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Anniwaer A, Muhetaer A, Yin Z, Zhu J, Jin C, Huang C. Influence of prosthetic index structures and implant materials on stress distribution in implant restorations: a three-dimensional finite element analysis. BMC Oral Health 2024; 24:901. [PMID: 39107754 PMCID: PMC11304626 DOI: 10.1186/s12903-024-04680-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Mechanical complications affect the stability of implant restorations and are a key concern for clinicians, especially with the frequent introduction of new implant designs featuring various structures and materials. This study evaluated the effect of different prosthetic index structure types and implant materials on the stress distribution of implant restorations using both in silico and in vitro methods. METHODS Four finite element analysis (FEA) models of implant restorations were created, incorporating two prosthetic index structures (cross-fit (CF) and torc-fit (TF)) and two implant materials (titanium and titanium-zirconium). A static load was applied to each group. An in vitro study using digital image correlation (DIC) with a research scenario identical to that of the FEA was conducted for validation. The primary strain, sensitivity index, and equivalent von Mises stress were used to evaluate the outcomes. RESULTS Changing the implant material from titanium to titanium-zirconium did not significantly affect the stress distribution or maximum stress value of other components, except for the implant itself. In the CF group, implants with a lower elastic modulus increased the stress on the screw. The TF group showed better stress distribution on the abutment and a lower stress value on the screw. The TF group demonstrated similar sensitivity for all components. DIC analysis revealed significant differences between TF-TiZr and CF-Ti in terms of the maximum (P < 0.001) and minimum principal strains (P < 0.05) on the implants and the minimum principal strains on the investment materials in both groups (P < 0.001). CONCLUSIONS Changes in the implant material significantly affected the maximum stress of the implant. The TF group exhibited better structural integrity and reliability.
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Affiliation(s)
- Annikaer Anniwaer
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, 430079, China
| | - Aihemaiti Muhetaer
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, 430079, China
| | - Zhengrong Yin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, 430079, China
| | - Jiakang Zhu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, 430079, China
| | - Chunxiao Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, 430079, China
| | - Cui Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, 430079, China.
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Zhang C, Zeng C, Wang Z, Zeng T, Wang Y. Optimization of stress distribution of bone-implant interface (BII). BIOMATERIALS ADVANCES 2023; 147:213342. [PMID: 36841109 DOI: 10.1016/j.bioadv.2023.213342] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/03/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
Many studies have found that the threshold of occlusal force tolerated by titanium-based implants is significantly lower than that of natural teeth due to differences in biomechanical mechanisms. Therefore, implants are considered to be susceptible to occlusal trauma. In clinical practice, many implants have shown satisfactory biocompatibility, but the balance between biomechanics and biofunction remains a huge clinical challenge. This paper comprehensively analyzes and summarizes various stress distribution optimization methods to explore strategies for improving the resistance of the implants to adverse stress. Improving stress resistance reduces occlusal trauma and shortens the gap between implants and natural teeth in occlusal function. The study found that: 1) specific implant-abutment connection design can change the force transfer efficiency and force conduction direction of the load at the BII; 2) reasonable implant surface structure and morphological character design can promote osseointegration, maintain alveolar bone height, and reduce the maximum effective stress at the BII; and 3) the elastic modulus of implants matched to surrounding bone tissue can reduce the stress shielding, resulting in a more uniform stress distribution at the BII. This study concluded that the core BII stress distribution optimization lies in increasing the stress distribution area and reducing the local stress peak value at the BII. This improves the biomechanical adaptability of the implants, increasing their long-term survival rate.
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Affiliation(s)
- Chunyu Zhang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China.
| | - Chunyu Zeng
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Zhefu Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Ting Zeng
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China
| | - Yuehong Wang
- Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Xiangya School of Stomatology, Central South University, No. 72 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China; Hunan 3D Printing Engineering Research Center of Oral Care, No. 64 Xiangya Street, Kaifu District, Changsha, 410008, Hunan, China.
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Strietzel FP, Neumann K, Hertel M. Impact of platform switching on marginal peri-implant bone-level changes. A systematic review and meta-analysis. Clin Oral Implants Res 2015; 26:342-58. [PMID: 24438506 PMCID: PMC4340042 DOI: 10.1111/clr.12339] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To address the focused question, is there an impact of platform switching (PS) on marginal bone level (MBL) changes around endosseous implants compared to implants with platform matching (PM) implant-abutment configurations? MATERIAL AND METHODS A systematic literature search was conducted using electronic databases PubMed, Web of Science, Journals@Ovid Full Text and Embase, manual search for human randomized clinical trials (RCTs) and prospective clinical controlled cohort studies (PCCS) reporting on MBL changes at implants with PS-, compared with PM-implant-abutment connections, published between 2005 and June 2013. RESULTS Twenty-two publications were eligible for the systematic review. The qualitative analysis of 15 RCTs and seven PCCS revealed more studies (13 RCTs and three PCCS) showing a significantly less mean marginal bone loss around implants with PS- compared to PM-implant-abutment connections, indicating a clear tendency favoring the PS technique. A meta-analysis including 13 RCTs revealed a significantly less mean MBL change (0.49 mm [CI95% 0.38; 0.60]) at PS implants, compared with PM implants (1.01 mm [CI95% 0.62; 1.40] (P < 0.0001). CONCLUSIONS The meta-analysis revealed a significantly less mean MBL change at implants with a PS compared to PM-implant-abutment configuration. Studies included herein showed an unclear as well as high risk of bias mostly, and relatively short follow-up periods. The qualitative analysis revealed a tendency favoring the PS technique to prevent or minimize peri-implant marginal bone loss compared with PM technique. Due to heterogeneity of the included studies, their results require cautious interpretation.
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Affiliation(s)
- Frank Peter Strietzel
- Department of Oral Medicine, Dental Radiology and Oral Surgery, Charité – Medical University of Berlin/Charité Centre 3 for Dental, Oral and Maxillary MedicineBerlin, Germany
| | - Konrad Neumann
- Charité – Medical University of Berlin/Charité Centre 4 for Therapeutic Research, Institute of Medical Biometrics and Clinical EpidemiologyBerlin, Germany
| | - Moritz Hertel
- Department of Oral Medicine, Dental Radiology and Oral Surgery, Charité – Medical University of Berlin/Charité Centre 3 for Dental, Oral and Maxillary MedicineBerlin, Germany
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