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Lee WT, Chen YC. Digitally Fabricated Dentures for Full Mouth Rehabilitation with Zirconia, Polyetheretherketone and Selective Laser Melted Ti-6Al-4V Material. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053021. [PMID: 35270714 PMCID: PMC8910438 DOI: 10.3390/ijerph19053021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022]
Abstract
CAD/CAM technologies have been embedded into the fabrication of removable partial denture (RPD). Various materials such as zirconia and polyetheretherketone (PEEK) are developed for subtractive manufacturing. As for additive manufacturing, dental professionals have begun to use selective laser melting (SLM) techniques for fabricating metallic RPD frameworks. This report demonstrates a case rehabilitated with a maxillary telescopic crown-retained combining PEEK and zirconia material denture and a mandibular Kennedy Class I RPD fabricated with SLM techniques. First, a conventional impression was performed and the master cast was mounted with a centric relation record. Digital models were obtained using tabletop scanners and then the telescopic primary zirconia crowns were designed and milled. After transferring the intraoral distribution of primary crowns using pick-up impression, secondary PEEK crowns and framework were designed, milled, and veneered with composite resin. Mandibular framework was designed and constructed using SLM technique with Ti-6Al-4V. Definitive prostheses for both jaws were finished and delivered. Delivered prostheses functioned well for a one-year period. The was patient satisfied with the improvements in chewing function and esthetics. Both substrative and additive manufacturing techniques are suitable for framework fabrication. Further investigation is needed for improving the mechanical performance and long-term prognosis of digitally made prostheses.
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Affiliation(s)
- Wei-Ting Lee
- Division of Prosthodontics, Department of Stomatology, National Cheng Kung University Hospital, Tainan 704, Taiwan;
| | - Yung-Chung Chen
- Division of Prosthodontics, Department of Stomatology, National Cheng Kung University Hospital, Tainan 704, Taiwan;
- School of Dentistry & Institute of oral medicine, Medical College, National Chen Kung University, Tainan 704, Taiwan
- Correspondence:
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Biomechanics in Removable Partial Dentures: A Literature Review of FEA-Based Studies. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5699962. [PMID: 34485518 PMCID: PMC8416386 DOI: 10.1155/2021/5699962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 12/12/2022]
Abstract
The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.
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Richert R, Alsheghri AA, Alageel O, Caron E, Song J, Ducret M, Tamimi F. Analytical model of I-bar clasps for removable partial dentures. Dent Mater 2021; 37:1066-1072. [PMID: 33867171 DOI: 10.1016/j.dental.2021.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/26/2021] [Accepted: 03/29/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Clasps of removable partial dentures (RPDs) often suffer from fatigue stress that leads to plastic deformation, loss of retention, and RPD failure. Recently, computer-based technologies were proposed to optimize clasp geometry design. The objective of this study was to create an analytic model of I-bar clasps for computer-aided design (CAD)-RPD. METHODS The analytical model based on mechanical laws was established to simulate I-bar clasp retention, and optimize its design. The model considered the lengths of the vertical (L1) and horizontal (L2) arms of the I-bar as well as the radius (r) of its half-round cross-section. The analytical model was validated with mechanical experiments evaluating the retention of cobalt-chromium (Co-Cr) clasps in vitro and compared with finite element analysis (FEA). RESULTS The analytical model was in good agreement with the mechanical experiments and FEA, and showed that I-bar clasp design could provide optimal mechanical performance as long as the length of arms (L1 and L2) do not exceed 6 mm. Clasps with L1 > 8 mm and L2 > 9 mm presented stress values exceeding the fatigue limit of Co-Cr. The proposed solution was to increase the radius of I-bar to conserve the initial mechanical performance of Co-Cr. SIGNIFICANCE Co-Cr I-bar clasps perform best on teeth with reduced mesiodistal dimensions (canine and premolar), and their designs could be optimized to prevent stress from reaching the yield strength and the fatigue failure limit.
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Affiliation(s)
- Raphaël Richert
- Hospices Civils de Lyon, PAM Odontologie, Lyon, France; Faculté d'Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Laboratoire de Mécanique des Contacts et structures, UMR 5259 CNRS/INSA Lyon, Lyon, France
| | - Ammar A Alsheghri
- Department of Mining Materials Engineering, McGill University, Montreal, QC, Canada; Department of Software and Computer Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Omar Alageel
- Faculty of Dentistry, McGill University, Montreal, QC, Canada; King Saud University, Riyadh, Saudi Arabia
| | | | - Jun Song
- Department of Mining Materials Engineering, McGill University, Montreal, QC, Canada
| | - Maxime Ducret
- Hospices Civils de Lyon, PAM Odontologie, Lyon, France; Faculté d'Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Faleh Tamimi
- College of Dental Medicine, Qatar University, Doha, Qatar.
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Virtual Bone Augmentation in Atrophic Mandible to Assess Optimal Implant-Prosthetic Rehabilitation—A Finite Element Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10010401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The scope of our study was to analyze the impact of implant prosthetic rehabilitation, in bilateral terminal partial edentulism with mandibular bone atrophy, and potential benefits of mandibular bone augmentation through finite element analysis. A 3D mandible model was made using patient-derived cone-beam computed tomography (CBCT) images, presenting a bilateral terminal edentation and mandibular atrophy. A virtual simulation of bone augmentation was then made. Implant-supported restorations were modeled for each edentulous area. Forces corresponding to the pterygoid and the masseter muscles, as well as mastication conditions for each quadrant, were applied. The resorbed mandible presented high values of strain and stress. A considerable variation between strain values among the two implant sites in each quadrant was found. In the augmented model, values of strain and stress showed a uniformization in both quadrants. Virtually increasing bone mass in the resorbed areas of the mandible showed that enabling larger implants drastically reduces strain and stress values in the implant sites. Also, although ridge height difference between the two quadrants was kept even after bone augmentation, there is a uniformization of the strain values between the two implant sites in each of the augmented mandible quadrants.
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The effect of build orientation on the microstructure and properties of selective laser melting Ti-6Al-4V for removable partial denture clasps. J Prosthet Dent 2020; 123:163-172. [DOI: 10.1016/j.prosdent.2018.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 12/05/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022]
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Schweiger J, Güth JF, Erdelt KJ, Edelhoff D, Schubert O. Internal porosities, retentive force, and survival of cobalt-chromium alloy clasps fabricated by selective laser-sintering. J Prosthodont Res 2019; 64:210-216. [PMID: 31680054 DOI: 10.1016/j.jpor.2019.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/04/2019] [Accepted: 07/09/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate internal porosities, retentive force values and survival of cobalt-chromium (Co-Cr) alloy clasps fabricated by direct metal laser-sintering (DMLS) and compare them to conventionally cast clasps. METHODS Embrasure clasps were digitally designed fitting teeth 35 and 36 on identical metal models (N = 32). Sixteen clasps were fabricated using DMLS (group DMLS) and another sixteen clasps were additively manufactured from wax and then cast from a Co-Cr alloy (group CAST). Internal porosities were examined using micro-focus X-ray (micro-CT) and analyzed applying Kolmogorov-Smirnov test, Mann-Whitney test, and T test (significance level: p < 0.050). A universal testing machine was used to determine the retentive force values at baseline and after 1095, 5475, 10,950 and 65,000 cycles of simulated aging. Data were analyzed employing Kolmogorov-Smirnov test, one-way ANOVA, and Scheffé's post-hoc test (significance level: p < 0.050). Survival was estimated for 65,000 cycles of artificial aging using Kaplan-Meier analysis. RESULTS Micro-CT analysis revealed a higher prevalence (p < 0.001), but a more homogeneous size and a significantly smaller mean (p = 0.009) and total volume (p < 0.001) of internal porosities for group DMLS. The groups showed mean initial retentive force values of 13.57 N (CAST) and 15.74 N (DMLS), which significantly declined over aging for group CAST (p = 0.003), but not for group DMLS (p = 0.107). Survival was considerably higher for group DMLS (93.8%) than for group CAST (43.8%) after 65,000 cycles of aging. CONCLUSIONS Clasps made by laser-sintering could be an alternative to conventional cast clasps for the fabrication of removable partial denture frameworks.
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Affiliation(s)
- Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany.
| | - Jan-Frederik Güth
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Kurt-Jürgen Erdelt
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
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Finite element analysis of implant-assisted removable partial dentures: Framework design considerations. J Prosthet Dent 2017; 118:177-186. [PMID: 28089330 DOI: 10.1016/j.prosdent.2016.10.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/31/2016] [Accepted: 10/31/2016] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Connecting an acrylic resin base to both a metal framework and a rigidly fixed implant may affect the rotational displacement of the prosthesis during loading. PURPOSE The purpose of this finite element analysis study was to analyze the effect of connecting a denture base metal framework to an implant with the aim of decreasing the rotational movement of an implant-assisted removable partial denture. MATERIAL AND METHODS A mesial occlusal rest direct retainer and a distal occlusal rest direct retainer were modeled and adapted to incorporate a modified denture base metal framework in the connection area for each model. The stress and deformation patterns of the prosthesis structure were determined using finite element analysis and compared for both situations. RESULTS A maximum von Mises stress of 923 MPa was observed on the metal framework of the prosthesis with a mesial occlusal rest, and the maximum value was 1478 MPa for the distal occlusal rest. A maximum von Mises stress of 17 MPa occurred on the acrylic resin denture base for the mesial occlusal rest, and a maximum von Mises stress of 29 MPa occurred for the distal occlusal rest. CONCLUSIONS The distal occlusal rest direct retainer is stiffer than the mesial design and undergoes approximately 66% less deformation. The modified denture base framework with an I-bar and distal occlusal rest design provides more effective support to the acrylic resin structure.
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Retentive forces and fatigue resistance of thermoplastic resin clasps. Dent Mater 2012; 28:273-8. [DOI: 10.1016/j.dental.2011.10.016] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2011] [Revised: 09/06/2011] [Accepted: 10/29/2011] [Indexed: 11/18/2022]
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Oyar P, Soyarslan C, Can G, Demirci E. Finite element analysis of stress distribution on modified retentive tips of bar clasp. Comput Methods Biomech Biomed Engin 2011; 15:609-13. [PMID: 21347911 DOI: 10.1080/10255842.2011.554406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study used finite element analysis to evaluate the retentive tips of bar clasps made from different alloys and using different designs in order to determine whether or not different materials and tip forms are suitable for bar clasp applications. Co-Cr, Ti and Type IV Au alloys were selected based on their physical and mechanical properties. The 3D finite element models of three different bar clasp retentive tip geometries prepared from Co-Cr, Ti and Type IV Au alloys were constructed using the finite element software package MSC.Marc. Analysis of a concentrated load of 5 N applied to the removable partial denture approach arms in an occlusal direction was performed. Although stress distribution and localisation within bar clasps with different retentive tips were observed to be similar and were concentrated in the approach arm, stress intensities differed in all models.
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Affiliation(s)
- P Oyar
- School of Dental Technology, Hacettepe University, Ankara, Turkey.
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Cheng H, Xu M, Zhang H, Wu W, Zheng M, Li X. Cyclic fatigue properties of cobalt-chromium alloy clasps for partial removable dental prostheses. J Prosthet Dent 2010; 104:389-96. [DOI: 10.1016/s0022-3913(10)60173-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kibi M, Ono T, Dong J, Mitta K, Gonda T, Maeda Y. Development of an RPD CAD system with finite element stress analysis. J Oral Rehabil 2010; 36:442-50. [PMID: 19554664 DOI: 10.1111/j.1365-2842.2009.01949.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The structural design of removable partial dentures (RPDs) is critical for preventing distortion of the prosthesis, protecting abutment teeth and residual ridges as well as for high masticatory performance. The aim of this study was to clarify the feasibility and utility of a computer-aided designing (CAD) system with finite element analysis (FEA) for molar teeth arrangement in unilateral distal extension base RPDs. The shapes of artificial teeth and residual ridge were measured and converted into point group data. Solid models were created from surface-modelled point group data in a 3D surface CAD format. An occlusal rim was created on the residual ridge mucosa and the occlusal rim - residual ridge mucosa model with FEA function was created. Stress distribution on the residual ridge mucosa was compared by changing the loading point. The artificial teeth were then arranged in locations with the lowest amount of stress. After building an artificial teeth - saddle - residual ridge mucosa model, stress distribution in the residual ridge mucosa was re-evaluated by simulating occlusal force. On the occlusal rim - residual ridge mucosa model, stress was reduced when the loading point was located around the buccal shelf where functional cusps of artificial teeth were charted. It was confirmed that stress distribution in the residual ridge mucosa was equalized on the artificial teeth - saddle - residual ridge mucosa model. This system might be clinically useful tool for designing RPDs if FEA-guided designing of retainers and connectors can be added.
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Affiliation(s)
- M Kibi
- Kibi Dental Clinic, Toyonaka, Japan
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Evaluation of Different Retention Systems on a Distal Extension Removable Partial Denture Associated With an Osseointegrated Implant. J Craniofac Surg 2010; 21:727-34. [DOI: 10.1097/scs.0b013e3181d8098a] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sandu L, Faur N, Bortun C. Finite element stress analysis and fatigue behavior of cast circumferential clasps. J Prosthet Dent 2007; 97:39-44. [PMID: 17280890 DOI: 10.1016/j.prosdent.2006.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Deformation and fracture of cast circumferential clasps may be a result of stresses induced during mastication. Most biomechanical clasp studies have been performed only under static conditions. There is little information regarding behavior of clasps over time. PURPOSE The purpose of this study was to evaluate stress distribution on cast circumferential clasps, and the displacements or deformations, depending on the load placement and range. Fatigue analysis was then conducted to evaluate the behavior of clasps over time. MATERIAL AND METHODS Static stress values and distribution induced in cast circumferential clasps were calculated and studied using 3-dimensional finite element experimental models for Co-Cr cast circumferential clasps. Average loads between 20 and 35 N were applied vertically along the clasp components to simulate static stress distribution during translation and rotation of the denture. After determination of stress concentration areas, the fatigue behavior of clasps was studied using finite element analysis during simulated cyclic masticatory loads (loads between 0 and 20 N included in 4500 masticatory cycles over 24 hours). RESULTS For the translation simulation, the maximum stress was 310.27 MPa, located near the lower margin of the retentive arm, and for the rotation simulation, the maximum stress was 310.31 MPa, located near the upper margin of the same arm. Under simulated static load, the magnitude of stresses found in the clasps was under the reported yield strength (640 MPa) of the Co-Cr alloy. The maximum stresses indicated the area of highest fracture risk, but fractures occurred only under a simulated cyclic mastication load representing 5.5 years of service. CONCLUSION Within the limitations of the simulation study, static stress analysis of cast circumferential clasps indicated the location of greatest fracture risk to be at the junction of the clasp arm with the body, for all situations. In addition, fatigue analysis estimated clasp degradation over time and the survival rate of the same clasps, which was found to be 5.5 years, on average.
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Affiliation(s)
- Liliana Sandu
- University School of Dentistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
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