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      The importance of correct implants positioning and masticatory load direction on a fixed prosthesis

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          Abstract

          Background

          Through the biomechanical study of dental implants, it is possible to understand the dissipation effects of masticatory loads in different situations and prevent the longevity of osseointegration. Aims: To evaluate the microstrains generated around external hexagon implants, using axial and non-axial loads in a fixed four-element prosthesis with straight implants and implants inclined at 17°.

          Material and Methods

          Three implants were modeled using CAD software following the manufacturer’s measurements. Then, implants were duplicated and divided into two groups: one with straight implants and respective abutments, and the other with angled implants at 17° and respective abutments. Both groups were arranged inside a block simulating bone tissue. A simplified fixed prosthesis was installed on both groups and the geometries were exported to CAE software. Five loads of 300N were performed at axial and non-axial points on the fixed prosthesis. Stress on the implants and strain on the block were both analyzed. An in vitro experiment was performed following all structures made in FEA in order to validate the model. In each experimental block, 4 strain gauges were linearly placed between the implants and the same loads were repeated with a loading applicator device.

          Results

          The deformations computed by the gauges were correlated with the FEA results, showing that the group with inclined implants had more damaging biomechanical behavior and was significantly different from the group with straight implants ( P<0.005).

          Conclusions

          The mathematical model used is valid and inclined implants can induce unwanted bone remodeling.

          Key words:Finite Element Analysis, Dental Implants, Fixed Prosthesis.

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          Most cited references30

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          Wolff's Law and bone's structural adaptations to mechanical usage: an overview for clinicians.

          H. Frost (1994)
          Basic Multicellular Unit-based bone remodeling can lead to the removal or conservation of bone, but cannot add to it. Decreased mechanical usage (MU) and acute disuse result in loss of bone next to marrow; normal and hypervigorous MU result in bone conservation. Bone modeling by resorption and formation drifts can add bone and reshape the trabeculae and cortex to strengthen them but collectively they do not remove bone. Hypervigorous MU turns this modeling on, and its architectural effects then lower typical peak bone strains caused by future loads of the same kind to a threshold range. Decreased and normal MU leave this modeling off. Where typical peak bone strains stay below a 50 microstrain region (the MESr) the largest disuse effects on remodeling occur. Larger strains depress it and make it conserve existing bone. Strains above a 1500 microstrain region (the MESm) tend to turn lamellar bone modeling drifts on. By adding to, reshaping and strengthening bone, those drifts reduce future strains under the same mechanical loads towards that strain region. Strains above a 3000 microstrain region (the MESp) can turn woven bone drifts on to suppress local lamellar drifts but can strengthen bone faster than lamellar drifts can. Such strains also increase bone microdamage and the remodeling that normally repairs it. Those values compare to bone's fracture strain of about 25,000 microstrain.
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            Intra-osseous anchorage of dental prostheses. I. Experimental studies.

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              Finite element analysis of the effect of cantilever and implant length on stress distribution in an implant-supported fixed prosthesis.

              This study investigated the stress distribution at the bone/implant interface with a three-dimensional finite element stress analysis by using three different cantilever and implant lengths in an implant-supported fixed partial denture. Simulation models were created as a bilateral distal cantilever fixed partial denture supported with six implants embedded in a model of the mandibular bone. Nine different simulation models had three different cantilevers (7, 14, and 28 mm) and implant lengths (7, 15, and 20 mm). Vertical forces of 75 N and horizontal forces of 25 N were applied to the distal end of the cantilever. Analysis of the von Mises stresses for the bone/implant interfaces revealed that the maximum stresses occurred at the most distal bone/ implant interface located on the loaded side and significantly increased with the length of the cantilever. However, there was no statistically significant change associated with the length of implants.
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                Author and article information

                Journal
                J Clin Exp Dent
                J Clin Exp Dent
                Medicina Oral S.L.
                Journal of Clinical and Experimental Dentistry
                Medicina Oral S.L.
                1989-5488
                1 January 2018
                January 2018
                : 10
                : 1
                : e81-e87
                Affiliations
                [1 ]DDs, MSc, PhD Student in Prosthodontics, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil
                [2 ]DDs, MSc, PhD, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil
                [3 ]DDs, MSc, PhD, Adjunct Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil
                [4 ]DDs, MSc, PhD, Adjunct Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil. Address: Av Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, São Paulo, Brazil
                Author notes
                Av Engenheiro Francisco José Longo 777, Jardim São Dimas, São José dos Campos São Paulo, Brazil. CEP 12245-000 , E-mail: amodalpiva@ 123456gmail.com

                Conflict of interest statement: Authors denied conflicts of interest of any kind.

                Article
                54489
                10.4317/jced.54489
                5899813
                e4cc00ed-3612-4c88-a6a4-67740641594e
                Copyright: © 2018 Medicina Oral S.L.

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

                History
                : 18 November 2017
                : 1 November 2017
                Categories
                Research
                Biomaterials and Bioengineering in Dentistry

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