casting technique, with a mean distortion of 100 μm/m. The minimal differences between the means of axial distortion do not indicate any significant differences between the techniques (P = 0.2076). Analysis of the sensor axial distortion in relation to the implant position produced a significant difference (P < 0.0001). Significantly higher measurements were recorded in the axial distortion analysis of the distal sensors of implants at the 34 and 44 regions than on the mesial positions at the 32 and 42 regions (P = 0.0481). The measuring technique recorded axial distortion in the implant-supported superstructures. Distortions were present at both casting techniques, with no significant difference between the sides.

A comparison of two soldering techniques on the misfit of bar-retained implant-supported overdentures.

PubMed

Alvarez, Angel; Lafita, Pedro; de Llanos, Hector; Gago, Angel; Brizuela, Aritza; Ellacuria, Joseba J

2014-02-01

This study was conducted to measure and compare the effect of the soldering method (torch soldering or ceramic furnace soldering) used for soldering bars to bar-retained, implant-supported overdentures on the fit between the bar gold cylinder and implant transgingival abutment. Thirty-two overdenture implant bars were manufactured and screw retained into two Bränemark implants, which were attached to a cow rib. The bars were randomly distributed in two groups: a torch-soldering group and a porcelain-furnace soldering group. Then all bars were cut and soldered using a torch and a ceramic furnace. The fit between the bar gold cylinders and implant transgingival abutments was measured with a light microscope on the opposite side to the screw tightening side before and after the bar soldering procedure. The data obtained were statistically processed for paired and independent data. The average misfit for all bars before soldering was 33.83 to 54.04 μm. After cutting and soldering the bars, the misfit increased up to a range of 71.74 to 78.79 μm. Both before and after the soldering procedure, the bars soldered using a torch showed a higher misfit when compared to the bars soldered using a porcelain furnace. After the soldering procedure, the misfit was slightly lower on the left side of the bars, which had been soldered using a ceramic furnace. According to our data, the soldering of bars using the torch or furnace oven soldering techniques does not improve the misfit of one-piece cast bars on two implants. The lower misfit was obtained using the porcelain furnace soldering technique. © 2013 by the American College of Prosthodontists.

Complication incidence of two implant systems up to six years: a comparison between internal and external connection implants.

PubMed

Chae, Sung-Wook; Kim, Young-Sung; Lee, Yong-Moo; Kim, Won-Kyung; Lee, Young-Kyoo; Kim, Su-Hwan

2015-02-01

This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS). The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test. A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (P<0.001). Within the limitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.

Guided bone regeneration in the treatment of periimplantitis.

PubMed

Persson, L G; Ericsson, I; Berglundh, T; Lindhe, J

1996-12-01

The objective of the present experiment was to study the soft and hard tissue healing following treatment of experimentally induced periimplantitis. 5 labrador dogs about 1-year old were used. The mandibular right and left 1st molars, 4th and 3rd premolars were removed, titanium fixtures (Brånemark System) were installed, and standard abutments were connected in a 2nd stage procedure. After 3 months experimental periimplantitis was induced by the placement of cotton floss ligatures in a submarginal position. 6 weeks later the ligatures were removed. 1 month after ligature removal, an antibiotic regimen was initiated. During a 3-week period, each dog was given tablets of amoxicillin and metronidazole. In the left side of the mandible, buccal and lingual mucoperiosteal flaps were elevated and granulation tissue within the bone craters curetted. The abutments were removed. The exposed outer surfaces and the internal part of the fixtures were carefully cleaned with a detergent (delmopinol HC1). An e-PTFE membrane was placed over each fixture and adjusted to cover the bone crater. New cover screws were fitted through the membranes to the cleaned fixtures. The implants were submerged and the flaps sutured. In the right side of the mandible no local treatment was performed. The dogs were sacrificed after 4 months and biopsies prepared for histological examination. The findings indicated that treatment of a periimplantitis lesion, including comprehensive systemic antimicrobial therapy and cleaning of submerged implants resulted in (i) the elimination of the inflammatory process in the periimplant tissues and (ii) the establishment of a dense connective tissue capsule in direct contact with the previously exposed surface of the implant system. It was also observed that (iii) new bone was frequently laid down on the pristine cover screws.

Distribution of peri-implant stresses with a countertorque device.

PubMed

Sendyk, Claudio Luiz; Lopez, Thais Torralbo; de Araujo, Cleudmar Amaral; Sendyk, Wilson Roberto; Goncalvez, Valdir Ferreira

2013-01-01

To verify the effectiveness of a countertorque device in dental implants in redistributing stress to the bone-implant interface during tightening of the abutment screw. Two prismatic photoelastic samples containing implants were made, one with a 3.75-mm-diameter implant and the other with a 5.0-mm-diameter implant (both implants had an external-hexagon interface) and the respective abutments were attached (CeraOne). The samples were placed in a support and submitted to torques of 10, 20, 32, and 45 Ncm with an electronic torque meter. The torque application was repeated 10 times on each sample (n = 10) with and without a countertorque device. Photoelastic patterns were detected; thus, a photographic register of each test was selected. The fringe patterns were analyzed at discrete points near the implants' external arch. In both implants analyzed, a stress gradient reduction was observed through the implant with the countertorque device. The countertorque device used in this study proved to be effective in reducing the stresses generated in the peri-implant bone tissue during torque application.

Pedicle screws with a thin hydroxyapatite coating for improving fixation at the bone-implant interface in the osteoporotic spine: experimental study in a porcine model.

PubMed

Ohe, Makoto; Moridaira, Hiroshi; Inami, Satoshi; Takeuchi, Daisaku; Nohara, Yutaka; Taneichi, Hiroshi

2018-03-30

OBJECTIVE Instrumentation failure caused by the loosening of pedicle screws (PSs) in patients with osteoporosis is a serious problem after spinal surgery. The addition of a thin hydroxyapatite (HA) surface coating applied by using a sputtering process was reported recently to be a promising method for providing bone conduction around an implant without a significant risk of coating-layer breakage. In this study, the authors evaluated the biomechanical and histological features of the bone-implant interface (BII) of PSs with a thin HA coating in an in vivo porcine osteoporotic spine model. METHODS Three types of PSs (untreated/standard [STPS], sandblasted [BLPS], and HA-coated [HAPS] PSs) were implanted into the thoracic and lumbar spine (T9-L6) of 8 mature Clawn miniature pigs (6 ovariectomized [osteoporosis group] and 2 sham-operated [control group] pigs). The spines were harvested from the osteoporosis group at 0, 2, 4, 8, 12, or 24 weeks after PS placement and from the control group at 0 or 24 weeks. Their bone mineral density (BMD) was measured by peripheral quantitative CT. Histological evaluation of the BIIs was conducted by performing bone volume/tissue volume and bone surface/implant surface measurements. The strength of the BII was evaluated with extraction torque testing. RESULTS The BMD decreased significantly in the osteoporosis group (p < 0.01). HAPSs exhibited the greatest mean extraction peak torque at 8 weeks, and HAPSs and BLPSs exhibited significantly greater mean torque than the STPSs at 12 weeks (p < 0.05). The bone surface/implant surface ratio was significantly higher for HAPSs than for STPSs after 2 weeks (p < 0.05), and bonding between bone and the implant surface was maintained until 24 weeks with no detachment of the coating layer. In contrast, the bone volume/tissue volume ratio was significantly higher for HAPSs than for BLPSs or STPSs only at 4 weeks. CONCLUSIONS Using PSs with a thin HA coating applied using a sputtering process strengthens bonding at the BII, which might improve early implant fixation after spinal surgery for osteoporosis. However, the absence of increased bone mass around the screw remains a concern; prescribing osteoporosis treatment to improve bone quality might be necessary to prevent fractures around the screws.

Survival and failure modes: platform-switching for internal and external hexagon cemented fixed dental prostheses.

PubMed

Anchieta, Rodolfo B; Machado, Lucas S; Hirata, Ronaldo; Coelho, Paulo G; Bonfante, Estevam A

2016-10-01

This study evaluated the probability of survival (reliability) of platform-switched fixed dental prostheses (FDPs) cemented on different implant-abutment connection designs. Eighty-four-three-unit FDPs (molar pontic) were cemented on abutments connected to two implants of external or internal hexagon connection. Four groups (n = 21 each) were established: external hexagon connection and regular platform (ERC); external hexagon connection and switched platform (ESC); internal hexagon and regular platform (IRC); and internal hexagon and switched platform (ISC). Prostheses were subjected to step-stress accelerated life testing in water. Weibull curves and probability of survival for a mission of 100,000 cycles at 400 N (two-sided 90% CI) were calculated. The beta values of 0.22, 0.48, 0.50, and 1.25 for groups ERC, ESC, IRC, and ISC, respectively, indicated a limited role of fatigue in damage accumulation, except for group ISC. Survival decreased for both platform-switched groups (ESC: 74%, and ISC: 59%) compared with the regular matching platform counterparts (ERC: 95%, and IRC: 98%). Characteristic strength was higher only for ERC compared with ESC, but not different between internal connections. Failures chiefly involved the abutment screw. Platform switching decreased the probability of survival of FDPs on both external and internal connections. The absence in loss of characteristic strength observed in internal hexagon connections favor their use compared with platform-switched external hexagon connections. © 2016 Eur J Oral Sci.

Comparative study on stress distribution around internal tapered connection implants according to fit of cement- and screw-retained prostheses.

PubMed

Lee, Mi-Young; Heo, Seong-Joo; Park, Eun-Jin; Park, Ji-Man

2013-08-01

The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of α=.05. The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 µm/m at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit.

Establishment of Epithelial Attachment on Titanium Surface Coated with Platelet Activating Peptide

PubMed Central

Sugawara, Shiho; Maeno, Masahiko; Lee, Cliff; Nagai, Shigemi; Kim, David M.; Da Silva, John; Kondo, Hisatomo

2016-01-01

The aim of this study was to produce epithelial attachment on a typical implant abutment surface of smooth titanium. A challenging complication that hinders the success of dental implants is peri-implantitis. A common cause of peri-implantitis may results from the lack of epithelial sealing at the peri-implant collar. Histologically, epithelial sealing is recognized as the attachment of the basement membrane (BM). BM-attachment is promoted by activated platelet aggregates at surgical wound sites. On the other hand, platelets did not aggregate on smooth titanium, the surface typical of the implant abutment. We then hypothesized that epithelial BM-attachment was produced when titanium surface was modified to allow platelet aggregation. Titanium surfaces were coated with a protease activated receptor 4-activating peptide (PAR4-AP). PAR4-AP coating yielded rapid aggregation of platelets on the titanium surface. Platelet aggregates released robust amount of epithelial chemoattractants (IGF-I, TGF-β) and growth factors (EGF, VEGF) on the titanium surface. Human gingival epithelial cells, when they were co-cultured on the platelet aggregates, successfully attached to the PAR4-AP coated titanium surface with spread laminin5 positive BM and consecutive staining of the epithelial tight junction component ZO1, indicating the formation of complete epithelial sheet. These in-vitro results indicate the establishment of epithelial BM-attachment to the titanium surface. PMID:27741287

The effects of two torque values on the screw preload of implant-supported prostheses with passive fit or misfit.

PubMed

Al-Otaibi, Hanan Nejer; Akeel, Riyadh Fadul

2014-01-01

To determine the effect of increased torque of the abutment screw and retorquing after 10 minutes on implant-supported fixed prostheses. Two strain gauges (SGs) were attached to four implants stabilized on an acrylic resin mandible. Four implant-supported frameworks were constructed to represent passive fit (PF) and different amounts of misfit (MF1, MF2, and MF3). Vertical misfit was measured using a traveling microscope. Each framework was torqued to 35 Ncm (the manufacturer's recommendation) and 40 Ncm, and the preload was recorded immediately and again after retorquing 10 minutes later (torque stage). The smallest gap was observed under the PF framework. Three-way analysis of variance revealed significant effects of the framework, torque value, and torque stage on preload. The PF showed the highest mean preload under both torque values. An independent-sample t test between the torque values revealed a statistically significant difference only for MF1 and MF2. A dependent-sample t test of the torque stage revealed a statistically significant difference at a torque value of 35 Ncm under the PF and MF3 frameworks. Increasing the torque value beyond the manufacturer's recommended amount and retorquing of the screws at 10 minutes after the initial torque did not necessarily lead to a significant increase in preload in full-arch implant-supported fixed prostheses, particularly under non-passively fitting frameworks.

In Vitro and In Vivo Evaluations of Nano-Hydroxyapatite/Polyamide 66/Glass Fibre (n-HA/PA66/GF) as a Novel Bioactive Bone Screw

PubMed Central

Su, Bao; Peng, Xiaohua; Jiang, Dianming; Wu, Jun; Qiao, Bo; Li, Weichao; Qi, Xiaotong

2013-01-01

In this study, we prepared nano-hydroxyapatite/polyamide 66/glass fibre (n-HA/PA66/GF) bioactive bone screws. The microstructure, morphology and coating of the screws were characterised, and the adhesion, proliferation and viability of MC3T3-E1 cells on n-HA/PA66/GF scaffolds were determined using scanning electron microscope, CCK-8 assays and cellular immunofluorescence analysis. The results confirmed that n-HA/PA66/GF scaffolds were biocompatible and had no negative effect on MC3T3-E1 cells in vitro. To investigate the in vivo biocompatibility, internal fixation properties and osteogenesis of the bioactive screws, both n-HA/PA66/GF screws and metallic screws were used to repair intercondylar femur fractures in dogs. General photography, CT examination, micro-CT examination, histological staining and biomechanical assays were performed at 4, 8, 12 and 24 weeks after operation. The n-HA/PA66/GF screws exhibited good biocompatibility, high mechanical strength and extensive osteogenesis in the host bone. Moreover, 24 weeks after implantation, the maximum push-out load of the bioactive screws was greater than that of the metallic screws. As shown by their good cytocompatibility, excellent biomechanical strength and fast formation and ingrowth of new bone, n-HA/PA66/GF screws are thus suitable for orthopaedic clinical applications. PMID:23861888

Stability of the anterior arm of three different Hyrax hybrid expanders: an in vitro study

PubMed Central

de la Iglesia, Gonzalo; Walter, André; de la Iglesia, Fernando; Winsauer, Heinz; Puigdollers, Andreu

2018-01-01

ABSTRACT Introduction: The force applied to the teeth by fixed orthopaedic expanders has previously been studied, but not the force applied to the orthodontic mini-implant (OMI) used to expand the maxilla with Hyrax hybrid expanders (HHE). Objective: The aim of this article was to evaluate the clinical safety of the components (OMI, abutment and double wire arms) of three different force-transmitting systems (FTS) for conducting orthopaedic maxillary expansion: Jeil Medical & Tiger Dental™, Microdent™ and Ortholox™. Methods: For the realization of this in vitro study of the resistance to mechanical load, three different abutment types (bonded, screwed on, and coupling) and three different OMIs’ diameters (Jeil™ 2.5 mm, Microdent™ 1.6 mm and Ortholox™ 2.2 mm) were used. Ten tests for each of these three FTS were carried out in a static lateral load in artificial bone blocks (Sawbones™) by a Galdabini universal testing machine, then comparing its performance. Comparisons of loads, deformations and fractures were carried out by means of radiographs of FTS components in each case. Results: At 1- mm load and within the elastic deformation, FTS values ranged from 67 ± 13 N to 183 ± 48 N. Under great deformations, Jeil & Tiger™ was the one who withstood the greatest loads, with an average 378 ± 22 N; followed by Microdent™, with 201 ± 18 N, and Ortholox™, with 103 ± 10 N. At 3 mm load, the OMIs shaft bends and deforms when the diameter is smaller than 2.5 mm. The abutment fixation is crucial to transmit forces and moments. Conclusions: The present study shows the importance of a rigid design of the different components of HHEs, and also that HHEs would be suitable for maxillary expansion in adolescents and young adults, since its mean expansion forces exceed 120N. Furthermore, early abutment detachment or smaller mini-implants diameter would only be appropriate for children. PMID:29791684

Effect of crown-to-implant ratio on peri-implant stress: a finite element analysis.

PubMed

Verri, Fellippo Ramos; Batista, Victor Eduardo de Souza; Santiago, Joel Ferreira; Almeida, Daniel Augusto de Faria; Pellizzer, Eduardo Piza

2014-12-01

The aim of this study was to evaluate stress distribution in the fixation screws and bone tissue around implants in single-implant supported prostheses with crowns of different heights (10, 12.5, 15 mm - crown-to-implant ratio 1:1, 1.25:1, 1.5:1, respectively). It was designed using three 3-D models. Each model was developed with a mandibular segment of bone block including an internal hexagon implant supporting a screw-retained, single metal-ceramic crown. The crown height was set at 10, 12.5, and 15 mm with crown-to-implant ratio of 1:1, 1.25:1, 1.5:1, respectively. The applied forces were 200N (axial) and 100 N (oblique). The increase of crown height showed differences with the oblique load in some situations. By von Mises' criterion, a high stress area was concentrated at the implant/fixation screw and abutment/implant interfaces at crown-to-implant ratio of 1:1, 1.25:1, 1.5:1, respectively. Using the maximum principal criteria, the buccal regions showed higher traction stress intensity, whereas the distal regions showed the largest compressive stress in all models. The increase of C/I ratio must be carefully evaluated by the dentist since the increase of this C/I ratio is proportional to the increase of average stress for both screw fixation (C/I 1:1 to 1:1.25 ratio=30.1% and C/I 1:1 to 1:1.5 ratio=46.3%) and bone tissue (C/I 1:1 to 1:1.25 ratio=30% and C/I 1:1 to 1:1.5 ratio=51.5%). Copyright © 2014 Elsevier B.V. All rights reserved.

Displacement of screw-retained splinted and nonsplinted restorations into implants with conical internal connections.

PubMed

Yilmaz, Burak; Seidt, Jeremy D; Clelland, Nancy L

2014-01-01

Variable abutment displacement could potentially affect proximal contacts, incisal edge position, or occlusion of implant-supported prostheses. This study aimed to measure and compare displacements of splinted and nonsplinted restorations into implants featuring internal conical connections as screws were tightened by hand or by torque driver. A stereolithic resin model was printed using computed tomography data from a patient missing mandibular left first and second molars. Two 5.0 × 11-mm implants were placed in the edentulous site using a surgical guide. Two sets (splinted and nonsplinted) of gold screw-retained prostheses were made indirectly to fit the implants in the stereolithic model representing the patient. The axial position of the crowns relative to a fixed location on the model was recorded following hand tightening using the three-dimensional image correlation technique and image correlation software. A pair of high-resolution digital cameras provided a synchronized view of the model during the experiment. Relative crown positions were again recorded after tightening with a torque driver to 25 Ncm. Testing was repeated randomly three times for each set of crowns. Displacement data after torque tightening were compared using a factorial analysis of variance with JMP 9.0 software (SAS) followed by a Tukey-Kramer post hoc test (α = .05). Interproximal contacts were evaluated using an 8-μm tin foil shim after tightening by hand and torque driver. Displacements for splinted and nonsplinted restorations differed only in a buccal direction. The nonsplinted crowns displaced significantly more than splinted crowns. Discernible differences were observed for the tin foil shim when dragged through proximal contacts following hand versus torque tightening. Differences between screw tightening by hand or torque driver should be taken into consideration during laboratory and clinical adjustments to prevent esthetic and functional complications.

Technical complications of implant-causes and management: A comprehensive review

PubMed Central

Gupta, Swati; Gupta, Hemant; Tandan, Amrit

2015-01-01

Given the increasing popularity of dental implants, the number of failures due to late implant fracture is also expected to increase. Hence, the scope for prevention and management needs to be emphasized. The objective of this review article is to analyze the various causes of failure of dental implants due to implant fixture/abutment screw fractures and also to enumerate the management and the preventive options for these failures, thereby aiming to help the clinicians to properly plan the implant-supported prosthesis treatment by considering the important biomechanical aspects of this type of rehabilitation. The present review emphasizes the causes and management of technical complications and not the incidence of such complications. PMID:26668445

Osseointegration and biocompatibility of different metal implants - a comparative experimental investigation in sheep

PubMed Central

2012-01-01

Background In the present study, 4 different metallic implant materials, either partly coated or polished, were tested for their osseointegration and biocompatibility in a pelvic implantation model in sheep. Methods Materials to be evaluated were: Cobalt-Chrome (CC), Cobalt-Chrome/Titanium coating (CCTC), Cobalt-Chrome/Zirconium/Titanium coating (CCZTC), Pure Titanium Standard (PTST), Steel, TAN Standard (TANST) and TAN new finish (TANNEW). Surgery was performed on 7 sheep, with 18 implants per sheep, for a total of 63 implants. After 8 weeks, the specimens were harvested and evaluated macroscopically, radiologically, biomechanically (removal torque), histomorphometrically and histologically. Results Cobalt-Chrome screws showed significantly (p = 0.031) lower removal torque values than pure titanium screws and also a tendency towards lower values compared to the other materials, except for steel. Steel screws showed no significant differences, in comparison to cobalt-chrome and TANST, however also a trend towards lower torque values than the remaining materials. The results of the fluorescence sections agreed with those of the biomechanical test. Histomorphometrically, there were no significant differences of bone area between the groups. The BIC (bone-to-implant-contact), used for the assessment of the osseointegration, was significantly lower for cobalt-chrome, compared to steel (p = 0.001). Steel again showed a lower ratio (p = 0.0001) compared to the other materials. Conclusion This study demonstrated that cobalt-chrome and steel show less osseointegration than the other metals and metal-alloys. However, osseointegration of cobalt-chrome was improved by zirconium and/or titanium based coatings (CCTC, TANST, TAN, TANNEW) being similar as pure titanium in their osseointegrative behavior. PMID:22400715

Electrical apparatus lockout device

DOEpatents

Gonzales, Rick

1999-01-01

A simple lockout device for electrical equipment equipped with recessed power blades is described. The device comprises a face-plate (12) having a threaded member (14) attached thereto and apertures suitable for accommodating the power blades of a piece of electrical equipment, an elastomeric nose (16) abutting the face-plate having a hole for passage of the threaded member therethrough and power blade apertures in registration with those of the face-plate, a block (20) having a recess (34) in its forward face for receiving at least a portion of the hose, a hole therein for receiving the threaded member and an integral extension (26) extending from its rear face. A thumb screw (22) suitable for turning with the hands and having internal threads suitable for engaging the threaded member attached to the face-plate is inserted into a passage in the integral extension to engage the threaded member in such a fashion that when the device is inserted over the recessed power blades of a piece of electrical equipment and the thumb screw (22) tightened, the elastomeric nose (16) is compressed between the face-plate (12) and the block (20) forcing it to expand laterally thereby securing the device in the recess and precluding the accidental or intentional energization of the piece of equipment by attachment of a power cord to the recessed power blades. Means are provided in the interval extension and the thumb screw for the attachment of a locking device (46) which will satisfy OSHA standards.

Influence of bicortical techniques in internal connection placed in premaxillary area by 3D finite element analysis.

PubMed

Verri, Fellippo Ramos; Cruz, Ronaldo Silva; Lemos, Cleidiel Aparecido Araújo; de Souza Batista, Victor Eduardo; Almeida, Daniel Augusto Faria; Verri, Ana Caroline Gonçales; Pellizzer, Eduardo Piza

2017-02-01

The aim of study was to evaluate the stress distribution in implant-supported prostheses and peri-implant bone using internal hexagon (IH) implants in the premaxillary area, varying surgical techniques (conventional, bicortical and bicortical in association with nasal floor elevation), and loading directions (0°, 30° and 60°) by three-dimensional (3D) finite element analysis. Three models were designed with Invesalius, Rhinoceros 3D and Solidworks software. Each model contained a bone block of the premaxillary area including an implant (IH, Ø4 × 10 mm) supporting a metal-ceramic crown. 178 N was applied in different inclinations (0°, 30°, 60°). The results were analyzed by von Mises, maximum principal stress, microstrain and displacement maps including ANOVA statistical test for some situations. Von Mises maps of implant, screws and abutment showed increase of stress concentration as increased loading inclination. Bicortical techniques showed reduction in implant apical area and in the head of fixation screws. Bicortical techniques showed slight increase stress in cortical bone in the maximum principal stress and microstrain maps under 60° loading. No differences in bone tissue regarding surgical techniques were observed. As conclusion, non-axial loads increased stress concentration in all maps. Bicortical techniques showed lower stress for implant and screw; however, there was slightly higher stress on cortical bone only under loads of higher inclinations (60°).

13. Looking north, from the southern approach to the bridge. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Looking north, from the southern approach to the bridge. The bridge deck, which is concrete with several patch coats of asphalt (now chiefly gravel and some turf), demonstrates a sharp gradient from the abutment to the bridge center line. - Vigo County Bridge No. 139, Spanning Sugar Creek at Seventy-fourth Place, Terre Haute, Vigo County, IN

Three tumor patients with total maxillectomy rehabilitated with implant-supported frameworks and maxillary obturators: a follow-up report.

PubMed

Örtorp, Anders

2010-12-01

Few reports are available on treatment using implant-supported frameworks with maxillary obturators after total maxillectomy on tumor patients. To describe, evaluate, and report the clinical and radiographic performance of implant-supported frameworks and maxillary obturators after maxillectomy during the first years of function. Three patients with cancer in the maxillary region treated by total maxillectomy were rehabilitated. Seventeen dental and two craniofacial implants were installed, and the patients each received implant-supported, screw-retained, three-unit frameworks with a U-shaped bar and obturators retained by four magnetic attachments. Clinical and radiographic data were collected up to 7 years of follow-up. The frequency of complications was low. Two craniofacial implants and one dental implant were loose and removed at abutment connection. No implants were lost after framework connection, and the mean marginal bone loss was small. Within the limitations of this report, dental implants are useful for rehabilitation of total maxillectomy patients, and a three-unit, screw-retained, implant-supported framework with maxillary obturator retained by magnetic attachment is a successful treatment concept for this patient group. © 2009, Copyright the Author. Journal Compilation © 2010, Wiley Periodicals, Inc.

An overview of U.S. predoctoral dental implant programs and their directors.

PubMed

Barwacz, Christopher A; Avila-Ortiz, Gustavo; Allareddy, Veerasathpurush; Tamegnon, Monelle; Hoogeveen, Kaitlin

2015-03-01

The aim of this study was to provide an overview of current predoctoral implant programs in the United States, including curricular characteristics and clinical practices regarding implant therapy education and program directors' characteristics. An electronic survey was sent to predoctoral implant program directors of all 64 accredited U.S. dental schools; 52 of the 60 eligible programs responded, for a response rate of 87%. The responding program directors were primarily affiliated with either prosthodontics departments (44%) or restorative dentistry departments (40%). Structurally, 80.8% of the responding schools integrate their implant programs into the third year of the curriculum. Clinical implant therapy exercises reported were simulation exercises without direct patient care (90.4% of responding schools) and direct patient care under supervision (94.2%). The most frequently taught restorative modalities are posterior single-tooth implant crown (96.2%), mandibular implant-retained overdenture (88.5%), and anterior implant-supported single crown (61.5%). A majority (74.5%) of responding programs utilize analog surgical guide planning, while 25.5% reported use of digital guided surgery planning software. All schools in the Northwest and 66.7% in the South Central regions utilize custom abutments as the primary abutment design, while a majority of schools in the North Central (62.5%), Northeast (53.8%), Southwest (66.7%), and Southeast (80%) regions use stock abutments (p=0.02). Regional differences were significant with regard to fixation modality, with all the Northwest programs using screw retention and 90% of Southeast and 87.5% of North Central programs using cement retention (p=0.002). This study demonstrated that while institutions share program director and curricular similarities, clinical practices and modalities vary significantly by region.

Effect of Steam Autoclaving on the Tensile Strength of Resin Cements Used for Bonding Two-Piece Zirconia Abutments.

PubMed

Fadanelli, Marcos Alexandre; Amaral, Flávia Lucisano Botelho do; Basting, Roberta Tarkany; Turssi, Cecilia Pedroso; Sotto-Maior, Bruno Salles; França, Fabiana Mantovani Gomes

2017-04-01

The purpose of this study was to evaluate the effects of steam autoclave sterilization on the tensile strength of two types of resin cements used to bond customized CAD/CAM zirconia abutments onto titanium bases. Forty sets of zirconia abutments cemented to screwed titanium bases of implants analogs were divided into 4 groups (n = 10). Two groups were treated with a conventional chemically activated resin cement (ML, Multilink Ivoclar Vivadent) and the other two groups with a self-adhesive dual resin cement (RelyX U200, 3M ESPE). One group from each cement was submitted to steam autoclaving. The autoclave sterilization cycle was performed after 72 hours of cementation for 15 minutes at 121°C and 2.1 Kgf/cm 2 . The samples were subjected to tensile strength testing in a universal testing machine (200 Kgf, 0.5 mm/min), from which the means and standard deviations were obtained in Newtons. Results showed (via ANOVA and Tukey's test; α = 0.05) that in the absence of steam autoclaving, no difference was observed in tensile strength between the cements tested: ML: 344.87 (93.79) and U200: 280 (92.42) (P = .314). Steam autoclaving, however, significantly increased tensile strength for the ML: 465.42 (87.87) compared to U200: 289.10 (49.02) (P < .001). Despite the significant increase in the ML samples (P = .013), autoclaving did not affect the tensile strength of the U200 samples (P > 0.05). The authors concluded that steam autoclaving increases the mean tensile strength of the chemically activated cement compared to the dual-cure self-adhesive cement. The performance of both cements evaluated was similar if the sterilization step was disconsidered.

Optimising implant anchorage (augmentation) during fixation of osteoporotic fractures: is there a role for bone-graft substitutes?

PubMed

Larsson, Sune; Procter, Philip

2011-09-01

When stabilising a fracture the contact between the screw and the surrounding bone is crucial for mechanical strength. Through development of screws with new thread designs, as well as optimisation of other properties, improved screw purchase has been gained. Other alternatives to improve screw fixation in osteoporotic bone, as well as normal bone if needed, includes the use of various coatings on the screw that will induce a bonding between the implant surface and the bone implant, as well as application of drugs such as bisphosphonates locally in the screw hole to induce improved screw anchorage through their anticatabolic effect on the bone tissue. As failure of internal fixation of fractures in osteoporotic bone typically occurs through breakage of the bone that surrounds the implant, rather than the implant itself, an alternative strategy in osteoporotic bone can include augmentation of the bone around the screw. This is useful when screws alone are being used for fixation, as it will increase pull-out resistance, but also when conventional plates and screws are used. In angularly stable plate-screw systems, screw back-out is not a problem if the locking mechanism between the screws and the plate works. However, augmentation that will strengthen the bone around the screws can also be useful in conjunction with angle-stable plate-screw systems, as the augmentation will provide valuable support when subjected to loading that might cause cut-out. For many years conventional bone cement, polymethylmethacrylate (PMMA), has been used for augmentation, but due to side effects--including great difficulties if removal becomes necessary--the use of PMMA has never gained wide acceptance. With the introduction of bone substitutes, such as calcium phosphate cement, it has been shown that augmentation around screws can be achieved without the drawbacks seen with PMMA. When dealing with fixation of fractures in osteoporotic bone where screw stability might be inadequate, it therefore seems an attractive option to include bone substitutes for augmentation around screws as part of the armamentarium. Clinical studies now are needed to determine the indications in which bone augmentation with bone-graft substitutes (BGSs) would merit clinical usage. Copyright © 2011. Published by Elsevier Ltd.

Effect of zirconium nitride physical vapor deposition coating on preosteoblast cell adhesion and proliferation onto titanium screws.

PubMed

Rizzi, Manuela; Gatti, Giorgio; Migliario, Mario; Marchese, Leonardo; Rocchetti, Vincenzo; Renò, Filippo

2014-11-01

Titanium has long been used to produce dental implants. Problems related to its manufacturing, casting, welding, and ceramic application for dental prostheses still limit its use, which highlights the need for technologic improvements. The aim of this in vitro study was to evaluate the biologic performance of titanium dental implants coated with zirconium nitride in a murine preosteoblast cellular model. The purpose of this study was to evaluate the chemical and morphologic characteristics of titanium implants coated with zirconium nitride by means of physical vapor deposition. Chemical and morphologic characterizations were performed by scanning electron microscopy and energy dispersive x-ray spectroscopy, and the bioactivity of the implants was evaluated by cell-counting experiments. Scanning electron microscopy and energy dispersive x-ray spectroscopy analysis found that physical vapor deposition was effective in covering titanium surfaces with zirconium nitride. Murine MC-3T3 preosteoblasts were seeded onto titanium-coated and zirconium nitride-coated screws to evaluate their adhesion and proliferation. These experiments found a significantly higher number of cells adhering and spreading onto zirconium nitride-coated surfaces (P<.05) after 24 hours; after 7 days, both titanium and zirconium nitride surfaces were completely covered with MC-3T3 cells. Analysis of these data indicates that the proposed zirconium nitride coating of titanium implants could make the surface of the titanium more bioactive than uncoated titanium surfaces. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

New 3D technologies applied to assess the long-term clinical effects of misfit of the full jaw fixed prosthesis on dental implants.

PubMed

Jokstad, Asbjørn; Shokati, Babak

2015-10-01

To assess implant:suprastructure misfit in patients with an edentulous jaw restored by an implant-retained fixed dental prosthesis (FDP) and its association with biologic and mechanical adverse events over an extensive period. Thirty patients with an edentulous mandible treated with implant-supported prosthetics before 2000 were examined clinically in 2012. Each patient had received 4 to 6 implants to retain a FDP made from acrylic and three different metal alloys, that is, Ag-Pd, Pd-Ag, and Au type IV. The implant intra-oral locations were recorded digitally by use of an intra-oral scanner, and the intaglio surface of the detached FDP was recorded using a desktop scanner. The fit was estimated by digital matching of the STL files using industrial metrological software. The average misfit was correlated with the average marginal bone loss and the prevalence of screw loosening or fractures, using the patient as the statistical unit. Over an average of 19 years (range 12 to 32), 5 implants had been lost in 4 participants (96.7% implant survival) and 8 eight prostheses (26.7%) had been remade. Anaverage misfit was 150 μm (SD 35, range 95-232, CI 138-163). An average marginal bone loss of 2.2 mm (SD = 0.7) had occurred (range 0.6 to 5.8 mm) for individual implants. The correlation between framework misfit and marginal bone loss was weak (R² = 0.04) (P = 0.29). The prostheses with a history of screw-related adverse events showed average misfit of 169 μm (SD = 32) vs. those with no history of screw-related adverse events, that is, 134 μm (SD = 30) (P = 0.005, Student's t-test). Fourteen of the 30 participants had experienced at least one incidence of screw loosening or fracture of prosthetic or abutment screw(s) over the period of follow-up. The occurrence among the frameworks fabricated with different metal alloys did not differ (P > 0.05, Fisher's exact test). Combining STL files with best-fit algorithms to appraise misfit is feasible using metrological software. The effect of misfit between the superstructures on its supporting implants up to ~230 μm on the long-term clinical outcomes appears to be minor, apart from a slightly higher risk of screw-related adverse events. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of the Surface Characteristics of Various Implant Abutment Materials Using Confocal Microscopy and White Light Interferometry.

PubMed

Park, Jun-Beom; Yang, Seung-Min; Ko, Youngkyung

2015-12-01

The purpose of this study was to evaluate the surface characteristics of various implant abutment materials, such as of titanium alloy (Ti6Al4V; Ma), machined cobalt-chrome-molybdenum alloy (CCM), titanium nitride coating on a titanium alloy disc (TiN), anodic oxidized titanium alloy disc (AO), composite resin coating on a titanium alloy disc (Res), and zirconia disc (Zr), using confocal microscopy and white light interferometry. Measurements from the 2 methods were evaluated to see if these methods would give equivalent results. The precision of measurements were evaluated by the coefficient of variation. Five discs each of Ma, CCM, TiN, AO, Res, and Zr were used. The surface roughness was evaluated by confocal laser microscopy and white light interferometry. Confocal microscopy showed that the Res group showed significantly greater Ra, Rq, Rz, Sa, Sq, and Sz values compared with those of the Ma group (P < 0.05). The white light interferometry results showed that the Res group had significantly higher Ra, Rq, Rz, Rt, Sa, Sq, Sz, and Sdr values compared with the Ma group (P < 0.05). All the roughness parameters obtained from the 2 methods differed, and the Sa values of the Zr group from confocal microscopy were greater by 0.163 μm than those obtained by white light interferometry. Least difference was seen in the TiN group where the difference was 0.058 μm. Roughness parameters of different abutment materials varied significantly. Precision of measurement differed according to the characteristics of the material used. White light interferometry could be recommended for measurement of TiN and AO. Confocal microscopy gave more precise measurements for Ma and CCM groups. The optical characteristics of the surface should be considered before choosing the examination method.

46 CFR 160.061-3 - Design and construction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... screw and shall be shaped to conform to the contour of the spoon. Feathers, if provided, shall be yellow hackle feathers attached to the hook by wrapping with thread, and the wrapping coated with red lacquer...

46 CFR 160.061-3 - Design and construction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... screw and shall be shaped to conform to the contour of the spoon. Feathers, if provided, shall be yellow hackle feathers attached to the hook by wrapping with thread, and the wrapping coated with red lacquer...

46 CFR 160.061-3 - Design and construction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... screw and shall be shaped to conform to the contour of the spoon. Feathers, if provided, shall be yellow hackle feathers attached to the hook by wrapping with thread, and the wrapping coated with red lacquer...

Improving the API dissolution rate during pharmaceutical hot-melt extrusion I: Effect of the API particle size, and the co-rotating, twin-screw extruder screw configuration on the API dissolution rate.

PubMed

Li, Meng; Gogos, Costas G; Ioannidis, Nicolas

2015-01-15

The dissolution rate of the active pharmaceutical ingredients in pharmaceutical hot-melt extrusion is the most critical elementary step during the extrusion of amorphous solid solutions - total dissolution has to be achieved within the short residence time in the extruder. Dissolution and dissolution rates are affected by process, material and equipment variables. In this work, we examine the effect of one of the material variables and one of the equipment variables, namely, the API particle size and extruder screw configuration on the API dissolution rate, in a co-rotating, twin-screw extruder. By rapidly removing the extruder screws from the barrel after achieving a steady state, we collected samples along the length of the extruder screws that were characterized by polarized optical microscopy (POM) and differential scanning calorimetry (DSC) to determine the amount of undissolved API. Analyses of samples indicate that reduction of particle size of the API and appropriate selection of screw design can markedly improve the dissolution rate of the API during extrusion. In addition, angle of repose measurements and light microscopy images show that the reduction of particle size of the API can improve the flowability of the physical mixture feed and the adhesiveness between its components, respectively, through dry coating of the polymer particles by the API particles. Copyright © 2014. Published by Elsevier B.V.

Soldering in prosthodontics--an overview, part I.

PubMed

Byrne, Gerard

2011-04-01

The fit of fixed multiunit dental prostheses (FDP), traditionally termed fixed partial dentures (FPDs), is an ongoing problem. Poorly fitting restorations may hasten mechanical failure, due to abutment caries or screw failure. Soldering and welding play an important role in trying to overcome misfit of fixed multiunit prostheses. The term FPD will be used to denote multiunit fixed dental prostheses in this review. This is the first of a series of articles that review the state of the art and science of soldering and welding in relation to the fit of cemented or screw-retained multiunit prostheses. A comprehensive archive of background information and scientific findings is presented. Texts in dental materials and prosthodontics were reviewed. Scientific data were drawn from the numerous laboratory studies up to and including 2009. The background, theory, terminology, and working principles, along with the applied research, are presented. This first article focuses on soldering principles and dimensional accuracy in soldering. There is some discussion and suggestions for future research and development. Soldering may improve dimensional accuracy or reduce the distortion of multiunit fixed prostheses. Many variables can affect the outcome in soldering technique. Research science has developed some helpful guidelines. Research projects are disconnected and limited in scope. © 2011 by The American College of Prosthodontists.

Fit of screw-retained fixed implant frameworks fabricated by different methods: a systematic review.

PubMed

Abduo, Jaafar; Lyons, Karl; Bennani, Vincent; Waddell, Neil; Swain, Michael

2011-01-01

The aim of this study was to review the published literature investigating the accuracy of fit of fixed implant frameworks fabricated using different materials and methods. A comprehensive electronic search was performed through PubMed (MEDLINE) using Boolean operators to combine key words. The search was limited to articles written in English and published through May 2010. In addition, a manual search through articles and reference lists retrieved from the electronic search and peer-reviewed journals was also conducted. A total of 248 articles were retrieved, and 26 met the specified inclusion criteria for the review. The selected articles assessed the fit of fixed implant frameworks fabricated by different techniques. The investigated fabrication approaches were one-piece casting, sectioning and reconnection, spark erosion with an electric discharge machine, computer-aided design/computer-assisted manufacturing (CAD/CAM), and framework bonding to prefabricated abutment cylinders. Cast noble metal frameworks have a predictable fit, and additional fit refinement treatment is not indicated in well-controlled conditions. Base metal castings do not provide a satisfactory level of fit unless additional refinement treatment is performed, such as sectioning and laser welding or spark erosion. Spark erosion, framework bonding to prefabricated abutment cylinders, and CAD/CAM have the potential to provide implant frameworks with an excellent fit; CAD/CAM is the most consistent and least technique-sensitive of these methods.

Fatigue Failure of External Hexagon Connections on Cemented Implant-Supported Crowns.

PubMed

Malta Barbosa, João; Navarro da Rocha, Daniel; Hirata, Ronaldo; Freitas, Gileade; Bonfante, Estevam A; Coelho, Paulo G

2018-01-17

To evaluate the probability of survival and failure modes of different external hexagon connection systems restored with anterior cement-retained single-unit crowns. The postulated null hypothesis was that there would be no differences under accelerated life testing. Fifty-four external hexagon dental implants (∼4 mm diameter) were used for single cement-retained crown replacement and divided into 3 groups: (3i) Full OSSEOTITE, Biomet 3i (n = 18); (OL) OEX P4, Osseolife Implants (n = 18); and (IL) Unihex, Intra-Lock International (n = 18). Abutments were torqued to the implants, and maxillary central incisor crowns were cemented and subjected to step-stress-accelerated life testing in water. Use-level probability Weibull curves and probability of survival for a mission of 100,000 cycles at 200 N (95% 2-sided confidence intervals) were calculated. Stereo and scanning electron microscopes were used for failure inspection. The beta values for 3i, OL, and IL (1.60, 1.69, and 1.23, respectively) indicated that fatigue accelerated the failure of the 3 groups. Reliability for the 3i and OL (41% and 68%, respectively) was not different between each other, but both were significantly lower than IL group (98%). Abutment screw fracture was the failure mode consistently observed in all groups. Because the reliability was significantly different between the 3 groups, our postulated null hypothesis was rejected.

Effect of Induced Periimplantitis on Dental Implants With and Without Ultrathin Hydroxyapatite Coating.

PubMed

Madi, Marwa; Zakaria, Osama; Ichinose, Shizuko; Kasugai, Shohei

2016-02-01

The aim of this study was to compare the effect of ligature-induced periimplantitis on dental implants with and without hydroxyapatite (HA) coat. Thirty-two dental implants (3.3 mm wide, 13 mm long) with 4 surface treatments (8 implant/group) (M: machined, SA: sandblasted acid etched, S: sputter HA coat and P: plasma-sprayed HA coat) were inserted into canine mandibles. After 12 weeks, oral hygiene procedures were stopped and silk ligatures were placed around the implant abutments to allow plaque accumulation for the following 16 weeks. Implants with the surrounding tissues were retrieved and prepared for histological examination. Bone-to-implant contact (BIC) and implant surfaces were examined using scanning electron microscopy and energy dispersive x-ray spectroscopy. Histological observation revealed marginal bone loss and large inflammatory cell infiltrates in the periimplant soft tissue. Sputter HA implants showed the largest BIC (98.1%) and machined implant showed the smallest values (70.4%). After 28 weeks, thin sputter HA coat was almost completely dissolved, whereas plasma-sprayed HA coat showed complete thickness preservation. Thin sputter HA-coated implants showed more bone implant contact and less marginal bone loss than thick HA-coated implants under periimplantitis condition.

Minimally Invasive Sacroiliac Joint Fusion Using a Novel Hydroxyapatite-Coated Screw: Preliminary 1-Year Clinical and Radiographic Results of a 2-Year Prospective Study.

PubMed

Rappoport, Louis H; Luna, Ingrid Y; Joshua, Gita

2017-05-01

Proper diagnosis and treatment of sacroiliac joint (SIJ) pain remains a clinical challenge. Dysfunction of the SIJ can produce pain in the lower back, buttocks, and extremities. Triangular titanium implants for minimally invasive surgical arthrodesis have been available for several years, with reputed high levels of success and patient satisfaction. This study reports on a novel hydroxyapatite-coated screw for surgical treatment of SIJ pain. Data were prospectively collected on 32 consecutive patients who underwent minimally invasive SIJ fusion with a novel hydroxyapatite-coated screw. Clinical assessments and radiographs were collected and evaluated at 3, 6, and 12 months postoperatively. Mean (standard deviation) patient age was 55.2 ± 10.7 years, and 62.5% were female. More patients (53.1%) underwent left versus right SIJ treatment, mean operative time was 42.6 ± 20.4 minutes, and estimated blood loss did not exceed 50 mL. Overnight hospital stay was required for 84% of patients, and the remaining patients needed a 2-day stay (16%). Mean preoperative visual analog scale back and leg pain scores decreased significantly by 12 months postoperatively (P < 0.01). Mechanical stability was achieved in 93.3% (28/30) of patients, and all patients who were employed preoperatively returned to work within 3 months. Two patients who required revision surgery reported symptom improvement within 3 weeks and did not require subsequent surgery. Positive clinical outcomes are reported 1 year postoperatively after implantation of a novel implant to treat sacroiliac joint pain. Future clinical studies with larger samples are warranted to assess long-term patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of effectiveness of cement removal from implant-retained crowns using a proposed circular crisscross flossing technique.

PubMed

Ferreira, Cimara Fortes; Shafter, Mohamed Amer; Jain, Vinay; Wicks, Russel Anthony; Linder, Erno; Ledo, Carlos Alberto da Silva

2018-02-13

Extruded cement during dental implant crown cementation may cause peri-implant diseases if not removed adequately. Evaluate the efficiency of removal of cement after cementation of implant crowns using an experimental "circular crisscross flossing technique (CCCFT) flossing technique, compared to the conventional "C" shape flossing technique (CSFT). Twenty-four patients rendered 29 experimental and 29 control crowns. Prefabricated abutments were secured to the implant with the margins at least 1 mm subgingivally. The abutments were scanned using CADCAM technology and Emax crowns were fabricated in duplicates. Each crown was cemented separately and excess cement was removed using the CSFT and the CCFT techniques. After completion of cementation was completed, the screw access holes were accessed and the crown was unscrewed along with the abutment. The samples were disinfected using 70% ethanol for 10 minutes. Crowns were divided into 4 parts using a marker in order to facilitate measurement data collection. Vertical and horizontal measurements were made for extruded cement for each control and experimental groups by means of a digital microscope. One-hundred and seventeen measurements were made for each group. Mann-Whitney test was applied to verify statistical significance between the groups. The CCFT showed a highly statistically significant result (104.8 ± 13.66, p<0.0001) for cement removal compared with the CSFT (291.8 ± 21.96, p<0.0001). The vertical lengths of the extruded cement showed a median of 231.1 µm (IQR = 112.79 -398.39) and 43.62 µm (IQR = 0 - 180.21) for the control and the experimental flossing techniques, respectively. The horizontal length of the extruded cement showed a median of 987.1 µm (IQR = 476.7 - 1,933.58) and 139.2 µm (IQR = 0 - 858.28) for the control and the experimental flossing techniques, respectively. The CCFT showed highly statistically significant less cement after implant crowns cementation when compared with the CSFT.

Clinical Outcome of Double Crown-Retained Mandibular Removable Dentures Supported by a Combination of Residual Teeth and Strategic Implants.

PubMed

Rinke, Sven; Ziebolz, Dirk; Ratka-Krüger, Petra; Frisch, Eberhard

2015-07-01

There is a lack of data regarding the clinical outcome of removable partial dentures (RPDs) supported by a combination of residual natural teeth and implants placed in strategic positions. The aim of the present case series was to conduct a retrospective investigation of the clinical outcome of mandibular tooth-implant-retained partial dentures (TIRPD) rigidly retained via telescopic double crowns. Between 1999 and 2010, 18 patients with reduced residual dentition (1 to 3 natural abutment teeth) and in need of an RPD received 1 to 3 implants in strategic positions for support of the removable prostheses. All TIRPDs were rigidly retained by telescopic crowns according to the Marburg Double Crown (MDC) technique; all prostheses were placed in a private practice. Tooth/implant survival and success rates, prosthetic maintenance requirements, and peri-implant parameters were analyzed retrospectively using patient records and clinical examinations during the final recall appointments. Only patients attending at least annual supportive post-implant hygiene therapy visits (SIT) were included. After a mean functional period of 5.84 ± 3 years (range: 3.01-12.21), 14 patients with 14 dentures supported by 24 implants and 27 teeth (mean number of abutments: 3.6) were available for assessment. Four teeth (survival rate: 85.19%) and no implants (survival rate: 100%) were lost. Peri-implantitis was observed around one implant (4.17%). All 14 dentures were functional (survival rate: 100%) and required only limited maintenance (i.e., screw loosening, acrylic resin fracture repairs, relining) amounting to 0.086 treatments per patient per year (T/P/Y). Within the limitations of this case series, it can be concluded that TIRPDs retained via MDCs might represent a viable treatment option in mandibles with few remaining abutment teeth. Further long-term clinical evaluations with a greater sample size are needed for a more detailed evaluation of this treatment concept. © 2014 by the American College of Prosthodontists.

Torque resistance of impression copings after direct implant impression: An in vitro evaluation of impression materials with and without adhesive.

PubMed

Auroy, Pascal; Nicolas, Emanuel; Bedouin, Yvan

2017-01-01

No data are available on the ability of an impression coping to resist the manual placement of an abutment replica (implant analog) during prosthodontic laboratory procedures after a direct (pick-up) impression. The purpose of this in vitro study was to evaluate the torque resistance of impression copings after a direct impression, that is, the amount of rotational torque sufficient to induce irreversible displacement of impression copings in the impression material bulk once the impression has been made. A reference model with 5 abutment replicas was constructed. Five impression copings were screwed onto the abutment replicas, and standardized impressions were made. A controlled twisting force was applied to each impression coping. A torque tester recorded the torque variation. Three elastomeric impression materials were tested. ANOVA and the Tukey test (α=.05) were performed using an average of 30 measurements per impression material, with and without adhesive. ANOVA and the Tukey test results showed that the adhesive, cohesive, and mechanical bonds between the impression coping and the impression material depended greatly on the type of material and that the average rupture threshold of these bonds was statistically significantly different in pairwise comparisons (P<.05). The curve analysis showed that when the impression materials are used with adhesives, the deformation of the interface is irreversible beyond 5 Ncm of torque. The polyether impression material is the direct impression material that showed the highest breakdown threshold for adhesive bonding when used without an adhesive. The use of an adhesive on impression copings leads to irreversible deformation of the interface at torque stresses well below the adhesive bond threshold of the same materials used without an adhesive. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Microstructure of titanium-cement-lithium disilicate interface in CAD-CAM dental implant crowns: a three-dimensional profilometric analysis.

PubMed

Cresti, Stefano; Itri, Angelo; Rebaudi, Alberto; Diaspro, Alberto; Salerno, Marco

2015-01-01

Peri-implantitis is an infection of the implant surface caused by adhesion of bacteria that generate bone resorption and sometimes even consequent implant loss. Both screw-retained and cemented fixed implants are affected. The purpose of this study is to investigate the morphological defects at the cemented interface between titanium abutment and ceramic crown, comparing different adhesive cements used to fill the marginal gap. Twelve computer-aided design-computer-aided manufacturing dental crowns were cemented to titanium abutments using three different resin composite cements. Sealed margins were polished using grommets with descending diamond particle size. Three groups of four crowns each were made according to the cement used, namely RelyX Unicem (3 M ESPE), Panavia F 2.0 (Kuraray), and NX3 (Nexus Kerr). Samples were analyzed using optical inspection, three-dimensional profilometry, and image analysis, including analysis of variance. Although RelyX showed significantly lower root mean square surface roughness (4.4 ± 1.5 μm) than that of NX3 (7.0 ± 2.9 μm), it showed no significant difference with Panavia (3.7 ± 1.5 μm). The marginal gap was significantly wider in Panavia (149 ± 108 μm) as compared with NX3 (71 ± 45 μm) and Relyx (64 ± 34 μm). For all groups, homogeneous heights of both metal-cement and ceramic-cement gaps were observed. Moreover, all samples showed homogeneity of the margins and absence of instrumental bias, thus validating both procedure and materials. When using the chosen polishing method, RelyX Unicem showed both low roughness and marginal width, and thus the smoothest and more continuous abutment-crown interlayer, promising a low probability of occurrence of peri-implantitis. © 2013 Wiley Periodicals, Inc.

[Effect of zirconia abutment angulation on stress distribution in the abutment and the bone around implant: a finite element study].

PubMed

Yang, Yan-zhong; Tian, Xiao-hua; Zhou, Yan-min

2015-08-01

To investigate the effect of three different zirconia angular abutments on the stress distribution in bone and abutment using three-dimensional finite element analysis, and provide instruction for clinical application. Finite element analysis (FEA) was applied to analyze the stress distribution of three different zirconia/titanium angular abutments and bone around implant. The maximum Von Minses stress that existed in abutment, bolt and bone of the angular abutment model was significantly higher than that existed in the straight abutment model. The maximum Von Minses stress that existed in abutment, bolt and bone of the 20 ° angular abutment model was significantly higher than that existed in 15 ° angular abutment model. There was no significant difference between zirconia abutment model and titanium abutment model. The abutment angulation has a significant influence on the stress distribution in the abutment, bolt and bone, and exacerbates as the angulation increases, which suggest that we should take more attention to the implant orientation and use straight abutment or little angular abutment. The zirconia abutment can be used safely, and there is no noticeable difference between zirconia abutment and titanium abutment on stress distribution.

Extraction of oil from Euphorbia Lagascae seeds by screw pressing

USDA-ARS?s Scientific Manuscript database

Euphorbia lagascae (Spreng.) is a drought tolerant plant native to Spain. Euphorbia seeds contain 45-50% oil with 60-65% of its fatty acids as vernolic (12S,13R-epoxy-cis-9-octadecenoic) acid. Vernolic acid has wide applications in paints and coatings, plasticizers, adhesives, polymers, and lubrican...

Effect of polymer coating on the osseointegration of CP-Ti dental implant

NASA Astrophysics Data System (ADS)

Al-Hassani, Emad; Al-Hassani, Fatima; Najim, Manar

2018-05-01

Modifications achieved coatings of titanium samples were investigated in order to improve their surface characteristics so as to facilitate bio-integration. Chitosan coating was use for commercial pure Ti alloys manufactured by two different methods in which commercial pure titanium rod converted in form of implant screw by using wire cut machine and lathe, second method included the used of powder technology for producing the implant screws. The coating process of chitosan polymer was carried out using advance technology (electrospnning process) to create fibrous structure from Nano to micro scale of the chitosan on the implant surface which result in a bioactive surface. The characterization includes; microstructure observation, surface chemical composition analysis (EDS), surface roughness (AFM), and the histological analysis. from the SEM No morphological differences were observed among the implants surfaces except for some inconsiderable morphological differences that results from the manufacturing process, by using EDX analysis the surfaces chemical compositions were completely changed and there was large decrease in the percentage of titanium element at the surface which indicates that the surface is covered with chitosan and had a new surface composition and topography. The sample was produced by powder technology process have higher roughness (845.36 nm) than sample produced by machining without any surface treatment (531.7nm),finally The histological view of implant samples after 4weeks of implantation, showed active bone formation in all implant surface which give clear indication of tissue acceptance.

Theoretical optimum of implant positional index design.

PubMed

Semper, W; Kraft, S; Krüger, T; Nelson, K

2009-08-01

Rotational freedom of the implant-abutment connection influences its screw joint stability; for optimization, influential factors need to be evaluated based on a previously developed closed formula. The underlying hypothesis is that the manufacturing tolerances, geometric pattern, and dimensions of the index do not influence positional stability. We used the dimensions of 5 commonly used implant systems with a clearance of 20 microm to calculate the extent of rotational freedom; a 3D simulation (SolidWorks) validated the analytical findings. Polygonal positional indices showed the highest degrees of rotational freedom. The polygonal profile displayed higher positional stability than the polygons, but less positional accuracy than the cam-groove connection. Features of a maximal rotation-safe positional index were determined. The analytical calculation of rotational freedom of implant positional indices is possible. Rotational freedom is dependent on the geometric design of the index and may be decreased by incorporating specific aspects into the positional index design.

Fracture strength of zirconia implant abutments on narrow diameter implants with internal and external implant abutment connections: A study on the titanium resin base concept.

PubMed

Sailer, Irena; Asgeirsson, Asgeir G; Thoma, Daniel S; Fehmer, Vincent; Aspelund, Thor; Özcan, Mutlu; Pjetursson, Bjarni E

2018-04-01

There is limited knowledge regarding the strength of zirconia abutments with internal and external implant abutment connections and zirconia abutments supported by a titanium resin base (Variobase, Straumann) for narrow diameter implants. To compare the fracture strength of narrow diameter abutments with different types of implant abutment connections after chewing simulation. Hundred and twenty identical customized abutments with different materials and implant abutment connections were fabricated for five groups: 1-piece zirconia abutment with internal connection (T1, Cares-abutment-Straumann BL-NC implant, Straumann Switzerland), 1-piece zirconia abutment with external hex connection (T2, Procera abutment-Branemark NP implant, Nobel Biocare, Sweden), 2-piece zirconia abutments with metallic insert for internal connection (T3, Procera abutment-Replace NP implant, Nobel Biocare), 2-piece zirconia abutment on titanium resin base (T4, LavaPlus abutment-VarioBase-Straumann BL-NC implant, 3M ESPE, Germany) and 1-piece titanium abutment with internal connection (C, Cares-abutment-Straumann BL-NC implant, Straumann, Switzerland). All implants had a narrow diameter ranging from 3.3 to 3.5 mm. Sixty un-restored abutments and 60 abutments restored with glass-ceramic crowns were tested. Mean bending moments were compared using ANOVA with p-values adjusted for multiple comparisons using Tukey's procedure. The mean bending moments were 521 ± 33 Ncm (T4), 404 ± 36 Ncm (C), 311 ± 106 Ncm (T1) 265 ± 22 Ncm (T3) and 225 ± 29 (T2) for un-restored abutments and 278 ± 84 Ncm (T4), 302 ± 170 Ncm (C), 190 ± 55 Ncm (T1) 80 ± 102 Ncm (T3) and 125 ± 57 (T2) for restored abutments. For un-restored abutments, C and T4 had similar mean bending moments, significantly higher than those of the three other groups (p < .05). Titanium abutments (C) had significantly higher bending moments than identical zirconia abutments (T1) (p < .05). Zirconia abutments (T1) with internal connection had higher bending moments than zirconia abutments with external connection (T2) (p < .05). For all test groups, the bending moments were significantly reduced when restored with all-ceramic crowns. For narrow diameter abutments, the fracture strength of 2-piece internal connected zirconia abutments fixed on titanium resin bases was similar to those obtained for 1-piece titanium abutments. Narrow diameter zirconia abutments with internal connection exhibited higher fracture strength than zirconia abutments with an external connection. Titanium abutments with an internal connection were significantly stronger than identical zirconia abutments. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Fracture Resistance of Implant Abutments Following Abutment Alterations by Milling the Margins: An In Vitro Study.

PubMed

Patankar, Anuya; Kheur, Mohit; Kheur, Supriya; Lakha, Tabrez; Burhanpurwala, Murtuza

2016-12-01

This in vitro study evaluated the effect of different levels of preparation of an implant abutment on its fracture resistance. The study evaluated abutments that incorporated a platform switch (Myriad Plus Abutments, Morse Taper Connection) and Standard abutments (BioHorizons Standard Abutment, BioHorizons Inc). Each abutment was connected to an appropriate implant and mounted in a self-cured resin base. Based on the abutment preparation depths, 3 groups were created for each abutment type: as manufactured, abutment prepared 1 mm apical to the original margin, and abutment prepared 1.5 mm to the original margin. All the abutments were prepared in a standardized manner to incorporate a 0.5 mm chamfer margin uniformly. All the abutments were torqued to 30 Ncm on their respective implants. They were then subjected to loading until failure in a universal testing machine. Abutments with no preparation showed the maximum resistance to fracture for both groups. As the preparation depth increased, the fracture resistance decreased. The fracture resistance of implant abutment junction decreases as the preparation depth increases.

16 CFR 305.3 - Description of covered products.

Code of Federal Regulations, 2011 CFR

2011-01-01

... operation. Some models may require user intervention to initiate these different segments of the cycle after... inner reflective coating on the outer bulb to direct the light, an R, PAR, or similar bulb shapes... bulb to direct the light, an R, PAR, ER, BR, BPAR, or similar bulb shapes with E26 medium screw bases...

Biodegradable composites from polyester and sugar beet pulp with antimicrobial coating for food packaging

USDA-ARS?s Scientific Manuscript database

Totally biodegradable, double-layered antimicrobial composite Sheets were introduced for food packaging. The substrate layers of the sheets were prepared from poly (lactic acid) (PLA) and sugar beet pulp (SBP) or poly (butylene adipate-co-terephthalate (PBAT) and SBP by a twin-screw extruder. The ac...

The total occlusal convergence of the abutment of a partial fixed dental prosthesis: A definition and a clinical technique for its assessment

PubMed Central

Mamoun, John S.

2013-01-01

The abutment(s) of a partial fixed dental prosthesis (PFDP) should have a minimal total occlusal convergence (TOC), also called a taper, in order to ensure adequate retention of a PFDP that will be made for the abutment(s), given the height of the abutment(s). This article reviews the concept of PFDP abutment TOC and presents an alternative definition of what TOC is, defining it as the extent to which the shape of an abutment differs from an ideal cylinder shape of an abutment. This article also reviews experimental results concerning what is the ideal TOC in degrees and explores clinical techniques of estimating the TOC of a crown abutment. The author suggests that Dentists use high magnification loupes (×6-8 magnification or greater) or a surgical operating microscope when preparing crown abutments, to facilitate creating a minimum abutment TOC. PMID:24932130

78 FR 20638 - Petitions to Revise General Permit for U.S. Navy to Transport Vessels for the Purpose of Sinking...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... a screw driver. --Drain and flush hydraulic equipment, heat transfer equipment, high/low pressure... insulation; and other non-liquid coatings and material, before sinking the vessel.'' To the extent that their... must be removed by heat, chemical stripping, scraping, abrasive blasting or similar process, or if...

Precision Fit of Screw-Retained Implant-Supported Fixed Dental Prostheses Fabricated by CAD/CAM, Copy-Milling, and Conventional Methods.

PubMed

de França, Danilo Gonzaga; Morais, Maria Helena; das Neves, Flávio D; Carreiro, Adriana Fonte; Barbosa, Gustavo As

The aim of this study was to evaluate the effectiveness of fabrication methods (computer-aided design/computer-aided manufacture [CAD/CAM], copy-milling, and conventional casting) in the fit accuracy of three-unit, screw-retained fixed dental prostheses. Sixteen three-unit implant-supported screw-retained frameworks were fabricated to fit an in vitro model. Eight frameworks were fabricated using the CAD/CAM system, four in zirconia and four in cobalt-chromium. Four zirconia frameworks were fabricated using the copy-milled system, and four were cast in cobalt-chromium using conventional casting with premachined abutments. The vertical and horizontal misfit at the implant-framework interface was measured using scanning electron microscopy at ×250. The results for vertical misfit were analyzed using Kruskal-Wallis and Mann-Whitney tests. The horizontal misfits were categorized as underextended, equally extended, or overextended. Statistical analysis established differences between groups according to the chi-square test (α = .05). The mean vertical misfit was 5.9 ± 3.6 μm for CAD/CAM-fabricated zirconia, 1.2 ± 2.2 μm for CAD/CAM-fabricated cobalt-chromium frameworks, 7.6 ± 9.2 μm for copy-milling-fabricated zirconia frameworks, and 11.8 (9.8) μm for conventionally fabricated frameworks. The Mann-Whitney test revealed significant differences between all but the zirconia-fabricated frameworks. A significant association was observed between the horizontal misfits and the fabrication method. The percentage of horizontal misfits that were underextended and overextended was higher in milled zirconia (83.3%), CAD/CAM cobaltchromium (66.7%), cast cobalt-chromium (58.3%), and CAD/CAM zirconia (33.3%) frameworks. CAD/CAM-fabricated frameworks exhibit better vertical misfit and low variability compared with copy-milled and conventionally fabricated frameworks. The percentage of interfaces equally extended was higher when CAD/CAM and zirconia were used.

[Dental implant restoration abutment selection].

PubMed

Bin, Shi; Hao, Zeng

2017-04-01

An increasing number of implant restoration abutment types are produced with the rapid development of dental implantology. Although various abutments can meet different clinical demands, the selection of the appropriate abutment is both difficult and confusing. This article aims to help clinicians select the appropriate abutment by describing abutment design, types, and selection criteria.

Displacement of dental implants in trabecular bone under a static lateral load in fresh bovine bone.

PubMed

Engelke, Wilfried; Müller, Alois; Decco, Oscar A; Rau, María J; Cura, Andrea C; Ruscio, Mara L; Knösel, Michael

2013-04-01

The study aims to provide objective data for the displacement of titanium screw implants in trabecular bone specimens. One hundred Semados implants (Bego, Bremen, Germany) were inserted in bovine type IV bone specimens. All implants had a diameter of 3.75 mm; 50 implants had a length of 8.5 mm and 50 implants had a length of 15 mm. Insertion torque was determined at intervals of 10, 20, and 30 Ncm. Implants were loaded horizontally with 10, 20, and 30 N for 2 seconds. An indicator strip was attached to the implant abutment to allow direct observation of implant movement relative to the bone surface. Horizontal displacement was assessed with an accuracy of measurement of 10 µm. Seven implants got lost by visible loosening. Degree of displacement was subject to evaluation with all others. Those implants showed a mean displacement of 59 µm for 10 N (n = 100), 173 µm for 20 N (n = 99), and 211 µm for 30 N (n = 93). The mean displacement of 15-mm implants (16, 37, 51 µm) was significantly lower compared with 8.5-mm implants (103, 311, 396 µm) corresponding to 10, 20, and 30 N as lateral loads. Displacement of screw implants in trabecular bone can be detected and visualized using commercially available endoscopes with a high magnification. A lateral load of 20 N indicates a mean displacement of over 100 µm and therefore results in a critical displacement. © 2011 Wiley Periodicals, Inc.

Impression of multiple implants using photogrammetry: description of technique and case presentation.

PubMed

Peñarrocha-Oltra, David; Agustín-Panadero, Rubén; Bagán, Leticia; Giménez, Beatriz; Peñarrocha, María

2014-07-01

To describe a technique for registering the positions of multiple dental implants using a system based on photogrammetry. A case is presented in which a prosthetic treatment was performed using this technique. Three Euroteknika® dental implants were placed to rehabilitate a 55-year-old male patient with right posterior maxillary edentulism. Three months later, the positions of the implants were registered using a photogrammetry-based stereo-camera (PICcamera®). After processing patient and implant data, special abutments (PICabutment®) were screwed onto each implant. The PICcamera® was then used to capture images of the implant positions, automatically taking 150 images in less than 60 seconds. From this information a file was obtained describing the relative positions - angles and distances - of each implant in vector form. Information regarding the soft tissues was obtained from an alginate impression that was cast in plaster and scanned. A Cr-Co structure was obtained using CAD/CAM, and its passive fit was verified in the patient's mouth using the Sheffield test and the screw resistance test. Twelve months after loading, peri-implant tissues were healthy and no marginal bone loss was observed. The clinical application of this new system using photogrammetry to record the position of multiple dental implants facilitated the rehabilitation of a patient with posterior maxillary edentulism by means of a prosthesis with optimal fit. The prosthetic process was accurate, fast, simple to apply and comfortable for the patient.

Prosthetic rehabilitation of an edentulous maxilla with microstomia, limited interarch space, and malaligned implants: a clinical report.

PubMed

Turkyilmaz, Ilser

2012-04-01

Although dental implant treatment is a very successful option today, a meticulous treatment planning and close collaboration between the oral surgeon and restorative doctor is crucial to eliminate undesired outcomes. To present a challenging case restored with a maxillary screw-retained fixed prosthesis using malpositioned/malaligned implants. A 47-year-old female had a Lefort I fracture and lost all maxillary teeth due to traumatic injury in a traffic accident. Seven maxillary implants were placed using a 1-stage surgical approach, 6 months after open reduction surgery in a private practice. Radiographic and clinical evaluation indicated marginal bone loss around 3 anterior implants. The malposition and malalignment of implants made impression and casting procedures very complicated. The other challenging factors with this patient were microstomia, limited mouth opening due to scar tissue from previous plastic surgery, and a very small maxilla. The 1-piece metal framework did not fit accurately so it was sectioned into 3 segments. The 3 separate segments were screwed on the abutments individually, then connected to each other using an acrylic resin. The 3 framework segments were laser welded. After the laser welding, a passive fit of the framework was achieved. It has been suggested that providing an implant treatment to a patient with implants placed in wrong positions with undesired angulations can be very difficult. Also, laser welding may be a viable option to eliminate misfit of full-arch metal frameworks.

Development of analytical procedures for the determination of hexavalent chromium in corrosion prevention coatings used in the automotive industry.

PubMed

Séby, F; Castetbon, A; Ortega, R; Guimon, C; Niveau, F; Barrois-Oudin, N; Garraud, H; Donard, O F X

2008-05-01

The European directive 2000/53/EC limits the use of Cr(VI) in vehicle manufacturing. Although a maximum of 2 g of Cr(VI) was authorised per vehicle for corrosion prevention coatings of key components, since July 2007 its use has been prohibited except for some particular applications. Therefore, the objective of this work was to develop direct analytical procedures for Cr(VI) determination in the different steel coatings used for screws. Instead of working directly with screws, the optimisation of the procedures was carried out with metallic plates homogeneously coated to improve the data comparability. Extraction of Cr(VI) from the metallic parts was performed by sonication. Two extraction solutions were tested: a direct water extraction solution used in standard protocols and an ammonium/ammonia buffer solution at pH 8.9. The extracts were further analysed for Cr speciation by high-performance liquid chromatography (HPLC) inductively coupled plasma (ICP) atomic emission spectrometry or HPLC ICP mass spectrometry depending on the concentration level. When possible, the coatings were also directly analysed by solid speciation techniques (X-ray photoelectron spectroscopy, XPS, and X-ray absorption near-edge structure, XANES) for validation of the results. Very good results between the different analytical approaches were obtained for the sample of coating made up of a heated paint containing Zn, Al and Cr when using the extracting buffer solution at pH 8.9. After a repeated four-step extraction procedure on the same portion test, taking into account the depth of the surface layer reached, good agreement with XPS and XANES results was obtained. In contrast, for the coatings composed of an alkaline Zn layer where Cr(VI) and Cr(III) are deposited, only the extraction procedure using water allowed the detection of Cr(VI). To elucidate the Cr(VI) reduction during extraction at pH 8.9, the reactivity of Cr(VI) towards different species of Zn generally present in the coatings (metallic Zn and zinc oxide) was studied. The results showed that metallic Zn rapidly reduces Cr(VI), whereas this reaction is less evident in the presence of zinc oxide. Water was then retained for coatings containing metallic Zn.

Spin-coating: A new approach for improving dispersion of cellulose nanocrystals and mechanical properties of poly (lactic acid) composites.

PubMed

Shojaeiarani, Jamileh; Bajwa, Dilpreet S; Stark, Nicole M

2018-06-15

This study systematically evaluated the influence of masterbatch preparation techniques, solvent casting and spin-coating methods, on composite properties. Composites were manufactured by combining CNCs masterbatches and PLA resin using twin screw extruder followed by injection molding. Different microscopy techniques were used to investigate the dispersion of CNCs in masterbatches and composites. Thermal, thermomechanical, and mechanical properties of composites were evaluated. Scanning electron microscopy (SEM) images showed superior dispersion of CNCs in spin-coated masterbatches compared to solvent cast masterbatches. At lower CNCs concentrations, both SEM and optical microscope images confirmed more uniform CNCs dispersion in spin-coated composites than solvent cast samples. Degree of crystallinity of PLA exhibited a major enhancement by 147% and 380% in solvent cast and spin-coated composites, respectively. Spin-coated composites with lower CNCs concentration exhibited a noticeable improvement in mechanical properties. However, lower thermal characteristics in spin-coated composites were observed, which could be attributed to the residual solvents in masterbatches. Copyright © 2018 Elsevier Ltd. All rights reserved.

Magnesium-containing mixed coatings on zirconia for dental implants: mechanical characterization and in vitro behavior.

PubMed

Pardun, Karoline; Treccani, Laura; Volkmann, Eike; Streckbein, Philipp; Heiss, Christian; Gerlach, Juergen W; Maendl, Stephan; Rezwan, Kurosch

2015-07-01

An important challenge in the field of dental and orthopedic implantology is the preparation of implant coatings with bioactive functions that feature a high mechanical stability and at the same time mimic structural and compositional properties of native bone for a better bone ingrowth. This study investigates the influence of magnesium addition to zirconia-calcium phosphate coatings. The mixed coatings were prepared with varying additions of either magnesium oxide or magnesium fluoride to yttria-stabilized zirconia and hydroxyapatite. The coatings were deposited on zirconia discs and screw implants by wet powder spraying. Microstructure studies confirm a porous coating with similar roughness and firm adhesion not hampered by the coating composition. The coating morphology, mechanical flexural strength and calcium dissolution showed a magnesium content-dependent effect. Moreover, the in vitro results obtained with human osteoblasts reveal an improved biological performance caused by the presence of Mg(2+) ions. The magnesium-containing coatings exhibited better cell proliferation and differentiation in comparison to pure zirconia-calcium phosphate coatings. In conclusion, these results demonstrate that magnesium addition increases the bioactivity potential of zirconia-calcium phosphate coatings and is thus a highly suitable candidate for bone implant coatings. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Reliability and failure modes of narrow implant systems.

PubMed

Hirata, Ronaldo; Bonfante, Estevam A; Anchieta, Rodolfo B; Machado, Lucas S; Freitas, Gileade; Fardin, Vinicius P; Tovar, Nick; Coelho, Paulo G

2016-09-01

Narrow implants are indicated in areas of limited bone width or when grafting is nonviable. However, the reduction of implant diameter may compromise their performance. This study evaluated the reliability of several narrow implant systems under fatigue, after restored with single-unit crowns. Narrow implant systems were divided (n = 18 each), as follows: Astra (ASC); BioHorizons (BSC); Straumann Roxolid (SNC), Intra-Lock (IMC), and Intra-Lock one-piece abutment (ILO). Maxillary central incisor crowns were cemented and subjected to step-stress accelerated life testing in water. Use level probability Weibull curves and reliability for a mission of 100,000 cycles at 130- and 180-N loads (90 % two-sided confidence intervals) were calculated. Scanning electron microscopy was used for fractography. Reliability for 100,000 cycles at 130 N was ∼99 % in group ASC, ∼99 % in BSC, ∼96 % in SNC, ∼99 % in IMC, and ∼100 % in ILO. At 180 N, reliability of ∼34 % resulted for the ASC group, ∼91 % for BSC, ∼53 % for SNC, ∼70 % for IMC, and ∼99 % for ILO. Abutment screw fracture was the main failure mode for all groups. Reliability was not different between systems for 100,000 cycles at the 130-N load. A significant decrease was observed at the 180-N load for ASC, SNC, and IMC, whereas it was maintained for BSC and ILO. The investigated narrow implants presented mechanical performance under fatigue that suggests their safe use as single crowns in the anterior region.

Comparison of fit accuracy and torque maintenance of zirconia and titanium abutments for internal tri-channel and external-hex implant connections.

PubMed

Siadat, Hakimeh; Beyabanaki, Elaheh; Mousavi, Niloufar; Alikhasi, Marzieh

2017-08-01

This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. Two regular platform dental implants, one with external connection (Brånemark, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at α=0.05 of significance. There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups ( P <.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom ( P <.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments ( P <.001). However, neither connection type ( P =.15) nor abutment material ( P =.38) affected torque loss. Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values.

Comparison of fit accuracy and torque maintenance of zirconia and titanium abutments for internal tri-channel and external-hex implant connections

PubMed Central

Siadat, Hakimeh; Beyabanaki, Elaheh; Mousavi, Niloufar

2017-01-01

PURPOSE This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. MATERIALS AND METHODS Two regular platform dental implants, one with external connection (Brånemark, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at α=0.05 of significance. RESULTS There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups (P<.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom (P<.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments (P<.001). However, neither connection type (P=.15) nor abutment material (P=.38) affected torque loss. CONCLUSION Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values. PMID:28874994

14. DETAIL, NORTH ABUTMENT, FROM EAST, SHOWING ABUTMENT, PORTION OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. DETAIL, NORTH ABUTMENT, FROM EAST, SHOWING ABUTMENT, PORTION OF SIMPLY ORNAMENTED EAST PARAPET, AND REMNANT OF STONE MASONRY ABUTMENT OF ORIGINAL (1890) FIFTH STREET VIADUCT - Fifth Street Viaduct, Spanning Bacon's Quarter Branch Valley on Fifth Street, Richmond, Independent City, VA

Displacement of Implant Abutments Following Initial and Repeated Torqueing.

PubMed

Yilmaz, Burak; Gilbert, Andy B; Seidt, Jeremy D; McGlumphy, Edwin A; Clelland, Nancy L

2015-01-01

To measure and compare the three-dimensional (3D) position of nine different abutments manufactured by different manufacturers after repeated torqueing on an internal-hexagon implant. Nine tapered implants were placed into an acrylic resin block. Five specimens each of nine different abutments (n = 45) were placed into one of nine implants. The abutments were handtightened and then torqued to the manufacturer-recommended torque of 30 Ncm. After 10 minutes, 30 Ncm of torque was reapplied. Another 10 minutes elapsed before testing was completed. Images were recorded in 12-second intervals. The spatial relationship of the abutments to the resin block was determined using 3D digital image correlation. Commercial image correlation software was used to analyze the displacements. Mean displacements for the abutments were calculated in three dimensions and overall for both torque applications. Statistical comparisons were done with a t test and a step-down Bonferroni correction. The overall 3D displacement of the Atlantis Titanium abutment after the second applied torque was significantly greater than that of two of the eight other abutments. Displacement in all three dimensions for the Atlantis Titanium abutment changed direction between the first and second torque applications. All abutments moved further in the same direction except for the Atlantis Titanium abutment, which moved back toward its original hand-tightened position horizontally after the second torque application. Re-torqueing of abutments after a 10-minute interval leads to minor displacement of varying degrees between the abutment and a tapered implant. A potential effect of embedment relaxation and/or manufacturing errors should be taken into consideration when selecting an abutment for a cement-retained crown on a tapered implant. Accordingly, clinicians may benefit from adjusting cement-retained implant crowns after re-torqueing the abutments to prevent potential occlusal and interproximal contact problems.

Diffusion bonding

DOEpatents

Anderson, Robert C.

1976-06-22

1. A method for joining beryllium to beryllium by diffusion bonding, comprising the steps of coating at least one surface portion of at least two beryllium pieces with nickel, positioning a coated surface portion in a contiguous relationship with an other surface portion, subjecting the contiguously disposed surface portions to an environment having an atmosphere at a pressure lower than ambient pressure, applying a force upon the beryllium pieces for causing the contiguous surface portions to abut against each other, heating the contiguous surface portions to a maximum temperature less than the melting temperature of the beryllium, substantially uniformly decreasing the applied force while increasing the temperature after attaining a temperature substantially above room temperature, and maintaining a portion of the applied force at a temperature corresponding to about maximum temperature for a duration sufficient to effect the diffusion bond between the contiguous surface portions.

Support Ratio Between Abutment and Soft Tissue Under Overdentures: A Comparison Between Use of Two and Four Abutments.

PubMed

Abe, Manami; Yang, Tsung-Chieh; Maeda, Yoshionobu; Ando, Takanori; Wada, Masahiro

The purpose of this preliminary in vivo study was to compare force distribution on abutments (tooth or implant) and tissues supporting overdentures with two or four abutments. A convenience sample of five subjects with tooth and/or implant-supported overdentures was enrolled. Recordings were completed on each subject using a force-measuring system mounted on a metal framework with four anteroposterior spread abutments (A), four abutments with denture bases (B), and on two anterior abutments with denture bases (C). The tissue-support ratio (TSR) was calculated as (A-B)/A or (A-C)/A. TSR values changed 1.5 to 2 times when the number of abutments was reduced from four to two. The amount of tissue strain on the posterior residual ridge increased when the number of abutments was reduced.

The influence of removable partial dentures on the periodontal health of abutment and non-abutment teeth.

PubMed

Dula, Linda J; Shala, Kujtim Sh; Pustina-Krasniqi, Teuta; Bicaj, Teuta; Ahmedi, Enis F

2015-01-01

The aim of this study was to evaluate the influence of removable partial dentures (RPD) on the periodontal health of abutment and non-abutment teeth. A total 107 patients with RPD participated in this study. It was examined 138 RPD, they were 87 with clasp-retained and 51 were RPD with attachments. The following periodontal parameters were evaluated for abutment and non-abutment teeth, plaque index (PLI), calculus index (CI), bleeding on probing (BOP), probing depth (PD) (mm) and tooth mobility (TM) index. These clinical measurements were taken immediately before insertion the RPD, then one and 3 months after insertion. The level of significance was set at (P < 0.05). The mean scores for PLI, CI, BOP, PD, and TM index, of the abutment teeth and non-abutment teeth were no statistically significant at the time of insertion of RPD. After 1-month, PLI was statistically significant (0.57 ± 0.55 for abutment and 0.30 ± 0.46 for non-abutment teeth). After 3 months, there were significant differences between abutment and non-abutment teeth with regard to the BOP (1.53 ± 0.50 and 1.76 ± 0.43 respectively), PD (0.28 ± 0.45 and 0.12 ± 0.33 respectively) and PLI (1.20 ± 0.46 and 0.75 ± 0.64 respectively). No significant mean difference in TM and CI was found between the abutment and non-abutment teeth (P > 0.05). With carefully planned prosthetic treatment and adequate maintenance of the oral and denture hygiene, we can prevent the periodontal diseases.

Similarities and differences in coatings for magnesium-based stents and orthopaedic implants

PubMed Central

Ma, Jun; Thompson, Marc; Zhao, Nan; Zhu, Donghui

2016-01-01

Magnesium (Mg)-based biodegradable materials are promising candidates for the new generation of implantable medical devices, particularly cardiovascular stents and orthopaedic implants. Mg-based cardiovascular stents represent the most innovative stent technology to date. However, these products still do not fully meet clinical requirements with regards to fast degradation rates, late restenosis, and thrombosis. Thus various surface coatings have been introduced to protect Mg-based stents from rapid corrosion and to improve biocompatibility. Similarly, different coatings have been used for orthopaedic implants, e.g., plates and pins for bone fracture fixation or as an interference screw for tendon-bone or ligament-bone insertion, to improve biocompatibility and corrosion resistance. Metal coatings, nanoporous inorganic coatings and permanent polymers have been proved to enhance corrosion resistance; however, inflammation and foreign body reactions have also been reported. By contrast, biodegradable polymers are more biocompatible in general and are favoured over permanent materials. Drugs are also loaded with biodegradable polymers to improve their performance. The key similarities and differences in coatings for Mg-based stents and orthopaedic implants are summarized. PMID:27695671

Clinical Evidence of OsseoSpeed EV Implants: A Retrospective Study and Characterization of the Newly Introduced System.

PubMed

Toia, Marco; Galli, Silvia; Cecchinato, Denis; Wennerberg, Ann; Jimbo, Ryo

2017-08-23

This retrospective study sought to compare a new implant (Astra Tech OsseoSpeed EV) with its predecessor (Astra Tech OsseoSpeed TX) by scanning electron microscopy and interferometry. Radiographic data from 19 patients who underwent implant restoration with EV (n = 49) with a median follow-up of 16 months were evaluated for mean bone level (MBL) changes from delivery of the definitive prosthesis. EV and TX did not differ in surface roughness, and both systems had a tight seal at the implant-abutment interface. The median MBL change of the EV was -0.02 mm mesiodistally after a median follow-up period of 16 months. Greater maintenance of MBL was found in the screw-retained restorations (n = 17) compared to cemented (0.35 ± 0.33 mm and -0.38 ± 0.76 mm, respectively; P = .03). The data suggest that EV shows minimal levels of bone loss and high implant survival.

Torsion analysis of cracked circular bars actuated by a piezoelectric coating

NASA Astrophysics Data System (ADS)

Hassani, A. R.; Faal, R. T.

2016-12-01

This study presents a formulation for a bar with circular cross-section, coated by a piezoelectric layer and subjected to Saint-Venant torsion loading. The bar is weakened by a Volterra-type screw dislocation. First, with aid of the finite Fourier transform, the stress fields in the circular bar and the piezoelectric layer are obtained. The problem is then reduced to a set of singular integral equations with a Cauchy-type singularity. Unknown dislocation density is achieved by numerical solution of these integral equations. Numerical results are discussed, to reveal the effect of the piezoelectric layer on the reduction of the mechanical stress intensity factor in the bar.

Measurement of the rotational misfit and implant-abutment gap of all-ceramic abutments.

PubMed

Garine, Wael N; Funkenbusch, Paul D; Ercoli, Carlo; Wodenscheck, Joseph; Murphy, William C

2007-01-01

The specific aims of this study were to measure the implant and abutment hexagonal dimensions, to measure the rotational misfit between implant and abutments, and to correlate the dimension of the gap present between the abutment and implant hexagons with the rotational misfit of 5 abutment-implant combinations from 2 manufacturers. Twenty new externally hexed implants (n = 10 for Nobel Biocare; n = 10 for Biomet/3i) and 50 new abutments were used (n = 10; Procera Zirconia; Procera Alumina; Esthetic Ceramic Abutment; ZiReal; and GingiHue post ZR Zero Rotation abutments). The mating surfaces of all implants and abutments were imaged with a scanning electron microscope before and after rotational misfit measurements. The distances between the corners and center of the implant and abutment hexagon were calculated by entering their x and y coordinates, measured on a measuring microscope, into Pythagoras' theorem. The dimensional difference between abutment and implant hexagons was calculated and correlated with the rotational misfit, which was recorded using a precision optical encoder. Each abutment was rotated (3 times/session) clockwise and counterclockwise until binding. Analysis of variance and Student-Newman-Keuls tests were used to compare rotational misfit among groups (alpha = .05). With respect to rotational misfit, the abutment groups were significantly different from one another (P < .001), with the exception of the Procera Zirconia and Esthetic Ceramic groups (P = .4). The mean rotational misfits in degrees were 4.13 +/- 0.68 for the Procera Zirconia group, 3.92 +/- 0.62 for the Procera Alumina group, 4.10 +/- 0.67 for the Esthetic Ceramic group, 3.48 +/- 0.40 for the ZiReal group, and 1.61 +/- 0.24 for the GingiHue post ZR group. There was no correlation between the mean implant-abutment gap and rotational misfit. Within the limits of this study, machining inconsistencies of the hexagons were found for all implants and abutments tested. The GingiHue Post showed the smallest rotational misfit. All-ceramic abutments without a metal collar showed a greater rotational misfit than those with a metal collar.

The influence of removable partial dentures on the periodontal health of abutment and non-abutment teeth

PubMed Central

Dula, Linda J.; Shala, Kujtim Sh.; Pustina–Krasniqi, Teuta; Bicaj, Teuta; Ahmedi, Enis F.

2015-01-01

Objective: The aim of this study was to evaluate the influence of removable partial dentures (RPD) on the periodontal health of abutment and non-abutment teeth. Materials and Methods: A total 107 patients with RPD participated in this study. It was examined 138 RPD, they were 87 with clasp-retained and 51 were RPD with attachments. The following periodontal parameters were evaluated for abutment and non-abutment teeth, plaque index (PLI), calculus index (CI), bleeding on probing (BOP), probing depth (PD) (mm) and tooth mobility (TM) index. These clinical measurements were taken immediately before insertion the RPD, then one and 3 months after insertion. The level of significance was set at (P < 0.05). Results: The mean scores for PLI, CI, BOP, PD, and TM index, of the abutment teeth and non-abutment teeth were no statistically significant at the time of insertion of RPD. After 1-month, PLI was statistically significant (0.57 ± 0.55 for abutment and 0.30 ± 0.46 for non-abutment teeth). After 3 months, there were significant differences between abutment and non-abutment teeth with regard to the BOP (1.53 ± 0.50 and 1.76 ± 0.43 respectively), PD (0.28 ± 0.45 and 0.12 ± 0.33 respectively) and PLI (1.20 ± 0.46 and 0.75 ± 0.64 respectively). No significant mean difference in TM and CI was found between the abutment and non-abutment teeth (P > 0.05). Conclusions: With carefully planned prosthetic treatment and adequate maintenance of the oral and denture hygiene, we can prevent the periodontal diseases. PMID:26430367

Settling of abutments into implants and changes in removal torque in five different implant-abutment connections. Part 1: Cyclic loading.

PubMed

Kim, Ki-Seong; Han, Jung-Suk; Lim, Young-Jun

2014-01-01

The aim of this study was to evaluate and compare the settling of abutments into implants and the removal torque values (RTVs) before and after cyclic loading. Five different implant-abutment connections were tested: Ext = external butt joint + two-piece abutment; Int-H2 = internal hexagon + two-piece abutment; Int-H1 = internal hexagon + one-piece abutment; Int-O2 = internal octagon + two-piece abutment; and Int-O1 = internal octagon + one-piece abutment. Ten abutments from each group were secured to their corresponding implants (total n = 50). All samples were tested in a universal testing machine with a vertical load of 250 N for 100,000 cycles of 14 Hz. The amount of settling of the abutment into the implant was calculated from the change in the total length of the implant-abutment sample before and after loading, as measured with an electronic digital micrometer. The RTV after cyclic loading was compared to the initial RTV with a digital torque gauge. Statistical analysis was performed at a 5% significance level. A multiple-comparison test showed specific significant differences in settling values in each group after 250 N cyclic loading (Int-H1, Ext < Int-H2 < Int-O2 < Int-O1). There were statistically significant decreases in RTVs after loading compared to the initial RTVs in the Int-H2 and Int-O2 groups. No statistically significant differences were found in the Ext, Int-H1, and Int-O1 groups. The results of this study demonstrated that the settling amount and RTV (loss of preload) after cyclic loading were specific to the abutment type and related to the design characteristics of the implant-abutment connection.

Fracture resistance of zirconia-based implant abutments after artificial long-term aging.

PubMed

Alsahhaf, Abdulaziz; Spies, Benedikt Christopher; Vach, Kirstin; Kohal, Ralf-Joachim

2017-02-01

To investigate the survival rate, fracture strength, bending moments, loading to fracture and fracture modes of different designs of zirconia abutments after dynamic loading with thermocycling, and compare these values to titanium abutments. A total of 80 abutment samples were divided into 5 test groups of 16 samples in each group. The study included the following groups, "Group 1" CAD/CAM produced all-zirconia abutments, "Group 2" titanium abutments, "Group 3" zirconia-abutments adhesively luted to a titanium base, "Group 4" prefabricated all-zirconia abutments and "Group 5" zirconia-abutments glass soldered to a titanium base. Half the number of samples in each group was exposed to 1.2 million loading cycles (5-years simulation) in the chewing simulator. The samples that survived the artificial aging were later tested for fracture strength in a universal testing machine. The remaining 8 samples of the group were directly tested for fracture strength. All samples exposed to the 5-years artificial aging survived except of six samples in one group (Group 1). The surviving samples were later fracture tested in the universal testing machine. The bending moments (Ncm) values were as follow: Exposed groups: "Group 1" 94.5Ncm; "Group 2" 599.2Ncm; "Group 3" 477.5Ncm; "Group 4" 314.4Ncm; "Group 5" 509.4Ncm. Non-exposed groups: "Group 1" 269.3Ncm; "Group 2" 474.2Ncm; "Group 3" 377.6Ncm; "Group 4" 265.4Ncm; "Group 5" 372.4Ncm. Except in Group 1, the values were higher in the exposed groups, although, statistically there was no difference (p>0.05). The one-piece ZrO2-abutment group (Group 1 and Group 4) exhibited lower values, while the two-piece ZrO2-abutment groups (Group 3 and Group 5) showed similar values and fracture modes like the titanium abutment group. The titanium abutment group showed the highest values of bending moments among all groups. The implant-abutment connection area appeared to influence the bending moment value and the fracture mode of the tested abutment groups, and it was found to be the weakest part of an internal connection one-piece zirconia abutment. The titanium base in the two-piece zirconia abutment worked as a substitute for the weakest part of the abutment. Therefore, the titanium base can reinforce the fracture strength of a zirconia abutment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Influence of Abutment Angle on Implant Strain When Supporting a Distal Extension Removable Partial Dental Prosthesis: An In Vitro Study.

PubMed

Hirata, Kiyotaka; Takahashi, Toshihito; Tomita, Akiko; Gonda, Tomoya; Maeda, Yoshinobu

This study evaluated the impact of angled abutments on strain in implants supporting a distal extension removable partial denture. An in vitro model of an implant supporting a distal extension removable partial denture was developed. The implant was positioned with a 17- or 30-degree mesial inclination, with either a healing abutment or a corrective multiunit abutment. Levels of strain under load were compared, and the results were compared using t test (P = .05). Correcting angulation with a multiunit angled abutment significantly decreased strain (P < .05) when compared with a healing abutment. An angled abutment decreased the strain on an inclined implant significantly more than a healing abutment when loaded under a distal extension removable partial denture.

Comparison of the impact of scaler material composition on polished titanium implant abutment surfaces.

PubMed

Hasturk, Hatice; Nguyen, Daniel Huy; Sherzai, Homa; Song, Xiaoping; Soukos, Nikos; Bidlack, Felicitas B; Van Dyke, Thomas E

2013-08-01

The purpose of this study was to compare the impact of the removal of biofilm with hand scalers of different material composition on the surface of implant abutments by assessing the surface topography and residual plaque after scaling using scanning electron microscopy (SEM). Titanium implant analogs from 3 manufacturers (Straumann USA LLC, Andover, Maine, Nobel BioCare USA LLC, Yorba Linda, Cali, Astra Tech Implant Systems, Dentsply, Mölndal, Sweden) were mounted in stone in plastic vials individually with authentic prosthetic abutments. Plaque samples were collected from a healthy volunteer, inoculated into growth medium and incubated with the abutments anaerobically for 1 week. A blinded, calibrated hygienist performed scaling to remove the biofilm using 6 implant scalers (in triplicate), 1 scaler for 1 abutment. The abutments were mounted on an imaging stand and processed for SEM. Images were captured in 3 randomly designated areas of interest on each abutment. Analysis of the implant polished abutment surface and plaque area measurements were performed using ImageJ image analysis software. Surface alterations were characterized by the number, length, depth and the width of the scratches observed. Glass filled resin scalers resulted in significantly more and longer scratches on all 3 abutment types compared to other scalers, while unfilled resin scalers resulted in the least surface change (p < 0.05). Filled resin-graphite reinforced scalers, carbon fiber reinforced resin scalers and titanium scalers resulted in more superficial scratches compared to glass filled resin, as well as more scratches than unfilled resin. No statistically significant differences were found between scalers and abutments with regard to plaque removal. The impact of scalers on implant abutment surfaces varies between abutment types presumably due to different surface characteristics with no apparent advantage of one abutment type over the other with regard to resistance to surface damage. Unfilled resin was found consistently to be the least damaging to abutment surfaces, although all scalers of all compositions caused detectable surface changes to polished surfaces of implant abutments.

Comparison of The Effect of Implant Abutment Surface Modifications on Retention of Implant-Supported Restoration with A Polymer Based Cement

PubMed Central

Sahu, Nabaprakash; Lakshmi, Namratha; Azhagarasan, N.S.; Agnihotri, Yoshaskam; Rajan, Manoj; Hariharan, Ramasubramanian

2014-01-01

Background: In cement-retained implant-supported restoration it is important to gain adequate retention of definitive restoration as well as retrievability of prosthesis. The surface of the abutment, alloy of the restoration and the type of cement used influences the retention of the restoration. There is a need to analyze the influence of surface modifications of abutments on the retentive capabilities of provisional implant cements. Purpose of study: To compare the effect of implant abutment surface modifications on retention of implant-supported restoration cemented with polymer based cement. Materials and method: Thirty solid titanium implant abutments (ADIN), 8mm height, were divided into 3 groups. Ten abutments with retentive grooves (Group I) as supplied by the manufacturer, Ten abutments milled to 20 taper circumferentially (Group II), and Ten abutments milled and air-abraded with 110 μm aluminum oxide (Group III) were used in this study. Ni-Cr coping were casted for each abutment and polymer based cement was used to secure them to the respective abutments. Using a universal testing machine at a crosshead speed of 0.5 cm/minute, tensile bond strength was recorded (N). Results: Mean tensile bond strength of Group I, II and III were found to be 408.3, 159.9 and 743.8 Newton respectively. The values were statistically different from each other (p<0.001). Conclusion: Abutments with milled and sandblasted surface provide the highest retention followed by abutments with retentive grooves and then by abutments with milled surface when cast copings were cemented to implant abutments with polymer based cement. Clinical implications: Retention of restoration depends on the surface of the abutment as well as the luting agents used. Incorporation of retentive grooves or particle abrasion can enhance retention especially in situation of short clinical crown. PMID:24596785

Fracture resistance of inter-joined zirconia abutment of dental implant system with injection molding technique.

PubMed

Yang, Jianjun; Wang, Ke; Liu, Guangyuan; Wang, Dashan

2013-11-01

Zirconia powder in nanometers can be fabricated into inter-joined abutment of dental implant system with the injection shaping technique. This study was to detect the resistance of inter-joined zirconia abutment with different angle loading for clinical applications. The inter-joined abutments were shaped with the technique of injection of zirconia powder in nanometers. Sixty Osstem GSII 5 × 10 mm implants were used with 30 zirconia abutments and 30 Osstem GSII titanium abutments for fixation using 40 N torque force. The loading applications included 90°, 30°, and 0° formed by the long axis of abutments and pressure head of universal test machine. The fracture resistances of zirconia and titanium abutments were documented and analyzed. The inter-joined zirconia abutments were assembled to the Osstem GSII implants successfully. In the 90° loading mode, the fracture resistance of zirconia abutment group and titanium abutment group were 301.5 ± 15.4 N and 736.4 ± 120.1 N, respectively. And those in the 30° groups were 434.7 ± 36.1 N and 1073.1 ± 74 N, correspondingly. Significant difference in the two groups was found using t-test and Wilcoxon test. No damage on the abutments of the two groups but S-shaped bending on the implants was found when the 0° loading was 1300-2000 N. Through the assembly of Zirconia abutments and implants, all the components presented sufficient resistance acquired for the clinical application under loadings with different angle. © 2012 John Wiley & Sons A/S.

Biodegradable nanocomposite coatings accelerate bone healing: In vivo evaluation

PubMed Central

Mehdikhani-Nahrkhalaji, Mehdi; Fathi, Mohammad Hossein; Mortazavi, Vajihesadat; Mousavi, Sayed Behrouz; Akhavan, Ali; Haghighat, Abbas; Hashemi-Beni, Batool; Razavi, Sayed Mohammad; Mashhadiabbas, Fatemeh

2015-01-01

Background: The aim of this study was to evaluate the interaction of bioactive and biodegradable poly (lactide-co-glycolide)/bioactive glass/hydroxyapatite (PBGHA) and poly (lactide-co-glycolide)/bioactive glass (PBG) nanocomposite coatings with bone. Materials and Methods: Sol-gel derived 58S bioactive glass nanoparticles, 50/50 wt% poly (lactic acid)/poly (glycolic acid) and hydroxyapatite nanoparticles were used to prepare the coatings. The nanocomposite coatings were characterized by scanning electron microscopy, X-ray diffraction and atomic force microscopy. Mechanical stability of the prepared nanocomposite coatings was studied during intramedullary implantation of coated Kirschner wires (K-wires) into rabbit tibia. Titanium mini-screws coated with nanocomposite coatings and without coating were implanted intramedullary in rabbit tibia. Bone tissue interaction with the prepared nanocomposite coatings was evaluated 30 and 60 days after surgery. The non-parametric paired Friedman and Kruskal-Wallis tests were used to compare the samples. For all tests, the level of significance was P < 0.05. Results: The results showed that nanocomposite coatings remained stable on the K-wires with a minimum of 96% of the original coating mass. Tissue around the coated implants showed no adverse reactions to the coatings. Woven and trabecular bone formation were observed around the coated samples with a minimum inflammatory reaction. PBG nanocomposite coating induced more rapid bone healing than PBGHA nanocomposite coating and titanium without coating (P < 0.05). Conclusion: It was concluded that PBG nanocomposite coating provides an ideal surface for bone formation and it could be used as a candidate for coating dental and orthopedic implants. PMID:25709681

Physicochemical and microscopic characterization of implant-abutment joints.

PubMed

Lopes, Patricia A; Carreiro, Adriana F P; Nascimento, Rubens M; Vahey, Brendan R; Henriques, Bruno; Souza, Júlio C M

2018-01-01

The purpose of this study was to investigate Morse taper implant-abutment joints by chemical, mechanical, and microscopic analysis. Surfaces of 10 Morse taper implants and the correlated abutments were inspected by field emission gun-scanning electron microscopy (FEG-SEM) before connection. The implant-abutment connections were tightened at 32 Ncm. For microgap evaluation by FEG-SEM, the systems were embedded in epoxy resin and cross-sectioned at a perpendicular plane of the implant-abutment joint. Furthermore, nanoindentation tests and chemical analysis were performed at the implant-abutment joints. Results were statistically analyzed via one-way analysis of variance, with a significance level of P < 0.05. Defects were noticed on different areas of the abutment surfaces. The minimum and maximum size of microgaps ranged from 0.5 μm up to 5.6 μm. Furthermore, defects were detected throughout the implant-abutment joint that can, ultimately, affect the microgap size after connection. Nanoindentation tests revealed a higher hardness (4.2 ± 0.4 GPa) for abutment composed of Ti6Al4V alloy when compared to implant composed of commercially pure Grade 4 titanium (3.2 ± 0.4 GPa). Surface defects produced during the machining of both implants and abutments can increase the size of microgaps and promote a misfit of implant-abutment joints. In addition, the mismatch in mechanical properties between abutment and implant can promote the wear of surfaces, affecting the size of microgaps and consequently the performance of the joints during mastication.

Impression of multiple implants using photogrammetry: Description of technique and case presentation

PubMed Central

Peñarrocha-Oltra, David; Agustín-Panadero, Rubén; Bagán, Leticia; Giménez, Beatriz

2014-01-01

Aim: To describe a technique for registering the positions of multiple dental implants using a system based on photogrammetry. A case is presented in which a prosthetic treatment was performed using this technique. Study Design: Three Euroteknika® dental implants were placed to rehabilitate a 55-year-old male patient with right posterior maxillary edentulism. Three months later, the positions of the implants were registered using a photogrammetry-based stereo-camera (PICcamera®). After processing patient and implant data, special abutments (PICabutment®) were screwed onto each implant. The PICcamera® was then used to capture images of the implant positions, automatically taking 150 images in less than 60 seconds. From this information a file was obtained describing the relative positions – angles and distances – of each implant in vector form. Information regarding the soft tissues was obtained from an alginate impression that was cast in plaster and scanned. A Cr-Co structure was obtained using CAD/CAM, and its passive fit was verified in the patient’s mouth using the Sheffield test and the screw resistance test. Results and Conclusions: Twelve months after loading, peri-implant tissues were healthy and no marginal bone loss was observed. The clinical application of this new system using photogrammetry to record the position of multiple dental implants facilitated the rehabilitation of a patient with posterior maxillary edentulism by means of a prosthesis with optimal fit. The prosthetic process was accurate, fast, simple to apply and comfortable for the patient. Key words:Dental implants, photogrammetry, dental impression technique, CAD/CAM. PMID:24608216

Effect of joining the sectioned implant-supported prosthesis on the peri-implant strain generated in simulated mandibular model.

PubMed

Singh, Ipsha; Nair, K Chandrasekharan; Shetty, Jayakar

2017-01-01

The aim of this study is to evaluate the strain developed in simulated mandibular model before and after the joining of an implant-supported screw-retained prosthesis by different joining techniques, namely, arc welding, laser welding, and soldering. A specimen simulating a mandibular edentulous ridge was fabricated in heat-cured acrylic resin. 4-mm holes were drilled in the following tooth positions; 36, 33, 43, 46. Implant analogs were placed in the holes. University of California, Los Angeles, abutment was attached to the implant fixture. Eight strain gauges were attached to the acrylic resin model. Six similar models were made. Implant-supported screw-retained fixed prosthesis was fabricated in nickel-chromium alloy. A load of 400 N was applied on the prosthesis using universal testing machine. Resultant strain was measured in each strain gauge. All the prostheses were sectioned at the area between 36 and 33, 33 and 43, and 43 and 46 using 35 micrometer carborundum disc, and strain was measured in each strain gauge after applying a load of 400 N on the prosthesis. Specimens were joined by arc welding, soldering, and laser welding. After joining, a load of 400 N was applied on each prosthesis and the resultant strain was measured in each strain gauge. Highest mean strain values were recorded before sectioning of the prostheses (889.9 microstrains). Lowest mean strain values were recorded after sectioning the prosthesis and before reuniting it (225.0 microstrains). Sectioning and reuniting the long-span implant prosthesis was found to be a significant factor in influencing the peri-implant strain.

A comparison of laser-welded titanium and conventional cast frameworks supported by implants in the partially edentulous jaw: a 3-year prospective multicenter study.

PubMed

Jemt, T; Henry, P; Lindén, B; Naert, I; Weber, H; Bergström, C

2000-01-01

The purpose of this prospective multicenter study was to evaluate and compare the clinical performance of laser-welded titanium fixed partial implant-supported prostheses with conventional cast frameworks. Forty-two partially edentulous patients were provided with Brånemark system implants and arranged into 2 groups. Group A was provided with a conventional cast framework with porcelain veneers in one side of the jaw and a laser-welded titanium framework with low-fusing porcelain on the other side. The patients in group B had an old implant prosthesis replaced by a titanium framework prosthesis. The patients were followed for 3 years after prosthesis placement. Clinical and radiographic data were collected and analyzed. Only one implant was lost, and all prostheses were still in function after 3 years. The 2 framework designs showed similar clinical performance with few clinical complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%) fractured. Four prostheses experienced loose gold screws (6%). In group A, marginal bone loss was similar for both designs of prostheses, with a mean of 1.0 mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was observed on average in group B. No significant relationship (P > 0.05) was observed between marginal bone loss and placement of prosthesis margin or prosthesis design. The use of laser-welded titanium frameworks seems to present similar clinical performance to conventional cast frameworks in partial implant situations after 3 years.

The clinical outcome and microbiological profile of bone-anchored hearing systems (BAHS) with different abutment topographies: a prospective pilot study.

PubMed

Trobos, Margarita; Johansson, Martin Lars; Jonhede, Sofia; Peters, Hanna; Hoffman, Maria; Omar, Omar; Thomsen, Peter; Hultcrantz, Malou

2018-06-01

In this prospective clinical pilot study, abutments with different topologies (machined versus polished) were compared with respect to the clinical outcome and the microbiological profile. Furthermore, three different sampling methods (retrieval of abutment, collection of peri-abutment exudate using paper-points, and a small peri-abutment soft-tissue biopsy) were evaluated for the identification and quantification of colonising bacteria. Twelve patients, seven with machined abutment and five with polished abutment, were included in the analysis. Three different sampling procedures were employed for the identification and quantification of colonising bacteria from baseline up to 12 months, using quantitative culturing. Clinical outcome measures (Holgers score, hygiene, pain, numbness and implant stability) were investigated. The clinical parameters, and total viable bacteria per abutment or in tissue biopsies did not differ significantly between the polished and machined abutments. The total CFU/mm 2 abutment and CFU/peri-abutment fluid space of anaerobes, aerobes and staphylococci were significantly higher for the polished abutment. Anaerobic bacteria were detected in the tissue biopsies before BAHS implantation. Anaerobes and Staphylococcus spp. were detected in all three compartments after BAHS installation. For most patients (10/12), the same staphylococcal species were found in at least two of the three compartments at the same time-point. The common skin coloniser Staphylococcus epidermidis was identified in all patients but one (11/12), whereas the pathogen Staphylococcus aureus was isolated in five of the patients. Several associations between clinical and microbiological parameters were found. There was no difference in the clinical outcome with the use of polished versus machined abutment at 3 and 12 months after implantation. The present pilot trial largely confirmed a suitable study design, sampling and analytical methodology to determine the effects of modified BAHS abutment properties. 2. Controlled prospective comparative study.

6. VIEW OF SOUTH ABUTMENT. MASONRY ON BOTH ABUTMENTS IS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. VIEW OF SOUTH ABUTMENT. MASONRY ON BOTH ABUTMENTS IS LAID UP IN SEMI-COURSED RUBBLE PATTERN. VIEW LOOKING SOUTHEAST. - Montgomery County Bridge No. 221, Metz Road spanning Towamencin Creek, Skippack, Montgomery County, PA

Upper bound of abutment scour in laboratory and field data

USGS Publications Warehouse

Benedict, Stephen

2016-01-01

The U.S. Geological Survey, in cooperation with the South Carolina Department of Transportation, conducted a field investigation of abutment scour in South Carolina and used those data to develop envelope curves that define the upper bound of abutment scour. To expand on this previous work, an additional cooperative investigation was initiated to combine the South Carolina data with abutment scour data from other sources and evaluate upper bound patterns with this larger data set. To facilitate this analysis, 446 laboratory and 331 field measurements of abutment scour were compiled into a digital database. This extensive database was used to evaluate the South Carolina abutment scour envelope curves and to develop additional envelope curves that reflected the upper bound of abutment scour depth for the laboratory and field data. The envelope curves provide simple but useful supplementary tools for assessing the potential maximum abutment scour depth in the field setting.

[Technology of cementless hip endoprosthetics].

PubMed

Ungethüm, M; Blömer, W

1987-06-01

The success achieved with non-cemented hip arthroplasty depends mainly on the stability of the fixation, the quality of the stabilizing bone being just as important as favourable biomechanical conditions. The results of the intensive research and development with respect to the particular features of a non-cemented hip endoprosthesis can be divided into the following basic categories: Biomechanical aspects with special reference to bone related to the design of the prosthesis; material characteristics, such as fatigue strength, tribology, corrosion resistance, and biocompatibility; and development of new materials and coatings to permit direct bonding of implant and bone. With regard to the stem of hip prostheses, the different design parameters of various types are examined to determine their typical design characteristics, such as bearing surface of the collar, geometry of cross section, anatomically adapted shaping, and surface of the implant forming the contact with the bone. The latter can be divided into macroprofiles and macro- and micro-porous coated surfaces. On the other hand, the methods of cementless fixation of acetabular cups can be primarily divided into conical and spherical screw fixation and pegged fixation with additional macroprofiles of porous surfaces. In a separate study of the biomechanical aspects of screwed sockets, the special importance of socket shape and thread geometry are presented with reference to primary stability and long-term fixation of prostheses.

Physicochemical and microscopic characterization of implant–abutment joints

PubMed Central

Lopes, Patricia A.; Carreiro, Adriana F. P.; Nascimento, Rubens M.; Vahey, Brendan R.; Henriques, Bruno; Souza, Júlio C. M.

2018-01-01

Objective: The purpose of this study was to investigate Morse taper implant–abutment joints by chemical, mechanical, and microscopic analysis. Materials and Methods: Surfaces of 10 Morse taper implants and the correlated abutments were inspected by field emission gun-scanning electron microscopy (FEG-SEM) before connection. The implant–abutment connections were tightened at 32 Ncm. For microgap evaluation by FEG-SEM, the systems were embedded in epoxy resin and cross-sectioned at a perpendicular plane of the implant–abutment joint. Furthermore, nanoindentation tests and chemical analysis were performed at the implant–abutment joints. Statistics: Results were statistically analyzed via one-way analysis of variance, with a significance level of P < 0.05. Results: Defects were noticed on different areas of the abutment surfaces. The minimum and maximum size of microgaps ranged from 0.5 μm up to 5.6 μm. Furthermore, defects were detected throughout the implant–abutment joint that can, ultimately, affect the microgap size after connection. Nanoindentation tests revealed a higher hardness (4.2 ± 0.4 GPa) for abutment composed of Ti6Al4V alloy when compared to implant composed of commercially pure Grade 4 titanium (3.2 ± 0.4 GPa). Conclusions: Surface defects produced during the machining of both implants and abutments can increase the size of microgaps and promote a misfit of implant–abutment joints. In addition, the mismatch in mechanical properties between abutment and implant can promote the wear of surfaces, affecting the size of microgaps and consequently the performance of the joints during mastication. PMID:29657532

Behavior and analysis of an integral abutment bridge.

DOT National Transportation Integrated Search

2013-08-01

As a result of abutment spalling on the integral abutment bridge over 400 South Street in Salt Lake City, Utah, the Utah Department of Transportation (UDOT) instigated research measures to better understand the behavior of integral abutment bridges. ...

Direct writing of bio-functional coatings for cardiovascular applications.

PubMed

Perkins, Jessica; Hong, Yi; Ye, Sang-Ho; Wagner, William R; Desai, Salil

2014-12-01

The surface modification of metallic biomaterials is of critical importance to enhance the biocompatibility of surgical implant materials and devices. This article investigates the use of a direct-write inkjet technique for multilayer coatings of a biodegradable polymer (polyester urethane urea (PEUU)) embedded with an anti-proliferation drug paclitaxel (Taxol). The direct-write inkjet technique provides selective patterning capability for depositing multimaterial coatings on three-dimensional implant devices such as pins, screws, and stents for orthopedic and vascular applications. Drug release profiles were studied to observe the influence of drug loading and coating thickness for obtaining tunable release kinetics. Platelet deposition studies were conducted following ovine blood contact and significant reduction in platelet deposition was observed on the Taxol loaded PEUU substrate compared with the unloaded control. Rat smooth muscle cells were used for cell proliferation studies. Significant reduction in cell growth was observed following the release of anti-proliferative drug from the biopolymer thin film. This research provides a basis for developing anti-proliferative biocompatible coatings for different biomedical device applications. © 2014 Wiley Periodicals, Inc.

Influence of reverse torque values in abutments with or without internal hexagon indexes.

PubMed

Cerutti-Kopplin, Daiane; Rodrigues Neto, Dimas João; Lins do Valle, Accácio; Pereira, Jefferson Ricardo

2014-10-01

The mechanical stability of the implant-abutment connection is of fundamental importance for successful implant-supported restorations. Therefore, understanding removal torque values is essential. The purpose of this study was to evaluate the reverse torque values of indexed and nonindexed abutments of the Morse Taper system. Twelve Morse taper implants with their respective abutments were divided into 2 groups (n=6): group NI, nonindexed abutments; and group IN, indexed abutments. Each abutment received a sequence of 2 consecutive torques for insertion (15 Ncm) at an interval of 10 minutes, and 1 reverse torque, all measured with a digital torque wrench. The Student t test with a 5% significance level was used to evaluate the data. Statistical analysis showed no significant difference in reverse torque values between nonindexed and indexed abutments (P=.57). When comparing insertion torque and reverse torque values between the groups, group NI presented a mean torque loosening percentage of 8% (P=.013), whereas group IN presented a loosening of 15.33% (P<.001). The use of indexed abutments for the Morse taper system presented similar biomechanical stability when compared with nonindexed abutments, both with a significant reduction in reverse torque values. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Fracture resistance of different implant abutments supporting 
all-ceramic single crowns after aging.

PubMed

Stimmelmayr, Michael; Heiß, Philipp; Erdelt, Kurt; Schweiger, Josef; Beuer, Florian

To test the mechanical properties of three different restorative materials for implant abutments supporting all-ceramic single crowns. Thirty implants with butt-joint connections were distributed into three test groups: Group A with 10 one-piece zirconia abutments, Group U with 10 titanium abutments, and Group T with 10 titanium-zirconia hybrid abutments. Monolithic zirconia single crowns were cemented and artificially aged. The crowns were loaded at a 30-degree angle in a universal testing machine until fracture or bending. Additionally, after removal of the restorations, the implant-abutment interface of the fixtures was inspected using a scanning electron microscope (SEM). In Group A, the abutments failed on average at 336.78 N, in Group U at 1000.12 N, and in Group T at 1296.55 N. The mean values between Groups T and U (P = 0.009), and between Group A and Groups T and U (P < 0.001) were significantly different. The abutments in Group A failed early due to fractures of the internal parts and parts close to the implant neck. In Groups T and U, failures occurred due to bending of the implant neck. This experimental study proves that hybrid and titanium abutments have similar mechanical properties. One-piece abutments made of zirconia showed significantly lower fracture resistance.

Evaluation of concordance between CAD/CAM and clinical positions of abutment shoulder against mucosal margin: an observational study.

PubMed

Pietruski, Jan K; Skurska, Anna; Bernaczyk, Anna; Milewski, Robert; Pietruska, Maria Julia; Gehrke, Peter; Pietruska, Małgorzata D

2018-05-02

While working on CAD/CAM-customized abutments, the use of standard impression copings with a circular diameter produces inconsistency within the emergence profile. It may begin with a collapse of the supra-implant mucosa during impression taking, then lead to a computer-generated mismatch of the position and outline of the abutment shoulder, and consequently result in a compromised outcome of anticipated treatment. The aim of the study was to compare the virtual and clinical positions of the abutment shoulder in relation to the mucosal margin after the abutment delivery. Conventional open-tray impression takings followed uncovering surgery. Master casts were scanned with a desktop scanner. Clinical examinations took place after abutment's insertion and temporization (T1) and prior to cementation of the definitive crown (T2). The distances between the abutment shoulder and marginal soft tissue were measured intraorally in four aspects and juxtaposed with those on the virtual model. The study evaluated 257 dental implants and CAD/CAM-customized abutments. As T1 and T2 showed, there was a positive correlation between the virtually designed abutment shoulder position and matching clinical location relative to the mucosal margin. In 42.1% of cases, the distance between the mucosal margin and the abutment shoulder did not change. It increased in 36.3% of cases while a decrease occurred in 21.6% of them. Computer-set position of the abutment shoulder in relation to the mucosal margin can be predictably implemented in clinical practice.

Detail, north abutment, from southeast, showing original squared cut stone ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Detail, north abutment, from southeast, showing original squared cut stone masonry abutment and portion of non-original concrete apron at west base of abutment - Castle Garden Bridge, Township Route 343 over Bennetts Branch of Sinnemahoning Creek, Driftwood, Cameron County, PA

Comparison of observed and predicted abutment scour at selected bridges in Maine.

DOT National Transportation Integrated Search

2008-01-01

Maximum abutment-scour depths predicted with five different methods were compared to : maximum abutment-scour depths observed at 100 abutments at 50 bridge sites in Maine with a : median bridge age of 66 years. Prediction methods included the Froehli...

A comparative finite elemental analysis of glass abutment supported and unsupported cantilever fixed partial denture.

PubMed

Ramakrishaniah, Ravikumar; Al Kheraif, Abdulaziz A; Elsharawy, Mohamed A; Alsaleh, Ayman K; Ismail Mohamed, Karem M; Rehman, Ihtesham Ur

2015-05-01

The purpose of this study was to investigate and compare the load distribution and displacement of cantilever prostheses with and without glass abutment by three dimensional finite element analysis. Micro-computed tomography was used to study the relationship between the glass abutment and the ridge. The external surface of the maxilla was scanned, and a simplified finite element model was constructed. The ZX-27 glass abutment and the maxillary first and second premolars were created and modified. The solid model of the three-unit cantilever fixed partial denture was scanned, and the fitting surface was modified with reference to the created abutments using the 3D CAD system. The finite element analysis was completed in ANSYS. The fit and total gap volume between the glass abutment and dental model were determined by Skyscan 1173 high-energy spiral micro-CT scan. The results of the finite element analysis in this study showed that the cantilever prosthesis supported by the glass abutment demonstrated significantly less stress on the terminal abutment and overall deformation of the prosthesis under vertical and oblique load. Micro-computed tomography determined a gap volume of 6.74162 mm(3). By contacting the mucosa, glass abutments transfer some amount of masticatory load to the residual alveolar ridge, thereby preventing damage to the periodontal microstructures of the terminal abutment. The passive contact of the glass abutment with the mucosa not only preserves the health of the mucosa covering the ridge but also permits easy cleaning. It is possible to increase the success rate of cantilever FPDs by supporting the cantilevered pontic with glass abutments. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Impact of abutment rotation and angulation on marginal fit: theoretical considerations.

PubMed

Semper, Wiebke; Kraft, Silvan; Mehrhof, Jurgen; Nelson, Katja

2010-01-01

Rotational freedom of various implant positional index designs has been previously calculated. To investigate its clinical relevance, a three-dimensional simulation was performed to demonstrate the influence of rotational displacements of the abutment on the marginal fit of prosthetic superstructures. Idealized abutments with different angulations (0, 5, 10, 15, and 20 degrees) were virtually constructed (SolidWorks Office Premium 2007). Then, rotational displacement was simulated with various degrees of rotational freedom (0.7, 0.95, 1.5, 1.65, and 1.85 degrees). The resulting horizontal displacement of the abutment from the original position was quantified in microns, followed by a simulated pressure-less positioning of superstructures with defined internal gaps (5 µm, 60 µm, and 100 µm). The resulting marginal gap between the abutment and the superstructure was measured vertically with the SolidWorks measurement tool. Rotation resulted in a displacement of the abutment of up to 157 µm at maximum rotation and angulation. Interference of a superstructure with a defined internal gap of 5 µm placed on the abutment resulted in marginal gaps up to 2.33 mm at maximum rotation and angulation; with a 60-µm internal gap, the marginal gaps reached a maximum of 802 µm. Simulation using a superstructure with an internal gap of 100 µm revealed a marginal gap of 162 µm at abutment angulation of 20 degrees and rotation of 1.85 degrees. The marginal gaps increased with the degree of abutment angulation and the extent of rotational freedom. Rotational displacement of the abutment influenced prosthesis misfit. The marginal gaps between the abutment and the superstructure increased with the rotational freedom of the index and the angulation of the abutment.

Sol-gel derived bioactive coating on zirconia: Effect on flexural strength and cell proliferation.

PubMed

Shahramian, Khalil; Leminen, Heidi; Meretoja, Ville; Linderbäck, Paula; Kangasniemi, Ilkka; Lassila, Lippo; Abdulmajeed, Aous; Närhi, Timo

2017-11-01

The purpose of this study was to evaluate the effect of sol-gel derived bioactive coatings on the biaxial flexural strength and fibroblast proliferation of zirconia, aimed to be used as an implant abutment material. Yttrium stabilized zirconia disc-shaped specimens were cut, ground, sintered, and finally cleansed ultrasonically in each of acetone and ethanol for 5 minutes. Three experimental groups (n = 15) were fabricated, zirconia with sol-gel derived titania (TiO 2 ) coating, zirconia with sol-gel derived zirconia (ZrO 2 ) coating, and non-coated zirconia as a control. The surfaces of the specimens were analyzed through images taken using a scanning electron microscope (SEM), and a non-contact tapping mode atomic force microscope (AFM) was used to record the surface topography and roughness of the coated specimens. Biaxial flexural strength values were determined using the piston-on-three ball technique. Human gingival fibroblast proliferation on the surface of the specimens was evaluated using AlamarBlue assay™. Data were analyzed using a one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test. Additionally, the biaxial flexural strength data was also statistically analyzed with the Weibull distribution. The biaxial flexural strength of zirconia specimens was unaffected (p > 0.05). Weibull modulus of TiO 2 coated and ZrO 2 coated groups (5.7 and 5.4, respectively) were lower than the control (8.0). Specimens coated with ZrO 2 showed significantly lower fibroblast proliferation compared to other groups (p < 0.05). In conclusion, sol-gel derived coatings have no influence on the flexural strength of zirconia. ZrO 2 coated specimens showed significantly lower cell proliferation after 12 days than TiO 2 coated or non-coated control. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2401-2407, 2017. © 2016 Wiley Periodicals, Inc.

Impact of abutment material on peri-implant soft tissue color. An in vitro study.

PubMed

Sala, Leticia; Bascones-Martínez, Antonio; Carrillo-de-Albornoz, Ana

2017-09-01

The objectives of the present study is to determine the differences in peri-implant soft tissue color with the utilization of titanium, titanium gold-plated, white zirconia, Vita Classical (VC) A4-shaded zirconia, and fluorescent white zirconia abutments and to establish the influence of gingival thickness on the resulting color. Four implants were contralaterally inserted in 19 fresh pig mandibles, and the color of the peri-implant mucosa with the different abutments was spectrophotometrically measured at 1-, 2-, and 3-mm height from the margin. At 1-mm height, titanium significantly differed from all zirconia abutments in lightness (L*), chroma along red axis (a*), and chroma along yellow-blue axis (b*) parameters. At 2 mm, all zirconia abutments differed from titanium in b* but only fluorescent zirconia in a*. At 3 mm, titanium differed from VC A4-shaded and fluorescent zirconia abutments in b*. At soft tissue thicknesses <1 and 1-2 mm, titanium differed from fluorescent zirconia in a* and b* and from VC A4-shaded zirconia in b*; at thickness >2 mm, no differences were found among abutments. All abutments differed from natural teeth in a* and b* at all heights and thicknesses except for fluorescent zirconia at thickness >2 mm. The Euclidean distance (ΔΕ) differed between titanium abutments and gold, VC A4, and fluorescent zirconia at <1- and 1-2-mm thicknesses. The natural gingival color was not reproduced with any abutment at gingival thicknesses <2 mm. The worst color match was with titanium abutments and the best with fluorescent zirconia, followed by VC A4-shaded zirconia. At gingival thicknesses >2 mm, no differences were detected among abutments. This study demonstrates that the type of abutment and the gingival thickness affect the resulting peri-implant gingival color.

Comparison of fracture strength and failure mode of different ceramic implant abutments.

PubMed

Elsayed, Adham; Wille, Sebastian; Al-Akhali, Majed; Kern, Matthias

2017-04-01

The whitish color of zirconia (ZrO 2 ) abutments offers favorable esthetics compared with the grayish color of titanium (Ti) abutments. Nonetheless, ZrO 2 has greater opacity, making it difficult to achieve natural tooth color. Therefore, lithium disilicate (LaT) abutments have been suggested to replace metal abutments. The purpose of this in vitro study was to evaluate the fracture strength and failure mode of single-tooth implant restorations using ZrO 2 and LaT abutments, and to compare them with titanium (Ti) abutments. Five different types of abutments, Ti; ZrO 2 with no metal base; ZrO 2 with a metal base (ZrT); LaT; and LaT combination abutment and crown (LcT) were assembled on 40 Ti implants and restored with LaT crowns. Specimens were subjected to quasistatic loading using a universal testing machine, until the implant-abutment connection failed. As bending of the metal would be considered a clinical failure, the values of force (N) at which the plastic deformation of the metal occurred were calculated, and the rate of deformation was analyzed. Statistical analysis was done using the Mann-Whitney U test (α=.05). Group ZrO 2 revealed the lowest resistance to failure with a mean of 202 ±33 N. Groups ZrT, LaT, and LaC withstood higher forces without fracture or debonding of the ceramic suprastructure, and failure was due to deformation of metal bases, with no statistically significant differences between these groups regarding the bending behavior. Within the limitations of this in vitro study, it was concluded that LaT abutments have the potential to withstand the physiological occlusal forces that occur in the anterior region and that ZrO 2 abutments combined with Ti inserts have much higher fracture strength than pure ZrO 2 abutments. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

21 CFR 872.3630 - Endosseous dental implant abutment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endosseous dental implant abutment. 872.3630... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component...

21 CFR 872.3630 - Endosseous dental implant abutment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endosseous dental implant abutment. 872.3630... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component...

21 CFR 872.3630 - Endosseous dental implant abutment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endosseous dental implant abutment. 872.3630... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component...

21 CFR 872.3630 - Endosseous dental implant abutment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endosseous dental implant abutment. 872.3630... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component...

21 CFR 872.3630 - Endosseous dental implant abutment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endosseous dental implant abutment. 872.3630... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component...

6. View of east side abutment and wing wall. The ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. View of east side abutment and wing wall. The detail of this abutment and wing wall is the same for the similar abutment treatment at the west side. - Tipp-Elizabeth Road Bridge, Spanning Great Miami River, Tipp City, Miami County, OH

Assessment and comparison of retention of zirconia copings luted with different cements onto zirconia and titanium abutments: An in vitro study

PubMed Central

Menon, Neelima Sreekumar; Kumar, G. P. Surendra; Jnanadev, K. R.; Satish Babu, C. L.; Shetty, Shilpa

2016-01-01

Aim: The purpose of this in vitro study was to assess and compare the retention of zirconia copings luted with different luting agents onto zirconia and titanium abutments. Materials and Methods: Titanium and zirconia abutments were torqued at 35 N/cm onto implant analogs. The samples were divided into two groups: Group A consisted of four titanium abutments and 32 zirconia copings and Group B consisted of four zirconia abutments and 32 zirconia copings and four luting agents were used. The cemented copings were subjected to tensile dislodgement forces and subjected to ANOVA test. Results: Zirconia abutments recorded a higher mean force compared to titanium. Among the luting agents, resin cement recorded the highest mean force followed by zinc phosphate, glass ionomer, and noneugenol zinc oxide cement, respectively. Conclusion: Highest mean retention was recorded for zirconia implant abutments compared to titanium abutments when luted with zirconia copings. PMID:27141162

The upper bound of abutment scour defined by selected laboratory and field data

USGS Publications Warehouse

Benedict, Stephen; Caldwell, Andral W.

2015-01-01

The U.S. Geological Survey, in cooperation with the South Carolina Department of Transportation, conducted a field investigation of abutment scour in South Carolina and used that data to develop envelope curves defining the upper bound of abutment scour. To expand upon this previous work, an additional cooperative investigation was initiated to combine the South Carolina data with abutment-scour data from other sources and evaluate the upper bound of abutment scour with the larger data set. To facilitate this analysis, a literature review was made to identify potential sources of published abutment-scour data, and selected data, consisting of 446 laboratory and 331 field measurements, were compiled for the analysis. These data encompassed a wide range of laboratory and field conditions and represent field data from 6 states within the United States. The data set was used to evaluate the South Carolina abutment-scour envelope curves. Additionally, the data were used to evaluate a dimensionless abutment-scour envelope curve developed by Melville (1992), highlighting the distinct difference in the upper bound for laboratory and field data. The envelope curves evaluated in this investigation provide simple but useful tools for assessing the potential maximum abutment-scour depth in the field setting.

Microbiological and clinical assessment of the abutment and non-abutment teeth of partial removable denture wearers.

PubMed

Costa, Luciana; do Nascimento, Cássio; de Souza, Valéria Oliveira Pagnano; Pedrazzi, Vinícius

2017-03-01

The aim of this study was assessing the changes in both clinical and microbiological parameters of healthy individuals after rehabilitation with removable partial denture (RPD). 11 women received unilateral or bilateral free-end saddle RPD in the mandibular arch. Clinical and microbiological parameters of abutment, non-abutment, and antagonist teeth were assessed at baseline (RPD installation) and after 7, 30, 90, and 180days of function. The Checkerboard DNA-DNA hybridization technique was used to identify and quantify up to 43 different microbial species from subgingival biofilm samples. Probing depth, gingival recession, and bleeding on probing were also investigated over time. The total and individual microbial genome counts were shown significantly increased after 180days with no significant differences between abutment, non-abutment, or antagonist teeth. Streptococcus spp., Aggregatibacter actinomycetemcomitans, and other species associated to periodontitis (Peptostreptococcus anaerobius, Prevotella nigrescens, and Tannerella forsythia), as well as opportunistic Candida spp., were recovered in moderate counts. Abutment teeth presented higher values of gingival recession when compared with non-abutment or antagonist teeth, irrespectively time of sampling (p<0.05). No significant differences were found between groups regarding bleeding on probing or probing depth over time. Overall, the microbial counts significantly increased after 6 months of denture loading for both abutment and non-abutment teeth with no significant differences regarding the microbial profile over time. Bleeding on probing and probing depth showed no significant difference between groups over time whereas gingival recession increased in the abutment teeth. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determination of Abutment Pressure in Coal Mines with Extremely Thick Alluvium Stratum: A Typical Kind of Rockburst Mines in China

NASA Astrophysics Data System (ADS)

Zhu, Sitao; Feng, Yu; Jiang, Fuxing

2016-05-01

This paper investigates the abutment pressure distribution in coal mines with extremely thick alluvium stratum (ETAS), which is a typical kind of mines encountering frequent intense rockbursts in China. This occurs due to poor understanding to abutment pressure distribution pattern and the consequent inappropriate mine design. In this study, a theoretical computational model of abutment pressure for ETAS longwall panels is proposed based on the analysis of load transfer mechanisms of key stratum (KS) and ETAS. The model was applied to determine the abutment pressure distribution of LW2302S in Xinjulong Coal Mine; the results of stress and microseismic monitoring verified the rationality of this model. The calculated abutment pressure of LW2302S was also used in the terminal mining line design of LW2301N for rockburst prevention, successfully protecting the main roadway from the adverse influence of the abutment pressure.

Mechanical resistance of zirconium implant abutments: A review of the literature

PubMed Central

Vaquero-Aguilar, Cristina; Torres-Lagares, Daniel; Jiménez-Melendo, Manuel; Gutiérrez-Pérez, José L.

2012-01-01

The increase of aesthetic demands, together with the successful outcome of current implants, has renewed interest in the search for new materials with enough mechanical properties and better aesthetic qualities than the materials customarily used in implanto-prosthetic rehabilitation. Among these materials, zirconium has been used in different types of implants, including prosthetic abutments. The aim of the present review is to analyse current scientific evidence supporting the use of this material for the above mentioned purposes. We carried out the review of the literature published in the last ten years (2000 through 2010) of in vitro trials of dynamic and static loading of zirconium abutments found in the databases of Medline and Cochrane using the key words zirconium abutment, fracture resistance, fracture strength, cyclic loading. Although we have found a wide variability of values among the different studies, abutments show favourable clinical behaviour for the rehabilitation of single implants in the anterior area. Such variability may be explained by the difficulty to simulate daily mastication under in vitro conditions. The clinical evidence, as found in our study, does not recommend the use of implanto-prosthetic zirconium abutments in the molar area. Key words: Zirconium abutment, zirconium implant abutment, zirconia abutment, fracture resistance, fracture strength, cyclic loading. PMID:22143702

Effects of Cement, Abutment Surface Pretreatment, and Artificial Aging on the Force Required to Detach Cantilever Fixed Dental Prostheses from Dental Implants.

PubMed

Kappel, Stefanie; Chepura, Taras; Schmitter, Marc; Rammelsberg, Peter; Rues, Stefan

To examine the in vitro effects of different cements, abutment surface preconditioning, and artificial aging on the maximum tensile force needed to detach cantilever fixed dental prostheses (FDPs) from dental implants with titanium abutments. A total of 32 tissue-level implants were combined with standardized titanium abutments. For each test group, eight cantilever FDPs were fabricated using selective laser melting (cobalt-chromium [CoCr] alloy). The inner surfaces of the cantilever FDPs and half of the abutments were sandblasted and then joined by use of four different cements (two permanent and two semi-permanent) in two different amounts per cement. Subgroups were tested after either artificial aging (thermocycling and chewing simulation) or 3 days of water storage. Finally, axial pull off-tests were performed for each abutment separately. Cement type and surface pretreatment significantly affected decementation behavior. The highest retention forces (approximately 1,200 N) were associated with sandblasted abutments and permanent cements. With unconditioned abutments, temporary cements (Fu < 100 N), as well as glass-ionomer cement (Fu ≈ 100 N), resulted in rather low retention forces. Zinc phosphate cement guaranteed high retention forces. After aging, retention was sufficient only for cementation with zinc phosphate cement and for the combination of sandblasted abutments and glass-ionomer cement. When glass-ionomer cement is used to fix cantilever FDPs on implants, sandblasting of standard titanium abutments may help prevent loss of retention. Retention forces were still high for FDPs fixed with zinc phosphate cement, even when the abutments were not pretreated. Use of permanent cements only, however, is recommended to prevent unwanted loosening of cantilever FDPs.

Histological evaluations and inflammatory responses of different dental implant abutment materials: A human histology pilot study.

PubMed

Sampatanukul, Teeratida; Serichetaphongse, Pravej; Pimkhaokham, Atiphan

2018-04-01

Improvements of soft tissue to the abutment surface results in more stable peri-implant conditions, however, few human histological studies have compared soft tissue responses around different abutment materials. To describe the peri-implant tissue around 3 abutment materials; titanium, zirconia, and gold alloy, over an 8-week healing period. Fifteen edentulous sites were treated with implants. Eight weeks later, peri-implant tissue was harvested and processed using a nonseparation resin embedded technique. The tissue attachment characteristics were assessed at clinical stages using the gingival index (GI) score, surgical stage (surgical score), and histological stage (histological attachment percentage). Additionally, the inflammatory responses were evaluated using inflammatory extent and inflammatory cellularity grades. Nonparametrical statistics were used to describe the GI and surgical scores, and analytical statistics were used to analyze the histological attachment percentages as well as the inflammatory extent and cellularity grades amongst the 3 groups. There were no statistically significant differences among the groups for GI score (P = .071) and surgical score (P = .262). Titanium and zirconia exhibited nearly similar mean histological attachment percentages while gold alloy had a significantly lower percentage (P = .004). For the inflammatory extent and cellularity grades, the odds of being one grade higher for gold alloy abutment was 5.18 and 17.8 times that of titanium abutment, respectively. However, for the zirconia abutment, the odds were 0.87 and 7.5 times higher than the titanium group. The tissue around the gold alloy abutments resulted in worse attachment conditions compared with the titanium and zirconia abutments. Inflammation tended to be higher in the tissue around the gold alloy abutments than the titanium and zirconia abutments. © 2017 Wiley Periodicals, Inc.

Analysis of load distribution in tooth-implant supported fixed partial dentures by the use of resilient abutment.

PubMed

Glisić, Mirko; Stamenković, Dragoslav; Grbović, Aleksandar; Todorović, Aleksandar; Marković, Aleksa; Trifković, Branka

2016-01-01

Differences between the tooth and implant response to load can lead to many biological and technical implications in the conditions of occlusal forces. The objective of this study was to analyze load distribution in tooth/implant-supported fixed partial dentures with the use of resilient TSA (Titan Shock Absorber, BoneCare GmbH, Augsburg, Germany) abutment and conventional non-resilient abutment using finite element method. This study presents two basic 3D models. For one model a standard non-resilient abutment is used, and on the implant of the second model a resilient TSA abutment is applied. The virtual model contains drawn contours of tooth, mucous membranes, implant, cortical bones and spongiosa, abutment and suprastructure. The experiment used 500 N of vertical force, applied in three different cases of axial load. Calculations of von Mises equivalent stresses of the tooth root and periodontium, implants and peri-implant tissue were made. For the model to which a non-resilient abutment is applied, maximum stress values in all three cases are observed in the cortical part of the bone (maximum stress value of 49.7 MPa). Measurements of stress and deformation in the bone tissue in the model with application of the resilientTSA abutment demonstrated similar distribution; however, these values are many times lower than in the model with non-resilient TSA abutment (maximum stress value of 28.9 MPa). Application of the resilient TSA abutment results in more equal distribution of stress and deformations in the bone tissue under vertical forces. These values are many times lower than in the model with the non-resilient abutment.

Scour around vertical wall abutment in cohesionless sediment bed

NASA Astrophysics Data System (ADS)

Pandey, M.; Sharma, P. K.; Ahmad, Z.

2017-12-01

At the time of floods, failure of bridges is the biggest disaster and mainly sub-structure (bridge abutments and piers) are responsible for this failure of bridges. It is very risky if these sub structures are not constructed after proper designing and analysis. Scour is a natural phenomenon in rivers or streams caused by the erosive action of the flowing water on the bed and banks. The abutment undermines due to river-bed erosion and scouring, which generally recognized as the main cause of abutment failure. Most of the previous studies conducted on scour around abutment have concerned with the prediction of the maximum scour depth (Lim, 1994; Melvill, 1992, 1997 and Dey and Barbhuiya, 2005). Dey and Barbhuiya (2005) proposed a relationship for computing maximum scour depth near an abutment, based on laboratory experiments, for computing maximum scour depth around vertical wall abutment, which was confined to their experimental data only. However, this relationship needs to be also verified by the other researchers data in order to support the reliability to the relationship and its wider applicability. In this study, controlled experimentations have been carried out on the scour near a vertical wall abutment. The collected data in this study along with data of the previous investigators have been carried out on the scour near vertical wall abutment. The collected data in this study along with data of the previous have been used to check the validity of the existing equation (Lim, 1994; Melvill, 1992, 1997 and Dey and Barbhuiya, 2005) of maximum scour depth around the vertical wall abutment. A new relationship is proposed to estimate the maximum scour depth around vertical wall abutment, it gives better results all relationships.

Effect of platform connection and abutment material on stress distribution in single anterior implant-supported restorations: a nonlinear 3-dimensional finite element analysis.

PubMed

Carvalho, Marco Aurélio; Sotto-Maior, Bruno Salles; Del Bel Cury, Altair Antoninha; Pessanha Henriques, Guilherme Elias

2014-11-01

Although various abutment connections and materials have recently been introduced, insufficient data exist regarding the effect of stress distribution on their mechanical performance. The purpose of this study was to investigate the effect of different abutment materials and platform connections on stress distribution in single anterior implant-supported restorations with the finite element method. Nine experimental groups were modeled from the combination of 3 platform connections (external hexagon, internal hexagon, and Morse tapered) and 3 abutment materials (titanium, zirconia, and hybrid) as follows: external hexagon-titanium, external hexagon-zirconia, external hexagon-hybrid, internal hexagon-titanium, internal hexagon-zirconia, internal hexagon-hybrid, Morse tapered-titanium, Morse tapered-zirconia, and Morse tapered-hybrid. Finite element models consisted of a 4×13-mm implant, anatomic abutment, and lithium disilicate central incisor crown cemented over the abutment. The 49 N occlusal loading was applied in 6 steps to simulate the incisal guidance. Equivalent von Mises stress (σvM) was used for both the qualitative and quantitative evaluation of the implant and abutment in all the groups and the maximum (σmax) and minimum (σmin) principal stresses for the numerical comparison of the zirconia parts. The highest abutment σvM occurred in the Morse-tapered groups and the lowest in the external hexagon-hybrid, internal hexagon-titanium, and internal hexagon-hybrid groups. The σmax and σmin values were lower in the hybrid groups than in the zirconia groups. The stress distribution concentrated in the abutment-implant interface in all the groups, regardless of the platform connection or abutment material. The platform connection influenced the stress on abutments more than the abutment material. The stress values for implants were similar among different platform connections, but greater stress concentrations were observed in internal connections. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Clinical Characteristics of Abutment Teeth with Gingival Discoloration.

PubMed

Ristic, Ljubisa; Dakovic, Dragana; Postic, Srdjan; Lazic, Zoran; Bacevic, Miljana; Vucevic, Dragana

2017-04-06

The grey-bluish discoloration of gingiva (known as "amalgam tattoo") does not appear only in the presence of amalgam restorations. It may also be seen in cases of teeth restored with cast dowels and porcelain-fused-to-metal (PFM) restorations. The aim of this article was to determine the clinical characteristics of abutment teeth with gingival discoloration. This research was conducted on 25 patients referred for cast dowel and PFM restorations. These restorations were manufactured from Ni-Cr alloys. Ninety days after cementing the fixed prosthodontic restorations, the abutment teeth (n = 61) were divided into a group with gingival discoloration (GD) (n = 25) and without gingival discoloration (NGD) (n = 36). The control group (CG) comprised the contralateral teeth (n = 61). Plaque index, gingival index, clinical attachment level, and probing depth were assessed before fabrication and also 90 days after cementation of the PFM restorations. The gingival index, clinical attachment level, and probing depths of the abutment teeth that had GD were statistically higher before restoration, in comparison with the abutment teeth in the NGD and control groups. Ninety days after cementation, the abutment teeth with GD had significantly lower gingival indexes and probing depths, compared to the abutment teeth in the NGD group. Both abutment teeth groups (GD and NGD) had significantly higher values of clinical attachment levels when compared to the control group. There were no statistically significant differences in plaque index values between the study groups. The results of this study indicated that impairment of periodontal status of abutment teeth seemed to be related to the presence of gingival discolorations. Therefore, fabrication of fixed prosthodontic restorations requires careful planning and abutment teeth preparation to minimize the occurrence of gingival discolorations. With careful preparation of abutment teeth for cast dowels and crown restorations it may be possible to decrease the frequency of gingival discolorations adjacent to abutment teeth. © 2017 by the American College of Prosthodontists.

Bending moments of zirconia and titanium implant abutments supporting all-ceramic crowns after aging.

PubMed

Mühlemann, Sven; Truninger, Thomas C; Stawarczyk, Bogna; Hämmerle, Christoph H F; Sailer, Irena

2014-01-01

To test the fracture load and fracture patterns of zirconia abutments restored with all-ceramic crowns after fatigue loading, exhibiting internal and external implant-abutment connections as compared to restored and internally fixed titanium abutments. A master abutment was used for the customization of 5 groups of zirconia abutments to a similar shape (test). The groups differed according to their implant-abutment connections: one-piece internal connection (BL; Straumann Bonelevel), two-piece internal connection (RS; Nobel Biocare ReplaceSelect), external connection (B; Branemark MkIII), two-piece internal connection (SP, Straumann StandardPlus) and one-piece internal connection (A; Astra Tech AB OsseoSpeed). Titanium abutments with internal implant-abutment connection (T; Straumann Bonelevel) served as control group. In each group, 12 abutments were fabricated, mounted to the respective implants and restored with glass-ceramic crowns. All samples were embedded in acrylic holders (ISO-Norm 14801). After aging by means of thermocycling in a chewing simulator, static load was applied until failure (ISO-Norm 14801). Fracture load was analyzed by calculating the bending moments. Values of all groups were compared with one-way ANOVA followed by Scheffé post hoc test (P-value<0.05). Failure mode was analyzed descriptively. The mean bending moments were 464.9 ± 106.6 N cm (BL), 581.8 ± 172.8 N cm (RS), 556.7 ± 128.4 N cm (B), 605.4 ± 54.7 N cm (SP), 216.4 ± 90.0 N cm (A) and 1042.0 ± 86.8 N cm (T). No difference of mean bending moments was found between groups BL, RS, B and SP. Test group A exhibited significantly lower mean bending moment than the other test groups. Control group T had significantly higher bending moments than all test groups. Failure due to fracture of the abutment and/or crown occurred in the test groups. In groups BL and A, fractures were located in the internal part of the connection, whereas in groups RS and SP, a partial deformation of the implant components occurred and cracks and fractures of the zirconia abutment were detected. The differently connected zirconia abutments exhibited similar bending moments with the exception of one group. Hence, the type of connection only had a minor effect on the stability of restored zirconia abutments. In general, restored titanium abutments exhibited the highest bending moments. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of nanoporous TiO2 coating and anodized Ca2+ modification of titanium surfaces on early microbial biofilm formation

PubMed Central

2011-01-01

Background The soft tissue around dental implants forms a barrier between the oral environment and the peri-implant bone and a crucial factor for long-term success of therapy is development of a good abutment/soft-tissue seal. Sol-gel derived nanoporous TiO2 coatings have been shown to enhance soft-tissue attachment but their effect on adhesion and biofilm formation by oral bacteria is unknown. Methods We have investigated how the properties of surfaces that may be used on abutments: turned titanium, sol-gel nanoporous TiO2 coated surfaces and anodized Ca2+ modified surfaces, affect biofilm formation by two early colonizers of the oral cavity: Streptococcus sanguinis and Actinomyces naeslundii. The bacteria were detected using 16S rRNA fluorescence in situ hybridization together with confocal laser scanning microscopy. Results Interferometry and atomic force microscopy revealed all the surfaces to be smooth (Sa ≤ 0.22 μm). Incubation with a consortium of S. sanguinis and A. naeslundii showed no differences in adhesion between the surfaces over 2 hours. After 14 hours, the level of biofilm growth was low and again, no differences between the surfaces were seen. The presence of saliva increased the biofilm biovolume of S. sanguinis and A. naeslundii ten-fold compared to when saliva was absent and this was due to increased adhesion rather than biofilm growth. Conclusions Nano-topographical modification of smooth titanium surfaces had no effect on adhesion or early biofilm formation by S. sanguinis and A. naeslundii as compared to turned surfaces or those treated with anodic oxidation in the presence of Ca2+. The presence of saliva led to a significantly greater biofilm biovolume but no significant differences were seen between the test surfaces. These data thus suggest that modification with sol-gel derived nanoporous TiO2, which has been shown to improve osseointegration and soft-tissue healing in vivo, does not cause greater biofilm formation by the two oral commensal species tested than the other surfaces. PMID:21385428

Application of reverse engineering in the production of individual dental abutments.

NASA Astrophysics Data System (ADS)

Yunusov, A. V.; Kashapov, R. N.; Kashapov, L. N.; Statsenko, E. O.

2017-09-01

The purpose of the research is to develop a method of manufacturing individual dental abutments for a variety of dental implants. System of industrial X-ray microtomography Phoenix V|tome|X S 240 has been applied for creation of highly accurate model of the dental abutment. Scanning of dental abutment and the optimization of model was produced. The program of milling the individual abutment with a standard conical neck of hexagon was produced for the five-axis milling machine imes - icore 450i from the materials titanium and zirconium oxide.

Influence of implantoplasty on stress distribution of exposed implants at different bone insertion levels.

PubMed

Tribst, João Paulo Mendes; Dal Piva, Amanda Maria de Oliveira; Shibli, Jamil Awad; Borges, Alexandre Luiz Souto; Tango, Rubens Nisie

2017-12-07

This study evaluated the effect of implantoplasty on different bone insertion levels of exposed implants. A model of the Bone Level Tapered implant (Straumann Institute, Waldenburg, Switzerland) was created through the Rhinoceros software (version 5.0 SR8, McNeel North America, Seattle, WA, USA). The abutment was fixed to the implant through a retention screw and a monolithic crown was modeled over a cementation line. Six models were created with increasing portions of the implant threads exposed: C1 (1 mm), C2 (2 mm), C3 (3 mm), C4 (4 mm), C5 (5 mm) and C6 (6 mm). The models were made in duplicates and one of each pair was used to simulate implantoplasty, by removing the threads (I1, I2, I3, I4, I5 and I6). The final geometry was exported in STEP format to ANSYS (ANSYS 15.0, ANSYS Inc., Houston, USA) and all materials were considered homogeneous, isotropic and linearly elastic. To assess distribution of stress forces, an axial load (300 N) was applied on the cusp. For the periodontal insert, the strains increased in the peri-implant region according to the size of the exposed portion and independent of the threads' presence. The difference between groups with and without implantoplasty was less than 10%. Critical values were found when the inserted portion was smaller than the exposed portion. In the exposed implants, the stress generated on the implant and retention screw was higher in the models that received implantoplasty. For the bone tissue, exposure of the implant's thread was a damaging factor, independent of implantoplasty. Implantoplasty treatment can be safely used to control peri-implantitis if at least half of the implant is still inserted in bone.

Effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts.

PubMed

Ebadian, Behnaz; Rismanchian, Mansor; Dastgheib, Badrosadat; Bajoghli, Farshad

2015-01-01

Different factors such as impression techniques and materials can affect the passive fit between the superstructure and implant. The aim of this study was to determine the effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts. Four internal hex implants (Biohorizons Ø4 mm) were placed on a metal maxillary model perpendicular to the horizontal plane in maxillary lateral incisors, right canine and left first premolar areas. Three impression techniques including open tray, closed tray using ball top screw abutments and closed tray using short impression copings and two impression materials (polyether and polyvinyl siloxane) were evaluated (n = 60). The changes in distances between implant analogues in mediolateral (x) and anteroposterior (y) directions and analogue angles in x/z and y/z directions in the horizontal plane on the definitive casts were measured by coordinate measuring machine. The data were analyzed by multivariate two-way analysis of variance and one sample t-test (α = 0.05). No statistical significant differences were observed between different impression techniques and materials. However, deviation and distortion of definitive casts had a significant difference with the master model when short impression copings and polyvinyl siloxane impression material were used (P < 0.05). In open tray technique, there was a significant difference in the rotation of analogs compared with the master model with both impression materials (P < 0.05). There was no difference between open and closed tray impression techniques; however, less distortion and deviation were observed in the open tray technique. In the closed tray impression technique, ball top screw was more accurate than short impression copings.

Effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts

PubMed Central

Ebadian, Behnaz; Rismanchian, Mansor; Dastgheib, Badrosadat; Bajoghli, Farshad

2015-01-01

Background: Different factors such as impression techniques and materials can affect the passive fit between the superstructure and implant. The aim of this study was to determine the effect of different impression materials and techniques on the dimensional accuracy of implant definitive casts. Materials and Methods: Four internal hex implants (Biohorizons Ø4 mm) were placed on a metal maxillary model perpendicular to the horizontal plane in maxillary lateral incisors, right canine and left first premolar areas. Three impression techniques including open tray, closed tray using ball top screw abutments and closed tray using short impression copings and two impression materials (polyether and polyvinyl siloxane) were evaluated (n = 60). The changes in distances between implant analogues in mediolateral (x) and anteroposterior (y) directions and analogue angles in x/z and y/z directions in the horizontal plane on the definitive casts were measured by coordinate measuring machine. The data were analyzed by multivariate two-way analysis of variance and one sample t-test (α = 0.05). Results: No statistical significant differences were observed between different impression techniques and materials. However, deviation and distortion of definitive casts had a significant difference with the master model when short impression copings and polyvinyl siloxane impression material were used (P < 0.05). In open tray technique, there was a significant difference in the rotation of analogs compared with the master model with both impression materials (P < 0.05). Conclusion: There was no difference between open and closed tray impression techniques; however, less distortion and deviation were observed in the open tray technique. In the closed tray impression technique, ball top screw was more accurate than short impression copings. PMID:25878678

Leakage evaluation of original and compatible implant–abutment connections: In vitro study using Rhodamine B

PubMed Central

Tehini, George; Rifai, Khaldoun; Bou Nasser Eddine, Farah; Badran, Bassam; Akl, Haidar

2014-01-01

Leakage has been addressed as a major contributing factor to inflammatory reactions at the implant–abutment connection, leading to problems such as oral malodor, inflammation, and marginal bone loss. The aim of this study was to investigate in vitro the leakage at implant–abutment interface of OsseoSpeed™ implants connected to original and compatible abutments. A total of 28 OsseoSpeed implants were divided into four groups (n = 7). Each group was connected to four different abutments according to manufacturers’ recommendations: group A (TiDesign™); group B (Natea™); group C (Dual™); and group D (Implanet™) abutments. The inner volume of each implant–abutment combination was calculated and leakage was detected for each group with spectrophotometric analysis at 1 h (D0) and 48 h (D1) of incubation time using Rhodamine B. At 1 h, leakage volume was significantly lower in TiDesign and Dual than in Natea and Implanet (P < 0.001). At 48 h, however, leakage was significantly lower between TiDesign and all other systems (P < 0.005). Compatible abutments do not fit internal connection of OsseoSpeed implants perfectly, which increases the leakage of the final assembly. PMID:25342984

Restraint deformation and corrosion protection of gold deposited aluminum mirrors for cold optics of mid-infrared instruments

NASA Astrophysics Data System (ADS)

Uchiyama, Mizuho; Miyata, Takashi; Sako, Shigeyuki; Kamizuka, Takafumi; Nakamura, Tomohiko; Asano, Kentaro; Okada, Kazushi; Onaka, Takashi; Sakon, Itsuki; Kataza, Hirokazu; Sarugaku, Yuki; Kirino, Okiharu; Nakagawa, Hiroyuki; Okada, Norio; Mitsui, Kenji

2014-07-01

We report the restraint deformation and the corrosion protection of gold deposited aluminum mirrors for mid-infrared instruments. To evaluate the deformation of the aluminum mirrors by thermal shrinkage, monitoring measurement of the surface of a mirror has been carried out in the cooling cycles from the room temperature to 100 K. The result showed that the effect of the deformation was reduced to one fourth if the mirror was screwed with spring washers. We have explored an effective way to prevent the mirror from being galvanically corroded. A number of samples have been prepared by changing the coating conditions, such as inserting an insulation layer, making a multi-layer and overcoating water blocking layer, or carrying out precision cleaning before coating. Precision cleaning before the deposition and protecting coat with SiO over the gold layer seemed to be effective in blocking corrosion of the aluminum. The SiO over-coated mirror has survived the cooling test for the mid-infrared use and approximately 1 percent decrease in the reflectance has been detected at 6-25 microns compared to gold deposited mirror without coating.

Hydroxyapatite-coated magnesium implants with improved in vitro and in vivo biocorrosion, biocompatibility, and bone response.

PubMed

Kim, Sae-Mi; Jo, Ji-Hoon; Lee, Sung-Mi; Kang, Min-Ho; Kim, Hyoun-Ee; Estrin, Yuri; Lee, Jong-Ho; Lee, Jung-Woo; Koh, Young-Hag

2014-02-01

Magnesium and its alloys are candidate materials for biodegradable implants; however, excessively rapid corrosion behavior restricts their practical uses in biological systems. For such applications, surface modification is essential, and the use of anticorrosion coatings is considered as a promising avenue. In this study, we coated Mg with hydroxyapatite (HA) in an aqueous solution containing calcium and phosphate sources to improve its in vitro and in vivo biocorrosion resistance, biocompatibility and bone response. A layer of needle-shaped HA crystals was created uniformly on the Mg substrate even when the Mg sample had a complex shape of a screw. In addition, a dense HA-stratum between this layer and the Mg substrate was formed. This HA-coating layer remarkably reduced the corrosion rate of the Mg tested in a simulated body fluid. Moreover, the biological response, including cell attachment, proliferation and differentiation, of the HA-coated samples was enhanced considerably compared to samples without a coating layer. The preliminary in vivo experiments also showed that the biocorrosion of the Mg implant was significantly retarded by HA coating, which resulted in good mechanical stability. In addition, in the case of the HA-coated implants, biodegradation was mitigated, particularly over the first 6 weeks of implantation. This considerably promoted bone growth at the interface between the implant and bone. These results confirmed that HA-coated Mg is a promising material for biomedical implant applications. © 2013 Wiley Periodicals, Inc.

4. South Elevation Columbia Island Abutment Four; South Elevation ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. South Elevation - Columbia Island Abutment Four; South Elevation - Washington Abutment One - Arlington Memorial Bridge, Spanning Potomac River between Lincoln Memorial & Arlington National Cemetery, Washington, District of Columbia, DC

In vitro analysis of post-fatigue reverse-torque values at the dental abutment/implant interface for a unitarian abutment design.

PubMed

Cashman, Paul M; Schneider, Robert L; Schneider, Galen B; Stanford, Clark M; Clancy, James M; Qian, Fang

2011-10-01

This study analyzed baseline and post-fatigue reverse-torque values (RTVs) for a specific brand control abutment relative to a third party compatible abutment. The purpose of this study was to compare the abutments' fatigue resistance to simulated function, using RTVs as an indication of residual preload at the implant/abutment interface. Forty Straumann tissue-level implants were mounted in resin and divided into four groups (n = 10). Forty abutments were seated, 20 control and 20 third-party abutments, according to manufacturer guidelines. Ten abutments from each manufacturer were evaluated for RTV without fatigue loading, using a calibrated digital torque gauge to provide a baseline RTVs. Fatigue loading was carried out on the remaining ten specimens from each manufacturer according to ISO 14801 guidelines. A moving-magnet linear motor was used to load one specimen per sequence, alternating from 10 to 200 N at 15 Hz for 5×10(6) cycles. RTV was recorded post-fatigue loading. The results were subjected to two-sample t-testing and two-way ANOVA. Scanning electron microphotography was carried out on three specimens from both manufacturers at baseline and post-fatigue cycling to visualize thread geometry and the abutment/implant interface. The data indicated that mean post-fatigue RTV observed for the control group was significantly higher than the third-party group (RTV 42.65 ± 6.70 N vs. 36.25 ± 2.63 N, p= 0.0161). Visual differences at the macro/microscopic level were also apparent for thread geometry, with third-party abutments demonstrating considerably greater variation in geometrical architecture than control specimens. Within the limitations of this in vitro model, the effect of component manufacturer resulted in a significantly higher RTV in the control group (two-way ANOVA, p= 0.0032) indicating greater residual preload; however, there was no significant decrease in post-fatigue RTV for either manufacturer compared to baseline. © 2011 by The American College of Prosthodontists.

Effect of abutment height on interproximal implant bone level in the early healing: A randomized clinical trial.

PubMed

Blanco, Juan; Pico, Alexandre; Caneiro, Leticia; Nóvoa, Lourdes; Batalla, Pilar; Martín-Lancharro, Pablo

2018-01-01

The aim of this randomized clinical trial was to compare the effect on the interproximal implant bone loss (IBL) of two different heights (1 and 3 mm) of definitive abutments placed at bone level implants with a platform switched design. Twenty-two patients received forty-four implants (6.5-10 mm length and 3.5-4 mm diameter) to replace at least two adjacent missing teeth, one bridge set to each patient-two implants per bridge. Patients were randomly allocated, and two different abutment heights, 1 and 3 mm using only one abutment height per bridge, were used. Clinical and radiological measurements were performed at 3 and 6 months after surgery. Interproximal bone level changes were compared between treatment groups. The association between IBL and categorical variables (history of periodontitis, smoking, implant location, implant diameter, implant length, insertion torque, width of keratinized mucosa, bone density, gingival biotype and antagonist) was also performed. At 3 months, implants with a 1-mm abutment had significantly greater IBL (0.83 ± 0.19 mm) compared to implants with a 3-mm abutment (0.14 ± 0.08 mm). At 6 months, a greater IBL was observed at implants with 1-mm abutments compared to implants with 3-mm abutments (0.91 ± 0.19 vs. 0.11 ± 0.09 mm). The analysis of the relation between patient characteristics and clinical variables with IBL revealed no significant differences at any moment except for smoking. Abutment height is an important factor to maintain interproximal implant bone level in early healing. Short abutments led to a greater interproximal bone loss in comparison with long abutments after 6 months. Other variables except smoking showed no relation with interproximal bone loss in early healing. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of tightening torque on the marginal adaptation of cement-retained implant-supported fixed dental prostheses

PubMed Central

Ghanbarzadeh, Jalil; Dashti, Hossin; Karamad, Reza; Alikhasi, Marzieh; Nakhaei, Mohammadreza

2015-01-01

Background: The final position of the abutment changes with the amount of tightening torque. This could eventually lead to loss of passivity and marginal misfit of prostheses. The aim of this study was to evaluate the effect of three different tightening torques on the marginal adaptation of 3-unit cement-retained implant-supported fixed dental prostheses (FDPs). Materials and Methods: Two implants (Straumann) were inserted in an acrylic block so that one of the implants was placed vertically and the other at a 15° vertical angle. A straight abutment and a 15° angulated abutment were connected to the vertically and obliquely installed implants, respectively, so that the two abutments were parallel. Then, 10 cement-retained FDPs were waxed and cast. Abutments were tightened with 10, 20, and 35 Ncm torques, respectively. Following each tightening torque, FDPs were luted on respective abutments with temporary cement. The marginal adaptation of the retainers was evaluated using stereomicroscope. FDPs were then removed from the abutments and were sectioned at the connector sites. The retainers were luted again on their respective abutments. Luting procedures and marginal adaptation measurement were repeated. Data were analyzed by ANOVA and least significant difference tests (α = 0.05). After cutting the FDP connectors, the independent samples t-test was used to compare misfit values (α = 0.05). Results: Following 10, 20, and 35 Ncm tightening torques, the marginal discrepancy of the retainers of FDPs significantly increased (P < 0.05). There was no significant difference between the marginal discrepancies of these two retainers (P > 0.05). The marginal gap values of angulated abutment retainers (ANRs) were significantly higher than those of the straight abutment after cutting the connectors (P = 0.026). Conclusion: Within the limitations of this study, the marginal misfit of cement-retained FDPs increased continuously when the tightening torque increased. After cutting the connectors, the marginal misfit of the ANRs was higher than those of the straight abutment retainers. PMID:26288627

Effect of tightening torque on the marginal adaptation of cement-retained implant-supported fixed dental prostheses.

PubMed

Ghanbarzadeh, Jalil; Dashti, Hossin; Karamad, Reza; Alikhasi, Marzieh; Nakhaei, Mohammadreza

2015-01-01

The final position of the abutment changes with the amount of tightening torque. This could eventually lead to loss of passivity and marginal misfit of prostheses. The aim of this study was to evaluate the effect of three different tightening torques on the marginal adaptation of 3-unit cement-retained implant-supported fixed dental prostheses (FDPs). Two implants (Straumann) were inserted in an acrylic block so that one of the implants was placed vertically and the other at a 15° vertical angle. A straight abutment and a 15° angulated abutment were connected to the vertically and obliquely installed implants, respectively, so that the two abutments were parallel. Then, 10 cement-retained FDPs were waxed and cast. Abutments were tightened with 10, 20, and 35 Ncm torques, respectively. Following each tightening torque, FDPs were luted on respective abutments with temporary cement. The marginal adaptation of the retainers was evaluated using stereomicroscope. FDPs were then removed from the abutments and were sectioned at the connector sites. The retainers were luted again on their respective abutments. Luting procedures and marginal adaptation measurement were repeated. Data were analyzed by ANOVA and least significant difference tests (α = 0.05). After cutting the FDP connectors, the independent samples t-test was used to compare misfit values (α = 0.05). Following 10, 20, and 35 Ncm tightening torques, the marginal discrepancy of the retainers of FDPs significantly increased (P < 0.05). There was no significant difference between the marginal discrepancies of these two retainers (P > 0.05). The marginal gap values of angulated abutment retainers (ANRs) were significantly higher than those of the straight abutment after cutting the connectors (P = 0.026). Within the limitations of this study, the marginal misfit of cement-retained FDPs increased continuously when the tightening torque increased. After cutting the connectors, the marginal misfit of the ANRs was higher than those of the straight abutment retainers.

Effects of modified abutment characteristics on peri-implant soft tissue health: A systematic review and meta-analysis.

PubMed

Sanz-Martín, Ignacio; Sanz-Sánchez, Ignacio; Carrillo de Albornoz, Ana; Figuero, Elena; Sanz, Mariano

2018-01-01

The purpose of this systematic review was to evaluate the impact of the abutment characteristics on peri-implant tissue health and to identify the most suitable material and surface characteristics. A protocol was developed aimed to answer the following focused question: "Which is the effect of the modification of the abutment design in regard to the maintenance of the peri-implant soft tissue health?" Further subanalysis aimed to investigate the impact of the abutment material, macroscopic design, surface topography and surface manipulation. Randomised controlled trials (RCTs) with a follow-up of at least 6 months after implant loading were considered as inclusion criteria. Meta-analyses were performed whenever possible. Nineteen final publications from thirteen investigations were included. The results from the meta-analysis indicated that zirconia abutments (Zi) experienced less increase in BOP values over time [n = 3; WMD = -26.96; 95% CI (-45.00; -8.92); p = .003] and less plaque accumulation [n = 1; MD = -20.00; 95% CI (-41.47; 1.47); p = .068] when compared with titanium abutments (Ti). Bone loss was influenced by the method of abutment decontamination [n = 1; MD = -0.44; 95% CI (-0.65; -0.23); p < .001]. The rest of the studied outcomes did not show statistically significant differences. The macroscopic design, the surface topography and the manipulation of the implant abutment did not have a significant influence on peri-implant inflammation. In contrast, the abutment material demonstrated increased BOP values over time for Ti when compared to Zi abutments. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparison Study of Percutaneous Osseointegrated Bone Conduction Device Complications When Using the 9 mm Abutment Versus 6 mm Abutment at Initial Implantation.

PubMed

Wise, Sean R; LaRouere, Jacqueline S; Bojrab, Dennis I; LaRouere, Michael J

2018-04-01

To assess differences in the incidence, type, and management of complications encountered with implantation of percutaneous osseointegrated bone conduction devices when using a 9 mm abutment versus 6 mm abutment at initial implantation. Retrospective cohort study. One hundred thirty consecutive patients between January 2010 and December 2011 underwent single-stage percutaneous osseointegrated bone conduction device implantation using a 9 or 6 mm abutment. Clinical outcomes assessed for the two groups included the incidence, type, and management of postoperative complications. Abutment size, age, sex, indication for surgery, implant device type, duration of follow-up, and patient comorbidities were evaluated as potential factors affecting outcomes. Average duration of follow-up was 16 months (range 6-29 mo). Postoperative complications occurred in 38 (29.2%) patients. Twenty-four (18.4%) patients experienced minor complications requiring simple, local care; eight (6.1%) patients required in-office procedural intervention; and six (4.6%) patients required revision surgery in the operating room. Implant extrusion occurred in three (2.3%) patients. Eleven (8.5%) patients required placement of a longer abutment. Patients receiving the 6 mm abutment at initial surgery were significantly more likely to encounter a complication requiring in-office procedural intervention or revision surgery (p = 0.001). Minor complications after implantation of percutaneous osseointegrated bone conduction devices are common. The vast majority of these complications are due to localized skin reactions, most of which are readily addressed through local care. Patients receiving the 9 mm abutment during initial implantation are significantly less likely to require in-office procedural intervention or revision surgery postoperatively as compared with those receiving the shorter, 6 mm abutment.

Effect of abutment shade, ceramic thickness, and coping type on the final shade of zirconia all-ceramic restorations: in vitro study of color masking ability.

PubMed

Oh, Seon-Hee; Kim, Seok-Gyu

2015-10-01

The aim of the study was to evaluate the effect of abutment shade, ceramic thickness, and coping type on the final shade of zirconia all-ceramic restorations. Three different types of disk-shaped zirconia coping specimens (Lava, Cercon, Zirkonzahn: ø10 mm × 0.4 mm) were fabricated and veneered with IPS e.max Press Ceram (shade A2), for total thicknesses of 1 and 1.5 mm. A total of sixty zirconia restoration specimens were divided into six groups based on their coping types and thicknesses. The abutment specimens (ø10 mm × 7 mm) were prepared with gold alloy, base metal (nickel-chromium) alloy, and four different shades (A1, A2, A3, A4) of composite resins. The average L*, a*, b* values of the zirconia specimens on the six abutment specimens were measured with a dental colorimeter, and the statistical significance in the effects of three variables was analyzed by using repeated measures analysis of variance (α=.05).The average shade difference (ΔE) values of the zirconia specimens between the A2 composite resin abutment and other abutments were also evaluated. The effects of zirconia specimen thickness (P<.001), abutment shade (P<.001), and type of zirconia copings (P<.003) on the final shade of the zirconia restorations were significant. The average ΔE value of Lava specimens (1 mm) between the A2 composite resin and gold alloy abutments was higher (close to the acceptability threshold of 5.5 ΔE) than th ose between the A2 composite resin and other abutments. This in-vitro study demonstrated that abutment shade, ceramic thickness, and coping type affected the resulting shade of zirconia restorations.

Enhanced biocorrosion resistance and biocompatibility of degradable Mg-Nd-Zn-Zr alloy by brushite coating.

PubMed

Niu, Jialin; Yuan, Guangyin; Liao, Yi; Mao, Lin; Zhang, Jian; Wang, Yongping; Huang, Feng; Jiang, Yao; He, Yaohua; Ding, Wenjiang

2013-12-01

To further improve the corrosion resistance and biocompatibility of Mg-Nd-Zn-Zr alloy (JDBM), a biodegradable calcium phosphate coating (Ca-P coating) with high bonding strength was developed using a novel chemical deposition method. The main composition of the Ca-P coating was brushite (CaHPO4·2H2O). The bonding strength between the coating and the JDBM substrate was measured to be over 10 MPa, and the thickness of the coating layer was about 10-30 μm. The in vitro corrosion tests indicated that the Ca-P treatment improved the corrosion resistance of JDBM alloy in Hank's solution. Ca-P treatment significantly reduced the hemolysis rate of JDBM alloy from 48% to 0.68%, and induced no toxicity to MC3T3-E1 cells. The in vivo implantation experiment in New Zealand's rabbit tibia showed that the degradation rate was reduced obviously by the Ca-P treatment and less gas was produced from Ca-P treated JDBM bone plates and screws in early stage of the implantation, and at least 10weeks degradation time can be prolonged by the present coating techniques. Both Ca-P treated and untreated JDBM Mg alloy induced bone growth. The primary results indicate that the present Ca-P treatment is a promising technique for the degradable Mg-based biomaterials for orthopedic applications. © 2013.

Microleakage Evaluation at Implant-Abutment Interface Using Radiotracer Technique

PubMed Central

Siadat, Hakimeh; Arshad, Mahnaz; Mahgoli, Hossein-Ali; Fallahi, Babak

2016-01-01

Objectives: Microbial leakage through the implant-abutment (I-A) interface results in bacterial colonization in two-piece implants. The aim of this study was to compare microleakage rates in three types of Replace abutments namely Snappy, GoldAdapt, and customized ceramic using radiotracing. Materials and Methods: Three groups, one for each abutment type, of five implants and one positive and one negative control were considered (a total of 17 regular body implants). A torque of 35 N/cm was applied to the abutments. The samples were immersed in thallium 201 radioisotope solution for 24 hours to let the radiotracers leak through the I-A interface. Then, gamma photons received from the radiotracers were counted using a gamma counter device. In the next phase, cyclic fatigue loading process was applied followed by the same steps of immersion in the radioactive solution and photon counting. Results: Rate of microleakage significantly increased (P≤0.05) in all three types of abutments (i.e. Snappy, GoldAdapt, and ceramic) after cyclic loading. No statistically significant differences were observed between abutment types after cyclic loading. Conclusions: Microleakage significantly increases after cyclic loading in all three Replace abutments (GoldAdapt, Snappy, ceramic). Lowest microleakage before and after cyclic loading was observed in GoldAdapt followed by Snappy and ceramic. PMID:28392814

Helical and tubular lipid microstructures that are electroless-coated with CoNiReP for wireless magnetic manipulation.

PubMed

Schuerle, Simone; Pané, Salvador; Pellicer, Eva; Sort, Jordi; Baró, Maria D; Nelson, Bradley J

2012-05-21

Hybrid magnetic phospholipidic-based tubular and helical microagents are wirelessly manipulated by means of a 5-DOF electromagnetic system. Two different strategies are used to manipulate these nanostructures in simulated biologic capillaries. Tubules are pulled by applying magnetic field gradients and oriented by magnetic fields. Helices exhibit a cork-screw motion similar to the swimming strategy used by motile bacteria such as E. coli. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Influence of abutment materials on the resultant color of heat-pressed lithium disilicate ceramics.

PubMed

Shimada, Kazuki; Nakazawa, Motoko; Kakehashi, Yoshiyuki; Matsumura, Hideo

2006-03-01

The purpose of this study was to evaluate the influence of abutment materials on the color of IPS Empress 2 ceramic coping with different thicknesses. Ceramic coping specimens (12.0x12.0x0.8-2.0 mm) were fabricated from IPS Empress 2 material (Ingot-100, n=5/group). Abutment specimens were fabricated from a build-up composite, a gold alloy, or a silver-palladium alloy. Color was evaluated using a colorimeter according to the CIE L*a*b* system. The L*a*b* values of the ceramic coping specimens of different thicknesses on each abutment specimen were measured. Following which, the color difference (deltaE*ab) values between the ceramic coping specimens on various abutment specimens were calculated. Significant differences in deltaE*ab value were observed among different abutment specimens at certain ceramic coping thicknesses (P<0.05). Thus, it was concluded that the color of IPS Empress 2 coping material was influenced significantly by both the thickness of the coping and the color of the abutment material.

Design of piles for integral abutment bridges.

DOT National Transportation Integrated Search

1984-08-01

More and more, integral abutment bridges are being used in place : of the more traditional bridge designs with expansion releases. In : this study, states which use integral abutment bridges were surveyed : to determine their current practice in the ...

19. DETAIL, WEST ABUTMENT, FROM NORTH, SHOWING SQUARED STONE MASONRY ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

19. DETAIL, WEST ABUTMENT, FROM NORTH, SHOWING SQUARED STONE MASONRY ABUTMENT, WITH PORTION OF SUPERSTRUCTURE - Virginia Department of Transportation Bridge No. 6051, Spanning Catoctin Creek at State Route 673 (Featherbottom Road), Waterford, Loudoun County, VA

Read-In Integrated Circuits for Large-Format Multi-Chip Emitter Arrays

DTIC Science & Technology

2015-03-31

chip has been designed and fabricated using ONSEMI C5N process to verify our approach. Keywords: Large scale arrays; Tiling; Mosaic; Abutment ...required. X and y addressing is not a sustainable and easily expanded addressing architecture nor will it work well with abutted RIICs. Abutment Method... Abutting RIICs into an array is challenging because of the precise positioning required to achieve a uniform image. This problem is a new design

Management of Broken Dental Implant Abutment in a Patient with Bruxism: A Rare Case Report and Review of Literature.

PubMed

Al-Almaie, Saad

2017-01-01

This rare case report describes prosthodontic complications resulting from a dental implant was placed surgically more distally in the area of the missing mandibular first molar with a cantilever effect and a crest width of >12 mm in a 59-year-old patient who had a history of bruxism. Fracture of abutment is a common complication in implant was placed in area with high occlusal forces. Inability to remove the broken abutment may most often end up in discarding the implant. Adding one more dental implant mesially to the previously placed implant, improvisation of technique to remove the broken abutment without sacrificing the osseointegrated dental implant, fabrication with cemented custom-made abutment to replace the broken abutment for the first implant, and the use of the two implants to replace a single molar restoration proved reliable and logical treatment solutions to avoid these prosthodontic complications.

Evaluation of Maryland abutment scour equation through selected threshold velocity methods

USGS Publications Warehouse

Benedict, S.T.

2010-01-01

The U.S. Geological Survey, in cooperation with the Maryland State Highway Administration, used field measurements of scour to evaluate the sensitivity of the Maryland abutment scour equation to the critical (or threshold) velocity variable. Four selected methods for estimating threshold velocity were applied to the Maryland abutment scour equation, and the predicted scour to the field measurements were compared. Results indicated that performance of the Maryland abutment scour equation was sensitive to the threshold velocity with some threshold velocity methods producing better estimates of predicted scour than did others. In addition, results indicated that regional stream characteristics can affect the performance of the Maryland abutment scour equation with moderate-gradient streams performing differently from low-gradient streams. On the basis of the findings of the investigation, guidance for selecting threshold velocity methods for application to the Maryland abutment scour equation are provided, and limitations are noted.

A Simplified Technique for Implant-Abutment Level Impression after Soft Tissue Adaptation around Provisional Restoration

PubMed Central

Kutkut, Ahmad; Abu-Hammad, Osama; Frazer, Robert

2016-01-01

Impression techniques for implant restorations can be implant level or abutment level impressions with open tray or closed tray techniques. Conventional implant-abutment level impression techniques are predictable for maximizing esthetic outcomes. Restoration of the implant traditionally requires the use of the metal or plastic impression copings, analogs, and laboratory components. Simplifying the dental implant restoration by reducing armamentarium through incorporating conventional techniques used daily for crowns and bridges will allow more general dentists to restore implants in their practices. The demonstrated technique is useful when modifications to implant abutments are required to correct the angulation of malpositioned implants. This technique utilizes conventional crown and bridge impression techniques. As an added benefit, it reduces costs by utilizing techniques used daily for crowns and bridges. The aim of this report is to describe a simplified conventional impression technique for custom abutments and modified prefabricated solid abutments for definitive restorations. PMID:29563457

Engineered Protein Coatings to Improve the Osseointegration of Dental and Orthopaedic Implants

PubMed Central

Raphel, Jordan; Karlsson, Johan; Galli, Silvia; Wennerberg, Ann; Lindsay, Christopher; Haugh, Matthew; Pajarinen, Jukka; Goodman, Stuart B.; Jimbo, Ryo; Andersson, Martin; Heilshorn, Sarah C.

2016-01-01

Here we present the design of an engineered, elastin-like protein (ELP) that is chemically modified to enable stable coatings on the surfaces of titanium-based dental and orthopaedic implants by novel photocrosslinking and solution processing steps. The ELP includes an extended RGD sequence to confer bio-signaling and an elastin-like sequence for mechanical stability. ELP thin films were fabricated on cp-Ti and Ti6Al4V surfaces using scalable spin and dip coating processes with photoactive covalent crosslinking through a carbene insertion mechanism. The coatings withstood procedures mimicking dental screw and hip replacement stem implantations, a key metric for clinical translation. They promoted rapid adhesion of MG63 osteoblast-like cells, with over 80% adhesion after 24 hours, compared to 38% adhesion on uncoated Ti6Al4V. MG63 cells produced significantly more mineralization on ELP coatings compared to uncoated Ti6Al4V. Human bone marrow mesenchymal stem cells (hMSCs) had an earlier increase in alkaline phosphatase activity, indicating more rapid osteogenic differentiation and mineral deposition on adhesive ELP coatings. Rat tibia and femur in vivo studies demonstrated that cell-adhesive ELP-coated implants increased bone-implant contact area and interfacial strength after one week. These results suggest that ELP coatings withstand surgical implantation and promote rapid osseointegration, enabling earlier implant loading and potentially preventing micromotion that leads to aseptic loosening and premature implant failure. PMID:26790146

The role of dental implant abutment design on the aesthetic outcome: preliminary 3-month post-loading results from a multicentre split-mouth randomised controlled trial comparing two different abutment designs.

PubMed

Esposito, Marco; Cardaropoli, Daniele; Gobbato, Luca; Scutellà, Fabio; Fabianelli, Andrea; Mascellani, Saverio; Delli Ficorelli, Gianluca; Mazzocco, Fabio; Sbricoli, Luca; Trullenque-Eriksson, Anna

To evaluate whether there are aesthetic and clinical benefits to using a newly designed abutment (Curvomax), over a conventional control abutment (GingiHue). A total of 49 patients, who required at least two implants, had two sites randomised according to a split-mouth design to receive one abutment of each type at seven different centres. The time of loading (immediate, early or delayed) and of prosthesis (provisional crowns of fixed prosthesis) was decided by the clinicians, but they had to restore both implants in a similar way. Provisional prostheses were replaced by definitive ones 3 months after initial loading, when the follow-up for the initial part of this study was completed. Outcome measures were: prosthesis failures, implant failures, complications, pink esthetic score (PES), peri-implant marginal bone level changes, and patient preference. In total, 49 Curvomax and 49 GingiHue abutments were delivered. Two patients dropped out. No implant failure, prosthesis failure or complication was reported. There were no differences at 3 months post-loading for PES (difference = -0.15, 95% CI -0.55 to 0.25; P (paired t test) = 0.443) and marginal bone level changes (difference = -0.02 mm, 95% CI -0.20 to 0.16; P (paired t test) = 0.817). The majority of the patients (30) had no preference regarding the two abutment designs; 11 patients preferred the Curvomax, while five patients preferred the GingiHue abutments (P (McNemar test) = 0.210). The preliminary results of the comparison between two different abutment designs did not disclose any statistically significant differences between the evaluated abutments. However the large number of missing radiographs and clinical pictures casts doubt on the reliability of the results. Longer follow-ups of wider patient populations are needed to better understand whether there is an effective advantage with one of the two abutment designs. Conflict of interest statement: This research project was originally partially funded by Biomax (Andover, MA, USA), the manufacturer of the Curvomax abutments evaluated in this investigation. Biomax, under pressure from some investigators, asked to modify the original agreed protocol. In a following phase, Zimmer-Biomet (Palm Beach Gardens, Florida, USA), the manufacturer of the implants and the GingiHue abutments, took over the funding of this project. Data belonged to the authors and the sponsors did not interfere with the publication of results.

Performance of conical abutment (Morse Taper) connection implants: a systematic review.

PubMed

Schmitt, Christian M; Nogueira-Filho, Getulio; Tenenbaum, Howard C; Lai, Jim Yuan; Brito, Carlos; Döring, Hendrik; Nonhoff, Jörg

2014-02-01

In this systematic review, we aimed to compare conical versus nonconical implant-abutment connection systems in terms of their in vitro and in vivo performances. An electronic search was performed using PubMed, Embase, and Medline databases with the logical operators: "dental implant" AND "dental abutment" AND ("conical" OR "taper" OR "cone"). Names of the most common conical implant-abutment connection systems were used as additional key words to detect further data. The search was limited to articles published up to November 2012. Recent publications were also searched manually in order to find any relevant studies that might have been missed using the search criteria noted above. Fifty-two studies met the inclusion criteria and were included in this systematic review. As the data and methods, as well as types of implants used was so heterogeneous, this mitigated against the performance of meta-analysis. In vitro studies indicated that conical and nonconical abutments showed sufficient resistance to maximal bending forces and fatigue loading. However, conical abutments showed superiority in terms of seal performance, microgap formation, torque maintenance, and abutment stability. In vivo studies (human and animal) indicated that conical and nonconical systems are comparable in terms of implant success and survival rates with less marginal bone loss around conical connection implants in most cases. This review indicates that implant systems using a conical implant-abutment connection, provides better results in terms of abutment fit, stability, and seal performance. These design features could lead to improvements over time versus nonconical connection systems. © 2013 Wiley Periodicals, Inc.

Microscopical and chemical surface characterization of CAD/CAM zircona abutments after different cleaning procedures. A qualitative analysis

PubMed Central

2015-01-01

PURPOSE To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non-quantitatively. RESULTS All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented. PMID:25932314

18. DETAIL, WEST ABUTMENT, FROM NORTHEAST, SHOWING SQUARED STONE MASONRY ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. DETAIL, WEST ABUTMENT, FROM NORTHEAST, SHOWING SQUARED STONE MASONRY ABUTMENT, WITH STRINGERS AND LATERAL BRACING - Virginia Department of Transportation Bridge No. 6051, Spanning Catoctin Creek at State Route 673 (Featherbottom Road), Waterford, Loudoun County, VA

Removal Torque and Biofilm Accumulation at Two Dental Implant-Abutment Joints After Fatigue.

PubMed

Pereira, Jorge; Morsch, Carolina S; Henriques, Bruno; Nascimento, Rubens M; Benfatti, Cesar Am; Silva, Filipe S; López-López, José; Souza, Júlio Cm

2016-01-01

The aim of this study was to evaluate the removal torque and in vitro biofilm penetration at Morse taper and hexagonal implant-abutment joints after fatigue tests. Sixty dental implants were divided into two groups: (1) Morse taper and (2) external hexagon implant-abutment systems. Fatigue tests on the implant-abutment assemblies were performed at a normal force (FN) of 50 N at 1.2 Hz for 500,000 cycles in growth medium containing human saliva for 72 hours. Removal torque mean values (n = 10) were measured after fatigue tests. Abutments were then immersed in 1% protease solution in order to detach the biofilms for optical density and colony-forming unit (CFU/cm²) analyses. Groups of implant-abutment assemblies (n = 8) were cross-sectioned at 90 degrees relative to the plane of the implant-abutment joints for the microgap measurement by field-emission guns scanning electron microscopy. Mean values of removal torque on abutments were significantly lower for both Morse taper (22.1 ± 0.5 μm) and external hexagon (21.1 ± 0.7 μm) abutments after fatigue tests than those recorded without fatigue tests (respectively, 24 ± 0.5 μm and 24.8 ± 0.6 μm) in biofilm medium for 72 hours (P = .04). Mean values of microgap size for the Morse taper joints were statistically signicantly lower without fatigue tests (1.7 ± 0.4 μm) than those recorded after fatigue tests (3.2 ± 0.8 μm). Also, mean values of microgap size for external hexagon joints free of fatigue were statistically signicantly lower (1.5 ± 0.4 μm) than those recorded after fatigue tests (8.1 ± 1.7 μm) (P < .05). The optical density of biofilms and CFU mean values were lower on Morse taper abutments (Abs630nm at 0.06 and 2.9 × 10⁴ CFU/cm²) than that on external hexagon abutments (Abs630nm at 0.08 and 4.5 × 10⁴ CFU/cm²) (P = .01). The mean values of removal torque, microgap size, and biofilm density recorded at Morse taper joints were lower in comparison to those recorded at external hexagon implant-abutment joints after fatigue tests in a simulated oral environment for 72 hours.

Influence of abutment material on peri-implant soft tissues in anterior areas with thin gingival biotype: a multicentric prospective study.

PubMed

Lops, Diego; Stellini, Edoardo; Sbricoli, Luca; Cea, Niccolò; Romeo, Eugenio; Bressan, Eriberto

2017-10-01

The aim of the present clinical trial was to analyze, through spectrophotometric digital technology, the influence of the abutment material on the color of the peri-implant soft tissue in patients with thin gingival biotype. Thirty-seven patients received an endosseous dental implant in the anterior maxilla. At time of each definitive prosthesis delivery, an all-ceramic crown has been tried on gold, titanium and zirconia abutment. Peri-implant soft-tissue color has been measured through a spectrophotometer after the insertion of each single abutment. Also facial peri-implant soft-tissue thickness was measured at the level of the implant neck through a caliper. A specific software has been utilized to identify a standardized tissue area and to collect the data before the statistical analysis in Lab* color space. ΔE parameters of the selected abutments were tested for correlation with mucosal thickness. Pearson correlation test was used. Only 15 patients met the study inclusion criteria on peri-implant soft-tissue thickness. Peri-implant soft-tissue color was different from that around natural teeth, no matter which type of restorative material was selected. Measurements regarding all the abutments were above the critical threshold of ΔE 8.74 for intraoral color distinction by the naked eye. The ΔE mean values of gold and zirconium abutments were similar (11.43 and 11.37, respectively) and significantly lower (P = 0.03 and P = 0.04, respectively) than the titanium abutment (13.55). In patients with a facial soft-tissue thickness ≤2 mm, the ΔE mean value of gold and zirconia abutments was significantly lower than that of titanium abutments (P = 0.03 and P = 0.04, respectively) and much more close to the reference threshold of 8.74. For peri-implant soft tissue of ≤2 mm, gold or zirconia abutments could be selected in anterior areas treatment. Moreover, the thickness of the peri-implant soft tissue seemed to be a crucial factor in the abutment impact on the color of soft tissues with a thickness of ≤2 mm. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Misfit of Three Different Implant-Abutment Connections Before and After Cyclic Load Application: An In Vitro Study.

PubMed

Gehrke, Sergio Alexandre; Delgado-Ruiz, Rafael Arcesio; Prados Frutos, Juan Carlos; Prados-Privado, María; Dedavid, Berenice Anina; Granero Marín, Jose Manuel; Calvo Guirado, José Luiz

This study aimed to evaluate the misfit of three different implant-abutment connections before and after cycling load. One hundred twenty dental implants and correspondent prefabricated titanium abutments were used. Three different implant-abutment connections were evaluated: Morse taper (MT group), external hexagon (EH group), and internal hexagon (IH group). Forty implants and 40 abutments were used per group. The parameters for the mechanical evaluation were set as: 360,000 cycles, load of 150 N, and frequency of 4 Hz. Samples were sectioned in their longitudinal and transversal axes, and the misfit of the implant-abutment connection was evaluated by scanning electron microscopy analysis. One-way analyses of variance, Tukey post hoc analyses (α = .05), and t test (P < .05) were used to determine differences between groups. At the longitudinal direction, all the groups showed the presence of microgaps before cycling load; after cycling load, microgaps were reduced in all groups (P > .05). Transversally, only the MT group showed full fitting after cycling load compared with the other groups (EH and IH) (P < .0001). The application of cycling load produces an accommodation of the implant-abutment connection in internal, external, and Morse taper connections. In the longitudinal direction, the accommodation decreases and/or eliminates the gap observed initially (before load). In the horizontal direction, Morse cone implant-abutment connections experience a complete accommodation with the elimination of the gap.

Influences of microgap and micromotion of implant-abutment interface on marginal bone loss around implant neck.

PubMed

Liu, Yang; Wang, Jiawei

2017-11-01

To review the influences and clinical implications of micro-gap and micro-motion of implant-abutment interface on marginal bone loss around the neck of implant. Literatures were searched based on the following Keywords: implant-abutment interface/implant-abutment connection/implant-abutment conjunction, microgap, micromotion/micromovement, microleakage, and current control methods available. The papers were then screened through titles, abstracts, and full texts. A total of 83 studies were included in the literature review. Two-piece implant systems are widely used in clinics. However, the production error and masticatory load result in the presence of microgap and micromotion between the implant and the abutment, which directly or indirectly causes microleakage and mechanical damage. Consequently, the degrees of microgap and micromotion further increase, and marginal bone absorption finally occurs. We summarize the influences of microgap and micromotion at the implant-abutment interface on marginal bone loss around the neck of the implant. We also recommend some feasible methods to reduce their effect. Clinicians and patients should pay more attention to the mechanisms as well as the control methods of microgap and micromotion. To reduce the corresponding detriment to the implant marginal bone, suitable Morse taper or hybrid connection implants and platform switching abutments should be selected, as well as other potential methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stock Versus CAD/CAM Customized Zirconia Implant Abutments – Clinical and Patient‐Based Outcomes in a Randomized Controlled Clinical Trial

PubMed Central

Meijer, Henny J.A.; Kerdijk, Wouter; Raghoebar, Gerry M.; Cune, Marco

2016-01-01

Abstract Background Single‐tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the abutment remain unclear. Purpose This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant abutments with respect to preservation of marginal bone level and several clinical and patient‐based outcome measures. Material and Methods Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Mölndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Mölndal, Sweden) zirconia abutment therapy. Peri‐implant bone level (primary outcome), Plaque‐index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. Results No implants were lost and no complications related to the abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia abutments could not be demonstrated for any of the operationalized variables. Conclusion The use of a CAD/CAM customized zirconia abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia abutment. PMID:27476829

Stock Versus CAD/CAM Customized Zirconia Implant Abutments - Clinical and Patient-Based Outcomes in a Randomized Controlled Clinical Trial.

PubMed

Schepke, Ulf; Meijer, Henny J A; Kerdijk, Wouter; Raghoebar, Gerry M; Cune, Marco

2017-02-01

Single-tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the abutment remain unclear. This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant abutments with respect to preservation of marginal bone level and several clinical and patient-based outcome measures. Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Mölndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Mölndal, Sweden) zirconia abutment therapy. Peri-implant bone level (primary outcome), Plaque-index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. No implants were lost and no complications related to the abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia abutments could not be demonstrated for any of the operationalized variables. The use of a CAD/CAM customized zirconia abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia abutment. © 2016 The Authors. Clinical Implant Dentistry and Related Research Published by Wiley Periodicals, Inc.

The effect of air abrasion of metal implant abutments on the tensile bond strength of three luting agents used to cement implant superstructures: an in vitro study.

PubMed

Jugdev, Jasvinder; Borzabadi-Farahani, Ali; Lynch, Edward

2014-01-01

To assess the effect of airborne particle abrasion of metal implant abutments on tensile bond strength (TBS) of TempBond, Retrieve, and Premier implant cements. Specimens were designed to replicate a single metal implant crown cemented to both smooth and airborne particle-abraded Osteo-Ti implant abutments with zero degrees of taper. Twenty castings were fabricated and cemented to either a smooth surface abutment (SSA) or to an airborne particle-abraded abutment (AAA). TBS was measured with a 50-kg load and a crosshead speed of 0.5 cm/min in a universal testing machine. Each cement was tested 10 times on both abutment types. The mean TBS values (standard deviations, 95% confidence intervals) of SSAs for TempBond, Retrieve, and Premier cements were 115.89 N (26.44, 96.98-134.81), 134.43 N (36.95, 108.25-160.60), and 132.51 N (55.10, 93.09-171.93), respectively. The corresponding values for AAAs were 129.69 N (30.39, 107.95-151.43), 298.67 N (80.36, 241.19-356.16), and 361.17 N (133.23, 265.86-456.48), respectively. There was no significant difference in TBS among the dental cements when used with an SSA. Air abrasion of abutments did not increase the TBS of TempBond but significantly increased crown retention with Retrieve and Premier. For SSAs, all failures were adhesive on the abutment surface; for AAAs, mostly cohesive cement failures occurred. The retention of copings cemented with Retrieve or Premier to zero-degree-taper abutments was significantly increased after airborne particle abrasion of the abutments. However, this was not significant when TempBond was used. Airborne particle abrasion of abutments and the use of Retrieve or Premier can be recommended for nonretrievable prostheses. Although TempBond functioned similarly to the two other cements in SSAs, it is advisable to limit its use to provisional prostheses; its long-term performance needs to be assessed clinically.

A parabolic mirror x-ray collimator

NASA Astrophysics Data System (ADS)

Franks, A.; Jackson, K.; Yacoot, A.

2000-05-01

A robust and stable x-ray collimator has been developed to produce a parallel beam of x-rays by total external reflection from a parabolic mirror. The width of the gold-coated silica mirror varies along its length, which allows it to be bent from a plane surface into a parabolic form by application of unequal bending forces at its ends. A family of parabolas of near constant focal length can be formed by changing the screw-applied bending force, thus allowing the collimator to cater for a range of wavelengths by the turning of a screw. Even with radiation with a wavelength as short as that as Mo Kicons/Journals/Common/alpha" ALT="alpha" ALIGN="TOP"/> 1 (icons/Journals/Common/lambda" ALT="lambda" ALIGN="TOP"/> = 0.07 nm), a gain in flux by a factor of 5.5 was achieved. The potential gain increases with wavelength, e.g. for Cu Kicons/Journals/Common/alpha" ALT="alpha" ALIGN="TOP"/> 1 radiation this amounts to over a factor of ten.

Soil-structure interaction studies for understanding the behavior of integral abutment bridges.

DOT National Transportation Integrated Search

2012-03-01

Integral Abutment Bridges (IAB) are bridges without any joints within the bridge deck or between the : superstructure and the abutments. An IAB provides many advantages during construction and maintenance of : a bridge. Soil-structure interactions at...

Hydraulic Performance of Shallow Foundations for the Support of Vertical-Wall Bridge Abutments

DOT National Transportation Integrated Search

2017-02-01

This study combined abutment flume experiments with numerical modeling using computational fluid dynamics (CFD) to investigate flow fields and scour at vertical-wall abutments with shallow foundations. The focus was situations dominated by flow contr...

Biomimetic composite coating on rapid prototyped scaffolds for bone tissue engineering.

PubMed

Arafat, M Tarik; Lam, Christopher X F; Ekaputra, Andrew K; Wong, Siew Yee; Li, Xu; Gibson, Ian

2011-02-01

The objective of this present study was to improve the functional performance of rapid prototyped scaffolds for bone tissue engineering through biomimetic composite coating. Rapid prototyped poly(ε-caprolactone)/tri-calcium phosphate (PCL/TCP) scaffolds were fabricated using the screw extrusion system (SES). The fabricated PCL/TCP scaffolds were coated with a carbonated hydroxyapatite (CHA)-gelatin composite via biomimetic co-precipitation. The structure of the prepared CHA-gelatin composite coating was studied by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy. Compressive mechanical testing revealed that the coating process did not have any detrimental effect on the mechanical properties of the scaffolds. The cell-scaffold interaction was studied by culturing porcine bone marrow stromal cells (BMSCs) on the scaffolds and assessing the proliferation and bone-related gene and protein expression capabilities of the cells. Confocal laser microscopy and SEM images of the cell-scaffold constructs showed a uniformly distributed cell sheet and accumulation of extracellular matrix in the interior of CHA-gelatin composite-coated PCL/TCP scaffolds. The proliferation rate of BMSCs on CHA-gelatin composite-coated PCL/TCP scaffolds was about 2.3 and 1.7 times higher than that on PCL/TCP scaffolds and CHA-coated PCL/TCP scaffolds, respectively, by day 10. Furthermore, reverse transcription polymerase chain reaction and Western blot analysis revealed that CHA-gelatin composite-coated PCL/TCP scaffolds stimulate osteogenic differentiation of BMSCs the most, compared with PCL/TCP scaffolds and CHA-coated PCL/TCP scaffolds. These results demonstrate that CHA-gelatin composite-coated rapid prototyped PCL/TCP scaffolds are promising for bone tissue engineering. Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Influence of artificial aging on the load-bearing capability of straight or angulated zirconia abutments in implant/tooth-supported fixed partial dentures.

PubMed

Nothdurft, Frank P; Doppler, Klaus E; Erdelt, Kurt J; Knauber, Andreas W; Pospiech, Peter R

2010-01-01

The aim of the study was to evaluate the influence of artificial aging on the fracture behavior of straight and angulated zirconia implant abutments used in ZirDesign (Astra Tech) implant/tooth-supported fixed partial dentures (FPDs) in the maxilla. Four different test groups (n = 8) representing anterior implant/tooth-supported FPDs were prepared. Groups 1 and 2 simulated a clinical situation with an ideal implant position (maxillary left central incisor) from a prosthetic point of view, which allowed for the use of a straight, prefabricated zirconia abutment. Groups 3 and 4 simulated a situation with a compromised implant position that required an angulated (20-degree) abutment. OsseoSpeed implants (4.5 3 13 mm, Astra Tech) as well as metal tooth analogs (maxillary right lateral incisor) with simulated periodontal mobility were mounted in polymethyl methacrylate. The FPDs (chromium-cobalt alloy) were cemented with glass ionomer. Groups 2 and 4 were thermomechanically loaded and subjected to static loading until failure. Statistical analysis of force data at the fracture site was performed using nonparametric tests. All samples survived thermomechanical loading. Artificial aging did not lead to a significant decrease in load-bearing capacity in either the straight abutments or the angulated abutments. The restorations that used angulated abutments exhibited higher fracture loads than the restorations with straight abutments (group 1: 209.13 ± 39.11 N; group 2: 233.63 ± 30.68 N; group 3: 324.62 ± 108.07 N; group 4: 361.75 ± 73.82 N). This difference in load-bearing performance was statistically significant, both with and without artificial aging. All abutment fractures occurred below the implant shoulder. Compensation for angulated implant positions with an angulated zirconia abutment is possible without reducing the load-bearing capacity of implant/tooth-supported anterior FPDs.

Effect of abutment shade, ceramic thickness, and coping type on the final shade of zirconia all-ceramic restorations: in vitro study of color masking ability

PubMed Central

Oh, Seon-Hee

2015-01-01

PURPOSE The aim of the study was to evaluate the effect of abutment shade, ceramic thickness, and coping type on the final shade of zirconia all-ceramic restorations. MATERIALS AND METHODS Three different types of disk-shaped zirconia coping specimens (Lava, Cercon, Zirkonzahn: ø10 mm × 0.4 mm) were fabricated and veneered with IPS e.max Press Ceram (shade A2), for total thicknesses of 1 and 1.5 mm. A total of sixty zirconia restoration specimens were divided into six groups based on their coping types and thicknesses. The abutment specimens (ø10 mm × 7 mm) were prepared with gold alloy, base metal (nickel-chromium) alloy, and four different shades (A1, A2, A3, A4) of composite resins. The average L*, a*, b* values of the zirconia specimens on the six abutment specimens were measured with a dental colorimeter, and the statistical significance in the effects of three variables was analyzed by using repeated measures analysis of variance (α=.05).The average shade difference (ΔE) values of the zirconia specimens between the A2 composite resin abutment and other abutments were also evaluated. RESULTS The effects of zirconia specimen thickness (P<.001), abutment shade (P<.001), and type of zirconia copings (P<.003) on the final shade of the zirconia restorations were significant. The average ΔE value of Lava specimens (1 mm) between the A2 composite resin and gold alloy abutments was higher (close to the acceptability threshold of 5.5 ΔE) than th ose between the A2 composite resin and other abutments. CONCLUSION This in-vitro study demonstrated that abutment shade, ceramic thickness, and coping type affected the resulting shade of zirconia restorations. PMID:26576252

Influence of implant abutment material on the color of different ceramic crown systems.

PubMed

Dede, Doğu Ömür; Armağanci, Arzu; Ceylan, Gözlem; Celik, Ersan; Cankaya, Soner; Yilmaz, Burak

2016-11-01

Ceramics are widely used for anterior restorations; however, clinical color reproduction still constitutes a challenge particularly when the ceramic crowns are used on titanium implant abutments. The purpose of this in vitro study was to investigate the effect of implant abutment material on the color of different ceramic material systems. Forty disks (11×1.5 mm, shade A2) were fabricated from medium-opacity (mo) and high-translucency (ht) lithium disilicate (IPS e.max) blocks, an aluminous ceramic (VITA In-Ceram Alumina), and a zirconia (Zirkonzahn) ceramic system. Disks were fabricated to represent 3 different implant abutments (zirconia, gold-palladium, and titanium) and dentin (composite resin, A2 shade) as background (11×2 mm). Disk-shaped composite resin specimens in A2 shade were fabricated to represent the cement layer. The color measurements of ceramic specimens were made on composite resin abutment materials using a spectrophotometer. CIELab color coordinates were recorded, and the color coordinates measured on composite resin background served as the control group. Color differences (ΔE 00 ) between the control and test groups were calculated. The data were analyzed with 2-way analysis of variance (ANOVA) and compared with the Tukey HSD test (α=.05). The ceramics system, abutment material, and their interaction were significant for ΔE 00 values (P<.001). Clinically unacceptable results (ΔE 00 >2.25) were observed for lithium disilicate ceramics on titanium abutments (2.46-2.50). The ΔE 00 values of lithium disilicate ceramics for gold-palladium and titanium abutments were significantly higher than for other groups (P<.05). The color results (ΔE 00 >2.25) of an implant-supported lithium disilicate ceramic restoration may be clinically unacceptable if it is fabricated over a titanium abutment. Zirconia may be a more suitable abutment material for implant-supported ceramic restorations. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluation of the Surface Treatment on Bone Healing in a Transmucosal 1-mm Area of Implant Abutment: An Experimental Study in the Rabbit Tibia.

PubMed

Gehrke, Sergio Alexandre; da Silva Neto, Ulisses Tavares

2016-06-01

The objective of the present study was to investigate the effect on bone tissue healing patterns in 1-mm area treated in the transmucosal surface of the abutment in the tibia of rabbits. Forty-six abutments were divided into two groups: control group (CG) with 14 abutments with smooth surface and experimental group (EG) with 32 abutments presenting a 1-mm area of the transmucosal surface treated through sandblasting with microparticles of titanium oxide followed by acid etching. Five samples of each group were analyzed using an optical laser profilometer for surface roughness characterization. Thirty-six Morse taper implants (3.5 mm in diameter and 7 mm in length) were inserted 1.5 mm subcrestal into the tibiae of nine rabbits. The implants were removed after 8, 10, and 12 weeks for histological analysis. The histological slides were prepared and analyzed qualitatively in relation to the new bone at the interface bone-abutment and quantitatively, in relation to bone height from the base of the implant. These data were computed and statistically compared inside the groups using analysis of variance and the U-test between groups for same time. Both groups exhibited bone growth in the direction and over the surface of the abutments, with good healing. However, the EG group showed an increased height of bone formation in the crestal direction, and highly significant differences were observed (p < .001) between these measured values. Under the limitations of the present study, histological follow-up at 8, 10, and 12 weeks showed that transmucosal 1-mm area of implant abutment with treatment of the surface facilitated the maintenance of bone height around the abutment compared with the same abutment with the totally smooth surface. © 2015 Wiley Periodicals, Inc.

Soft Tissue Response to Titanium Abutments with Different Surface Treatment: Preliminary Histologic Report of a Randomized Controlled Trial.

PubMed

Canullo, Luigi; Dehner, Jan Friedrich; Penarrocha, David; Checchi, Vittorio; Mazzoni, Annalisa; Breschi, Lorenzo

2016-01-01

The aim of this preliminary prospective RCT was to histologically evaluate peri-implant soft tissues around titanium abutments treated using different cleaning methods. Sixteen patients were randomized into three groups: laboratory customized abutments underwent Plasma of Argon treatment (Plasma Group), laboratory customized abutments underwent cleaning by steam (Steam Group), and abutments were used as they came from industry (Control Group). Seven days after the second surgery, soft tissues around abutments were harvested. Samples were histologically analyzed. Soft tissues surrounding Plasma Group abutments predominantly showed diffuse chronic infiltrate, almost no acute infiltrate, with presence of few polymorphonuclear neutrophil granulocytes, and a diffuse presence of collagenization bands. Similarly, in Steam Group, the histological analysis showed a high variability of inflammatory expression factors. Tissues harvested from Control Group showed presence of few neutrophil granulocytes, moderate presence of lymphocytes, and diffuse collagenization bands in some sections, while they showed absence of acute infiltrate in 40% of sections. However, no statistical difference was found among the tested groups for each parameter (p > 0.05). Within the limit of the present study, results showed no statistically significant difference concerning inflammation and healing tendency between test and control groups.

A new system of implant abutment connection: how to improve a two piece implant system sealing.

PubMed

Grecchi, F; DI Girolamo, M; Cura, F; Candotto, V; Carinci, F

2017-01-01

Implant dentistry has become one of the most successful dentistry techniques for replacing missing teeth. The success rate of implant dentistry is above 80%. However, peri-implantitis is a later complication of implant dentistry that if untreated, can lead to implant loss. One of the hypotized causes of peri-implantis is the bacterial leakage at the level of implant-abutment connection. Bacterial leakage is favored to the presence of a micro gap at the implant-abutment interface, allowing microorganisms to penetrate and colonize the inner part of the implant leading to biofilm accumulation and consequently to peri-implantitis development. To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified Escherichia coli across implant-abutment interface was evaluated. Implants were immerged in a bacterial culture for twenty-four hours and then bacteria amount was measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 9%. The reported results are better to those of previous studies carried out on different implant systems. Until now, none implant-abutment system has been proven to seal the gap between implant and abutment.

Comparison of load distribution for implant overdenture attachments.

PubMed

Porter, Joseph A; Petropoulos, Vicki C; Brunski, John B

2002-01-01

The aim of this study was to compare the force and moment distributions that develop on different implant overdenture attachments when vertical compressive forces are applied to an implant-retained overdenture. The following attachments were examined: Nobel Biocare bar and clip (NBC), Nobel Biocare standard ball (NSB), Nobel Biocare 2.25-mm-diameter ball (NB2), Zest Anchor Advanced Generation (ZAAG), Sterngold ERA white (SEW), Sterngold ERA orange (SEO), Compliant Keeper System with titanium shims (CK-Ti), Compliant Keeper System with black nitrile 2SR90 sleeve rings (CK-70), and Compliant Keeper System with clear silicone 2SR90 sleeve rings (CK-90). The attachments were tested using custom strain-gauged abutments and 2 Brånemark System implants placed in a test model. Each attachment type had one part embedded in a denture-like housing and the other part (the abutment) screwed into the implants. Compressive static loads of 100 N were applied (1) bilaterally, over the distal midline (DM); (2) unilaterally, over the right implant (RI); (3) unilaterally, over the left implant (LI); and (4) between implants in the mid-anterior region (MA). Both the force and bending moment on each implant were recorded for each loading location and attachment type. Results were analyzed using 2-way analysis of variance and the Duncan multiple-range test. Both loading location and attachment type were statistically significant factors (P < .05). In general, the force and moment on an implant were greater when the load was applied directly over the implant or at MA. While not significant at every loading location, the largest implant forces tended to occur with ZAAG attachments; the smallest were found with the SEW, the SEO, the NSB, the CK-70, and the CK-90. Typically, higher moments existed for NBC and ZAAG, while lower moments existed for SEW, SEO, NSB, CK-90, and CK-70. For different loading locations, significant differences were found among the different overdenture attachment systems.

Use of 5-mm-diameter implants: Periotest values related to a clinical and radiographic evaluation.

PubMed

Aparicio, C; Orozco, P

1998-12-01

A modified design of the original Brånemark implant consisting of a cp. Titanium 5.0-mm-diameter self-tapping implant threaded up to the marginal platform has been proposed for specific indications. From February 1992 to November 1995, a total of 185 machined screw implants (Nobel Biocare, Gothenburg, Sweden) were installed in 45 patients to withstand 58 prostheses. Of these, 91 were 3.75-mm diameter and 94 were 5.0-mm wide. Most of the implants were placed in type B and C bone quantity and type 2 and 3 bone quality. A retrospective evaluation with regard to indications, marginal bone remodelling, Periotest values (PTv) and survival rate is presented. PTv and radiographic measurements were made at abutment connection and repeated 3, 6 and 12 months later and thereafter every year. The follow-up ranged from 16 to 55 months (mean 32.9 months) post-loading. Three patients with 8 5.0-mm implants dropped-out of the study at different stages. Out of the wide implants, 1 was expelled during the healing period; 3 were found mobile at the abutment connection; 1 lost its osseointegration suddenly after 2 years of function; 4 belonging to 1 patient did not meet the success criteria due to continuous marginal bone loss. The cumulative success rate of 5.0-mm implants (CSR) after 1 year of function was 97.2% for upper jaws and 88.4% in mandibles, whereas the CSR in maxilla after 48 months was 97.2% and 83.4% in mandibles. The obtained PTv from 5.0-mm-wide fixtures in maxilla and mandibles were respectively 1.1 and 0.6 units lower than those obtained PTv for 3.75-mm-diameter implants in the same patients. The hypothesis that there are differences in the damping capacity of the bone surrounding a 5.0-mm-wide implant compared to the 3.75-mm-diameter implant is supported by the PTv results.

Wear at the Implant-Abutment Interface of Zirconia Abutments Manufactured by Three CAD/CAM Systems.

PubMed

Pinheiro Tannure, Ana Luiza; Cunha, Alfredo Gonçalves; Borges Junior, Luiz Antônio; da Silva Concílio, Laís Regiane; Claro Neves, Ana Christina

To evaluate the changes in the external-hexagon surface of the titanium (Ti) implant before and after mechanical cycling, when coupled with zirconia (Zr) abutments (A) manufactured by three computer-aided design/computer-aided manufacturing (CAD/CAM) systems (Neodent Digital, Zirkonzahn, and AmannGirrbach) and the ZrTi abutment manufactured by Neodent. Four groups were formed (n = 6): titanium implant with Zr AmannGirrbach abutment (AZrAG), with Zr Zirkonzahn abutment (AZrZ), with Zr Neodent abutment (AZrN), and with Zr abutment with infrastructure in Ti Neodent (AZrTiN). Standardized abutments were made from three identical abutments milled in wax. Images of the surface of each side of the hexagons of the implant were obtained by scanning electron microscopy, before and after mechanical cycling, to evaluate the parameters: (1) scratches in the hexagon face; (2) hexagon superior shoulder kneading; (3) hexagon shoulder wear; (4) alterations on the hexagon base; and (5) scratches on the hexagon top. The abutments were coupled with the implants, and Cr-Co crowns were cemented. The implant/abutment/crown assemblies were submitted to mechanical cycling (400 N, 8.0 Hz) for 1 million cycles. The observed changes were classified as follows: absence (0), mild (1), moderate (2), and severe (3). The results were analyzed using the Mann-Whitney, Kruskal-Wallis, and Dunn tests (P < .05). For parameter 1, a significant difference (P = .008) was observed between AZrZ and AZrAG, with more scratches in AZrZ; and between AZrN and AZrTiN (P = .006), with more scratches in AZrN. For parameter 2, a significant difference (P < .05) was observed between AZrZ and AZrAG and between AZrZ and AZrN, with greater kneading in AZrZ; among AZrN and AZrTiN, there was no significant difference (P = .103). For parameter 3, a significant difference (P < .05) was observed between AZrZ and the other groups of Zr, with more wear in AZrZ; between AZrN and AZrTiN, there was no significant difference (P = .107). For parameter 4, a significant difference (P < .05) was observed between AZrZ and AZrN, with more scratches in AZrZ; a significant difference (P = .002) was also observed between AZrN and AZrTiN, with more scratches in AZrN. For parameter 5, a significant difference (P < .05) was observed between AZrZ and AZrAG and between AZrZ and AZrN, with the fewest scratches in AZrZ; a significant difference (P = .006) was also observed between AZrN and AZrTiN, with more alterations in AZrN. Considering all the alterations, the AZrZ group showed more surface alteration, 1.74 (0.99); followed by AZrN, 1.43 (0.92); AZrAG, 1.32 (0.96); and AZrTiN, 0.88 (0.94). Among the Neodent abutments, the AZrN group had shown more surface alterations. Among the Zr groups, AZrZ samples had shown the most altered surfaces, suggesting that alterations on the implant/Zr abutment hexagon surfaces are related to the abutment milled hexagon shape.

Potential-scour assessments and estimates of maximum scour at selected bridges in Iowa

USGS Publications Warehouse

Fischer, E.E.

1995-01-01

Although the abutment-scour equation predicted deep scour holes at many of the sites, the only significant abutment scour that was measured was erosion of the embankment at the left abutment at one bridge after a flood.

Prosthetic management of malpositioned implant using custom cast abutment

PubMed Central

Chatterjee, Aishwarya; Ragher, Mallikarjuna; Patil, Sanket; Chatterjee, Debopriya; Dandekeri, Savita; Prabhu, Vishnu

2015-01-01

Two cases are reported with malpositioned implants. Both the implants were placed 6–7 months back. They had osseointegrated well with the surrounding bone. However, they presented severe facial inclination. Case I was restored with custom cast abutment with an auto polymerizing acrylic gingival veneer. Case II was restored with custom cast UCLA type plastic implant abutment. Ceramic was directly fired on the custom cast abutments. The dual treatment strategy resulted in functional and esthetic restorations despite facial malposition of the implants. PMID:26538957

The effect of zirconia or titanium as abutment material on soft peri-implant tissues: a systematic review and meta-analysis.

PubMed

Linkevicius, Tomas; Vaitelis, Julius

2015-09-01

The objective of this review was to analyze research with regard to the effect of zirconia or titanium as abutment material on soft peri-implant tissues. Clinical studies were selected via electronic and hand searches in English language journals until December 1, 2014. Only randomized clinical trials (RCTs) and prospective controlled clinical trials (CCTs) showing direct comparison between zirconia (Zr) and titanium (Ti) abutments in the same patient were considered. The outcome measures were (1) soft tissue color, (2) soft tissue recession, (3) peri-implant probing, (4) bleeding on probing, (5) esthetic indexes, (6) patient-reported outcome, (7) marginal bone level, and (8) biological complications. Nine relevant studies (11 papers) were identified: 4 RCTs and 5 CCTs. Due to heterogeneity in the study design, statistical methods, and reported results, a meta-analysis of the data was feasible only for soft tissue color. The outcome was found to be significantly superior for Zr abutments. For the other outcome measures, a qualitative analysis of the selected articles was performed. The studies did not show any statistically significant differences between Zr and Ti abutments on soft tissue recession, probing depths, bleeding on probing, marginal bone level, and patient-reported outcome. One study reported significantly higher pink esthetic score (PES) scores at Zr implants with Zr abutments, compared to metal implants and Ti abutments. Overall, the research does not support any obvious advantage of Ti or Zr abutments over each other. However, there is a significant tendency in Zr abutments evoking better color response of peri-implant mucosa and superior esthetic outcome measured by PES score. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influence of Four Different Abutment Materials and the Adhesive Joint of Two-Piece Abutments on Cervical Implant Bone and Soft Tissue.

PubMed

Mehl, Christian; Gassling, Volker; Schultz-Langerhans, Stephan; Açil, Yahya; Bähr, Telse; Wiltfang, Jörg; Kern, Matthias

The main aim of this study was to evaluate the influence of four different abutment materials and the adhesive joint of two-piece abutments on the cervical implant bone and soft tissue. Sixty-four titanium implants (Camlog Conelog; 4.3 ± 9 mm) were placed bone level into the edentulous arches of four minipigs. Four different types of abutments were placed at implant exposure: zirconium dioxide, lithium disilicate, and titanium bonded to a titanium luting base with resin cement; one-piece titanium abutments served as the control. The animals were sacrificed 6 months after implant exposure, and the bone-to-implant contact (BIC) area, sulcus depth, the length of the junctional epithelium and the connective tissue, the biologic width, and first cervical BIC-implant shoulder distance were measured using histomorphometry and light and fluorescence microscopy. Overall, 14 implants were lost (22%). At exposure, the implant shoulder-bone distance was 0.6 ± 0.7 mm. Six months later, the bone loss was 2.1 ± 1.2 mm measured histomorphometrically. There was a significant difference between the two measurements (P ≤ .0001). No significant influence could be found between any of the abutment materials with regard to bone loss or soft tissue anatomy (P > .05), with the exception of zirconium dioxide and onepiece titanium abutments when measuring the length of the junctional epithelium (P ≤ .01). The maxilla provided significantly more soft tissue and less bone loss compared with the mandible (P ≤ .02). All tested abutment materials and techniques seem to be comparable with regard to soft tissue properties and the cervical bone level.

Effects of the implant design on peri-implant bone stress and abutment micromovement: three-dimensional finite element analysis of original computer-aided design models.

PubMed

Yamanishi, Yasufumi; Yamaguchi, Satoshi; Imazato, Satoshi; Nakano, Tamaki; Yatani, Hirofumi

2014-09-01

Occlusal overloading causes peri-implant bone resorption. Previous studies examined stress distribution in alveolar bone around commercial implants using three-dimensional (3D) finite element analysis. However, the commercial implants contained some different designs. The purpose of this study is to reveal the effect of the target design on peri-implant bone stress and abutment micromovement. Six 3D implant models were created for different implant-abutment joints: 1) internal joint model (IM); 2) external joint model (EM); 3) straight abutment (SA) shape; 4) tapered abutment (TA) shapes; 5) platform switching (PS) in the IM; and 6) modified TA neck design (reverse conical neck [RN]). A static load of 100 N was applied to the basal ridge surface of the abutment at a 45-degree oblique angle to the long axis of the implant. Both stress distribution in peri-implant bone and abutment micromovement in the SA and TA models were analyzed. Compressive stress concentrated on labial cortical bone and tensile stress on the palatal side in the EM and on the labial side in the IM. There was no difference in maximum principal stress distribution for SA and TA models. Tensile stress concentration was not apparent on labial cortical bone in the PS model (versus IM). Maximum principal stress concentrated more on peri-implant bone in the RN than in the TA model. The TA model exhibited less abutment micromovement than the SA model. This study reveals the effects of the design of specific components on peri-implant bone stress and abutment displacement after implant-supported single restoration in the anterior maxilla.

One-time versus repeated abutment connection for platform-switched implant: A systematic review and meta-analysis

PubMed Central

Wang, Qing-qing; Dai, Ruoxi; Cao, Chris Ying; Fang, Hui; Han, Min; Li, Quan-Li

2017-01-01

Objective This review aims to compare peri-implant tissue changes in terms of clinical and radiographic aspects of implant restoration protocol using one-time abutment to repeated abutment connection in platform switched implant. Method A structured search strategy was applied to three electronic databases, namely, Pubmed, Embase and Web of Science. Eight eligible studies, including seven randomised controlled studies and one controlled clinical study, were identified in accordance with inclusion/exclusion criteria. Outcome measures included peri-implant bone changes (mm), peri-implant soft tissue changes (mm), probing depth (mm) and postsurgical complications. Result Six studies were pooled for meta-analysis on bone tissue, three for soft tissue, two for probing depth and four for postsurgical complications. A total of 197 implants were placed in one-time abutment group, whereas 214 implants were included in repeated abutment group. The implant systems included Global implants, Ankylos, JDEvolution (JdentalCare), Straumann Bone level and Conelog-Screwline. One-time abutment group showed significantly better outcomes than repeated abutment group, as measured in the standardised differences in mean values (fixed- and random-effect model): vertical bone change (0.41, 3.23) in 6 months, (1.51, 14.81) in 12 months and (2.47, 2.47) in 3 years and soft tissue change (0.21, 0.23). No significant difference was observed in terms of probing depth and complications. Conclusion Our meta-analysis revealed that implant restoration protocol using one-time abutment is superior to repeated abutment for platform switched implant because of less bone resorption and soft tissue shifts in former. However, future randomised clinical trials should be conducted to further confirm these findings because of the small samples and the limited quality of the original research. PMID:29049323

One-time versus repeated abutment connection for platform-switched implant: A systematic review and meta-analysis.

PubMed

Wang, Qing-Qing; Dai, Ruoxi; Cao, Chris Ying; Fang, Hui; Han, Min; Li, Quan-Li

2017-01-01

This review aims to compare peri-implant tissue changes in terms of clinical and radiographic aspects of implant restoration protocol using one-time abutment to repeated abutment connection in platform switched implant. A structured search strategy was applied to three electronic databases, namely, Pubmed, Embase and Web of Science. Eight eligible studies, including seven randomised controlled studies and one controlled clinical study, were identified in accordance with inclusion/exclusion criteria. Outcome measures included peri-implant bone changes (mm), peri-implant soft tissue changes (mm), probing depth (mm) and postsurgical complications. Six studies were pooled for meta-analysis on bone tissue, three for soft tissue, two for probing depth and four for postsurgical complications. A total of 197 implants were placed in one-time abutment group, whereas 214 implants were included in repeated abutment group. The implant systems included Global implants, Ankylos, JDEvolution (JdentalCare), Straumann Bone level and Conelog-Screwline. One-time abutment group showed significantly better outcomes than repeated abutment group, as measured in the standardised differences in mean values (fixed- and random-effect model): vertical bone change (0.41, 3.23) in 6 months, (1.51, 14.81) in 12 months and (2.47, 2.47) in 3 years and soft tissue change (0.21, 0.23). No significant difference was observed in terms of probing depth and complications. Our meta-analysis revealed that implant restoration protocol using one-time abutment is superior to repeated abutment for platform switched implant because of less bone resorption and soft tissue shifts in former. However, future randomised clinical trials should be conducted to further confirm these findings because of the small samples and the limited quality of the original research.

Scalloped Implant-Abutment Connection Compared to Conventional Flat Implant-Abutment Connection: a Systematic Review and Meta-Analysis

PubMed Central

Christensen, Ann-Eva; Lorenzen, Henning

2017-01-01

ABSTRACT Objectives The objective was to test the hypothesis of no difference in implant treatment outcome after installation of implants with a scalloped implant-abutment connection compared to a flat implant-abutment connection. Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. No language or year of publication restriction was applied. Results The search provided 298 titles. Three studies fulfilled the inclusion criteria. The included studies were characterized by low or moderate risk of bias. Survival of suprastructures has never been compared within the same study. High implant survival rate was reported in all the included studies. Significantly more peri-implant marginal bone loss, higher probing depth score, bleeding score and gingival score was observed around implants with a scalloped implant-abutment connection. There were no significant differences between the two treatment modalities regarding professional or patient-reported outcome measures. Meta-analysis disclosed a mean difference of peri-implant marginal bone loss of 1.56 mm (confidence interval: 0.87 to 2.25), indicating significant more bone loss around implants with a scalloped implant-abutment connection. Conclusions A scalloped implant-abutment connection seems to be associated with higher peri-implant marginal bone loss compared to a flat implant-abutment connection. Therefore, the hypothesis of the present systematic review must be rejected. However, further long-term randomized controlled trials assessing implant treatment outcome with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of implants with a scalloped implant-abutment connection on preservation of the peri-implant marginal bone level. PMID:28496962

Effects of different abutment material and surgical insertion torque on the marginal adaptation of an internal conical interface: an in vitro study.

PubMed

Farronato, Davide; Pieroni, Stefano; Mangano, Francesco Guido; Briguglio, Francesco; Re, Dino

2014-10-01

To evaluate the marginal adaptation at implant-abutment connection of an implant featuring a conical (45° taper) internal hexagonal abutment with a connection depth of 2.5mm, comparing the performance of two identical abutments of different material (titanium grade-4 and Co-Cr-alloy). Twenty implants (3.75 mm×15 mm) were connected to non-matching abutments (5.5 mm×10 mm) of two different materials (titanium grade-4: n=10; Co-Cr-alloy: n=10). The specimens were separately embedded in epoxylite resin, inside copper cylinders, and submerged without covering the most coronal portion (5 mm) of the fixture. Five specimens per group were stressed simulating a surgical 100 Ncm insertion torque, while the others had no torque simulation. All specimens were subjected to a non-axial static load (100 N) in a universal testing machine, under an angle of 30° with respect to the implant axis. Once 100 N load was reached, low shrinkage self-curing resin was injected inside the cylinders, and load was maintained until complete resin polymerization. Specimens were cut and analyzed with optical and scanning-electron-microscope (SEM) to evaluate the marginal adaptation at the implant-abutment connection. Statistical analysis was performed using one-way ANOVA (p=0.02). None of the 20 samples failed. The implant-abutment connection was able to guarantee a good optical seal; SEM analysis confirmed the absence of microgaps. Within the limits of this study (small sample size, limited time) the marginal adaptation of the implant-abutment connection was not affected by the abutment material nor by the application of surgical insertion torque. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Scalloped Implant-Abutment Connection Compared to Conventional Flat Implant-Abutment Connection: a Systematic Review and Meta-Analysis.

PubMed

Starch-Jensen, Thomas; Christensen, Ann-Eva; Lorenzen, Henning

2017-01-01

The objective was to test the hypothesis of no difference in implant treatment outcome after installation of implants with a scalloped implant-abutment connection compared to a flat implant-abutment connection. A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. No language or year of publication restriction was applied. The search provided 298 titles. Three studies fulfilled the inclusion criteria. The included studies were characterized by low or moderate risk of bias. Survival of suprastructures has never been compared within the same study. High implant survival rate was reported in all the included studies. Significantly more peri-implant marginal bone loss, higher probing depth score, bleeding score and gingival score was observed around implants with a scalloped implant-abutment connection. There were no significant differences between the two treatment modalities regarding professional or patient-reported outcome measures. Meta-analysis disclosed a mean difference of peri-implant marginal bone loss of 1.56 mm (confidence interval: 0.87 to 2.25), indicating significant more bone loss around implants with a scalloped implant-abutment connection. A scalloped implant-abutment connection seems to be associated with higher peri-implant marginal bone loss compared to a flat implant-abutment connection. Therefore, the hypothesis of the present systematic review must be rejected. However, further long-term randomized controlled trials assessing implant treatment outcome with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of implants with a scalloped implant-abutment connection on preservation of the peri-implant marginal bone level.

3D Printing Surgical Implants at the clinic: A Experimental Study on Anterior Cruciate Ligament Reconstruction

PubMed Central

Liu, An; Xue, Guang-huai; Sun, Miao; Shao, Hui-feng; Ma, Chi-yuan; Gao, Qing; Gou, Zhong-ru; Yan, Shi-gui; Liu, Yan-ming; He, Yong

2016-01-01

Desktop three-dimensional (3D) printers (D3DPs) have become a popular tool for fabricating personalized consumer products, favored for low cost, easy operation, and other advantageous qualities. This study focused on the potential for using D3DPs to successfully, rapidly, and economically print customized implants at medical clinics. An experiment was conducted on a D3DP-printed anterior cruciate ligament surgical implant using a rabbit model. A well-defined, orthogonal, porous PLA screw-like scaffold was printed, then coated with hydroxyapatite (HA) to improve its osteoconductivity. As an internal fixation as well as an ideal cell delivery system, the osteogenic scaffold loaded with mesenchymal stem cells (MSCs) were evaluated through both in vitro and in vivo tests to observe bone-ligament healing via cell therapy. The MSCs suspended in Pluronic F-127 hydrogel on PLA/HA screw-like scaffold showed the highest cell proliferation and osteogenesis in vitro. In vivo assessment of rabbit anterior cruciate ligament models for 4 and 12 weeks showed that the PLA/HA screw-like scaffold loaded with MSCs suspended in Pluronic F-127 hydrogel exhibited significant bone ingrowth and bone-graft interface formation within the bone tunnel. Overall, the results of this study demonstrate that fabricating surgical implants at the clinic (fab@clinic) with D3DPs can be feasible, effective, and economical. PMID:26875826

Total knee replacement-cementless tibial fixation with screws: 10-year results.

PubMed

Ersan, Önder; Öztürk, Alper; Çatma, Mehmet Faruk; Ünlü, Serhan; Akdoğan, Mutlu; Ateş, Yalım

2017-12-01

The aim of this study was to evaluate the long term clinical and radiological results of cementless total knee replacement. A total of 51 knees of 49 patients (33 female and 16 male; mean age: 61.6 years (range, 29-66 years)) who underwent TKR surgery with a posterior stabilized hydroxyapatite coated knee implant were included in this study. All of the tibial components were fixed with screws. The HSS scores were examined preoperatively and at the final follow-up. Radiological assessment was performed with Knee Society evaluating and scoring system. Kaplan-Meier survival analysis was performed to rule out the survival of the tibial component. The mean HSS scores were 45.8 (range 38-60) and 88.1 (range 61-93), preoperatively and at the final follow-up respectively. Complete radiological assessment was performed for 48 knees. Lucent lines at the tibial component were observed in 4 patients; one of these patients underwent a revision surgery due to the loosening of the tibial component. The 10-year survival rate of a tibial component was 98%. Cementless total knee replacement has satisfactory long term clinical results. Primary fixation of the tibial component with screws provides adequate stability even in elderly patients with good bone quality. Level IV, Therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Polyether ether ketone implants achieve increased bone fusion when coated with nano-sized hydroxyapatite: a histomorphometric study in rabbit bone

PubMed Central

Johansson, Pär; Jimbo, Ryo; Naito, Yoshihito; Kjellin, Per; Currie, Fredrik; Wennerberg, Ann

2016-01-01

Polyether ether ketone (PEEK) possesses excellent mechanical properties similar to those of human bone and is considered the best alternative material other than titanium for orthopedic spine and trauma implants. However, the deficient osteogenic properties and the bioinertness of PEEK limit its fields of application. The aim of this study was to limit these drawbacks by coating the surface of PEEK with nano-scaled hydroxyapatite (HA) minerals. In the study, the biological response to PEEK, with and without HA coating, was investigated. Twenty-four screw-like and apically perforated implants in the rabbit femur were histologically evaluated at 3 weeks and 12 weeks after surgery. Twelve of the 24 implants were HA coated (test), and the remaining 12 served as uncoated PEEK controls. At 3 weeks and 12 weeks, the mean bone–implant contact was higher for test compared to control (P<0.05). The bone area inside the threads was comparable in the two groups, but the perforating hole showed more bone area for the HA-coated implants at both healing points (P<0.01). With these results, we conclude that nano-sized HA coating on PEEK implants significantly improved the osteogenic properties, and in a clinical situation this material composition may serve as an implant where a rapid bone fusion is essential. PMID:27103801

Polyether ether ketone implants achieve increased bone fusion when coated with nano-sized hydroxyapatite: a histomorphometric study in rabbit bone.

PubMed

Johansson, Pär; Jimbo, Ryo; Naito, Yoshihito; Kjellin, Per; Currie, Fredrik; Wennerberg, Ann

2016-01-01

Polyether ether ketone (PEEK) possesses excellent mechanical properties similar to those of human bone and is considered the best alternative material other than titanium for orthopedic spine and trauma implants. However, the deficient osteogenic properties and the bioinertness of PEEK limit its fields of application. The aim of this study was to limit these drawbacks by coating the surface of PEEK with nano-scaled hydroxyapatite (HA) minerals. In the study, the biological response to PEEK, with and without HA coating, was investigated. Twenty-four screw-like and apically perforated implants in the rabbit femur were histologically evaluated at 3 weeks and 12 weeks after surgery. Twelve of the 24 implants were HA coated (test), and the remaining 12 served as uncoated PEEK controls. At 3 weeks and 12 weeks, the mean bone-implant contact was higher for test compared to control (P<0.05). The bone area inside the threads was comparable in the two groups, but the perforating hole showed more bone area for the HA-coated implants at both healing points (P<0.01). With these results, we conclude that nano-sized HA coating on PEEK implants significantly improved the osteogenic properties, and in a clinical situation this material composition may serve as an implant where a rapid bone fusion is essential.

[A computer aided design approach of all-ceramics abutment for maxilla central incisor].

PubMed

Sun, Yu-chun; Zhao, Yi-jiao; Wang, Yong; Han, Jing-yun; Lin, Ye; Lü, Pei-jun

2010-10-01

To establish the computer aided design (CAD) software platform of individualized abutment for the maxilla central incisor. Three-dimentional data of the incisor was collected by scanning and geometric transformation. Data mainly included the occlusal part of the healing abutment, the location carinae of the bedpiece, the occlusal 1/3 part of the artificial gingiva's inner surface, and so on. The all-ceramic crown designed in advanced was "virtual cutback" to get the original data of the abutment's supragingival part. The abutment's in-gum part was designed to simulate the individual natural tooth root. The functions such as "data offset", "bi-rail sweep surface" and "loft surface" were used in the process of CAD. The CAD route of the individualized all-ceramic abutment was set up. The functions and application methods were decided and the complete CAD process was realized. The software platform was basically set up according to the requests of the dental clinic.

Five-year multicenter study of magnetic attachments used for natural overdenture abutments.

PubMed

Gonda, T; Yang, T C; Maeda, Y

2013-04-01

The purpose of this study was to examine a longitudinal clinical performance of magnetic attachments used for natural overdenture abutments. The study included 131 patients who had used removable prostheses (complete overdentures 31%, partial dentures 69%) more than 5 years (40-90 years old) with 211 magnetic attachments on natural abutments (Magfit 400 or 600; Aichi Steel co., Aichi, Japan) treated in 15 clinics using a standardized protocol. Analyses were performed on the degree of patient satisfaction regarding retention, complications of magnets (corrosion, detachment from denture base), abutments (pain during mastication, periodontal pocket formation, inflammation, mobility), and dentures (fracture etc.). Ninety-seven percent of patients were satisfied with the retention and stability of their dentures. No corrosion of magnet was observed, and 19 magnets were detached. Most frequent complication of abutments was periodontal pocket formation (52%), followed by the inflammation (29%), increase in mobility (27%) and pain (4%). Magnetic attachment on natural tooth abutments provided a viable and long-term treatment option. © 2013 Blackwell Publishing Ltd.

Stress distribution difference between Lava Ultimate full crowns and IPS e.max CAD full crowns on a natural tooth and on tooth-shaped implant abutments.

PubMed

Krejci, Ivo; Daher, René

2017-04-01

The goal of this short communication is to present finite element analysis comparison of the stress distribution between CAD/CAM full crowns made of Lava Ultimate and of IPS e.max CAD, adhesively luted to natural teeth and to implant abutments with the shape of natural teeth. Six 3D models were prepared using a 3D content-creating software, based on a micro-CT scan of a human mandibular molar. The geometry of the full crown and of the abutment was the same for all models representing Lava Ultimate full crowns (L) and IPS e.max CAD full crowns (E) on three different abutments: prepared natural tooth (n), titanium abutment (t) and zirconia abutment (z). A static load of 400 N was applied on the vestibular and lingual cusps, and fixtures were applied to the base of the models. After running the static linear analysis, the post-processing data we analyzed. The stress values at the interface between the crown and the abutment of the Lt and Lz groups were significantly higher than the stress values at the same interface of all the other models. The high stress concentration in the adhesive at the interface between the crown and the abutment of the Lava Ultimate group on implants might be one of the factors contributing to the reported debondings of crowns.

Load to failure of different zirconia implant abutments with titanium components.

PubMed

Mascarenhas, Faye; Yilmaz, Burak; McGlumphy, Edwin; Clelland, Nancy; Seidt, Jeremy

2017-06-01

Abutments with a zirconia superstructure and a titanium insert have recently become popular. Although they have been tested under static load, their performance under simulated mastication is not well known. The purpose of this in vitro study was to compare the cyclic load to failure of 3 types of zirconia abutments with different mechanisms of retention of the zirconia to the titanium interface. Fifteen implants (n=5 per system) and abutments (3 groups: 5 friction fit [Frft]; 5 bonded; and 5 titanium ring friction fit [Ringfrft]) were used. Abutments were thermocycled in water between 5°C and 55°C for 15000 cycles and then cyclically loaded for 20000 cycles or until failure at a frequency of 2 Hz by using a sequentially increased loading protocol up to a maximum of 720 N. The load to failure for each group was recorded, and 1-way analysis of variance was performed. The mean load-to-failure values for the Frft group was 526 N, for the Bond group 605 N, and for the Ringfrft group 288 N. A statistically significant difference was found among all abutments tested (P<.05). Abutments with the bonded connection showed the highest load-to-failure value, and the abutment with the titanium ring friction fit connection showed the lowest load-to-failure value. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Stability of rock riprap for protection at the toe of abutments located at the floodplain.

DOT National Transportation Integrated Search

1991-09-01

This report presents the results of a research conducted in a hydraulic flume to : determine the stability of rock riprap protecting abutments located on flood : plains. The observed vulnerable zone for rock riprap failure is presented for : two abut...

Long-term behavior of integral abutment bridges : appendix E, INDOT design manual : selected recommendations for integral abutment bridges.

DOT National Transportation Integrated Search

2011-01-01

Integral abutment (IA) construction has become the preferred method over conventional construction for use with typical highway bridges. However, the use of these structures is limited due to state mandated length and skew limitations. To expand thei...

Monitoring of in-service geosynthetic reinforced soil (GRS) bridge abutments in Louisiana : research project capsule.

DOT National Transportation Integrated Search

2014-09-01

The primary objectives of this research are to monitor the : short-term and long-term behavior and performance of inservice : GRS-IBS abutments in the state of Louisiana, and to : verify important design factors and parameters for GRS-IBS : abutment,...

Microleakage of composite crowns luted on CAD/CAM-milled human molars: a new method for standardized in vitro tests.

PubMed

Schlenz, Maximiliane Amelie; Schmidt, Alexander; Rehmann, Peter; Niem, Thomas; Wöstmann, Bernd

2018-04-24

To investigate debonding of full crowns made of CAD/CAM composites, CAD/CAM technology was applied to manufacture standardized test abutments to increase the reproducibility of human teeth used in in vitro studies. A virtual test abutment and the corresponding virtual crown were designed and two STL data sets were generated. Sixty-four human third molars and CAD/CAM blocks were milled using a CNC machine. Crowns of four different composite blocks (Lava Ultimate (LU), Brilliant Crios (BC), Cerasmart (CS), Experimental (EX)) were adhesively bonded with their corresponding luting system (LU: Scotchbond Universal/RelyX Ultimate; BC: One Coat 7 Universal/DuoCem; CS: G-PremioBond/G-Cem LinkForce; EX: Experimental-Bond/Experimental-Luting-Cement). Half of the specimens were chemical-cured (CC) and the others were light-cured (LC). Afterwards, specimens were artificially aged in a chewing simulator (WL-tec, 1 million cycles, 50-500 N, 2 Hz, 37 °C). Finally, a dye penetration test was used to detect debonding. For inspection, the specimens were sliced, and penetration depth was measured with a digital microscope. Data were analyzed with the Mann-Whitney U test. No cases of total debonding were observed after cyclic loading. However, the LC specimens showed a significantly lower amount of leakage than the CC ones (p < 0.05). Furthermore, the CC specimens exhibited broad scattering. Only the LC-EX blocks showed no debonding. The CC-CS blocks showed the highest leakage and scattering of all tested specimens. Natural human teeth can be manufactured by CAD/CAM technology in highly standardized test abutments for in vitro testing. For CAD/CAM composites, light curing should be performed. The success of a restoration depends on the long-term sealing ability of the luting materials, which avoids debonding along with microleakage. For CAD/CAM composites, separate light curing of the adhesive and luting composite is highly recommended.

A novel abutment construction technique for rapid bridge construction : controlled low strength Materials (CLSM) with full-height concrete panels.

DOT National Transportation Integrated Search

2012-01-01

One of the major obstacles facing rapid bridge construction for typical span type bridges is the time required to construct bridge abutments and foundations. This can be remedied by using the controlled low strength materials (CLSM) bridge abutment. ...

A digital approach to fabricating an abutment replica to control cement volume in a cement-retained implant prosthesis.

PubMed

Lee, Ju-Hyoung; Park, In-Sook; Sohn, Dong-Seok

2016-07-01

If a cement-retained implant prosthesis is placed on an abutment, excess cement should be minimized or removed to prevent periimplant inflammation. Various methods for fabricating an abutment replica have been introduced to maintain tissue health and reduce clean-up time. The purpose of this article is to present an alternative technique for fabricating an abutment replica with computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

A novel dental implant abutment with micro-motion capability--development and biomechanical evaluations.

PubMed

Chen, Yen-Yin; Chen, Weng-Pin; Chang, Hao-Hueng; Huang, Shih-Hao; Lin, Chun-Pin

2014-02-01

The aim of this study was to develop a novel dental implant abutment with a micro-motion mechanism that imitates the biomechanical behavior of the periodontal ligament, with the goal of increasing the long-term survival rate of dental implants. Computer-aided design software was used to design a novel dental implant abutment with an internal resilient component with a micro-motion capability. The feasibility of the novel system was investigated via finite element analysis. Then, a prototype of the novel dental implant abutment was fabricated, and the mechanical behavior was evaluated. The results of the mechanical tests and finite element analysis confirmed that the novel dental implant abutment possessed the anticipated micro-motion capability. Furthermore, the nonlinear force-displacement behavior apparent in this micro-motion mechanism imitated the movement of a human tooth. The slope of the force-displacement curve of the novel abutment was approximately 38.5 N/mm before the 0.02-mm displacement and approximately 430 N/mm after the 0.03-mm displacement. The novel dental implant abutment with a micro-motion mechanism actually imitated the biomechanical behavior of a natural tooth and provided resilient function, sealing, a non-separation mechanism, and ease-of-use. Copyright © 2013 Academy of Dental Materials. All rights reserved.

A study of possible ground-motion amplification at the Coyote Lake Dam, California

USGS Publications Warehouse

Boore, D.M.; Graizer, V.M.; Tinsley, J.C.; Shakal, A.F.

2004-01-01

The abutment site at the Coyote Lake Dam recorded an unusually large peak acceleration of 1.29g during the 1984 Morgan Hill earthquake. Following this earthquake another strong-motion station was installed about 700 m downstream from the abutment station. We study all events (seven) recorded on these stations, using ratios of peak accelerations, spectral ratios, and particle motion polarization (using holograms) to investigate the relative ground motion at the two sites. We find that in all but one case the motion at the abutment site is larger than the downstream site over a broad frequency band. The polarizations are similar for the two sites for a given event, but can vary from one event to another. This suggests that the dam itself is not strongly influencing the records. Although we can be sure that the relative motion is usually larger at the abutment site, we cannot conclude that there is anomalous site amplification at the abutment site. The downstream site could have lower-than-usual near-surface amplifications. On the other hand, the geology near the abutment site is extremely complex and includes fault slivers, with rapid lateral changes in materials and presumably seismic velocities. For this reason alone, the abutment site should not be considered a normal free-field site.

Heat Generation on Implant Surface During Abutment Preparation at Different Elapsed Time Intervals.

PubMed

Al-Keraidis, Abdullah; Aleisa, Khalil; Al-Dwairi, Ziad Nawaf; Al-Tahawi, Hamdi; Hsu, Ming-Lun; Lynch, Edward; Özcan, Mutlu

2017-10-01

The purpose of this study was to evaluate heat generation at the implant surface caused by abutment preparation using a diamond bur in a high-speed dental turbine in vitro at 2 different water-coolant temperatures. Thirty-two titanium-alloy abutments were connected to a titanium-alloy implant embedded in an acrylic resin placed within a water bath at a controlled temperature of 37°C. The specimens were equally distributed into 2 groups (16 each). Group 1: the temperature was maintained at 20 ± 1°C; and group 2: the temperature was maintained at 32 ± 1°C. Each abutment was prepared in the axial plane for 1 minute and in the occlusal plane for 1 minute. The temperature of the heat generated from abutment preparation was recorded and measured at 3 distinct time intervals. Water-coolant temperature (20°C vs 32°C) had a statistically significant effect on the implant's temperature change during preparation of the abutment (P < 0.0001). The use of water-coolant temperature of 20 ± 1°C during preparation of the implant abutment decreased the temperature recorded at the implant surface to 34.46°C, whereas the coolant temperature of 32 ± 1°C increased the implant surface temperature to 40.94°C.

Abutment Material Effect on Peri-implant Soft Tissue Color and Perceived Esthetics.

PubMed

Kim, Aram; Campbell, Stephen D; Viana, Marlos A G; Knoernschild, Kent L

2016-12-01

The purpose of this study was to evaluate the effect of implant abutment material on peri-implant soft tissue color using intraoral spectrophotometric analysis and to compare the clinical outcomes with patient and clinician perception and satisfaction. Thirty patients and four prosthodontic faculty members participated. Abutments were zirconia, gold-hued titanium, and titanium. Peri-implant mucosa color of a single anterior implant restoration was compared to the patient's control tooth. Spectrophotometric analysis using SpectroShade TM Micro data determined the color difference (ΔE, ΔL*, Δa*, Δb*) between the midfacial peri-implant soft tissue for each abutment material and the marginal gingiva of the control tooth. Color difference values of the abutment groups were compared using ANOVA (α = 0.05). Patient and clinician satisfaction surveys were also conducted using a color-correcting light source. The results of each patient and clinician survey question were compared using chi-square analysis (α = 0.05). Pearson correlation analyses identified the relationship between the total color difference (ΔE) and the patient/clinician perception and satisfaction, as well as between ΔE and tissue thickness. Zirconia abutments displayed significantly smaller spectrophotometric gingival color difference (ΔE) compared to titanium and gold-hued titanium abutments (respectively, 3.98 ± 0.99; 7.22 ± 3.31; 5.65 ± 2.11; p < 0.05). Among ΔL*, Δa*, and Δb*, only Δa* (red-green spectrum) showed significant difference between groups. There was no significant correlation between measured soft tissue thickness and ΔE, but thick gingival phenotype, determined by a probe test, demonstrated a smaller ΔE than thin phenotype (4.82 ± 1.49; 6.41 ± 3.27; p = 0.097). There was no statistical difference in patient or clinician satisfaction among abutment materials, and no correlation between ΔE and the patient and clinician satisfaction. Patient satisfaction was significantly higher than clinician, and patient-perceived differences were lower than clinicians' (p < 0.01). Clinicians' satisfaction was higher for gingival (pink) esthetics than crown (white) esthetics (p < 0.05). Peri-implant mucosa with zirconia abutments demonstrated significantly lower mean color difference compared to titanium or gold-hued titanium abutments as measured spectrophotometrically; however, no statistical difference in patient or clinician perception/satisfaction among abutment materials was demonstrated. Patients were significantly more satisfied than clinicians. © 2015 by the American College of Prosthodontists.

Bacterial colonization of the implant-abutment interface of conical connection with an internal octagon: an in vitro study using real-time PCR.

PubMed

Baj, A; Beltramini, G A; Bolzoni, A; Cura, F; Palmieri, A; Scarano, A; Ottria, L; Giannì, A B

2017-01-01

Bacterial leakage at the implant-abutment connection of a two-piece implant system is considered the main cause of peri-implantitis. Prevention of bacterial leakage at the implant-abutment connection is mandatory for reducing inflammation process around implant neck and achieving bone stability. Micro-cavities at implant-abutment connection level can favour bacterial leakage, even in modern two-piece implant systems. The conical connection with an internal octagon (CCIO) is considered to be more stable mechanically and allows a more tight link between implant and abutment. As P. gingivalis and T. forsythia penetration might have clinical relevance, it was the purpose of this investigation to evaluate molecular leakage of these two bacteria in a new two-implant system with an internal conical implant-abutment connection with internal octagon (Shiner XT, FMD Falappa Medical Devices S.p.A. Rome, Italy). To verify the ability of the implant in protecting the internal space from the external environment, the passage of genetically modified Escherichia c oli across implant-abutment interface was evaluated. Four Shiner XT implants (FMD, Falappa Medical Devices®, Rome, Italy) were immerged in a bacterial culture for 24 h and bacteria amount was measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 6% for P. gingivalis and 5% for T. forsythia. Other comparable studies about the tightness of the tested implant system reported similar results. The gap size at the implant-abutment connection of CCIOs was measured by other authors discovering a gap size of 1–2μm of the AstraTech system and of 4μm for the Ankylos system. Bacterial leakage along implant-abutment connection of cylindrical and tapered implants, Shiner XT, (FMD Falappa Medical Devices S.p.A. Rome, Italy) showed better results compared to other implants. Additional studies are needed to explore the relationship in terms of microbiota of the CCIO. In addition, the dynamics of internal colonization needs to be thoroughly documented in longitudinal in vivo studies.

Relationship Between Insertion Torque and Resonance Frequency Measurements, Performed by Resonance Frequency Analysis, in Micromobility of Dental Implants: An In Vitro Study.

PubMed

Brizuela-Velasco, Aritza; Álvarez-Arenal, Ángel; Gil-Mur, Francisco Javier; Herrero-Climent, Mariano; Chávarri-Prado, David; Chento-Valiente, Yelko; Dieguez-Pereira, Markel

2015-10-01

To evaluate the micromobility of dental implants under occlusal loading in relation to stability measurements of resonance frequency analysis and insertion torque. The sample comprised of 24 implants inserted in 12 fresh cow ribs. Insertion torque and Osstell implant stability quotient (ISQ) measurements were recorded. An "ad hoc" acrylic premolar was made on a temporary abutment and screwed to each implant, and a force of 100 N was subsequently applied at an angle of 6 degrees. Implant micromotion was measured using a Questar microscope with a resolution of 2 μm and an image analysis program. Data show a statistically significant inverse correlation between the ISQ values and implant micromotion under a load of 100 N (R = 0.86, P < 0.0001). The same relationship is found between insertion torque and implant micromotion, although the relationship is linear up to 34 N·cm and becomes exponential for higher values (R = 0.78, P < 0.0001). A direct correlation is established between insertion torque and ISQ values. There is an inverse relationship between both ISQ and insertion torque values and implant micromotion under a load of 100 N.

COMPRESSIVE FATIGUE IN TITANIUM DENTAL IMPLANTS SUBMITTED TO FLUORIDE IONS ACTION

PubMed Central

Ribeiro, Ana Lúcia Roselino; Noriega, Jorge Roberto; Dametto, Fábio Roberto; Vaz, Luís Geraldo

2007-01-01

The aim of this study was to assess the influence of a fluoridated medium on the mechanical properties of an internal hexagon implant-abutment set, by means of compression, mechanical cycling and metallographic characterization by scanning electronic microscopy. Five years of regular use of oral hygiene with a sodium fluoride solution content of 1500 ppm were simulated, immersing the samples in this medium for 184 hours, with the solutions being changed every 12 hours. Data were analyzed at a 95% confidence level with Fisher's exact test. After the action of fluoride ions, a negative influence occurred in the mechanical cycling test performed in a servohydraulic machine (Material Test System-810) set to a frequency of 15 Hz with 100,000 cycles and programmed to 60% of the maximum resistance of static compression test. The sets tended to fracture by compression on the screw, characterized by mixed ruptures with predominance of fragile fracture, as observed by microscopy. An evidence of corrosion by pitting on sample surfaces was found after the fluoride ions action. It may be concluded that prolonged contact with fluoride ions is harmful to the mechanical properties of commercially pure titanium structures. PMID:19089148

X-ray absorption fine structure (XAFS) analysis of titanium-implanted soft tissue.

PubMed

Uo, Motohiro; Asakura, Kiyotaka; Yokoyama, Atsuro; Ishikawa, Makoto; Tamura, Kazuchika; Totsuka, Yasunori; Akasaka, Tsukasa; Watari, Fumio

2007-03-01

Tissues contacting Ti dental implants were subjected to X-ray absorption fine structure (XAFS) analysis to examine the chemical state of Ti transferred from the placed implant into the surrounding tissue. Nine tissues that contacted pure Ti cover screws for several months were excised in a second surgery whereby healing abutments were set. Six tissues that surrounded implants retrieved due to their failure were also excised. Ti distributions in the excised specimens were confirmed by X-ray scanning analytical microscopy (XSAM), and the specimens were subjected to fluorescence XAFS analysis to determine the chemical states of the low concentrations of Ti in the tissues surrounding Ti dental implants. Ti mostly existed in the metallic state and was considered to be debris derived from the abrasion of implant pieces during implant surgery. Oxidized forms of Ti, such as anatase and rutile, were also detected in a few specimens-and existed in either a pure state or mixed state with metallic Ti. It was concluded that the existence of Ti in the tissue did not cause implant failure. Moreover, the usefulness of XAFS for analysis of the chemical states of rarely contained elements in biological tissue was demonstrated.

Influence of platform and abutment angulation on peri-implant bone. A three-dimensional finite element stress analysis.

PubMed

Martini, Ana Paula; Barros, Rosália Moreira; Júnior, Amilcar Chagas Freitas; Rocha, Eduardo Passos; de Almeida, Erika Oliveira; Ferraz, Cacilda Cunha; Pellegrin, Maria Cristina Jimenez; Anchieta, Rodolfo Bruniera

2013-12-01

The aim of this study was to evaluate stress distribution on the peri-implant bone, simulating the influence of Nobel Select implants with straight or angulated abutments on regular and switching platform in the anterior maxilla, by means of 3-dimensional finite element analysis. Four mathematical models of a central incisor supported by external hexagon implant (13 mm × 5 mm) were created varying the platform (R, regular or S, switching) and the abutments (S, straight or A, angulated 15°). The models were created by using Mimics 13 and Solid Works 2010 software programs. The numerical analysis was performed using ANSYS Workbench 10.0. Oblique forces (100 N) were applied to the palatine surface of the central incisor. The bone/implant interface was considered perfectly integrated. Maximum (σmax) and minimum (σmin) principal stress values were obtained. For the cortical bone the highest stress values (σmax) were observed in the RA (regular platform and angulated abutment, 51 MPa), followed by SA (platform switching and angulated abutment, 44.8 MPa), RS (regular platform and straight abutment, 38.6 MPa) and SS (platform switching and straight abutment, 36.5 MPa). For the trabecular bone, the highest stress values (σmax) were observed in the RA (6.55 MPa), followed by RS (5.88 MPa), SA (5.60 MPa), and SS (4.82 MPa). The regular platform generated higher stress in the cervical periimplant region on the cortical and trabecular bone than the platform switching, irrespective of the abutment used (straight or angulated).

Influence of transmucosal height in abutments of single and multiple implant-supported prostheses: a non-linear three-dimensional finite element analysis.

PubMed

Borie, Eduardo; Leal, Eduardo; Orsi, Iara Augusta; Salamanca, Carlos; Dias, Fernando José; Weber, Benjamin

2018-01-01

The aim of this study was to analyze the influence of three different transmucosal heights of the abutments in single and multiple implant-supported prostheses through the finite element method. External hexagon implants, MicroUnit, and EsthetiCone abutments were scanned and placed in an edentulous maxillary model obtained from a tomography database. The simulations were divided into two groups: (1) one implant with 3.75 × 10 mm placed in the upper central incisor, simulating a single implant-supported fixed prosthesis with an EsthetiCone abutment; and (2) two implants with 3.75 × 10 mm placed in the upper lateral incisors with MicroUnit abutments, simulating a multiple implant-supported prosthesis. Subsequently, each group was subdivided into three models according to the transmucosal height (1, 2, and 3 mm). A static oblique load at an angle of 45 degrees to the long axis of the implant in palatal-buccal direction of 150 and 75 N was applied for multiple and single implant-supported prosthesis, respectively. The implants and abutments were assessed according to the equivalent Von Mises stress analyses while the bone and ceramics were analyzed through maximum and minimum principal stresses. The total deformation values increased in all models, while the transmucosal height was augmented. The transmucosal height of the abutments influences the stress values at the bone, ceramics, implants, and abutments of both the single and multiple implant-supported prostheses, with the transmucosal height of 1 mm showing the lowest stress values.

Management of overdenture abutments health by an innovative cleaning aid

PubMed Central

Mall, Priyanka; Singh, Kamleshwar; Singh, Saumyendra Vikram; Agrawal, Kaushal Kishor; Siddharth, Ramashanker; Chand, Pooran

2012-01-01

This article describes a method for fabrication of a custom-made device for cleaning dome-shaped overdenture abutments. A kid toothbrush and a rubber cup were used for fabrication of a prophylactic device. After regular use of this device periodontal health status of the overdenture abutments patients improved satisfactorily. PMID:23230248

23. VIEW LOOKING UPSTREAM AND TOWARD LEFT ABUTMENT OF DAM. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. VIEW LOOKING UPSTREAM AND TOWARD LEFT ABUTMENT OF DAM. NOTE FORMS FOR LEFT GRAVITY ABUTMENT AT UPPER RIGHT CORNER OF PICTURE. ARCHES 3, 4, 5, AND 7 COMPLETED TO ELEVATION 1795. 5 OR 7.5 FEET BELOW TOP OF PARAPET WALL. November 29, 1938 - Bartlett Dam, Verde River, Phoenix, Maricopa County, AZ

Creep and shrinkage effects on integral abutment bridges

NASA Astrophysics Data System (ADS)

Munuswamy, Sivakumar

Integral abutment bridges provide bridge engineers an economical design alternative to traditional bridges with expansion joints owing to the benefits, arising from elimination of expensive joints installation and reduced maintenance cost. The superstructure for integral abutment bridges is cast integrally with abutments. Time-dependent effects of creep, shrinkage of concrete, relaxation of prestressing steel, temperature gradient, restraints provided by abutment foundation and backfill and statical indeterminacy of the structure introduce time-dependent variations in the redundant forces. An analytical model and numerical procedure to predict instantaneous linear behavior and non-linear time dependent long-term behavior of continuous composite superstructure are developed in which the redundant forces in the integral abutment bridges are derived considering the time-dependent effects. The redistributions of moments due to time-dependent effects have been considered in the analysis. The analysis includes nonlinearity due to cracking of the concrete, as well as the time-dependent deformations. American Concrete Institute (ACI) and American Association of State Highway and Transportation Officials (AASHTO) models for creep and shrinkage are considered in modeling the time dependent material behavior. The variations in the material property of the cross-section corresponding to the constituent materials are incorporated and age-adjusted effective modulus method with relaxation procedure is followed to include the creep behavior of concrete. The partial restraint provided by the abutment-pile-soil system is modeled using discrete spring stiffness as translational and rotational degrees of freedom. Numerical simulation of the behavior is carried out on continuous composite integral abutment bridges and the deformations and stresses due to time-dependent effects due to typical sustained loads are computed. The results from the analytical model are compared with the published laboratory experimental and field data. The behavior of the laterally loaded piles supporting the integral abutments is evaluated and presented in terms of the lateral deflection, bending moment, shear force and stress along the pile depth.

Innovation in abutment-free bone-anchored hearing devices in children: Updated results and experience.

PubMed

Baker, Shaun; Centric, Aaron; Chennupati, Sri Kiran

2015-10-01

Bone-anchored hearing devices are an accepted treatment option for hearing restoration in various types of hearing loss. Traditional devices have a percutaneous abutment for attachment of the sound processor that contributes to a high complication rate. Previously, our institution reported on the Sophono (Boulder, CO, USA) abutment-free system that produced similar audiologic results to devices with abutments. Recently, Cochlear Americas (Centennial, CO, USA) released an abutment-free bone-anchored hearing device, the BAHA Attract. In contrast to the Sophono implant, the BAHA Attract utilizes an osseointegrated implant. This study aims to demonstrate patient benefit abutment-free devices, compare the results of the two abutment-free devices, and examine complication rates. A retrospective chart review was conducted for the first eleven Sophono implanted patients and for the first six patients implanted with the BAHA Attract at our institution. Subsequently, we analyzed patient demographics, audiometric data, clinical course and outcomes. Average improvement for the BAHA Attract in pure-tone average (PTA) and speech reception threshold (SRT) was 41dB hearing level (dBHL) and 56dBHL, respectively. Considering all frequencies, the BAHA Attract mean improvement was 39dBHL (range 32-45dBHL). The Sophono average improvement in PTA and SRT was 38dBHL and 39dBHL, respectively. The mean improvement with Sophono for all frequencies was 34dBHL (range 24-43dBHL). Significant improvements in both pure-tone averages and speech reception threshold for both devices were achieved. In direct comparison of the two separate devices using the chi-square test, the PTA and SRT data between the two devices do not show a statistically significant difference (p-value 0.68 and 0.56, respectively). The complication rate for these abutment-free devices is lower than that of those featuring the transcutaneous abutment, although more studies are needed to further assess this potential advantage. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of removal forces of implant-supported zirconia copings depending on abutment geometry, luting agent and cleaning method during re-cementation

PubMed Central

Rödiger, Matthias; Rinke, Sven; Ehret-Kleinau, Fenja; Pohlmeyer, Franziska; Lange, Katharina; Bürgers, Ralf

2014-01-01

PURPOSE To evaluate the effects of different abutment geometries in combination with varying luting agents and the effectiveness of different cleaning methods (prior to re-cementation) regarding the retentiveness of zirconia copings on implants. MATERIALS AND METHODS Implants were embedded in resin blocks. Three groups of titanium abutments (pre-fabricated, height: 7.5 mm, taper: 5.7°; customized-long, height: 6.79 mm, taper: 4.8°; customized-short, height: 4.31 mm, taper: 4.8°) were used for luting of CAD/CAM-fabricated zirconia copings with a semi-permanent (Telio CS) and a provisional cement (TempBond NE). Retention forces were evaluated using a universal testing machine. Furthermore, the influence of cleaning methods (manually, manually in combination with ultrasonic bath or sandblasting) prior to re-cementation with a provisional cement (TempBond NE) was investigated with the pre-fabricated titanium abutments (height: 7.5 mm, taper: 5.7°) and SEM-analysis of inner surfaces of the copings was performed. Significant differences were determined via two-way ANOVA. RESULTS Significant interactions between abutment geometry and luting agent were observed. TempBond NE showed the highest level of retentiveness on customized-long abutments, but was negatively affected by other abutment geometries. In contrast, luting with Telio CS demonstrated consistent results irrespective of the varying abutment geometries. Manual cleaning in combination with an ultrasonic bath was the only cleaning method tested prior to re-cementation that revealed retentiveness levels not inferior to primary cementation. CONCLUSION No superiority for one of the two cements could be demonstrated because their influences on retentive strength are also depending on abutment geometry. Only manual cleaning in combination with an ultrasonic bath offers retentiveness levels after re-cementation comparable to those of primary luting. PMID:25006388

The influence of repeated abutment changes on peri-implant tissue stability: 3-year post-loading results from a multicentre randomised controlled trial.

PubMed

Bressan, Eriberto; Grusovin, Maria Gabriella; D'Avenia, Ferdinando; Neumann, Konrad; Sbricoli, Luca; Luongo, Giuseppe; Esposito, Marco

To evaluate the influence of at least three abutment disconnections in conventional loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue changes. A secondary aim was to evaluate whether the presence of less than 2 mm of keratinised mucosa is associated with increased peri-implant marginal bone loss and soft tissue recessions. Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments that were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments, which were delayed loaded after 3 months and removed at least three times: 1. At impression taking (3 months after implant placement); 2. When checking the zirconium core on titanium abutments at single crowns or the fitting the metal structure at prostheses supported by multiple implants; 3. At delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated at four centres and each patient contributed to the study, with only one prosthesis followed for 3 years after initial loading. Outcome measures were: prosthesis failures, implant failures, complications, pink aesthetic score (PES), buccal recessions, patient satisfaction, peri-implant marginal bone level changes and height of the keratinised mucosa. Forty patients were randomly allocated to each group according to a parallel group design. Six patients from the definitive abutment group dropped out or died, and one left from the repeated disconnection group. One implant, from the repeated disconnection group, fractured (difference = 3%; CI 95%: -2%, 8%; P = 1). Four provisional crowns and one definitive single crown had to be remade because of poor fitting, and one definitive crown and one definitive prosthesis because of ceramic and implant fracture, respectively, in the repeated disconnection group vs one provisional prosthesis from the definitive abutment group due to frequent debondings (difference = 15%; CI 95%: 2%, 28%; P = 0.060). Five patients from the definitive abutment group and four patients from the repeated disconnection group were affected by complications (difference = 4%; CI 95%: -11%, 20%; P = 0.725). PES scores assessed at 3 years post-loading were 11.7 (standard deviation = 1.8) mm for the definitive abutment group and 11.3 (1.5) mm for the repeated abutment changes group (difference = 0.4; CI 95%: -0.4, 1.2; P = 0.315). However, there was a difference of 0.26 out of a maximum score of 2 in favour of the definitive abutment group for soft tissue contour only. Buccal recessions at 3 years post-loading amounted to -0.1 (0.8) mm for the definitive abutment group and -0.1 (1.2) mm for the repeated abutment changes group (it was actually a soft tissue gain; difference = 0.01 mm CI 95%: -0.48, 0.50; P = 0.965). All patients declared being very satisfied or satisfied with the function and aesthetics of the prostheses and said they would undergo the same procedure again, with the exception of one patient from the repeated disconnection group who was uncertain regarding function. Mean peri-implant marginal bone loss 3 years after loading was 0.07 (0.18) mm for the definitive abutment group and 0.50 (0.93) mm for the repeated abutment changes group (difference = 0.43 mm; CI 95%: 0.13, 0.74; P = 0.007). The height of keratinised mucosa at 3 years post-loading was 2.8 (1.3) mm for the definitive abutment group and 2.8 (1.6) mm for the repeated abutment changes group (difference = 0.03; CI 95%: -0.67, 0.73; P = .926). Up to 3 years after initial loading there were no statistically significant differences between the two procedures, with the exception of 0.4 mm more marginal bone loss at implants subjected to three abutment disconnections. There were no significantly increased marginal bone loss (difference = 0.1 mm, CI 95%: -0.3, 0.5, P = 0.590) or buccal recessions (difference = 0.1 mm, CI 95%: -0.4, 0.7, P = 0.674) at implants with less than 2 mm of keratinised mucosa at loading. Three-year post-loading data showed that repeated abutment disconnections significantly increased bone loss of 0.43 mm, but this difference may not be considered clinically relevant; therefore clinicians can use the procedure they find more convenient for each specific patient. Immediately non-occlusally loaded dental implants are a viable alternative to conventional loading and no increased bone loss or buccal recessions were noticed at implants with less than 2 mm of keratinised mucosa. Conflict of interest statement: This trial was partially funded by Dentsply Sirona Implants, the manufacturer of the implants and other products evaluated in this investigation. However, data belonged to the authors and by no means did the manufacturer interfere with the conduct of the trial or the publication of the results, with the exception of rejecting a proposal to change the protocol, after the trial was started, allowing the use of indexed abutments.

Retention Strength of Conical Welding Caps for Fixed Implant-Supported Prostheses.

PubMed

Nardi, Diego; Degidi, Marco; Sighinolfi, Gianluca; Tebbel, Florian; Marchetti, Claudio

This study evaluated the retention strength of welding caps for Ankylos standard abutments using a pull-out test. Each sample consisted of an implant abutment and its welding cap. The tests were performed with a Zwick Roell testing machine with a 1-kN load cell. The retention strength of the welding caps increased with higher abutment diameters and higher head heights and was comparable or superior to the values reported in the literature for the temporary cements used in implant dentistry. Welding caps provide a reliable connection between an abutment and a fixed prosthesis without the use of cement.

Assessment of the NCHRP abutment scour prediction equations with laboratory and field data

USGS Publications Warehouse

Benedict, Stephen T.

2014-01-01

The U.S. Geological Survey, in coopeation with nthe National Cooperative Highway Research Program (NCHRP) is assessing the performance of several abutment-scour predcition equations developed in NCHRP Project 24-15(2) and NCHRP Project 24-20. To accomplish this assssment, 516 laboratory and 329 fiels measurements of abutment scor were complied from selected sources and applied tto the new equations. Results will be used to identify stregths, weaknesses, and limitations of the NCHRP abutment scour equations, providing practical insights for applying the equations. This paper presents some prelimiray findings from the investigation.

Influence of abutment design on the success of immediately loaded dental implants: experimental and numerical studies.

PubMed

Hasan, I; Röger, B; Heinemann, F; Keilig, L; Bourauel, C

2012-09-01

The aim of the present study was to investigate experimentally and numerically the influence of a fine threaded- against a roughened-cervical region of immediately loaded dental implants in combination with straight and 20°-angled abutments on the implant primary stability. A total of 30 implants were inserted in bovine rib-segments, 14 cervically roughened implants and 16 implants with fine cervical threads. Each implant system received two abutments, straight and 20°-angled. Implant displacements and rotations were measured using a biomechanical measurement system. Subsequently, eight samples were selected for geometrical reconstruction and numerical investigation of stress and strain distributions in the bone by means of the finite element method. Experimentally, both implant systems showed similar behaviour with the straight abutments concerning displacements and rotations. However, fine threaded implants showed much less displacement and rotation against roughened implants when angled abutments were considered. Numerically, stresses were within 35-45 MPa in the cortical bone for both implant systems. The strains showed highest values within the spongious bone with the roughened implants connected to angled abutments. The results indicate that implants with fine cervical threads could be recommended in particular with angled abutments. The outcomes of this study are currently confirmed by long-term clinical investigations. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

Color variation induced by abutments in the superior anterior maxilla: an in vitro study in the pig gingiva.

PubMed

Atash, Ramin; Boularbah, Mohamed-Reda; Sibel, Cetik

2016-12-01

The aim of this work is to evaluate different types of materials used for making implant abutments, by means of an in vitro study and a review of the literature, in order to identify the indications for a better choice of an implant-supported restoration in the anterior section. 5 implant abutments were tested in a random order in the superior anterior maxilla of pig gingiva (n = 8): titanium dioxide (Nobel Biocare); zirconium dioxide, Standard BO shade (Nobel Biocare, Kloten, Switzerland); zirconium dioxide, Light BI shade (Nobel Biocare); zirconium dioxide, Intense A 3.5 shade (Nobel Biocare); and aluminium oxide. Each abutment was tested for 2 mm and 3 mm thickness. To determine color variation, VITA Easyshade Advance spectrophotometer (Vita Zahnfabrik, Bad Sackingen, Germany) was used. Results showed that the color variation induced by the abutment would be affected by the abutment material and gingival thickness, when the gingival thickness is 2 mm. All materials except zirconium dioxide (Standard shade) caused a visible change of color. Then, as the thickness of the gingiva increased to 3 mm, the color variation was attenuated in a significant manner and became invisible for all types of abutments, except those made of aluminium oxide. Zirconium dioxide is the material causing the lowest color variation at 2 mm and at 3 mm, whereas aluminium oxide causes the highest color variation no matter the thickness.

Custom CAD-CAM healing abutment and impression coping milled from a poly(methyl methacrylate) block and bonded to a titanium insert.

PubMed

Proussaefs, Periklis

2016-11-01

This article describes a technique in which a custom-made computer-aided design and computer-aided manufacturing (CAD-CAM) healing abutment milled from a poly(methyl methacrylate) (PMMA) block is fabricated and bonded to a titanium metal insert. An impression is made during dental implant surgery, and the CAD-CAM custom-made healing abutment is fabricated before second-stage surgery while appropriate healing time is allowed for the dental implant to osseointegrate. The contours of the healing abutment are based on the contours of a tentatively designed definitive prosthesis. The healing tissue obtains contours that will be compatible with the contours of the definitive prosthesis. After the milling process is complete, a titanium metal insert is bonded to the healing abutment. Placement of the custom-made CAD-CAM healing abutment at second-stage surgery allows the tissue to obtain contours similar to those of the definitive prosthesis. A custom-made CAD-CAM impression coping milled from a PMMA block and with a titanium insert is used for the definitive impression after the soft tissue has healed. This technique allows guided soft tissue healing by using a custom-made CAD-CAM healing abutment and impression coping. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Morse taper dental implants and platform switching: The new paradigm in oral implantology

PubMed Central

Macedo, José Paulo; Pereira, Jorge; Vahey, Brendan R.; Henriques, Bruno; Benfatti, Cesar A. M.; Magini, Ricardo S.; López-López, José; Souza, Júlio C. M.

2016-01-01

The aim of this study was to conduct a literature review on the potential benefits with the use of Morse taper dental implant connections associated with small diameter platform switching abutments. A Medline bibliographical search (from 1961 to 2014) was carried out. The following search items were explored: “Bone loss and platform switching,” “bone loss and implant-abutment joint,” “bone resorption and platform switching,” “bone resorption and implant-abutment joint,” “Morse taper and platform switching.” “Morse taper and implant-abutment joint,” Morse taper and bone resorption,” “crestal bone remodeling and implant-abutment joint,” “crestal bone remodeling and platform switching.” The selection criteria used for the article were: meta-analysis; randomized controlled trials; prospective cohort studies; as well as reviews written in English, Portuguese, or Spanish languages. Within the 287 studies identified, 81 relevant and recent studies were selected. Results indicated a reduced occurrence of peri-implantitis and bone loss at the abutment/implant level associated with Morse taper implants and a reduced-diameter platform switching abutment. Extrapolation of data from previous studies indicates that Morse taper connections associated with platform switching have shown less inflammation and possible bone loss with the peri-implant soft tissues. However, more long-term studies are needed to confirm these trends. PMID:27011755

33 CFR 118.75 - Lights on single-opening drawbridges.

Code of Federal Regulations, 2010 CFR

2010-07-01

... span. (c) Pier or abutment lights. Every swing bridge shall be lighted so that the end of each pier, abutment or fixed portion of the bridge adjacent to the navigable channel through the draw, or each end of the protection piers for such piers, abutments, or fixed portion of the bridge will be marked by a red...

Influence of different abutment diameter of implants on the peri-implant stress in the crestal bone: A three-dimensional finite element analysis--In vitro study.

PubMed

Aradya, Anupama; Kumar, U Krishna; Chowdhary, Ramesh

2016-01-01

The study was designed to evaluate and compare stress distribution in transcortical section of bone with normal abutment and platform switched abutment under vertical and oblique forces in posterior mandible region. A three-dimensional finite element model was designed using ANSYS 13.0 software. The type of bone selection for the model was made of type II mandibular bone, having cortical bone thickness ranging from 0.595 mm to 1.515 mm with the crestal region measuring 1.5 mm surrounding dense trabecular bone. The implant will be modulated at 5 mm restorative platform and tapering down to 4.5 mm wide at the threads, 13 mm long with an abutment 3 mm in height. The models will be designed for two situations: (1) An implant with a 5 mm diameter abutment representing a standard platform in the posterior mandible region. (2) An implant with a 4.5 mm diameter abutment representing platform switching in the posterior mandible region. Force application was performed in both oblique and vertical conditions using 100 N as a representative masticatory force. For oblique loading, a force of 100 N was applied at 15° from the vertical axis. von Mises stress analysis was evaluated. The results of the study showed cortical stress in the conventional and platform switching model under oblique forces were 59.329 MPa and 39.952 MPa, respectively. Cortical stress in the conventional and platform switching model under vertical forces was 13.914 MPa and 12.793 MPa, respectively. Results from this study showed the platform switched abutment led to relative decrease in von Mises stress in transcortical section of bone compared to normal abutment under vertical and oblique forces in posterior mandible region.

Microleakage at the Different Implant Abutment Interface: A Systematic Review

PubMed Central

Chowdhary, Ramesh; Kumari, Shail

2017-01-01

Introduction Presence of gap at the implant-abutment interface, leads to microleakage and accumulation of bacteria which can affect the success of dental implants. Aim To evaluate the sealing capability of different implant connections against microleakage. Materials and Methods In January 2017 an electronic search of literature was performed, in Medline, EBSCO host and Pubmed data base. The search was focused on ability of different implant connections in preventing microleakage. The related titles and abstracts available in English were screened, and the articles that fulfilled the inclusion criteria were selected for full text reading. Results In this systematic review, literature search initially resulted in 78 articles among which 30 articles only fulfilled the criteria for inclusion and were finally included in the review. Almost all the studies showed that there was some amount of microleakage at abutment implant interface. Microleakage was very less in Morse taper implants in comparison to other implant connections. Majority of studies showed less microleakage in static loading conditions and microleakage increases in dynamic loading conditions. Conclusion In this systematic review maximum studies showed that there was some amount of microleakage at abutment implant interface. External hexagon implants failed completely to prevent microleakage in both static and dynamic loading conditions of implants. Internal hexagon implants mainly internal conical (Morse taper) implants are very promising in case of static loading and also showed less microleakage in dynamic loading conditions. Torque recommended by manufacturer should be followed strictly to get a better seal at abutment implant interface. Zirconia abutments are more to microleakage than Titanium abutments and there use should be discouraged. Zirconia abutments should be only restricted to cases where there was very high demand of aesthetics. PMID:28764310

[Analysis of the movement of long axis and the distribution of principal stress in abutment tooth retained by conical telescope].

PubMed

Lin, Ying-he; Man, Yi; Qu, Yi-li; Guan, Dong-hua; Lu, Xuan; Wei, Na

2006-01-01

To study the movement of long axis and the distribution of principal stress in the abutment teeth in removable partial denture which is retained by use of conical telescope. An ideal three dimensional finite element model was constructed by using SCT image reconstruction technique, self-programming and ANSYS software. The static loads were applied. The displacement of the long axis and the distribution of the principal stress in the abutment teeth was analyzed. There is no statistic difference of displacenat and stress distribution among different three-dimensional finite element models. Generally, the abutment teeth move along the long axis itself. Similar stress distribution was observed in each three-dimensional finite element model. The maximal principal compressive stress was observed at the distal cervix of the second premolar. The abutment teeth can be well protected by use of conical telescope.

Comparison of Observed and Predicted Abutment Scour at Selected Bridges in Maine

USGS Publications Warehouse

Lombard, Pamela J.; Hodgkins, Glenn A.

2008-01-01

Maximum abutment-scour depths predicted with five different methods were compared to maximum abutment-scour depths observed at 100 abutments at 50 bridge sites in Maine with a median bridge age of 66 years. Prediction methods included the Froehlich/Hire method, the Sturm method, and the Maryland method published in Federal Highway Administration Hydraulic Engineering Circular 18 (HEC-18); the Melville method; and envelope curves. No correlation was found between scour calculated using any of the prediction methods and observed scour. Abutment scour observed in the field ranged from 0 to 6.8 feet, with an average observed scour of less than 1.0 foot. Fifteen of the 50 bridge sites had no observable scour. Equations frequently overpredicted scour by an order of magnitude and in some cases by two orders of magnitude. The equations also underpredicted scour 4 to 14 percent of the time.

[A study on the mechanical behaviors of abutment teeth with various coping designs under overdenture].

PubMed

Vang, M S; Cho, J H

1990-04-01

An overdenture is a complete denture supported by both soft tissue and a few remaining natural teeth. The purpose of this study was to analyze the stress distribution of the teeth and supporting structures when various type of coping under overdenture was applied. The analysis was conducted by using the finite element method and changing the condition such as the direction of the load, the shape of coping on the abutment: The model included overdenture copings, abutment tooth and supporting structures. The results of analysis were as follows: 1. The short dome coping showed well distribution of stress. 2. The dome shaped design produced higher stress distribution than square and inclined plane design. 3. As the height of copings on the abutment was increased, the displacements increased. 4. The magnitude and direction of the abutment displacements were influenced by the direction of load application.

New advanced surface modification technique: titanium oxide ceramic surface implants: long-term clinical results

NASA Astrophysics Data System (ADS)

Szabo, Gyorgy; Kovacs, Lajos; Barabas, Jozsef; Nemeth, Zsolt; Maironna, Carlo

2001-11-01

The purpose of this paper is to discuss the background to advanced surface modification technologies and to present a new technique, involving the formation of a titanium oxide ceramic coating, with relatively long-term results of its clinical utilization. Three general techniques are used to modify surfaces: the addition or removal of material and the change of material already present. Surface properties can also be changed without the addition or removal of material, through the laser or electron beam thermal treatment. The new technique outlined in this paper relates to the production of a corrosion-resistant 2000-2500 A thick, ceramic oxide layer with a coherent crystalline structure on the surface of titanium implants. The layer is grown electrochemically from the bulk of the metal and is modified by heat treatment. Such oxide ceramic-coated implants have a number of advantageous properties relative to implants covered with various other coatings: a higher external hardness, a greater force of adherence between the titanium and the oxide ceramic coating, a virtually perfect insulation between the organism and the metal (no possibility of metal allergy), etc. The coated implants were subjected to various physical, chemical, electronmicroscopic, etc. tests for a qualitative characterization. Finally, these implants (plates, screws for maxillofacial osteosynthesis and dental root implants) were applied in surgical practice for a period of 10 years. Tests and the experience acquired demonstrated the good properties of the titanium oxide ceramic-coated implants.

Assessment of a polyelectrolyte multilayer film coating loaded with BMP-2 on titanium and PEEK implants in the rabbit femoral condyle

PubMed Central

Guillot, R.; Pignot-Paintrand, I.; Lavaud, J.; Decambron, A.; Bourgeois, E.; Josserand, V.; Logeart-Avramoglou, D.; Viguier, E.; Picart, C.

2016-01-01

The aim of this study was to evaluate the osseointegration of titanium implants (Ti-6Al-4V, noted here TA6V) and poly(etheretherketone) PEEK implants induced by a BMP-2-delivering surface coating made of polyelectrolyte multilayer films. The in vitro bioactivity of the polyelectrolyte film-coated implants was assessed using the alkaline phosphatase assay. BMP-2-coated TA6V and PEEK implants with a total dose of 9.3 µg of BMP-2 were inserted into the femoral condyles of New Zealand white rabbits and compared to uncoated implants. Rabbits were sacrificed 4 and 8 weeks after implantation. Histomorphometric analyses on TA6V and PEEK implants and microcomputed tomography on PEEK implants revealed that the bone-to-implant contact and bone area around the implants were significantly lower for the BMP-2-coated implants than for the bare implants. This was confirmed by scanning electron microscopy imaging. This difference was more pronounced at 4 weeks in comparison to the 8-week time point. However, bone growth inside the hexagonal upper hollow cavity of the screws was higher in the case of the BMP-2 coated implants. Overall, this study shows that a high dose of BMP-2 leads to localized and temporary bone impairment, and that the dose of BMP-2 delivered at the surface of an implant needs to be carefully optimized. PMID:26965394

An in vitro biomechanical comparison of hydroxyapatite coated and uncoated ao cortical bone screws for a limited contact: dynamic compression plate fixation of osteotomized equine 3rd metacarpal bones.

PubMed

Durham, Myra E; Sod, Gary A; Riggs, Laura M; Mitchell, Colin F

2015-02-01

To compare the monotonic biomechanical properties of a broad 4.5 mm limited contact-dynamic compression plate (LC-DCP) fixation secured with hydroxyapatite (HA) coated cortical bone screws (HA-LC-DCP) versus uncoated cortical bone screws (AO-LC-DCP) to repair osteotomized equine 3rd metacarpal (MC3) bones. Experimental. Adult equine cadaveric MC3 bones (n = 12 pair). Twelve pairs of equine MC3 were divided into 3 test groups (4 pairs each) for: (1) 4 point bending single cycle to failure testing; (2) 4 point bending cyclic fatigue testing; and (3) torsional single cycle to failure testing. For the HA-LC-DCP-MC3 construct, an 8-hole broad LC-DCP (Synthes Ltd, Paoli, PA) was secured on the dorsal surface of each randomly selected MC3 bone with a combination of four 5.5 mm and four 4.5 mm HA-coated cortical screws. For the AO-LC-DCP-MC3 construct, an 8-hole 4.5 mm broad LC-DCP was secured on the dorsal surface of the contralateral MC3 bone with a combination of four 5.5 mm and four 4.5 mm uncoated cortical screws. All MC3 bones had mid-diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P < .05. Mean yield load, yield bending moment, composite rigidity, failure load, and failure bending moment, under 4 point bending, single cycle to failure, of the HA-LC-DCP fixation were significantly greater than those of the AO-LC-DCP fixation. Mean ± SD values for the HA-LC-DCP and the AO-LC-DCP fixation techniques, respectively, in single cycle to failure under 4 point bending were: yield load, 26.7 ± 2.15 and 16.3 ± 1.38 kN; yield bending moment, 527.4 ± 42.4 and 322.9 ± 27.2 N-m; composite rigidity, 5306 ± 399 and 3003 ± 300 N-m/rad; failure load, 40.6 ± 3.94 and 26.5 ± 2.52 kN; and failure bending moment, 801.9 ± 77.9 and 522.9 ± 52.2 N-m. Mean cycles to failure in 4 point bending of the HA-LC-DCP fixation (116,274 ± 13,211) was significantly greater than that of the AO-LC-DCP fixation 47,619 ± 6580. Mean yield load, mean composite rigidity, and mean failure load under torsional testing, single cycle to failure was significantly greater for the broad HA-LC-DCP fixation compared with the AO-LC-DCP fixation. In single cycle to failure under torsion, mean ± SD values for the HA-LC-DCP and the AO-LC-DCP fixation techniques, respectively, were: yield load, 101.3 ± 14.68 and 70.54 ± 10.20 N-m; composite rigidity, 437.9 ± 32.9 and 220.7 ± 17.6 N-m/rad; and failure load: 105.7 ± 15.5 and 75.28 ± 10.1 N-m. HA-LC-DCP was superior to AO-LC-DCP in resisting the static overload forces (palmarodorsal 4 point bending and torsional) and in resisting cyclic fatigue under palmarodorsal 4 point bending. © Copyright 2014 by The American College of Veterinary Surgeons.

Osseoconductivity of a Specific Streptavidin-Biotin-Fibronectin Surface Coating of Biotinylated Titanium Implants - A Rabbit Animal Study.

PubMed

Kämmerer, Peer W; Lehnert, Michael; Al-Nawas, Bilal; Kumar, Vinay V; Hagmann, Sebastien; Alshihri, Abdulmonem; Frerich, Bernhard; Veith, Michael

2015-10-01

Biofunctionalized implant surfaces may accelerate bony integration and increase long-term stability. The aim of the study was to evaluate the osseous reaction toward biomimetic titanium implants surfaces coated with quasicovalent immobilized fibronectin in an in vivo animal model. A total of 84 implants (uncoated [control 1, n = 36], streptavidin-biotin coated [test 1, n = 24], streptavidin-biotin-fibronectin coated [test 2, n = 24]) were inserted 1 mm supracortically in the proximal tibia of 12 rabbits. The samples were examined after 3 and 6 weeks. Total bone-implant contact (tBIC; %), bone-implant contact in the cortical (cBIC; %) and in the spongious bone (sBIC; %) as well as the percentage of linear bone fill (PLF; %) were evaluated. After 3 weeks, streptavidin-biotin-fibronectin implants had a significant higher sBIC (p = .043) and PLF (p = .007) compared with the uncoated samples. After 6 weeks, this difference was significant for tBIC (p = .016) and cBIC (p < .001). Additionally, uncoated screws showed a significant higher sBIC when compared with the fibronectin coating (p < .001). Streptavidin-biotin-coated implants showed less bone growth at both time points of all examined parameters when compared with their counterparts (all p < .001). Quasicovalent immobilization of biotinylated fibronectin with the streptavidin-biotin-fibronectin system on smooth surface titanium shows a beneficial faster osseous healing in vivo. Besides, an antifouling effect of the streptavidin-biotin coating was proven. © 2015 Wiley Periodicals, Inc.

Evaluation of Dynamic Characteristics of the Footbridge with Integral Abutments

NASA Astrophysics Data System (ADS)

Pańtak, Marek; Jarek, Bogusław

2017-09-01

The paper presents the results of dynamic field tests and numerical analysis of the footbridge designed as a three-span composite structure with integral abutments. The adopted design solution which has allowed to achieve a high resistance of the structure to dynamic loads and to meet the requirements of the criteria of comfort of use with a large reserve has been characterized. For comparative purposes, numerical analyzes of three construction variants of the footbridge were presented: F-1 - construction with integral abutments (realized variant), F-2 - construction with girders anchored in the abutments by means of tension rocker bearings, F-3 - construction with concrete side spans.

Comparisons of maximum deformation and failure forces at the implant–abutment interface of titanium implants between titanium-alloy and zirconia abutments with two levels of marginal bone loss

PubMed Central

2013-01-01

Background Zirconia materials are known for their optimal aesthetics, but they are brittle, and concerns remain about whether their mechanical properties are sufficient for withstanding the forces exerted in the oral cavity. Therefore, this study compared the maximum deformation and failure forces of titanium implants between titanium-alloy and zirconia abutments under oblique compressive forces in the presence of two levels of marginal bone loss. Methods Twenty implants were divided into Groups A and B, with simulated bone losses of 3.0 and 1.5 mm, respectively. Groups A and B were also each divided into two subgroups with five implants each: (1) titanium implants connected to titanium-alloy abutments and (2) titanium implants connected to zirconia abutments. The maximum deformation and failure forces of each sample was determined using a universal testing machine. The data were analyzed using the nonparametric Mann–Whitney test. Results The mean maximum deformation and failure forces obtained the subgroups were as follows: A1 (simulated bone loss of 3.0 mm, titanium-alloy abutment) = 540.6 N and 656.9 N, respectively; A2 (simulated bone loss of 3.0 mm, zirconia abutment) = 531.8 N and 852.7 N; B1 (simulated bone loss of 1.5 mm, titanium-alloy abutment) = 1070.9 N and 1260.2 N; and B2 (simulated bone loss of 1.5 mm, zirconia abutment) = 907.3 N and 1182.8 N. The maximum deformation force differed significantly between Groups B1 and B2 but not between Groups A1 and A2. The failure force did not differ between Groups A1 and A2 or between Groups B1 and B2. The maximum deformation and failure forces differed significantly between Groups A1 and B1 and between Groups A2 and B2. Conclusions Based on this experimental study, the maximum deformation and failure forces are lower for implants with a marginal bone loss of 3.0 mm than of 1.5 mm. Zirconia abutments can withstand physiological occlusal forces applied in the anterior region. PMID:23688204

Bone augmentation in dental implantology using press-fit bone cylinders and twin-principle diamond hollow drills: a case series.

PubMed

Draenert, Florian Guy; Huetzen, Dominic; Kämmerer, Peer; Wagner, Wilfried

2011-09-01

Bone transplants are mostly prepared with cutting drills, chisels, and rasps. These techniques are difficult for unexperienced surgeons, and the implant interface is less precise due to unstandardized preparation. Cylindrical bone transplants are a known alternative. Current techniques include fixation methods with osteosynthesis screws or the dental implant. A new bone cylinder transplant technique is presented using a twin-drill principle resulting in a customized pressfit of the transplant without fixation devices and combining this with the superior grinding properties of a diamond coating. New cylindrical diamond hollow drills are used for customized press fit bone transplants in a case series of five patients for socket reconstruction in the front and molar region of maxilla and mandibula with and without simultaneous implant placement. The technical approach was successful without intra or postoperative complications during the acute healing phase. The customized press fit completes a technological trias of bone cylinder transplant techniques adding to the assisted press fit with either osteosynthesis screws or the dental implant itself. © 2009 Wiley Periodicals, Inc.

PIXE microbeam analysis of the metallic debris release around endosseous implants

NASA Astrophysics Data System (ADS)

Buso, G. P.; Galassini, S.; Moschini, G.; Passi, P.; Zadro, A.; Uzunov, N. M.; Doyle, B. L.; Rossi, P.; Provencio, P.

2005-10-01

The mechanical friction that occurs during the surgical insertion of endosseous implants, both in dentistry and orthopaedics, may cause the detachment of metal debris which are dislodged into the peri-implant tissues and can lead to adverse clinical effects. This phenomenon more likely happens with coated or roughened implants that are the most widely employed. In the present study were studied dental implants screws made of commercially pure titanium and coated using titanium plasma-spray (TPS) technique. The implants were inserted in the tibia of rabbits, and removed "en bloc" with the surrounding bone after one month. After proper processing and mounting on plastic holders, samples from bones were analysed by EDXRF setup at of National Laboratories of Legnaro, INFN, Italy, and consequently at 3 MeV proton microbeam setup at Sandia National Laboratories. Elemental maps were drawn, showing some occasional presence of metal particles in the peri-implant bone.

Evaluation of bone response to titanium-coated polymethyl methacrylate resin (PMMA) implants by X-ray tomography.

PubMed

Shalabi, Manal M; Wolke, Johannes G C; Cuijpers, Vincent M J I; Jansen, John A

2007-10-01

High-resolution three-dimensional data about the bone response to oral implants can be obtained by using microfocus computer tomography. However, a disadvantage is that metallic implants cause streaking artifacts due to scattering of X-rays, which prevents an accurate evaluation of the interfacial bone-to-implant contact. It has been suggested that the use of thin titanium coatings deposited on polymeric implants can offer an alternative option for analyzing bone contact using micro-CT imaging. Consequently, the aim of the current study was to investigate bone behavior to titanium-coated polymethylmethacrylate (PMMA) implants by micro-CT and histological evaluation. For the experiment titanium-coated PMMA implants were used. The implants had a machined threaded appearance and were provided with a 400-500 nm thick titanium coating. The implants were inserted in the right or left tibia of 10 goats. After an implantation period of 12 weeks the implants were retrieved and prepared for micro-computer tomography (microCT), light microscopy, and X-ray microanalysis. The micro-CT showed that the screw-threads and typical implant configuration were well maintained through the installation procedure. Overall, histological responses showed that the titanium-coated implants were well tolerated and caused no atypical tissue response. In addition, the bone was seen in direct contact with the titanium-coated layer. The X-ray microanalysis results confirmed the light microscopical data. In conclusion, the obtained results proof the final use of titanium-coated PMMA implants for evaluation of the bone-implant response using microCT. However, this study also confirms that for a proper analysis of the bone-implant interface the additional use of microscopical techniques is still required.

Mechanical properties of resin glass fiber-reinforced abutment in comparison to titanium abutment

PubMed Central

Andreasi Bassi, Mirko; Bedini, Rossella; Pecci, Raffella; Ioppolo, Pietro; Lauritano, Dorina; Carinci, Francesco

2015-01-01

Purpose: So far, definitive implant abutments have been performed with high elastic modulus materials, which prevented any type of shock absorption of the chewing loads and as a consequence, the protection of the bone-fixture interface. This is particularly the case when the esthetic restorative material chosen is ceramic rather than composite resin. The adoption of an anisotropic abutment, characterized by an elastic deformability, could allow decreasing the impulse of chewing forces transmitted to the crestal bone. Materials and Methods: According to research protocol, the mechanical resistance to cyclical load was evaluated in a tooth-colored fiber-reinforced abutment (TCFRA) prototype and compared to that of a titanium abutment (TA), thus eight TCFRAs and eight TAs were adhesively cemented on as many titanium implants. The swinging that the two types of abutments showed during the application of sinusoidal load was also analyzed. Results: In the TA group, both fracture and deformation occurred in 12.5% of samples while debonding 62.5%. In the TCFRA group, only debonding was present in 37.5% of samples. In comparison to the TAs, the TCFRAs exhibited a greater swinging during the application of sinusoidal load. In the TA group, the extrusion prevailed, whereas in the TCFRA group, the intrusion was more frequent. Conclusion: The greater elasticity of TCFRA to the flexural load allows absorbing part of the transversal load applied on the fixture during the chewing function, thus reducing the stress on the bone-implant interface. PMID:26229266

Abutment height influences the effect of platform switching on peri-implant marginal bone loss.

PubMed

Galindo-Moreno, Pablo; León-Cano, Ana; Monje, Alberto; Ortega-Oller, Inmaculada; O'Valle, Francisco; Catena, Andrés

2016-02-01

The purpose was to radiographically analyze and compare the marginal bone loss (MBL) between implants with different mismatching distance and to study the influence of the prosthetic abutment height on the MBL in association with the related mismatching distances. This retrospective study included 108 patients in whom 228 implants were placed, 180 with diameter of 4.5 mm and 48 with diameter of 5 mm. All patients received OsseoSpeed™ implants with internal tapered conical connection (Denstply Implants). Different mismatching distances were obtained, given that all implants were loaded with the same uni-abutment type (Lilac; Denstply Implants). Data were gathered on age, gender, bone substratum, smoking habits, previous history of periodontitis, and prosthetic features. MBL was analyzed radiographically at 6 and 18 months post-loading. Mixed linear analysis of mesial and distal MBL values yielded significant effects of abutment, implant diameter, follow-up period, bone substratum, smoking, and abutment × time interaction. MBL was greater at 18 vs. 6 months, for short vs. long abutments, for grafted vs. pristine bone, for a heavier smoking habit, and for implants with a diameter of 5.0 vs. 4.5 mm. Greater mismatching does not minimize the MBL; abutment height, smoking habit, and bone substratum may play a role in the MBL over the short- and medium term. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Three Dimensional Finite Element Analysis of Distal Abutment Stresses of Removable Partial Dentures with Different Retainer Designs.

PubMed

Zarrati, Simindokht; Bahrami, Mehran; Heidari, Fatemeh; Kashani, Jamal

2015-06-01

This finite element method study aimed to compare the amount of stress on an isolated mandibular second premolar in two conventional reciprocal parallel interface designs of removable partial dentures (RPDs) and the same RPD abutment tooth (not isolated). A Kennedy Class 1, modification 1 RPD framework was simulated on a 3D model of mandible with three different designs: an isolated tooth with a mesial rest, an isolated tooth with mesial and distal rests and an abutment with a mesial rest (which was not isolated); 26 N occlusal forces were exerted bilaterally on the first molar sites. Stress on the abutment teeth was analyzed using Cosmos Works 2009 Software. In all designs, the abutment tooth stress concentration was located in the buccal alveolar crest. In the first model, the von Mises stress distribution in the contact area of I-bar clasp and cervical portion of the tooth was 19 MPa and the maximum stress was 30 MPa. In the second model, the maximum von Mises stress distribution was 15 MPa in the cervical of the tooth. In the third model, the maximum von Mises stress was located in the cervical of the tooth and the distal proximal plate. We recommend using both mesial and distal rests on the distal abutment teeth of distal extension RPDs. The abutment of an extension base RPD, which is not isolated in presence of its neighboring more anterior tooth, may have a better biomechanical prognosis.

The effect of repeated torque tightening on total lengths of implant abutments in different internal implant‒abutment connections.

PubMed

Saleh Saber, Fariba; Abolfazli, Nader; Jannatii Ataei, Soheil; Taghizade Motlagh, Mahsa; Gharekhani, Vahede

2017-01-01

Background. Since the misfit of crown has an important role in clinical performance of implant-supported prostheses, and due to the impact of the settling effect on misfit, the aim of this study was to investigate the impact of torque forces on the total lengths of narrow and short implant abutments in different internal implant‒abutment connections. Methods. In four different implant‒abutment connections, 8 analog implants with a normal diameter (4 mm) and narrow abutment (4.5 mm) were selected from groups of internal hex, internal octagon, morse hex 6° and morse hex 11°. Each of them was mounted within plaster type IV, and 32 samples were obtained. Then, the amount of vertical displacement was measured by closing the impression copings and applying torques of 20 25 and 30 Ncm. This stage was repeated for the abutment. In the next stage, the resin pattern was built and measurements were performed after applying the torques mentioned. Finally, after making the frame, this stage was repeated, and the settling effect was statistically analyzed with ANOVA. Results. In the stages of impression coping, resin pattern and final prosthesis, HEXAGONE had significantly the highest and OCTAGONE had the lowest rates of settling, and the settling of morse hex 11° and 6° was between them. Conclusion. Octagon implant had significantly the lowest settling in various clinical and laboratory stages by applying different torques.

The effect of repeated torque tightening on total lengths of implant abutments in different internal implant‒abutment connections

PubMed Central

Saleh Saber, Fariba; Abolfazli, Nader; Jannatii Ataei, Soheil; Taghizade Motlagh, Mahsa; Gharekhani, Vahede

2017-01-01

Background. Since the misfit of crown has an important role in clinical performance of implant-supported prostheses, and due to the impact of the settling effect on misfit, the aim of this study was to investigate the impact of torque forces on the total lengths of narrow and short implant abutments in different internal implant‒abutment connections. Methods. In four different implant‒abutment connections, 8 analog implants with a normal diameter (4 mm) and narrow abutment (4.5 mm) were selected from groups of internal hex, internal octagon, morse hex 6° and morse hex 11°. Each of them was mounted within plaster type IV, and 32 samples were obtained. Then, the amount of vertical displacement was measured by closing the impression copings and applying torques of 20 25 and 30 Ncm. This stage was repeated for the abutment. In the next stage, the resin pattern was built and measurements were performed after applying the torques mentioned. Finally, after making the frame, this stage was repeated, and the settling effect was statistically analyzed with ANOVA. Results. In the stages of impression coping, resin pattern and final prosthesis, HEXAGONE had significantly the highest and OCTAGONE had the lowest rates of settling, and the settling of morse hex 11° and 6° was between them. Conclusion. Octagon implant had significantly the lowest settling in various clinical and laboratory stages by applying different torques. PMID:28748052

Assessment of reliability of CAD-CAM tooth-colored implant custom abutments.

PubMed

Guilherme, Nuno Marques; Chung, Kwok-Hung; Flinn, Brian D; Zheng, Cheng; Raigrodski, Ariel J

2016-08-01

Information is lacking about the fatigue resistance of computer-aided design and computer-aided manufacturing (CAD-CAM) tooth-colored implant custom abutment materials. The purpose of this in vitro study was to investigate the reliability of different types of CAD-CAM tooth-colored implant custom abutments. Zirconia (Lava Plus), lithium disilicate (IPS e.max CAD), and resin-based composite (Lava Ultimate) abutments were fabricated using CAD-CAM technology and bonded to machined titanium-6 aluminum-4 vanadium (Ti-6Al-4V) alloy inserts for conical connection implants (NobelReplace Conical Connection RP 4.3×10 mm; Nobel Biocare). Three groups (n=19) were assessed: group ZR, CAD-CAM zirconia/Ti-6Al-4V bonded abutments; group RC, CAD-CAM resin-based composite/Ti-6Al-4V bonded abutments; and group LD, CAD-CAM lithium disilicate/Ti-6Al-4V bonded abutments. Fifty-seven implant abutments were secured to implants and embedded in autopolymerizing acrylic resin according to ISO standard 14801. Static failure load (n=5) and fatigue failure load (n=14) were tested. Weibull cumulative damage analysis was used to calculate step-stress reliability at 150-N and 200-N loads with 2-sided 90% confidence limits. Representative fractured specimens were examined using stereomicroscopy and scanning electron microscopy to observe fracture patterns. Weibull plots revealed β values of 2.59 for group ZR, 0.30 for group RC, and 0.58 for group LD, indicating a wear-out or cumulative fatigue pattern for group ZR and load as the failure accelerating factor for groups RC and LD. Fractographic observation disclosed that failures initiated in the interproximal area where the lingual tensile stresses meet the compressive facial stresses for the early failure specimens. Plastic deformation of titanium inserts with fracture was observed for zirconia abutments in fatigue resistance testing. Significantly higher reliability was found in group ZR, and no significant differences in reliability were determined between groups RC and LD. Differences were found in the failure characteristics of group ZR between static and fatigue loading. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The effects of healing abutments of different size and anatomic shape placed immediately in extraction sockets on peri-implant hard and soft tissues. A pilot study in foxhound dogs.

PubMed

López-López, Patricia J; Mareque-Bueno, Javier; Boquete-Castro, Ana; Aguilar-Salvatierra Raya, Antonio; Martínez-González, José M; Calvo-Guirado, José L

2016-01-01

The aim of this animal study was to compare the effects of narrow, concave-straight and wide anatomic healing abutments on changes to soft tissues and crestal bone levels around implants immediately placed into extraction sockets in foxhound dogs. Forty-eight titanium implants (Bredent Medical GMBH, Germany) of the same dimensions were placed in six foxhound dogs. They were divided into two groups (n = 24): test (implants with anatomic abutment) and control (implants with concave-straight abutment). The implants were inserted randomly in the post extraction sockets of P2 , P3 , P4, and M1 bilaterally in six dogs. After eight and twelve weeks, the animals were sacrificed and samples extracted containing the implants and the surrounding soft and hard tissues. Soft tissue and crestal bone loss (CBL) were evaluated by histology and histomorphometry. All implants were clinically and histologically osseointegrated. Healing patterns were examined microscopically at eight and twelve weeks. After eight and twelve weeks, for hard tissues, the distance from the implant shoulder to the first bone-to-implant contact (IS-C) was higher for control group in the lingual aspect with statistical significance (P < 0.05). For soft tissues (STL), the distance from the top of the peri-implant mucosa to the apical portion of the junction epithelium (PM-Je) was significantly less on the lingual aspect in the test group (with wider abutment) at eight and twelve weeks (P < 0.05). The distance from the top of the apical portion of the junction epithelium to the first bone-to-implant contact (Je-C) was significantly higher in the test group (wider abutment) in the lingual aspect at eight and twelve weeks (P < 0.05). There was no connective tissue contact with any abutment surface. Within the limitations of this animal study, anatomic healing abutments protect soft and hard tissues and reduce crestal bone resorption compared with concave-straight healing abutments. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of abutment angulation on the strain on the bone around an implant in the anterior maxilla: a finite element study.

PubMed

Saab, Xavier E; Griggs, Jason A; Powers, John M; Engelmeier, Robert L

2007-02-01

Angled abutments are often used to restore dental implants placed in the anterior maxilla due to esthetic or spatial needs. The effect of abutment angulation on bone strain is unknown. The purpose of the current study was to measure and compare the strain distribution on the bone around an implant in the anterior maxilla using 2 different abutments by means of finite element analysis. Two-dimensional finite element models were designed using software (ANSYS) for 2 situations: (1) an implant with a straight abutment in the anterior maxilla, and (2) an implant with an angled abutment in the anterior maxilla. The implant used was 4x13 mm (MicroThread). The maxillary bone was modeled as type 3 bone with a cortical layer thickness of 0.5 mm. Oblique loads of 178 N were applied on the cingulum area of both models. Seven consecutive iterations of mesh refinement were performed in each model to observe the convergence of the results. The greatest strain was found on the cancellous bone, adjacent to the 3 most apical microthreads on the palatal side of the implant where tensile forces were created. The same strain distribution was observed around both the straight and angled abutments. After several iterations, the results converged to a value for the maximum first principal strain on the bone of both models, which was independent of element size. Most of the deformation occurred in the cancellous bone and ranged between 1000 and 3500 microstrain. Small areas of cancellous bone experienced strain above the physiologic limit (4000 microstrain). The model predicted a 15% higher maximum bone strain for the straight abutment compared with the angled abutment. The results converged after several iterations of mesh refinement, which confirmed the lack of dependence of the maximum strain at the implant-bone interface on mesh density. Most of the strain produced on the cancellous and cortical bone was within the range that has been reported to increase bone mass and mineralization.