The influence of various occlusal materials on stresses transferred to implant-supported prostheses and supporting bone: A three-dimensional finite-element study

Static and dynamic stress analysis of different crown materials on a titanium base abutment in an implant-supported single crown: a 3D finite element analysis

BACKGROUND

This Finite Element Analysis was conducted to analyze the biomechanical behaviors of titanium base abutments and several crown materials with respect to fatigue lifetime and stress distribution in implants and prosthetic components.

METHODS

Five distinct designs of implant-supported single crowns were modeled, including a polyetheretherketone (PEEK), polymer-infiltrated ceramic network, monolithic lithium disilicate, and precrystallized and crystallized zirconia-reinforced lithium silicates supported by a titanium base abutment. For the static load, a 100 N oblique load was applied to the buccal incline of the palatal cusp of the maxillary right first premolar. The dynamic load was applied in the same way as in static loading with a frequency of 1 Hz. The principal stresses in the peripheral bone as well as the von Mises stresses and fatigue strength of the implants, abutments, prosthetic screws, and crowns were assessed.

RESULTS

All of the models had comparable von Mises stress values from the implants and abutments, as well as comparable maximum and minimum principal stress values from the cortical and trabecular bones. The PEEK crown showed the lowest stress (46.89 MPa) in the cervical region. The prosthetic screws and implants exhibited the highest von Mises stress among the models. The lithium disilicate crown model had approximately 9.5 times more cycles to fatique values for implants and 1.7 times more cycles to fatique values for abutments than for the lowest ones.

CONCLUSIONS

With the promise of at least ten years of clinical success and favorable stress distributions in implants and prosthetic components, clinicians can suggest using an implant-supported lithium disilicate crown with a titanium base abutment.

Biomechanical behavior of implant retained prostheses in the posterior maxilla using different materials: a finite element study

BACKGROUND

The aim of this study is to evaluate the biomechanical behavior of the mesial and distal off-axial extensions of implant-retained prostheses in the posterior maxilla with different prosthetic materials using finite element analysis (FEA).

METHODS

Three dimensional (3D) finite element models with three implant configurations and prosthetic designs (fixed-fixed, mesial cantilever, and distal cantilever) were designed and modelled depending upon cone beam computed tomography (CBCT) images of an intact maxilla of an anonymous patient. Implant prostheses with two materials; Monolithic zirconia (Zr) and polyetherketoneketone (PEKK) were also modeled .The 3D modeling software Mimics Innovation Suite (Mimics 14.0 / 3-matic 7.01; Materialise, Leuven, Belgium) was used. All the models were imported into the FE package Marc/Mentat (ver. 2015; MSC Software, Los Angeles, Calif). Then, individual models were subjected to separate axial loads of 300 N. Von mises stress values were computed for the prostheses, implants, and bone under axial loading.

RESULTS

The highest von Mises stresses in implant (111.6 MPa) and bone (100.0 MPa) were recorded in distal cantilever model with PEKK material, while the lowest values in implant (48.9 MPa) and bone (19.6 MPa) were displayed in fixed fixed model with zirconia material. The distal cantilever model with zirconia material yielded the most elevated levels of von Mises stresses within the prosthesis (105 MPa), while the least stresses in prosthesis (35.4 MPa) were recorded in fixed fixed models with PEKK material.

CONCLUSIONS

In the light of this study, the combination of fixed fixed implant prosthesis without cantilever using a rigid zirconia material exhibits better biomechanical behavior and stress distribution around bone and implants. As a prosthetic material, low elastic modulus PEKK transmitted more stress to implants and surrounding bone especially with distal cantilever.

Assessment of crestal bone loss and periodontal parameters of polymer infiltrated ceramic network versus lithium disilicate implant hybrid abutment crowns in the esthetic zone (A randomized clinical trial)

BACKGROUND

Lithium disilicate can be reliable when restoring implants in the esthetic zone. However, it has a high elastic modulus. This might increase the amount of forces transmitted to the crestal bone.

AIM OF THE STUDY

To evaluate the crestal bone loss and peri-implant periodontal parameters of polymer infiltrated ceramic network compared to lithium disilicate implant-supported hybrid abutment crowns after 12 months of follow-up.

METHODOLOGY

44 patients were enrolled. They were randomly assigned into two groups (n = 22). The first group received 22 implants restored with polymer-infiltrated ceramic network (Vitaenamic) hybrid abutment crowns. The second group received 22 implants restored with lithium disilicate (e.max) hybrid abutment crowns over immediately placed implants in the esthetic zone. Periapical radiographs were taken immediately after prosthetic placement and 1 year later utilizing a parallel technique, to assess crestal bone loss. Periodontal parameters were assessed after 1 year.

RESULTS

Regarding crestal bone loss, a comparison between group I (Vitaenamic) and group II (e.max) was made by using an Independent t-test, which showed an insignificant difference between them (p > 0.05). A comparison between groups I and II revealed insignificant differences regarding periodontal parameters (probing depth, bleeding on probing, visible plaque, and suppuration).

CONCLUSIONS

Regarding bone stability and periodontal parameters, polymer infiltrated ceramic network and lithium disilicate hybrid abutment crowns showed comparable results. Both materials showed clinically acceptable hard and soft tissue responses.

Biomechanical effects of inclined implant shoulder design in all-on-four treatment concept: a three-dimensional finite element analysis

OBJECTIVES

The aim of the present study was to assess the biomechanical behaviour of using a posterior implant design with inclined shoulder designs in all-on-four treatment via three-dimensional finite element analysis.

METHODS

Implants with standard and inclined shoulder designs were modelled for posterior implants. Implants were positioned into the maxilla and mandible models according to the all-on-four concept. Compressive stresses in the peri-implant bone, the von Mises stresses in the different components of the prosthetic restoration, and movement of the prosthesis were obtained.

RESULTS

The compressive stresses of the models with inclined shoulder design resulted in 15-58 % decrease compared with standard shoulder design. The von Mises stresses in the posterior implants reduced 18-47 %, stresses in the implant body increased 38-78 %, stresses in the abutment screw reduced 20-65 %, stresses in the framework of prosthesis reduced 1-18 % and deformation of the prosthesis was reduced 6-37 % in the models of inclined shoulder design compared with models of standard shoulder design. The compressive and von Mises stresses were generally higher in the mandible models than in the maxilla models for standard and inclined shoulder designs.

CONCLUSIONS

All evaluated components of the simulated treatment except for posterior abutment bodies showed better biomechanical behaviour with inclined shoulder design. The clinical success of all-on-four treatment maybe enhanced by using posterior implants with an inclined shoulder design.

Effect of gingival height of a titanium base on the biomechanical behavior of 2-piece custom implant abutments: A 3-dimensional nonlinear finite element study

STATEMENT OF PROBLEM

Titanium base (TiBase) abutments to restore an implant-supported single crown are available in different gingival heights, but information on the biomechanical effects of the gingival heights is lacking.

PURPOSE

The purpose of this nonlinear finite element analysis study was to evaluate the effects of TiBase gingival heights on the biomechanical behavior of custom zirconia (CustomZir) abutments and TiBase, including von Mises stress and maximum and minimum principal stress.

MATERIAL AND METHODS

TiBases with different gingival heights (0.5 mm, 1 mm, 1.5 mm, and 2 mm) with internal hexagon Morse taper connections were simulated in 3-dimensional models. The simulations (ANSYS Workbench 2020; ANSYS Inc) included the OsseoSpeed EV implant (Ø5.4 mm) (AstraTech; Dentsply Sirona), restoration, and surrounding bone in the mandibular first molar region. An occlusal force of 200 N was applied with a 2-mm horizontal offset toward the buccal side and a 30-degree inclination from the vertical axis.

RESULTS

High-stress concentration was observed in the uppermost internal connection area on the buccal side and the antirotational part of the titanium abutment on the lingual side in all models. CustomZir abutments with a shorter gingival height exhibited larger concentrated areas of volume average stress von Mises stress and higher magnitude of maximum and minimum principal stress compared with a taller gingival height.

CONCLUSIONS

A TiBase abutment with a taller gingival height reduced the fracture risk of a CustomZir abutment without increasing any mechanical risk.

Stress distribution and fracture resistance of green reprocessed polyetheretherketone (PEEK) single implant crown restorations compared to unreprocessed PEEK and Zirconia: an in-vitro study

BACKGROUND

It is unclear which crown materials are optimum to disperse the generated stresses around dental implants. The objective of this study is to assess stress distribution and fracture resistance of green reprocessed Polyetheretherketone (PEEK) in comparison to un-reprocessed PEEK and zirconia single implant crown restorations.

METHODS

Twenty crowns (n = 20) were obtained, five from zirconia and fifteen from pressed PEEK that were subdivided into 3 groups of five specimens each (n = 5) according to weight% of reprocessed material used. A 100% new PEEK was used for the first group, 50% new and 50% reprocessed PEEK were used for the second group, and a 100% reprocessed PEEK was used for the third group. Epoxy resin model with dental implant in the second mandibular premolar was constructed with strain gauges located mesially and distally to the implant to record strain while a load of 100 N was applied with 0.5 mm/min then specimens of all groups were vertically loaded till failure in a universal testing machine at cross head speed 1 mm/min. Data was statistically analyzed by using One-way Analysis of Variance (ANOVA) followed by Post-hoc test when ANOVA test is significant.

RESULTS

No significant difference between strain values of tested groups (p = 0.174) was noticed. However, a significant difference between fracture resistance values was noticed where the zirconia group recorded a significantly higher value (p < 0.001).

CONCLUSIONS

Implant restorative materials with different moduli of elasticity have similar effects regarding stresses distributed through dental implant and their surrounding bone. Reprocessed PEEK implant restorations transmit similar stresses to dental implant and surrounding bone as non-reprocessed PEEK and zirconia restorations. Zirconia failed at higher load values than all tested PEEK restorations but all can be safely used in the posterior area as crown restorations for single implants.

CLINICAL RELEVANCE

Applying "green dentistry" principles may extend to include reprocessing of pressed PEEK restorative materials without affecting the material's shock absorption properties.

In Silico Finite Element Analysis of Implant-Supported CAD-CAM Resin Composite Crowns

PURPOSE

The aim of this study was to evaluate the mechanical behavior of an implant-supported crown made using computer-aided design and computer-aided manufacturing (CAD-CAM) resin composite (RC) blocks in the posterior region.

MATERIAL AND METHODS

Four commercially available CAD-CAM RC blocks were used in this study: Cerasmart 300 (CS300; GC, Tokyo, Japan), Katana Avencia P Block (KAP; Kuraray Noritake Dental, Niigata, Japan); KZR HR3 Gamma Theta (HR3; Yamakin, Osaka, Japan), and Estelite P block (ESP; Tokuyama Dental, Tokyo, Japan). Katana Zirconia STML (ST; Kuraray Noritake Dental) was used as the control group. The elastic moduli of each material were determined by a three-point bending test. After the CAD models were designed, two different loading scenarios (oblique, vertical) were created. 3D finite element analysis was conducted with the prepared models.

RESULTS

The elastic modulus of the material utilized for the implant restorations did not cause any change in the stresses transmitted to the implant or peripheral bone. An important difference was detected in the abutment-crown junction area. The minimum von Mises value at the abutment-crown interface was obtained in ST, which has the closest elastic modulus to the titanium abutment.

CONCLUSIONS

The 3D finite element model designed in this study was used to demonstrate that implant-supported crowns fabricated with four different CAD-CAM RCs showed no critical stress concentrations in the bone or implant under all loading conditions. These results suggest that CAD-CAM RC blocks could be used as an alternative material for implant-supported restorations in the posterior region in terms of stress distribution.

Clinical assessment of different implant-supported esthetic crown systems fabricated with semi-digital workflow: Two-year prospective study

OBJECTIVE

To assess the clinical outcome of three esthetic implant-supported crown systems fabricated with semi-digital workflow and their influence on the clinical outcome of dental implants.

MATERIAL AND METHODS

A total of 30 participants had received dental implants restoring missing maxillary first/second premolars. After 6 weeks, customized zirconia abutments were early loaded. Two months later, the definitive crowns were fabricated using semi-digital workflow and cemented. According to the crown material, 3 groups were randomly allocated; group (Z): ultrahigh-translucent monolithic zirconia, group (C): resin-matrix ceramic and group (P): polyetherketoneketone veneered with light-cured composite resin. Clinical outcomes including the survival and success rates were evaluated at baseline, 6, 12, 18, and 24 months.

RESULTS

The survival rate for all studied groups was 100%, while their success rate was 100% for group (Z) and 90% for group (C) and group (P). Based on the functional implant prosthodontic score, a statistically significant difference was detected between group (Z) and group (P) (p < 0.001) as well as between group (C) and group (P) (p = 0.01).

CONCLUSIONS

The zirconia group had the most favorable clinical behavior, while the polyetherketoneketone had the least. All crown systems had comparable success rates with similar values of the peri-implant marginal bone loss.

CLINICAL SIGNIFICANCE

Using semi-digital workflow, ultrahigh-translucent monolithic zirconia, resin-matrix ceramic and polyetherketoneketone veneered with light-cured composite resin can be considered as favorable implant-supported crowns. The implant-supported crown system based on polyetherketoneketone veneered with light-cured composite resin is counted as a promising esthetic and restorative option.

The Effect of Abutment Angulation and Crown Material Compositions on Stress Distribution in 3-Unit Fixed Implant-Supported Prostheses: A Finite Element Analysis

Objective

The aim of this study was to evaluate influence of abutment angulation and restoration material compositions on the stress pattern in dental implants and their surrounding bone.

Materials and Methods

In this finite element study, the six different solid 3D models of “mandibular 3-unit fixed implant-supported prostheses” were analyzed. In all of these models, a straight abutment was used for anterior implants at the second premolar site, and in order to posterior implant at the second molar site, abutments with three different angles (straight, 15, and 20°) were used. Also, two different restoration material compositions (porcelain fused to base metal (PFBM) and porcelain fused to noble metal (PFNM)) were considered for fixed implant supported restorations. A 450 N static force was exerted in a straight manner along the longitudinal axis of the anterior implant in a tripod, and the stress distribution was measured based on the restoration materials and abutment angulations of the models in the 3 sites of cortical, cancellous bone, and fixtures. The simulation was performed with ABAQUS 6.13 Software.

Results

In all models, stress values in surrounding cortical bone were more than in spongy bone. Maximum stress levels in an anterior abutment-implant complex were seen in models with angled implants. In models with parallel implants, the stress level of a molar straight abutment-implant complex was less than that of premolar straight ones. In an angled posterior abutment-implant complex, less stress level was detected compared to straight ones. In all PFNB models, stress values were slightly more and distributed in a wider area of premolar straight abutments.

Conclusion

Increasing an abutment angle, increases stress in surrounding bone and straight implant-abutment combination. It seems that the crown material composition affects stress distribution of the implant-abutment combination but does not affect stress distribution of surrounding bone.

A Systematic Study of Restorative Crown-Materials Combinations for Dental Implants: Characterization of Mechanical Properties under Dynamic Loads

This study aimed to find the optimum mechanical characteristics of the restorative materials for the manufacture of implant crowns subjected to impact loading when different combinations of materials are used for the inner and outer crown. Several combinations of external–internal crown restorative materials were analyzed. The dynamic stresses at eight different zones of a dental implant subjected to an impact load and the influence of several mechanical properties, such as the Young’s modulus, Poisson’s ratio, density, and initial velocity, were analyzed and compared. A detailed 3D model was created, including the crown, the retention screw, the implant, and a mandible section. The model was then built by importing the 3D geometries from CAD software. The whole 3D model was carefully created in order to guarantee a finite element mesh that produced results adjusted to physical reality. Then, we conducted a numerical simulation using the finite element method (FEM). The results of the FEM analysis allowed for evaluating the effect that different combinations of restorative materials and mechanical properties had on the stress distribution in various regions of the implant. The choice of restorative material is a factor to be considered in order to preserve the integrity of osseointegration. Restorative materials transfer more or less stress to the dental implant and surrounding bone, depending on their stiffness. Therefore, an inadequate Young’s modulus of the rehabilitation material can affect the survival of the implant over time. Eight interactive graphics were provided on a web-based surface platform to help clinical dentists, researchers, and manufacturers to select the best restorative materials combination for the crown.

Effect of implant placement depth on bone remodeling on implant-supported single zirconia abutment crown: A 3D finite element study

PURPOSE

This study aimed to evaluate the influence of subcrestal implant placement depth on bone remodeling using time-dependent finite element analysis (FEA) with a bone-remodeling algorithm over 12 months.

METHODS

Seven models of different subcrestal implant placement depths (0, 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm) were analyzed using FEA to evaluate the biomechanical responses in the bone and implant, including von Mises equivalent stress, strain energy density (SED), and overloading elements. SED was used as a mechanical stimulus to simulate cortical and cancellous bone remodeling over the first 12 months after final prosthesis delivery.

RESULTS

The highest increase in cortical bone density was observed at Depth 1.5, whereas the lowest increase was observed at Depth 3.0. In contrast, the highest increase in bone density was observed at Depth 3.0 in the cancellous bone, whereas the lowest increase was observed at Depth 0. The highest peak von Mises stress in the cortical bone occurred at Depth 2.5 (107.24 MPa), while that in the cancellous bone was at Depth 2.5 (34.55 MPa). Notably, the maximum von Mises stress values in the cancellous bone exceeded the natural limit of the bony material, as indicated by the overloading elements observed at the depths of 2.0, 2.5, and 3.0 mm.

CONCLUSION

Greater bone density apposition is observed with deeper implant placement. An implant depth of more than 1.5 mm exhibited a higher maximum von Mises stress and greater overloading elements.

Influence of Different Restoring Materials on Stress Distribution in Prosthesis on Implants: A Review of Finite Element Studies

The selection of material used on the occlusal surface of implant-supported prostheses is important, as these materials can transmit destructive forces to the interface between the alveolar bone and the implant. Different prosthetic materials are suggested for implant-supported prostheses. The choice of prosthetic material is a controversial issue, and there is a consensus that implant survival is not affected by the prosthetic material. Three-dimensional finite element studies are often used in dentistry to estimate the stress distribution that occurs in the implant system, peri-implant bone, and prosthetic components. To analyze the influence of the prosthetic restorative material on the stresses in bone tissue and peri-implant through a literature review of three-dimensional finite element studies. The search for articles was performed in the PubMed/Medline database up to November 2021. The selected articles were independently evaluated by two different reviewers. The information collected was author and year of publication, dimensions of implants used, the material used in the prosthetic crown, simulated force and direction, and conclusion and effect. After searching, 14 studies were selected for full reading, and based on the inclusion and exclusion criteria, all could be included in this review. The articles were based on evidence-based laboratory medicine. After analyzing these articles, it was concluded that the prosthetic materials used on the occlusal surface do not interfere with the destruction of stresses to the bone and peri-implant tissue, both in single prostheses and protocol-type prostheses, when three-dimensional finite element method is used.

Stress Distribution on Various Implant-Retained Bar Overdentures

The purpose of this study was to evaluate the effects of various fabrication techniques and materials used in implant-supported mandibular overdentures with a Hader bar attachment over added stress distribution. Three-dimensional geometric solid models, consisting of two implants (3.3 mm × 12 mm) placed at the bone level on both mandibular canine regions and a Hader bar structure, were prepared. Model 1 simulated a bar retentive system made from Titanium Grade 5 material by Computer Numerical Control (CNC) milling technique without using any converting adapter/multi-unit element on the implants, while Model 2 simulated the same configuration, but with converting adapters on the implants. Model 3 simulated a bar retentive system made from Cobalt-Chromium material, made by using conventional casting technique with converting adapters on the implants. Static loads of 100 Newton were applied on test models from horizontal, vertical and oblique directions. ANSYS R15.0 Workbench Software was used to compare Von Mises stress distribution and minimum/maximum principal stress values, and the results were evaluated by using Finite Element Analysis method. As a result, the highest stress distribution values under static loading in three different directions were obtained in Model 1. Stress was observed intensely around the necks of the implants and the surrounding cortical bone areas in all models. In scope of the results obtained, using converting adapters on implants has been considered to decrease transmission of forces onto implants and surrounding bone structures, thus providing a better stress distribution. It has also been observed that the type of material used for bar fabrication has no significant influence on stress values in those models where converting adapters were used.

Influence of different combinations of CAD-CAM crown and customized abutment materials on the force absorption capacity in implant supported restorations - In vitro study

OBJECTIVES

To evaluate the force absorption capacity of implant supported restorations utilizing different CAD-CAM materials for the fabrication of crowns and customized abutments.

METHODS

80 titanium inserts were scanned to design customized abutments and crowns. The specimens were divided into four groups (n = 20/material): (Z): zirconia, (P): PEEK, (V): VITA Enamic, and (E): IPS e.max. Each group was subdivided into two subgroups according to customized abutment material: (Z) zirconia, and (P) for PEEK. For the assessment of force absorption, all specimens were loaded in a universal testing machine, applied loads curves were collected from the machine's software, and resulting loads curves were collected from forcemeter below the assembly. The slopes of all curves were analyzed using Two-way multivariate analysis of variance with pairwise comparisons using Tukey Post Hoc test (p < 0.05).

RESULTS

The curve progression of the applied and resulting forces varied among the investigated materials for each specimen. For zirconia abutments, ZZ showed the highest slope values of the applied and resulting force curves, followed by EZ, VZ, and PZ demonstrating statistically significant differences (P < .001). As for PEEK abutments, ZP and EP showed the least slope values, followed by PP then VP demonstrating statistically significant differences (P < .001). For Zirconia and e.max crowns, using PEEK abutments significantly increased slope loss. As for PEEK and Vita Enamic crowns changing abutment material did not significantly affect slope loss.

SIGNIFICANCE

Combining rigid crown materials with less rigid abutments might enhance their force absorption capacity. However, with less rigid crown materials a stiff substructure might be mandatory to preserve their force absorption behavior.

Short-Term Evaluation of Prosthetic Rehabilitation of Thin Wiry Ridge by Ridge Splitting and Simultaneous Implants Placement: Non-randomized Control Trial

Objective  This article evaluates the success of prosthetic rehabilitation of thin wiry ridge and implants placed simultaneously in splitted ridge both clinically and radiographically.

Materials and Methods  Twenty-one participants were enrolled of which 13 patients (8 females and 5 males) were suffering from maxillary ridge atrophy and 8 patients (5 females and 3 males) had mandibular ridge atrophy; a total of 42 implants were performed using the ridge expansion technique. The expansion was performed using the conventional disk technique, piezoelectric corticotomy, and self-threading expanders. Implants were placed and loaded with fixed partial denture after 4 months for the mandible and 6 months for the maxilla. Implant stability quotient (ISQ) was measured at T0 (implant placement) and TL (loading). Crestal bone levels were measured at different times: T0, TL, and T12 (12 months). Evaluation of prosthetic and surgical complications was carried out. Data were analyzed and compared using analysis of variance and paired t -tests at a significance level of 5%.

Results  All implants met the criteria for success. All implants showed a higher mean bone loss from T0 to TL (1.259 ± 0.3020) than from TL to T12 (0.505 ± 0.163) with a statistically significant difference ( p  < 0.0001). ISQ values sharply increased at the time of loading (72.52 ± 2.734) than at implant insertion (44.5 ± 4.062) with a significant difference ( p  < 0.0001). Minor prosthetic and surgical complications were reported.

Conclusion  The results from this study support the efficacy of prosthetic rehabilitation of thin wiry ridge using split ridge technique and the success of implants placed simultaneously in splitted ridge.

A 3D Finite Element Analysis Model of Single Implant-Supported Prosthesis under Dynamic Impact Loading for Evaluation of Stress in the Crown, Abutment and Cortical Bone Using Different Rehabilitation Materials

In the literature, many researchers investigated static loading effects on an implant. However, dynamic loading under impact loading has not been investigated formally using numerical methods. This study aims to evaluate, with 3D finite element analysis (3D FEA), the stress transferred (maximum peak and variation in time) from a dynamic impact force applied to a single implant-supported prosthesis made from different materials. A 3D implant-supported prosthesis model was created on a digital model of a mandible section using CAD and reverse engineering. By setting different mechanical properties, six implant-supported prostheses made from different materials were simulated: metal (MET), metal-ceramic (MCER), metal-composite (MCOM), carbon fiber-composite (FCOM), PEEK-composite (PKCOM), and carbon fiber-ceramic (FCCER). Three-dimensional FEA was conducted to simulate the collision of 8.62 g implant-supported prosthesis models with a rigid plate at a speed of 1 m/s after a displacement of 0.01 mm. The stress peak transferred to the crown, titanium abutment, and cortical bone, and the stress variation in time, were assessed.

Comparative evaluation of peri-implant stress distribution in implant protected occlusion and cuspally loaded occlusion on a 3 unit implant supported fixed partial denture: A 3D finite element analysis study

PURPOSE

To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion.

MATERIALS AND METHODS

A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points.

RESULTS

In Group 1 for vertical load , maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1.

CONCLUSION

In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.

In vitro evaluation of material dependent force damping behavior of implant-supported restorations using different CAD-CAM materials and luting conditions

STATEMENT OF PROBLEM

Although force-damping behavior that matches natural teeth may be unobtainable, an optimal combination of crown material and luting agent might have a beneficial effect on the force absorption capacity of implant-supported restorations. However, the force-absorbing behavior of various restorative materials has not yet been satisfactorily investigated.

PURPOSE

The purpose of this in vitro study was to evaluate the material dependent force-damping behavior of implant-supported crowns fabricated from different computer-aided design and computer-aided manufacturing (CAD-CAM) materials luted to implant abutments under different conditions.

MATERIAL AND METHODS

Titanium inserts (N=84) were screwed to implant analogs, scanned to design zirconia abutments, and divided into 4 groups to receive CAD-CAM fabricated crowns in 4 materials: zirconia, polyetheretherketone (PEEK), polymer-infiltrated ceramics (VITA ENAMIC), and lithium disilicate (e.max). The crowns were subdivided as per the luting agent: none, interim cement, and adhesive resin cement. Measurements were performed by loading specimens in a universal testing machine with an increasing force and measuring the resulting force with a digital forcemeter, followed by image processing and data acquisition. Two-way multivariate analysis of variance (MANOVA) was used to assess all interactions with multiple pairwise comparisons (α=.05).

RESULTS

The curve progression of the applied and resulting forces varied significantly among the investigated materials, resulting in differently inclined slopes for each material (P<.001). With no cementation, the mean slope values of the resulting force curves ranged from 77.5 ±0.03 degrees for zirconia, followed by 71.8 ±0.03 degrees for lithium disilicate, 56.2 ±0.1 degrees for polymer-infiltrated ceramics, and 51.1 ±0.01 degrees for polyetheretherketone. With interim cementation, the mean slope values ranged from 75.4 ±0.01 degrees for zirconia, followed by 70.05 ±0.02 degrees for lithium disilicate, 56.1 ±0.02 degrees for polymer-infiltrated ceramics, and 52.2 ±0.1 degrees for polyetheretherketone. As with adhesive cementation, curve slopes ranged from 73.2 ±0.02 degrees for zirconia, followed by 70.5 ±0.2 degrees for lithium disilicate, 55.9 ±0.04 degrees for polymer-infiltrated ceramics, and 52.3 ±0.1 degrees for polyetheretherketone. Slope loss was significant after the cementation of zirconia and lithium disilicate crowns but less significant for polymer-infiltrated ceramics and polyetheretherketone.

CONCLUSIONS

Force damping is generally material dependent, yet implant-supported crowns fabricated from resilient materials such as polymer-infiltrated ceramics and PEEK show better force absorption than rigid materials such as zirconia and lithium disilicate ceramics. Furthermore, cementation of rigid materials significantly increased slope loss, indicating enhancement in their force-damping behavior, whereas less-rigid materials benefit less from cementation. Further studies are essential to investigate the effect of prosthetic materials on the stress distribution to the peri-implant bone in the crown-abutment-implant complex.

Influence of Implant Dimensions in the Resorbed and Bone Augmented Mandible: A Finite Element Study

Aims:

The scope of this study was to analyze the influence of clinically feasible implant diameter and length on the stress transmitted to the peri-implant bone in the case of a resorbed and bone augmented mandible through finite element analysis.

Settings and Design:

The study was carried out in silico.

Subjects and Methods:

Resorbed and bone-augmented 3D models were derived from in vivo cone-beam computed tomography scans of the same patient. Corresponding implant systems were modeled with the diameter ranging from 3.3 to 6 mm and length ranging from 5 to 13 mm, and masticatory loads were applied on the abutment surface.

Statistical Analysis Used:

None.

Results:

In the bone augmented ridge, maximum stress values in the peri-implant region drastically decreased only when using implants of a diameter of 5 mm and 6 mm. Implants up to 4 mm in diameter led to comparable stress values with the ones obtained in the resorbed ridge, when using the larger implants. The increase of length reduced stress in the resorbed mandible, whereas in the bone augmented model, it led to small variations only in implants up to 4 mm in diameter.

Conclusions:

It was concluded that bone augmentation provides the optimal framework for clinicians to use larger implants, which, in turn, reduces stress in the peri-implant region. Diameter and length play an equally important role in decreasing stress. Implant dimensions should be carefully considered with ridge geometry.

Comparison of CAD/CAM manufactured implant-supported crowns with different analyses

Background

Present study compared the failure load of CAD/CAM-manufactured implant-supported crowns and the stress distribution on the prosthesis-implant-bone complex with different restoration techniques.

Methods

The materials were divided into four groups: group L-M: lithium disilicate ceramic (LDS, monolithic), group L-V: LDS ceramic (veneering), group ZL-M: zirconia-reinforced lithium silicate ceramic (ZLS, monolithic), group ZL-V: ZLS ceramic (veneering). Crown restorations were subjected to load-to-failure test (0.5 mm/min). Failure loads of each group were statistically analyzed (two-way ANOVA, post hoc Tukey HSD, α = 0.05). Finite element analysis (FEA) was used to compare the stress distribution of crown restorations.

Results

Group L-M had the highest failure load (2891.88 ± 410.12 N) with a significant difference from other groups (p < 0.05). Although there was a significant difference between group ZL-M (1750.28 ± 314.96 N) and ZL-V (2202.55 ± 503.14 N), there was no significant difference from group L-V in both groups (2077.37 ± 356.59 N) (p > 0.05).

Conclusions

The veneer application had opposite effects on ceramics, increased the failure load of ZLS and reduced it for LDS without a statistically significant difference. Both materials are suitable for implant-supported crowns. Different restorative materials did not influence the stress distribution, but monolithic restorations reduced the stress concentration on the implant and bone.

Morphological Measurement of Supracondylar Femur Based on Digital Technology in Chinese Han Population

Objective

Relatively few studies have reported on the morphology of the supracondylar femur, which is a fundamental factor affecting prosthetic reconstruction. The objectives of the present study were to measure the morphological parameters of the supracondylar femur, to classify the supracondylar femur, and to provide theoretical guidance for the development of distal femoral prostheses.

Methods

The study consisted of 82 patients of Han Chinese nationality in North China. There were 57 men and 25 women included in the study, with an average age of 50.9 years (range, 18–87 years). Effective CT data should include a range of more than 10 cm for the distal femur. CT data for the right distal supracondylar femurs was obtained from DICOM files. Results for the cancellous bone and marrow cavity were retained, and information for the cortical bone was erased to obtain information of the lumen. Measurements of the intracortical cavity have not been reported previously. Lumen models were reconstructed with Mimics 17.0 software. The surfaces of the lumen models were smoothed with Geomagic studio 12.0 software. Using the Solidworks 2014 software, we established a 3‐D coordinate system, where variables of the lumen were examined. Correlations between the various measurements were calculated.

Results

The supracondylar region of the femur was divided into five levels, and the length, breadth, height, and angle values were measured at each level. There were strong correlations between the length indexes (transverse diameter [EF], medial anteroposterior diameter [AC], middle anteroposterior diameter [GH], and lateral anteroposterior diameter [BD]) and the volume index (V). There were also strong correlations among the length indicators (EF, AC, GH, and BD) in each layer. Angle γ was correlated with the lateral anteroposterior diameter (BD) at L2–L6 layers (r = −0.383, −0.385, −0.296, −0.258, −0.24; all P < 0.05) and with the height index (h) at L4–L6 layers (r = −0.244, −0.385, −0.506; all P < 0.05). The most representative parameters were the medial anteroposterior diameter (AC₂R₂ = 0.865; AC₆R₂ = 0.932), the coronal width ratio, and the sagittal width ratio with volume. The analysis found that the lumen shape of flower–top hat accounted for 81% at most.

Conclusions

The supracondylar femur has an asymmetrical structural area. The coronal plane is dominated by a flowerpot‐like morphology, and the sagittal plane is narrowest in the lateral 1/3 and resembles a top‐hat‐like morphology. Our results provide theoretical guidance for developing distal femoral prostheses and for their clinical application.

Numerical Evaluation of Biomechanical Stresses in Dental Bridges Supported by Dental Implants

The number of supporting dental implants is an important criterion for the surgical outcome of dental bridge fixation, which has considerable impact on biomechanical load transfer characteristics. Excessive stress at the bone–implant interface by masticatory loading may result in implant failure. The aim of this study was to evaluate the impact of the number of implants supporting the dental bridge on stress in neighboring tissues around the implants. Results of the study will provide useful information on appropriate surgical techniques for dental bridge fixation. In this study, osseointegrated smooth cylindrical dental implants of same diameter and length were numerically analyzed, using three-dimensional bone–implant models. The effect of the number of supporting implants on biomechanical stability of dental bridge was examined, using two, three and four supporting implants. All materials were assumed to be linearly elastic and isotropic. Masticatory load was applied in coron-apical direction on the external part of dental bridge. Finite Element (FE) analyses were run to solve for von Mises stress. Maximum von Mises stresses were located in the cervical line of cortical bone around dental implants. Peak von Mises stress values decreased with an increase in the number of implants that support the dental bridge. Results of this study demonstrate the importance of using the correct number of supporting implants to for dental bridge fixation.

Mechanical Characterisation and Biomechanical and Biological Behaviours of Ti-Zr Binary-Alloy Dental Implants

The objective of the study is to characterise the mechanical properties of Ti-15Zr binary alloy dental implants and to describe their biomechanical behaviour as well as their osseointegration capacity compared with the conventional Ti-6Al-4V (TAV) alloy implants. The mechanical properties of Ti-15Zr binary alloy were characterised using Roxolid© implants (Straumann, Basel, Switzerland) via ultrasound. Their biomechanical behaviour was described via finite element analysis. Their osseointegration capacity was compared via an in vivo study performed on 12 adult rabbits. Young's modulus of the Roxolid© implant was around 103 GPa, and the Poisson coefficient was around 0.33. There were no significant differences in terms of Von Mises stress values at the implant and bone level between both alloys. Regarding deformation, the highest value was observed for Ti-15Zr implant, and the lowest value was observed for the cortical bone surrounding TAV implant, with no deformation differences at the bone level between both alloys. Histological analysis of the implants inserted in rabbits demonstrated higher BIC percentage for Ti-15Zr implants at 3 and 6 weeks. Ti-15Zr alloy showed elastic properties and biomechanical behaviours similar to TAV alloy, although Ti-15Zr implant had a greater BIC percentage after 3 and 6 weeks of osseointegration.

Biomechanical behavior of titanium and zirconia frameworks for implant-supported full-arch fixed dental prosthesis

BACKGROUND

The biomechanical behavior of implant-supported titanium and zirconia full-arch fixed dental prosthesis (FAFDP) frameworks require further investigation.

PURPOSE

Strains transferred by implant-supported titanium (Ti) and zirconia (Zr) FAFDP frameworks were analyzed.

MATERIALS AND METHODS

Maxillary 14-unit FAFDPs supported by 6 implants and 12-unit FAFDPs supported by 4 implants were tested. One-piece frameworks were fabricated by computer-aided design/computer-aided manufacturing. Four groups were divided (n = 3): G1, Ti-6 implants; G2, Zr-6 implants; G3, Ti-4 implants; G4, Zr-4 implants. A 250 N single-point load was applied on the second premolar. A three-dimensional digital image correlation system recorded framework and maxilla model surface deformation.

RESULTS

The following strains (μS) averaged over the length of the second premolar were calculated: frameworks, G1 (321.82 ± 111.29), G2 (638.87 ± 108.64), G3 (377.77 ± 28.64), G4 (434.18 ± 132.21); model surface, G1 (473.99 ± 48.69), G2 (653.93 ± 45.26), G3 (1082.50 ± 71.14), G4 (1218.26 ± 230.37). Zirconia frameworks supported by 6 implants (G2) presented higher surface strains (P < .05). FAFDPs with titanium frameworks transferred significantly lower strains to the supporting maxilla when 6 implants were used (G1) (P < .05). Both framework materials transferred similar strains when supported by 4 implants (G3 and G4) (P > .05).

CONCLUSIONS

Zirconia frameworks supported by 6 implants showed higher strains. FAFDPs supported by 6 implants transferred less strains to the supporting maxilla, irrespective of framework material.

The effect of implant angulation and splinting on stress distribution in implant body and supporting bone: A finite element analysis

Objective:

The aim of this study was to investigate the influence of implant crown splinting and the use of angulated abutment on stress distribution in implant body and surrounding bone by three-dimensional finite element analysis.

Materials and Methods:

For this study, three models with two implants at the site of mandibular right second premolar and first molar were designed (1): Both implants, parallel to adjacent teeth, with straight abutments (2): Anterior implant with 15 mesial angulations and posterior implant were placed parallel to adjacent tooth, (3): Both implants with 15 mesial angulations and parallel to each other with 15° angulated abutments. Restorations were modeled in two shapes (splinted and nonsplinted). Loading in tripod manner as each point 50 N and totally 300 N was applied. Stress distribution in relation to splinting or nonsplinting restorations and angulations was done with ABAQUS6.13.

Results:

Splinting the restorations in all situations, led to lower stresses in all implant bodies, cortical bone and spongy bone except for the spongy bone around angulated first molar. Angulated implant in nonsplinted restoration cause lower stresses in implant body and bone but in splinted models more stresses were seen in implant body in comparison with straight abutment (model 2). Stresses in nonsplinted and splinted restorations in cortical bone of angulated molar region were more than what was observed in straight molar implant (model 3).

Conclusion:

Implant restorations splinting lead to a better distribution of stresses in implant bodies and bone in comparison with nonsplinted restorations, especially when the load is applied off center to implant body. Angulations of implant can reduce stresses when the application of the load is in the same direction as the implant angulation.

Stress distribution in fixed-partial prosthesis and peri-implant bone tissue with different framework materials and vertical misfit levels: a three-dimensional finite element analysis

The purpose of this study was to evaluate the influence of superstructure material and vertical misfits on the stresses created in an implant-supported partial prosthesis. A three-dimensional (3-D) finite element model was prepared based on common clinical data. The posterior part of a severely resorbed jaw with two osseointegrated implants at the second premolar and second molar regions was modeled using specific modeling software (SolidWorks 2010). Finite element models were created by importing the solid model into mechanical simulation software (ANSYS Workbench 11). The models were divided into groups according to the prosthesis framework material (type IV gold alloy, silver-palladium alloy, commercially pure titanium, cobalt-chromium alloy, or zirconia) and vertical misfit level (10 µm, 50 µm, and 100 µm) created at one implant-prosthesis interface. The gap of the vertical misfit was set to be closed and the stress values were measured in the framework, porcelain veneer, retention screw, and bone tissue. Stiffer materials led to higher stress concentration in the framework and increased stress values in the retention screw, while in the same circumstances, the porcelain veneer showed lower stress values, and there was no significant difference in stress in the peri-implant bone tissue. A considerable increase in stress concentration was observed in all the structures evaluated within the misfit amplification. The framework material influenced the stress concentration in the prosthetic structures and retention screw, but not that in bone tissue. All the structures were significantly influenced by the increase in the misfit levels.

Effect of type of luting agents on stress distribution in the bone surrounding implants supporting a three-unit fixed dental prosthesis: 3D finite element analysis

Background:

Osseointegration of dental implants is influenced by many biomechanical factors that may be related to stress distribution. The aim of this study was to evaluate the effect of type of luting agent on stress distribution in the bone surrounding implants, which support a three-unit fixed dental prosthesis (FDP) using finite element (FE) analysis.

Materials and Methods:

A 3D FE model of a three-unit FDP was designed replacing the maxillary first molar with maxillary second premolar and second molar as the abutments using CATIA V5R18 software and analyzed with ABAQUS/CAE 6.6 version. The model was consisted of 465108 nodes and 86296 elements and the luting agent thickness was considered 25 μm. Three load conditions were applied on eight points in each functional cusp in horizontal (57.0 N), vertical (200.0 N) and oblique (400.0 N, θ = 120°) directions. Five different luting agents were evaluated. All materials were assumed to be linear elastic, homogeneous, time independent and isotropic.

Results:

For all luting agent types, the stress distribution pattern in the cortical bone, connectors, implant and abutment regions was almost uniform among the three loads. Furthermore, the maximum von Mises stress of the cortical bone was at the palatal side of second premolar. Likewise, the maximum von Mises stress in the connector region was in the top and bottom of this part.

Conclusion:

Luting agents transfer the load to cortical bone and different types of luting agents do not affect the pattern of load transfer.

Effect of the Parafunctional Occlusal Loading and Crown Height on Stress Distribution

The aim of this study was to assess, by the three-dimensional finite element method, the influence of crown-to-implant ratio and parafunctional occlusal loading on stress distribution in single external hexagon implant-supported prosthesis. Computer-aided design software was used to confection three models. Each model was composed of a block bone and an external hexagon implant (5x10.0 mm) with screw-retained implant prostheses, varying the height crown: 10, 12.5 and 15 mm. Finite element analysis software was used to generate the finite element mesh and to establish the loading and boundary conditions. Normal (200 N axial and 100 N oblique load) and parafunctional forces (1,000 N axial and 500 N oblique load) were applied. The results were visualized by von Mises and maximum principal stress. In comparison with the normal occlusal force, the parafunctional occlusal force induced an increase in stress concentration and magnitude on implant (platform and first threads) and screw (neck). The cortical bone showed the highest tensile stress under parafunctional force (oblique load). The stress concentration increased as the crown height increased. It was concluded that: increasing the C/I increased stress concentration in both implant components and cortical bone; parafunctional loading increased between 4-5 times the value of stresses in bone tissue compared with functional loading; the type of loading variation factor is more influential than the crown-to-implant factor.

Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis

OBJECTIVE

This study evaluated the influence of framework material and vertical misfit on stress created in an implant-supported partial prosthesis under load application.

MATERIALS AND METHODS

The posterior part of a severely reabsorbed jaw with a fixed partial prosthesis above two osseointegrated titanium implants at the place of the second premolar and second molar was modeled using SolidWorks 2010 software. Finite element models were obtained by importing the solid model into an ANSYS Workbench 11 simulation. The models were divided into 15 groups according to their prosthetic framework material (type IV gold alloy, silver-palladium alloy, commercially pure titanium, cobalt-chromium alloy or zirconia) and vertical misfit level (10 µm, 50 µm and 100 µm). After settlement of the prosthesis with the closure of the misfit, simultaneous loads of 110 N vertical and 15 N horizontal were applied on the occlusal and lingual faces of each tooth, respectively. The data was evaluated using Maximum Principal Stress (framework, porcelain veneer and bone tissue) and a von Mises Stress (retention screw) provided by the software.

RESULTS

As a result, stiffer frameworks presented higher stress concentrations; however, these frameworks led to lower stresses in the porcelain veneer, the retention screw (faced to 10 µm and 50 µm of the misfit) and the peri-implant bone tissues.

CONCLUSION

The increase in the vertical misfit resulted in stress values increasing in all of the prosthetic structures and peri-implant bone tissues. The framework material and vertical misfit level presented a relevant influence on the stresses for all of the structures evaluated.

Analysis of stress on mucosa and basal bone underlying complete dentures with different reliner material thicknesses: a three-dimensional finite element study

The aim of this study was to determine the optimal thickness of reliner material that provides the least amount of stress on thin mucosa and supporting bone in patients with complete removable dentures using a three-dimensional finite element analyses. The model was obtained from two CT scans of edentulous mandibles with dentures supported by the alveolar ridge. After virtual reconstruction, the three-dimensional models were exported to the solidworks cad software and divided into six groups based on the thickness of the reliner material as follows: (i) without material, (ii) 0·5 mm, (iii) 1 mm, (iv) 1·5 mm, (v) 2 mm and (vi) 2·5 mm. The applied load was 60 N and perpendicular to the long axis of the alveolar ridge of all the prosthetic teeth, and the mucosal thickness used was 1 mm. The analyses were based on the maximum principal stress in the fibromucosa and the minimum principal stress in the basal bone. Stress concentration was observed in the anterior zone of the mandible in the mucosa and in the bone. The maximum and minimum principal stress in the mucosa and bone, respectively, decreased, whereas the thickness of the reliner material increased until 2 mm, which transmitted the lowest stress, compared with the control. Reliner materials with a thickness of 2·5 mm showed higher stress values than those with a thickness of 2 mm. In conclusion, reliner material with a thickness of 2 mm transmitted the lowest amount of stress to the mucosa and bone in 1 mm of mucosa thickness.

Influence of the casting technique and dynamic loading on screw detorque and misfit of single unit implant-supported prostheses

OBJECTIVE

This study aimed to evaluate the influence of the casting procedure and cyclic loading of prosthetic frameworks on detorque of prosthetic screws and marginal misfit of single unit implant-supported prostheses.

MATERIALS AND METHODS

Twenty specimens were obtained, each one consisting of a set of an implant (external hexagon 3.75 × 13 mm - Branemark type), a prosthetic abutment (entirely calcinable or overcasted UCLA) and a prosthetic screw. After the specimens were obtained, the prosthetic screws were tightened with 30 Ncm torque and released 24 h later in order to evaluate initial detorque. The screws were retightened and marginal gaps were assessed. All specimens were submitted to 10(6) loading cycles, performed with 2 Hz frequency and 130 N load. The specimens were re-evaluated for marginal misfit and detorque after the mechanical loading (final marginal misfit/final detorque). The results were submitted to analysis of variance for repeated measurements, followed by Tukey HSD test (α = 0.05).

RESULTS

No statistically significant differences were found on detorque values of the prosthetics screws for all groups and intervals evaluated (p = 0.8922). The entirely calcinable abutments showed higher initial marginal misfit compared to the overcasted ones (p = 0.0438). There was no statistically significant difference on marginal misfit before and after mechanical loading for both groups (p > 0.05).

CONCLUSIONS

It can be concluded that the overcasted abutments showed lower misfit values when compared to the entirely casted abutments. No difference was observed on detorque values of prosthetic screws. After mechanical loading there was no difference on marginal misfit and detorque between the groups.

Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts

Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial. In this study, the current status of implant occlusion was reviewed and discussed. Further randomized clinical research to investigate the correlation between implant occlusion, the implant success rate, and its risk factors is warranted to determine best clinical practices.

Digitization and its futuristic approach in prosthodontics

Digitization has become part and parcel of the contemporary prosthodontics with the probability of most of the procedures being based on the digital techniques in near future. Let us think of X-rays or photographs, making impressions, recording jaw movements or fabricating prosthesis, educating and training new dentists or patient motivation for practice build up, all has become digital. CAD-CAM has revolutionized not just the ceramic technology but has also been used for the CAD-CAM implant surgeries, maxillofacial prosthesis and diagnostic splints. Today a practicing dentist needs to be abreast with the latest but with the technology changing so fast, this poses a great challenge. There is endless scope of digitisation and technology in prosthodontics- let it be in the clinical and lab procedures like use of CAD-CAM technology, stereolithography, rapid prototyping, use of virtual articulators and digital face bows, digital radiographs, or in the field of training, education and research by the use of virtual patient programs, dental softwares, optoelectronic recording of jaw motion, digital instron machine, retention testing device, audiovisual aids,… the list will remain endless. The article reviews those various aspects of prosthodontics where digitization has modified the conventional procedures. For discussion they have been considered under the educational aspect, diagnostics, treatment procedures, prosthesis fabrication and lastly the research and futuristic development. The day is not far when remote sensing robotic devices would be performing the restorations under the command and surveillance of the master-the dentist without his immediate presence.