Failure and complication rates of different materials, designs, and bonding techniques of ceramic cantilever resin-bonded fixed dental prostheses for restoring missing anterior teeth: A systematic review and meta-analysis

OBJECTIVES

The objective of this review was to assess clinical trials that have examined the materials, design, and bonding of ceramic cantilevered resin-bonded fixed dental prostheses (RBFDPs) as a potential option for replacing missing anterior teeth. The evaluation primarily focuses on the rate of restoration failure and clinical complications.

MATERIALS AND METHODS

A thorough search of databases including PubMed/MEDLINE, Scopus, and the Cochrane Library, was conducted. The most recent search was performed in October 2023. Clinical studies that compared ceramic cantilevered RBFDPs with double retainers or cantilevered RBFDPs using different ceramic materials or bonding systems were included. The outcome measures considered were restoration failure and complication rates.

RESULTS

Twelve studies met the eligibility criteria. The pooled data showed a statistically significant decrease in complication events when using cantilever designs compared with double retainer designs (p < 0.05); however, there were no differences found between the two designs in terms of restoration failure. The complication and failure rate of cantilever RBFDPs did not show a statistically significant difference with or without ceramic primer application before luting with phosphate monomer-containing luting resin (p > 0.05).

CONCLUSIONS

Ceramic cantilevered RBFDPs have lower complication rates compared with those with double retainers. The use of a ceramic primer prior to luting composite resin for ceramic cantilevered RBFDPs decreases the occurrence of complications and failures, although this effect was not statistically significant. Additional research is required to confirm these findings. Glass ceramic cantilever RBFDPs showed a decrease in success after 6 years, requiring ongoing monitoring, but both zirconia and glass-infiltrated alumina cantilever RBFDPs have demonstrated durability with excellent long-term success and survival rates for up to 10 and 15 years.

CLINICAL SIGNIFICANCE

Cantilever ceramic RBFDPs in the anterior region are a less invasive and valuable treatment option, providing good esthetic results.

Influence of retainer design and number of inlay boxes on the biomechanical behavior of zirconia cantilever resin bonded fixed dental prosthesis

OBJECTIVES

The development of dental adhesives with enhanced bond strength has assisted minimally invasive dentistry. The aim of this study was to evaluate the fracture load and stress distribution pattern of two retainer designs for posterior cantilever resin bonded fixed dental protheses (RBFDPs).

MATERIALS AND METHODS

Forty human mandibular molars were divided into two groups according to the retainer design; lingual coverage (LC) and occlusal coverage (OC) retainers. Each main group was then divided according to the number of inlay boxes (n = 10); one inlay and two inlay boxes. High translucency (3Y) zirconia was used to manufacture all restorations, and a dual-polymerizing adhesive resin cement was used for bonding. All specimens underwent 10,000 cycles of thermocycling (5-55°C), 240,000 cycles of dynamic loading (50 N, descending speed v = 30 mm/second, frequency = 1.6 Hz), and failure load test. Both one-way and two-way ANOVA tests were used to analyze the data. The four models included in the in-vitro study are part of the finite element analysis (FEA). When the restorations failed, maximal principal stress values on restorations, enamel, dentin, and luting resin were investigated.

RESULTS

A statistically significant (p = 0.018) higher failure load was recorded for OC1 (627.00 ± 153.4 N) than the other groups; (548.0 ± 75.6 N, 521.20 ± 11.3 N, and 509.20 ± 14.9 N for LC1, LC2, and OC2, respectively). With regard to failure mode, one inlay box designs showed more favorable failure pattern than those of two inlay boxes. FEA showed higher stress magnitude transmitted to the tooth structure in models LC2 and OC2.

CONCLUSIONS

Lingual coverage and occlusal coverage retainers are promising designs capable to withstand the normal occlusal force for cantilever RBFDP in premolar area. The use of two inlay boxes decreased the fracture load of the two retainer designs and increased the stress transmitted to the tooth and resulted in high incidence of catastrophic failure.

CLINICAL SIGNIFICANCE

Monolithic high translucent zirconia RBFDP could be considered as a viable treatment option to substitute missing posterior tooth, with improved esthetics and biocompatibility.

Effect of implant type on the stability of cantilever fixed dental prostheses: An in vitro study

OBJECTIVES

To simulate the replacement of a premolar with an implant-supported cantilever fixed dental prosthesis (ICFDP) and how the fracture load is affected by implant type, positioning within the zirconia blank, and aging protocol.

MATERIALS AND METHODS

Seventy-two ICFDPs were designed either within the enamel- or dentin layer of a 4Y-PSZ blank for bone-level and tissue-level titanium-zirconium implants. Fracture load was obtained on the cantilever at baseline (no aging) or after aging in a chewing simulator with the load applied within the implant axis (axial aging) or on the cantilever (12 groups with n = 6). A three-way ANOVA was applied (α = .05).

RESULTS

A three-way ANOVA revealed a significant effect on fracture load values of implant type (p = .006) and aging (p < .001) but not for the position within the zirconia blank (p = .847). Fracture load values significantly increased from baseline bone level (608 ± 118 N) and tissue level (880 ± 293 N) when the implants were aged axially, with higher values for tissue level (1065 ± 182 N) than bone level (797 ± 113 N) (p < .001). However, when the force was applied to the cantilever, fracture load values decreased significantly for tissue-level (493 ± 70 N), while values for bone-level implants remained stable (690 ± 135 N).

CONCLUSIONS

For ICFDPs, the use of bone-level implants is reasonable as catastrophic failures are likely to be restricted to the restoration, whereas with tissue-level implants, the transmucosal portion of the implant is susceptible to deformation, making repair more difficult.

Cardiotoxicity Assessment through a Polymer-Based Cantilever Platform: An Integrated Electro-Mechanical Screening Approach

Preclinical drug screening for cardiac toxicity has traditionally relied on observing changes in cardiomyocytes' electrical activity, primarily through invasive patch clamp techniques or non-invasive microelectrode arrays (MEA). However, relying solely on field potential duration (FPD) measurements for electrophysiological assessment can miss the full spectrum of drug-induced toxicity, as different drugs affect cardiomyocytes through various mechanisms. A more comprehensive approach, combining field potential and contractility measurements, is essential for accurate toxicity profiling, particularly for drugs targeting contractile proteins without affecting electrophysiology. However, previously proposed platform has significant limitations in terms of simultaneous measurement. The novel platform addresses these issues, offering enhanced, non-invasive evaluation of drug-induced cardiotoxicity. It features eight cantilevers with patterned strain sensors and MEA, enabling real-time monitoring of both cardiomyocyte contraction force and field potential. This system can detect minimum cardiac contraction force of ≈2 µN and field potential signals with 50 µm MEA diameter, using the same cardiomyocytes in measurements of two parameters. Testing with six drugs of varied mechanisms of action, the platform successfully identifies these mechanisms and accurately assesses toxicity profiles, including drugs not inhibiting potassium channels. This innovative approach presents a comprehensive, non-invasive method for cardiac function assessment, poised to revolutionize preclinical cardiotoxicity screening.

Mechanical stability of posterior implant-supported monolithic zirconia cantilever on titanium-base abutments. An in vitro study

PURPOSE

Investigate survival and technical complications of two-unit posterior implant-supported cantilever made of monolithic zirconia on titanium-base abutments (Zr-TiB) vs. porcelain-fused-to-metal on castable gold abutments (PFM-GA) using two different implant connections, internal butt-joint (IBJ) and internal conical (IC).

MATERIALS AND METHODS

Forty-eight implants (4.3 mm diameter) were divided into four groups (n = 12) to support 2-unit mandibular premolar cantilevers with two different materials (Zr-TiB vs. PFM-GA) and two connection types (IBJ vs. IC). Tested groups were as follows: (1) IBJ/Zr-TiB; (2) IBJ/PFM-GA; (3) IC/Zr-TiB; and (4) IC/PFM-GA. Specimens were thermomechanical aged (1,200,000 cycles, 98 N, 5-55°C) with occlusal axial load on the pontic. Catastrophic and non-catastrophic events were registered, and removal torque values measured before and after aging. Specimens surviving aging were subjected to loading until failure. Survival, total complication rates, torque loss (%), and bending moments were calculated.

RESULTS

From 48 specimens, 38 survived aging. Survival rates significantly varied from 16.7% (IC/PFM-GA) to 100% (IBJ/Zr-TiB; IBJ/PFM-GA; IC/Zr-TiB) (p < .01). Internal conical connection revealed significantly higher torque loss (IC/ZrTiB - 67%) compared to internal butt-joint (IBJ/Zr-TiB - 44%; IBJ/PFM-GA - 46%) (p < .01). Bending moments were higher in internal butt-joint connections than in internal conical (p < .05).

CONCLUSION AND CLINICAL IMPLICATIONS

Two-unit posterior implant-supported cantilever FDPs replacing mandibular premolars composed of monolithic zirconia on titanium-base abutments demonstrated higher mechanical stability compared to porcelain-fused-to-metal on castable gold abutments in this in vitro study. The internal conical connection combined with porcelain-fused-to-metal on gold abutments revealed a high number of failures; therefore, their clinical use may be considered cautiously for this indication.

Parametric Amplification of Acoustically Actuated Micro Beams Using Fringing Electrostatic Fields

We report on theoretical and experimental investigation of parametric amplification of acoustically excited vibrations in micromachined single-crystal silicon cantilevers electrostatically actuated by fringing fields. The device dynamics are analyzed using the Mathieu-Duffing equation, obtained using the Galerkin order reduction technique. Our experimental results show that omnidirectional acoustic pressure used as a noncontact source for linear harmonic driving is a convenient and versatile tool for the mechanical dynamic characterization of unpackaged, nonintegrated microstructures. The fringing field's electrostatic actuation allows for efficient parametric amplification of an acoustic signal. The suggested amplification approach may have applications in a wide variety of micromechanical devices, including resonant sensors, microphones and microphone arrays, and hearing aids. It can be used also for upward frequency tuning.

Dental implant treatment for two adjacent missing teeth in the esthetic region: A systematic review and 10-year results of a prospective comparative pilot study

OBJECTIVES

The aim of the systematic review was to compare studies on implant-supported two-unit cantilever crowns with two adjacent implant-supported crowns in the anterior region. The second aim was to assess in a 10-year prospective comparative pilot study, hard and soft peri-implant tissue changes in patients with a missing central and adjacent lateral upper incisor, treated with either an implant-supported two-unit cantilever crown or two single implant-supported crowns.

MATERIALS AND METHODS

Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched (last search March 1, 2023). Inclusion criteria were studies reporting outcomes of two missing adjacent teeth in the esthetic region and treated with a single implant-supported two-unit cantilever fixed dental prosthesis, or with two solitary implant-supported crowns. Outcome measures assessed included implant survival (primary), changes in marginal bone and gingiva level, restoration survival, subjective and objective esthetic scores, papilla volume, mid-facial marginal mucosa level, probing depth, bleeding on probing, and biological and technical complications with ≥1-year follow-up. In addition, in a 10-year pilot study, the same outcome measures were assessed of five patients with a single implant-supported two-unit cantilever crown and compared with five patients with two adjacent single implant-supported crowns in the esthetic zone.

RESULTS

Nine articles with 11 study groups were found eligible for data extraction. Meta-analyses of implant survival rates were 96.9% (mean follow-up 3.4 ± 1.4 years) for the implant-cantilever treatment and 97.6% (mean follow-up 3.0 ± 1.8 years) for the adjacent implants treatment (p = .79). In the 10-year comparative pilot study, no clinically relevant changes in hard and soft peri-implant tissue levels occurred in both groups. Patient satisfaction was also high in both groups.

CONCLUSION

Single implant-supported two-unit crowns can be a viable alternative to the placement of two adjacent single implant crowns in the esthetic zone.

Chairside posterior cantilevered fixed partial denture: Case report

The cantilevered fixed partial denture (CFPD) is gaining recognition as a sound method of replacing missing teeth in the posterior sector. The purpose of this case report is to demonstrate that this type of restoration can be performed in a single appointment. A 39-year-old patient presented herself to the dental department; she showed agenesis of the two first maxillary premolars with a totally closed mesio-distal gap and a recent loss of the 2 s maxillary premolars. This case report concerns the replacement of the upper left second premolar. The patient was treated with a mesial CFPD resting on an "onlay-like" retainer on the first molar and replacing the missing premolar with a cantilevered pontic. The dimensions of the connection's cross-section were maximized as much as possible (>20 mm2). The restoration was designed and produced using chairside CAD-CAM from a milled-reinforced glass-ceramic block (Emax CAD, Ivoclar Vivadent). The aesthetic and functional integration of the prosthesis was successful. The patient was examined at 11 months for a follow-up. At this early stage, satisfactory dental hygiene was observed, associated with a smooth prosthetic fit, no periodontal inflammation, normal probing, and no abnormal dental mobility.

Esthetic and functional rehabilitation of a patient with a bilateral cleft of lip, alveolar process, and palate with anterior all-ceramic cantilever resin-bonded fixed dental prostheses

OBJECTIVES

Addressing a single-tooth gap in the anterior region, resulting from aplasia or trauma, poses both esthetic and functional challenges. This case report presents the restoration of a young adult with a cleft, exhibiting anterior hypoplasia and aplasia in the canine and incisor regions, using all-ceramic cantilever resin-bonded fixed dental prostheses.

METHOD AND MATERIALS

After verification of esthetic and functional considerations through a diagnostic wax-up and an intraoral mock-up, three anterior all-ceramic cantilever resin-bonded fixed dental prostheses made of veneered zirconium dioxide were planned in the region of the maxillary right lateral incisor and maxillary left canine. The impression was made with an intraoral scanner. The framework fit was evaluated. Glaze firing and full adhesive cementation under rubber dam followed.

RESULTS

The final restoration met the patients' expectations and restored facial esthetics and function.

CONCLUSIONS

All-ceramic cantilever resin-bonded fixed dental prostheses offer a promising minimally invasive therapeutic option for cleft patients.

Characteristics and Functionality of Cantilevers and Scanners in Atomic Force Microscopy

In this paper, we provide a systematic review of atomic force microscopy (AFM), a fast-developing technique that embraces scanners, controllers, and cantilevers. The main objectives of this review are to analyze the available technical solutions of AFM, including the limitations and problems. The main questions the review addresses are the problems of working in contact, noncontact, and tapping AFM modes. We do not include applications of AFM but rather the design of different parts and operation modes. Since the main part of AFM is the cantilever, we focused on its operation and design. Information from scientific articles published over the last 5 years is provided. Many articles in this period disclose minor amendments in the mechanical system but suggest innovative AFM control and imaging algorithms. Some of them are based on artificial intelligence. During operation, control of cantilever dynamic characteristics can be achieved by magnetic field, electrostatic, or aerodynamic forces.

Modeling and Analysis of Wave Energy Harvester with Symmetrically Distributed Galfenol Cantilever Beams

In response to the challenges of difficult energy supply and high costs in ocean wireless sensor networks, as well as the limited working cycle of chemical batteries, a cylindrical wave energy harvester with symmetrically distributed multi-cantilever beams was designed with Galfenol sheet as the core component. The dynamic equation of the device was established, and ANSYS transient dynamic simulations and Jiles-Atherton hysteresis model analysis were conducted to develop a mathematical model of the induced electromotive force of the Galfenol cantilever beam as a function of deformation. Experimental validation demonstrated that the simulated results of the cantilever beam deformation had an average error of less than 7% compared to the experimental results, while the average error between the theoretical and experimental values of the induced electromotive force of the device was around 15%, which preliminarily verifies the validity of the mathematical model of the device, and should be subject to further research and improvement.

The Development of Optomechanical Sensors-Integrating Diffractive Optical Structures for Enhanced Sensitivity

The term optomechanical sensors describes devices based on coupling the optical and mechanical sensing principles. The presence of a target analyte leads to a mechanical change, which, in turn, determines an alteration in the light propagation. Having higher sensitivity in comparison with the individual technologies upon which they are based, the optomechanical devices are used in biosensing, humidity, temperature, and gases detection. This perspective focuses on a particular class, namely on devices based on diffractive optical structures (DOS). Many configurations have been developed, including cantilever- and MEMS-type devices, fiber Bragg grating sensors, and cavity optomechanical sensing devices. These state-of-the-art sensors operate on the principle of a mechanical transducer coupled with a diffractive element resulting in a variation in the intensity or wavelength of the diffracted light in the presence of the target analyte. Therefore, as DOS can further enhance the sensitivity and selectivity, we present the individual mechanical and optical transducing methods and demonstrate how the DOS introduction can lead to an enhanced sensitivity and selectivity. Their (low-) cost manufacturing and their integration in new sensing platforms with great adaptability across many sensing areas are discussed, being foreseen that their implementation on wider application areas will further increase.

Single-implant-supported zirconia fixed partial denture with a mesial cantilever extension: a case report

A 50-year-old man sought treatment for missing maxillary second premolar and first molar teeth. Treatment planning software demonstrated that the mesiodistal space of the edentulous ridge was insufficient to receive 2 implants. A screw-retained, single-implant-supported zirconia fixed partial denture with a mesial cantilever extension was used to replace the 2 missing posterior teeth. This prosthesis, produced with a computer-aided design/computer-aided manufacturing workflow and consisting of monolithic zirconia with a connector cross-sectional area of 16 mm², offered adequate resistance to chewing loads and still provided satisfactory esthetics at a 2-year follow-up examination.

Machine Learning-Based Modeling and Generic Design Optimization Methodology for Radio-Frequency Microelectromechanical Devices

RF-MEMS technology has evolved significantly over the years, during which various attempts have been made to tailor such devices for extreme performance by leveraging novel designs and fabrication processes, as well as integrating unique materials; however, their design optimization aspect has remained less explored. In this work, we report a computationally efficient generic design optimization methodology for RF-MEMS passive devices based on multi-objective heuristic optimization techniques, which, to the best of our knowledge, stands out as the first approach offering applicability to different RF-MEMS passives, as opposed to being customized for a single, specific component. In order to comprehensively optimize the design, both electrical and mechanical aspects of RF-MEMS device design are modeled carefully, using coupled finite element analysis (FEA). The proposed approach first generates a dataset, efficiently spanning the entire design space, based on FEA models. By coupling this dataset with machine-learning-based regression tools, we then generate surrogate models describing the output behavior of an RF-MEMS device for a given set of input variables. Finally, the developed surrogate models are subjected to a genetic algorithm-based optimizer, in order to extract the optimized device parameters. The proposed approach is validated for two case studies including RF-MEMS inductors and electrostatic switches, in which the multiple design objectives are optimized simultaneously. Moreover, the degree of conflict among various design objectives of the selected devices is studied, and corresponding sets of optimal trade-offs (pareto fronts) are extracted successfully.

Effect of different designs of minimally invasive cantilever resin-bonded fixed dental prostheses replacing mandibular premolar: Long-term fracture load and 3D finite element analysis

PURPOSE

To evaluate the fracture load and stress magnitude of different retainer designs of minimally invasive cantilever resin-bonded fixed dental prostheses (RBFDPs) after artificial aging.

MATERIALS AND METHODS

Fifty caries-free human mandibular molars were prepared as abutments for cantilever fixed dental prostheses using different retainer designs: one wing (OW), two wings (TW), inlay ring (IR), lingual coverage (LC), and occlusal coverage (OC). Computer-aided design and computer-aided manufacturing were used for milling the RBFDPs using fiber-reinforced composite (FRC), and the restorations were adhesively bonded. The specimens were then subjected to thermomechanical aging and loaded until failure. The 3D finite element analysis (FEA) was performed with five models of retainer designs similar to the in vitro test. Modified von Mises stress values on enamel, dentine, luting resin, and restorations were examined. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests (p < 0.001).

RESULTS

A statistically significant difference (p < 0.001) was found between all groups except between IR and LC and between OW and TW designs, with the highest mean failure load detected for OC (534.70 N) and the lowest detected for OW (129.80 N). With regard to failure mode, OW, TW, and LC showed more incidences of favorable failure patterns than IR and OC designs. FEA showed that FRC transmitted low stresses in tooth structure and high stresses to the luting resin.

CONCLUSIONS

LC and OC designs can be used to design cantilever RBFDPs in premolar area. IR design transmitted more stresses to the tooth structure and resulted in 30% catastrophic failure. OW and TW were below the normal occlusal force and should be carefully used.

Variable-Sensitivity Force Sensor Based on Structural Modification

Force sensors are used in a wide variety of fields. They require different measurement ranges and sensitivities depending on the operating environment because there is generally a trade-off between measurement range and sensitivity. In this study, we developed a variable-sensitivity, variable-measurement-range force sensor that utilizes structural modification, namely changes in the distance between the force application point and the detection area, and changes in the cross-sectional area. The use of shape-memory materials allows the sensor structure to be easily changed and fixed by controlling the temperature. First, we describe the theory of the proposed sensor. Then, we present prototypes and the experimental methods used to verify the performance of the sensor. We fabricated the prototypes by attaching two strain gauges to two sides of a shape-memory alloy and shape-memory polymer plates. Experiments on the prototypes show that the relationship between the applied force and the detected strain can be changed by bending the plate. This allows the sensitivity and measurement range of the sensor to be changed.

Performance Analysis of Resonantly Driven Piezoelectric Sensors Operating in Amplitude Mode and Phase Mode

Piezoelectric layers coupled to micromechanical resonators serve as the basis for sensors to detect a variety of different physical quantities. In contrast to passive sensors, actively operated sensors exploit a detuning of the resonance frequency caused by the signal to be measured. To detect the time-varying resonance frequency, the piezoelectric resonator is resonantly excited by a voltage, with this signal being modulated in both amplitude and phase by the signal to be measured. At the same time, the sensor signal is impaired by amplitude noise and phase noise caused by sensor-intrinsic noise sources that limit the reachable detectivities. This leads to the question of the optimum excitation frequency and the optimum readout type for such sensors. In this article, based on the fundamental properties of micromechanical resonators, a detailed analysis of the performance of piezoelectric resonators in amplitude mode and phase mode is presented. In particular, the sensitivities, the noise behavior, and the resulting limits of detection (LOD) are considered and analytical expressions are derived. For the first time, not only the influence of a static measurand is analyzed, but also the dynamic operation, i.e., physical quantities to be detected that quickly change over time. Accordingly, frequency-dependent limits of detection can be derived in the form of amplitude spectral densities. It is shown that the low-frequency LOD in phase mode is always about 6 dB better than the LOD in amplitude mode. In addition, the bandwidth, in terms of detectivity, is generally significantly larger in phase mode and never worse compared with the amplitude mode.

Graphene-Doped Polymethyl Methacrylate (PMMA) as a New Restorative Material in Implant-Prosthetics: In Vitro Analysis of Resistance to Mechanical Fatigue

BACKGROUND AND PURPOSE

Provisional prostheses in restorations over several implants with immediate loading in completely edentulous patients increase the risk of frequent structural fractures. An analysis was performed of the resistance to fracture of prosthetic structures with cantilevers using graphene-doped polymethyl methacrylate (PMMA) resins and CAD-CAM technology.

METHODS

A master model was produced with four implants measuring 4 mm in diameter and spaced 3 mm apart, over which 44 specimens representing three-unit fixed partial prostheses with a cantilever measuring 11 mm were placed. These structures were cemented over titanium abutments using dual cure resin cement. Twenty-two of the 44 units were manufactured from machined PMMA discs, and 22 were manufactured from PMMA doped with graphene oxide nanoparticles (PMMA-G). All of the samples were tested in a chewing simulator with a load of 80 N until fracture or 240,000 load applications.

RESULTS

The mean number of load applications required for temporary restoration until the fracture was 155,455 in the PMMA-G group versus 51,136 in the PMMA group.

CONCLUSIONS

Resistance to fracture under cyclic loading was three times greater in the PMMA-G group than in the PMMA group.

Radiographic density changes may be associated with overloading and implant loss on short implants: A 5-year analysis of a randomized controlled clinical trial

OBJECTIVES

To analyze changes in radiographic bone density around short implants with and without cantilevers at 5 years post-loading.

MATERIALS AND METHODS

Thirty-six patients with two adjacent posterior missing teeth participated in this randomized controlled clinical trial. All patients were randomly allocated to receive either two short implants (6 mm) with single-unit restorations (group TWO) or one single short implant (6 mm) with a cantilever restoration (group ONE-C). Patients were followed up at 6 months, 1, 3, and 5 years. Radiographic analysis was performed, through an arbitrary gray scale value (GSV) of the peri-implant bone, assessing the changes in radiographic density between groups and between time points. Differences in GSV between groups and over time were calculated using a generalized estimating equation to allow for adjustments for the correlation within individuals and between time points.

RESULTS

At 5 years, 26 patients remained in the study (15 in group ONE-C; 11 in group TWO). Implant survival rates were 80.4% in group TWO and 84.2% in group ONE-C (p = 0.894). The radiographic analysis revealed that GSVs increased in both groups over time (p < 0.001). The overall radiographic density was higher in group ONE-C than in group TWO in the maxilla (p = 0.030). Conversely, in the mandible, these significant differences between the groups were not found (p > 0.05). Compared to the implants that survived, the implants that failed demonstrated a distinct radiographic density pattern (p < 0.05).

CONCLUSION

Within the limitations of the present study, the radiographic bone density in the maxilla appears to increase distinctly around short implants when cantilevers are used. In contrast, the radiographic density in the mandible appears to be unaffected by the use of a cantilever, suggesting a lower threshold of adaptation to occlusal forces and thus a higher susceptibility to overload and implant loss at earlier time points.

Comparison of Tensile Bond Strength of Fixed-Fixed Versus Cantilever Single- and Double-Abutted Resin-Bonded Bridges Dental Prosthesis

Resin-bonded fixed dental prostheses (RBFDP) are minimally invasive alternatives to traditional full-coverage fixed partial dentures as they rely on resin cements for retention. This study compared and evaluated the tensile bond strength of three different resin-bonded bridge designs, namely, three-unit fixed-fixed, two-unit cantilever single abutment, and three-unit cantilever double-abutted resin-bonded bridge. Furthermore, the study attempted to compare the tensile bond strengths of the Maryland and Rochette types of resin-bonded bridges. Based on the inclusion and exclusion criteria, a total of seventy-five extracted maxillary incisors were collected and later were mounted on the acrylic blocks. Three distinct resin-bonded metal frameworks were designed: three-unit fixed-fixed (n = 30), two-unit cantilever single abutment (n = 30), and a three-unit cantilever double abutment (n = 30). The main groups were further divided into two subgroups based on the retainer design such as Rochette and Maryland. The different prosthesis designs were cemented to the prepared teeth. Later, abutment preparations were made on all specimens keeping the preparation as minimally invasive and esthetic oriented. Impression of the preparations were made using polyvinyl siloxane impression material, followed by pouring cast using die stone. A U-shaped handle of 1.5 mm diameter sprue wax with a 3 mm hole in between was attached to the occlusal surface of each pattern. The wax patterns were sprued and cast in a cobalt-chromium alloy. The castings were cleaned by sandblasting, followed by finishing and polishing. Lastly, based on the study group, specimens for Rochette bridge were perforated to provide mechanical retention between resin cement and metal, whereas the remaining 15 specimens were sandblasted on the palatal side to provide mechanical retention (Maryland bridge). In order to evaluate the tensile bond strength, the specimens were subjected to tensile forces on a universal testing machine with a uniform crosshead speed. The fixed-fixed partial prosthesis proved superior to both cantilever designs, whereas the single abutment cantilever design showed the lowest tensile bond strength. Maryland bridges uniformly showed higher bond strengths across all framework designs. Within the limitations of this study, the three-unit fixed-fixed design and Maryland bridges had greater bond strengths, implying that they may demonstrate lower clinical failure than cantilever designs and Rochette bridges.

Quantitative dynamic force microscopy with inclined tip oscillation

In the mathematical description of dynamic atomic force microscopy (AFM), the relation between the tip-surface normal interaction force, the measurement observables, and the probe excitation parameters is defined by an average of the normal force along the sampling path over the oscillation cycle. Usually, it is tacitly assumed that tip oscillation and force data recording follows the same path perpendicular to the surface. Experimentally, however, the sampling path representing the tip oscillating trajectory is often inclined with respect to the surface normal and the data recording path. Here, we extend the mathematical description of dynamic AFM to include the case of an inclined sampling path. We find that the inclination of the tip movement can have critical consequences for data interpretation, especially for measurements on nanostructured surfaces exhibiting significant lateral force components. Inclination effects are illustrated by simulation results that resemble the representative experimental conditions of measuring a heterogeneous atomic surface. We propose to measure the AFM observables along a path parallel to the oscillation direction in order to reliably recover the force along this direction.

Impact of Polymerization Technique and ZrO2 Nanoparticle Addition on the Fracture Load of Interim Implant-Supported Fixed Cantilevered Prostheses in Comparison to CAD/CAM Material

ZrO₂ nanoparticles (ZNPs) have excellent physical properties. This study investigated the fracture load of implant-supported, fixed cantilevered prosthesis materials, reinforced with ZNPs and various polymerization techniques, compared with conventional and CAD/CAM materials. Sixty specimens were made from two CAD/CAM; milled (MIL) (Ceramill TEMP); and 3D-printed (NextDent Denture 3D+). Conventional heat-polymerized acrylic resin was used to fabricate the other specimens, which were grouped according to their polymerization technique: conventionally (HP) and autoclave-polymerized (AP); conventionally cured and reinforced with 5 wt% ZNPs (HPZNP); and autoclave reinforced with 5 wt% ZNPs (APZNP). The specimens were thermocycled (5000 cycles/30 s dwell time). Each specimen was subjected to static vertical loading (1 mm/min) using a universal Instron testing machine until fracture. Scanning electron microscopy was used for fracture surface analyses. The ANOVA showed significant fracture load differences between all the tested groups (p = 0.001). The Tukey post hoc tests indicated a significant difference in fracture load between all tested groups (p ˂ 0.001) except HP vs. HPZNP and AP vs. MIL. APZNP had the lowest mean fracture load value (380.7 ± 52.8 N), while MIL had the highest (926.6 ± 82.8 N). The CAD/CAM materials exhibited the highest fracture load values, indicating that they could be used in long-term interim prostheses. Autoclave polymerization improved fracture load performance, whereas ZrO₂ nanoparticles decreased the fracture load performance of cantilevered prostheses.

Stability of Cantilever Fixed Dental Prostheses on Zirconia Implants

Background: The objective was to determine the optimal connector size and position within zirconia disks for implant-supported cantilever fixed dental prostheses (ICFDP). Methods: Two-unit ICFDPs (n = 60) were designed for the premolar region with connector sizes of either 9 or 12 mm² and positioned in the enamel or dentin layer of two different types of zirconia disks. The restorations were milled and cemented onto zirconia implants. After simulated chewing for 1.2 Mio cycles, the fracture load was measured and fractures were analyzed. Results: No fractures of ICFDPs or along the implants were detected after simulated aging. The mean fracture load values were significantly higher for a connector size of 9 mm² (951 N) compared with 12 mm² (638 N). For the zirconia material with a higher biaxial flexural strength, the fracture load values were increased from 751 to 838 N, but more implant fractures occurred. The position within the zirconia disk did not influence the fracture load. Conclusions: A connector size of 9 mm² and a zirconia material with a lower strength should be considered when designing ICFDPS on zirconia implants to reduce the risk of fractures along the intraosseous implant portion.

Influence of Digital Technologies and Framework Design on the Load to Fracture of Co-Cr Posterior Fixed Partial Denture Frameworks

PURPOSE

To compare the load to fracture of cobalt-chromium (Co-Cr) 3-unit posterior fixed partial denture (FPD) frameworks manufactured by conventional and digital techniques and to evaluate the influence of the framework design on the fracture load.

MATERIAL AND METHODS

Eighty 3-unit Co-Cr posterior FPD frameworks were fabricated with two designs: intermediate pontic (n = 40) and cantilever (n = 40). Each design was randomly divided into four groups (n = 10): casting, direct metal laser sintering, soft metal milling, and hard metal milling. After thermal cycling, all specimens were subjected to a 3-point bending test until fracture. Data were statistically analyzed using one-way ANOVA, Welch and Brown-Forsythe test, Ryan-Einot-Gabriel-Welsch F and Tamhane T2 post hoc test, Student's t test, and Weibull statistics (α = 0.05).

RESULTS

Significant differences (p < 0.001; F = 39.59) were found among intermediate pontic frameworks (except between laser sintering and hard metal milling), and cantilevered frameworks (F = 36.75) (except between laser sintering and hard metal milling, and casting and soft metal milling). The cantilever groups showed load to fracture values significantly lower than those of the intermediate pontic (p < 0.001; F = 28.29). The Weibull statistics corroborated the results.

CONCLUSIONS

Hard metal milling and laser sintered frameworks exhibited the highest load to fracture values. However, all tested frameworks demonstrated clinically acceptable load to fracture values. The framework design directly affected the fracture load, with drastically lower values in cantilevered frameworks.

Modeling and Parallel Operation of Exchange-Biased Delta-E Effect Magnetometers for Sensor Arrays

Recently, Delta-E effect magnetic field sensors based on exchange-biased magnetic multilayers have shown the potential of detecting low-frequency and small-amplitude magnetic fields. Their design is compatible with microelectromechanical system technology, potentially small, and therefore, suitable for arrays with a large number N of sensor elements. In this study, we explore the prospects and limitations for improving the detection limit by averaging the output of N sensor elements operated in parallel with a single oscillator and a single amplifier to avoid additional electronics and keep the setup compact. Measurements are performed on a two-element array of exchange-biased sensor elements to validate a signal and noise model. With the model, we estimate requirements and tolerances for sensor elements using larger N. It is found that the intrinsic noise of the sensor elements can be considered uncorrelated, and the signal amplitude is improved if the resonance frequencies differ by less than approximately half the bandwidth of the resonators. Under these conditions, the averaging results in a maximum improvement in the detection limit by a factor of N. A maximum N≈200 exists, which depends on the read-out electronics and the sensor intrinsic noise. Overall, the results indicate that significant improvement in the limit of detection is possible, and a model is presented for optimizing the design of delta-E effect sensor arrays in the future.

Magnetoelectric Response of Laminated Cantilevers Comprising a Magnetoactive Elastomer and a Piezoelectric Polymer, in Pulsed Uniform Magnetic Fields

The voltage response to pulsed uniform magnetic fields and the accompanying bending deformations of laminated cantilever structures are investigated experimentally in detail. The structures comprise a magnetoactive elastomer (MAE) slab and a commercially available piezoelectric polymer multilayer. The magnetic field is applied vertically and the laminated structures are customarily fixed in the horizontal plane or, alternatively, slightly tilted upwards or downwards. Six different MAE compositions incorporating three concentrations of carbonyl iron particles (70 wt%, 75 wt% and 80 wt%) and two elastomer matrices of different stiffness are used. The dependences of the generated voltage and the cantilever’s deflection on the composition of the MAE layer and its thickness are obtained. The appearance of the voltage between the electrodes of a piezoelectric material upon application of a magnetic field is considered as a manifestation of the direct magnetoelectric (ME) effect in a composite laminated structure. The ME voltage response increases with the increasing total quantity of the soft-magnetic filler in the MAE layer. The relationship between the generated voltage and the cantilever’s deflection is established. The highest observed peak voltage around 5.5 V is about 8.5-fold higher than previously reported values. The quasi-static ME voltage coefficient for this type of ME heterostructures is about 50 V/A in the magnetic field of ≈100 kA/m, obtained for the first time. The results could be useful for the development of magnetic field sensors and energy harvesting devices relying on these novel polymer composites.

Two short implants versus one short implant with a cantilever: 5-Year results of a randomized clinical trial

Aim

To test whether or not the use of a short implant with a cantilever results in similar clinical and radiographic outcomes compared to two adjacent short implants with single tooth reconstructions.

Materials and methods

Thirty‐six patients with two adjacent missing teeth in the posterior region were randomly assigned to receive either a single 6‐mm implant with a cantilever (ONE‐C) or two 6‐mm implants (TWO). Fixed reconstructions were inserted 3–6 months after implant placement and patients were re‐examined up to 5 years (FU‐5).

Results

A total of 26 patients were available for re‐examination at FU‐5. The survival rate amounted to 84.2% in ONE‐C and to 80.4% in TWO (inter‐group: p = .894). Technical complication rates amounted to 64.2% (ONE‐C) and to 54.4% (TWO) (inter‐group: p = 1.000). From baseline to FU‐5, the median changes of the marginal bone levels were 0.13 mm in ONE‐C and 0.05 mm in TWO (inter‐group: p = .775). Probing depth, bleeding on probing, and plaque control record values showed no significant differences between the two treatment modalities (p > .05).

Conclusions

Short implants with a cantilever render similar clinical and radiographic outcomes compared to two adjacent short implants at 5 years, however, they tend to fail at earlier time points suggesting an overload of the implants. Considering the modest survival rates, the clinical indication of either treatment option needs to be carefully evaluated. ClinicalTrials.gov (NCT01649531).

Cantilever-based differential pressure sensor with a bio-inspired bristled configuration

Inspired by the bristled wing configuration of tiny insects, we proposed a novel polyimide (PI) cantilever-based differential pressure (DP) sensor. This bristled PI cantilever with a thin metallic piezoresistor was designed to detect the pressure difference that induced the aerodynamic loading on the surface of the cantilever. Owing to the aerodynamic characteristics of the bristled cantilever, the DP-sensor with the bristled cantilever could not only retain a comparable sensitivity with that of the paddle cantilever under low differential pressures but also achieve a higher theoretical upper detection limit due to the enhanced leakage of the bristles. Experimental results indicated that the DP-sensor with bristled cantilevers extended the detection range by ∼30% in comparison with the DP-sensor with paddle cantilevers. The high sensitivity, wide detection range, and facile fabrication process of these bio-inspired DP-sensors make them promising for future applications.

Wide Bandwidth Vibration Energy Harvester with Embedded Transverse Movable Mass

One of the biggest challenges associated with vibration energy harvesters is their limited bandwidth, which reduces their effectiveness when utilized for Internet of Things applications. This paper presents a novel method of increasing the bandwidth of a cantilever beam by using an embedded transverse out-of-plane movable mass, which continuously changes the resonant frequency due to mass change and non-linear dynamic impact forces. The concept was investigated through experimentation of a movable mass, in the form of a solid sphere, that was embedded within a stationary proof mass with hollow cylindrical chambers. As the cantilever oscillated, it caused the movable mass to move out-of-plane, thus effectively altering the overall effective mass of the system during operation. This concept combined high bandwidth non-linear dynamics from the movable mass with the high power linear dynamics from the stationary proof mass. This paper experimentally investigated the frequency and power effects of acceleration, the amount of movable mass, the density of the mass, and the size of the movable mass. The results demonstrated that the bandwidth can be significantly increased from 1.5 Hz to >40 Hz with a transverse movable mass, while maintaining high power output. Dense movable masses are better for high acceleration, low frequency applications, whereas lower density masses are better for low acceleration applications.

Mask-Type Sensor for Pulse Wave and Respiration Measurements and Eye Blink Detection

This paper reports on a mask-type sensor for simultaneous pulse wave and respiration measurements and eye blink detection that uses only one sensing element. In the proposed sensor, a flexible air bag-shaped chamber whose inner pressure change can be measured by a microelectromechanical system-based piezoresistive cantilever was used as the sensing element. The air bag-shaped chamber is fabricated by wrapping a sponge pad with plastic film and polyimide tape. The polyimide tape has a hole to which the substrate with the piezoresistive cantilever adheres. By attaching the sensor device to a mask where it contacts the nose of the subject, the sensor can detect the pulses and eye blinks of the subject by detecting the vibration and displacement of the nose skin caused by these physiological parameters. Moreover, the respiration of the subject causes pressure changes in the space between the mask and the face of the subject as well as slight vibrations of the mask. Therefore, information about the respiration of the subject can be extracted from the sensor signal using either the low-frequency component (<1 Hz) or the high-frequency component (>100 Hz). This paper describes the sensor fabrication and provides demonstrations of the pulse wave and respiration measurements as well as eye blink detection using the fabricated sensor.

Biomechanical Performance of Charcot-Specific Implants

Over the past 2 decades, an increased number of diabetic Charcot neuroarthropathy reconstructions have been performed. Despite advances in implant technology, arthrodesis complication rates remain high. This study examined the biomechanical properties (4-point bending, cantilever bending, and thread pullout resistance) of intramedullary implants designed for midfoot reconstruction. Large implants included A1 (7.4 mm cannulated stainless steel beam), B1 (6.5 mm solid titanium bolt), and C1 (7.0 mm cannulated titanium beam). Smaller implants included A2 (5.4 mm cannulated stainless steel beam) and C2 (5.0 mm solid titanium bolt). Four-point bending testing compared flexural properties of the body of the implants. Cantilever-bending testing was performed with the maximum bending moment being applied off the main thread of the implant to assess the thread portion. Thread pullout strength was tested by fixing the implants to a Sawbone block on a platform, and the distal portion of the implant in a clamp connected to loading actuator. Implant A1 demonstrated higher stiffness, force to failure, and fatigue compared to implants B1 and C1 (p < .05). Pullout strength of implant A1 was higher than implant B1 (p < .05). Thread fatigue strength of implant A1 was higher than implant C1 (p < .05). Implant A2 demonstrated higher stiffness, force to failure, tip fatigue strength, and thread pullout strength compared to implant C2 (p < .05), while implant C2 demonstrated higher body fatigue failure than implant A2 (p < .05). Alteration of beam/bolt parameters influences the biomechanical performance of implants used in Charcot reconstruction. Greater stiffness resists deformation, providing improved stability. Greater static failure load and fatigue limit improves the implant's ability to withstand higher and repetitive loads before failing This study should stimulate further clinical research to determine if these biomechanical properties translate into reduced implant failure rates and improved clinical outcomes in patients with diabetic Charcot neuroarthropathy.

Quantitative Visualization of the Nanomechanical Young's Modulus of Soft Materials by Atomic Force Microscopy

The accurate measurement of nanoscale mechanical characteristics is crucial in the emerging field of soft condensed matter for industrial applications. An atomic force microscope (AFM) can be used to conduct nanoscale evaluation of the Young’s modulus on the target surface based on site-specific force spectroscopy. However, there is still a lack of well-organized study about the nanomechanical interpretation model dependence along with cantilever stiffness and radius of the tip apex for the Young’s modulus measurement on the soft materials. Here, we present the fast and accurate measurement of the Young’s modulus of a sample’s entire scan surface using the AFM in a newly developed PinPoint^TM nanomechanical mode. This approach enables simultaneous measurements of topographical data and force–distance data at each pixel within the scan area, from which quantitative visualization of the pixel-by-pixel topographical height and Young’s modulus of the entire scan surface was realized. We examined several models of contact mechanics and showed that cantilevers with proper mechanical characteristics such as stiffness and tip radius can be used with the PinPoint^TM mode to accurately evaluate the Young’s modulus depending on the sample type.

Framework Fracture of Zirconia Supported Full Arch Implant Rehabilitation: A Retrospective Evaluation of Cantilever Length and Distal Cross-Sectional Connection Area in 140 Patients Over an Up-To-7 Year Follow-Up Period

PURPOSE

To evaluate the relationship between different dimensional parameters in implant-supported monolithic zirconia fixed complete dental prostheses (IFCDPs) and the incidence of framework fracture in a large sample of cases in vivo.

MATERIALS AND METHODS

This retrospective observational study evaluated all patients rehabilitated with screw-retained zirconia IFCDPs between January 2013 and April 2019 at a private practice. The minimum follow-up period was 1 year after occlusal loading. Fractures were classified as: type I-fractures that happened between but not involving the two most posterior screw-access openings (SAOs) and type II-fractures of the distal cantilever. Cantilever length, distal connector cross-sectional area, and screw access opening length were measured using data obtained from digital scans. Logistic regression was performed to evaluate the relationship between types I and II fractures and the independent variables (dimensional parameters). Using the receiver operating characteristic curves, two parameters were identified to be useful for establishing a cut-off and predicting type II fractures.

RESULTS

A total of 180 prostheses delivered to 140 patients were analyzed. Five implants failed in three patients: three before delivery of the definitive prostheses and two after. Ten prostheses failed (5.6% prosthetic failure rate): 2 because of implant failures, and 8 because of framework fractures. Five fractures were classified as type I and three as type II. Significant associations were found between cantilever length and type I fractures (Wald = 5.772, df = 1, p = 0.016), distal connector cross-sectional area and type II fractures (Wald = 3.806, df = 1, p = 0.051), and cantilever length and the total number of fractures (Wald = 6.117, df = 1, p = 0.013).

CONCLUSION

Zirconia IFCDPs may be reliable medium-term solutions if some dimensional parameters are followed. The ratios between the cantilever length and cross-sectional connector area should be <0.51, while the ratio between the cantilever length and screw access opening length should be <1.48.

Nano-Motion Analysis for Rapid and Label Free Assessing of Cancer Cell Sensitivity to Chemotherapeutics

Background and Objectives: Optimization of chemotherapy is crucial for cancer patients. Timely and costly efficient treatments are emerging due to the increasing incidence of cancer worldwide. Here, we present a methodology of nano-motion analysis that could be developed to serve as a screening tool able to determine the best chemotherapy option for a particular patient within hours. Materials and Methods: Three different human cancer cell lines and their multidrug resistant (MDR) counterparts were analyzed with an atomic force microscope (AFM) using tipless cantilevers to adhere the cells and monitor their nano-motions. Results: The cells exposed to doxorubicin (DOX) differentially responded due to their sensitivity to this chemotherapeutic. The death of sensitive cells corresponding to the drop in signal variance occurred in less than 2 h after DOX application, while MDR cells continued to move, even showing an increase in signal variance. Conclusions: Nano-motion sensing can be developed as a screening tool that will allow simple, inexpensive and quick testing of different chemotherapeutics for each cancer patient. Further investigations on patient-derived tumor cells should confirm the method’s applicability.

Cantilever Beam with a Single Fiber Bragg Grating to Measure Temperature and Transversal Force Simultaneously

This work investigates a new interrogation method of a fiber Bragg grating (FBG) sensor based on longer and shorter wavelengths to distinguish between transversal forces and temperature variations. Calibration experiments were carried out to examine the sensor’s repeatability in response to the transversal forces and temperature changes. An automated calibration system was developed for the sensor’s characterization, calibration, and repeatability testing. Experimental results showed that the FBG sensor can provide sensor repeatability of 13.21 pm and 17.015 pm for longer and shorter wavelengths, respectively. The obtained calibration coefficients expressed in the linear model using the matrix enabled the sensor to provide accurate predictions for both measurements. Analysis of the calibration and experiment results implied improvements for future work. Overall, the new interrogation method demonstrated the potential to employ the FBG sensing technique where discrimination between two/three measurands is needed.

Analytic Optimization of Cantilevers for Photoacoustic Gas Sensor with Capacitive Transduction

We propose a new concept of photoacoustic gas sensing based on capacitive transduction which allows full integration while conserving the required characteristics of the sensor. For the sensor’s performance optimization, trial and error method is not feasible due to economic and time constrains. Therefore, we focus on a theoretical optimization of the sensor reinforced by computational methods implemented in a Python programming environment. We present an analytic model to optimize the geometry of a cantilever used as a capacitive transducer in photoacoustic spectroscopy. We describe all the physical parameters which have to be considered for this optimization (photoacoustic force, damping, mechanical susceptibility, capacitive transduction, etc.). These parameters are characterized by opposite trends. They are studied and compared to obtain geometric values for which the signal output and signal-to-noise ratio are maximized.

A finite element analysis to study the stress distribution on distal implants in an all-on-four situation in atrophic maxilla as affected by the tilt of the implants and varying cantilever lengths

Aim:

The aim of this work was to evaluate stress distribution on implants in All-on-Four situation with varying distal implant angulations (30°,40°,45°) and varying cantilever lengths (4 mm, 8 mm, 12 mm, 16 mm) in atrophic maxilla using finite element analysis.

Setting and Design:

A in vitro study, finite element analysis.

Materials and Methodology:

Three-dimensional finite element model of an edentulous maxilla restored with a prosthesis supported by four implants was reconstructed to carry out the analysis. Three different configurations, corresponding to 3 tilt degrees of the distal implants (30°, 40°, and 45°) were subjected to 4 loading simulations.

Statistical Analysis Used:

The results of the simulations obtained were evaluated in terms of Von Mises equivalent stress levels at the bone-implant interface.

Result:

From a stress-level viewpoint, the 45° model was revealed to be the most critical for peri-implant bone. In all the loading simulations, the maximum stress values were always found at the neck of the distal implants. With increasing distal implant tilt, cantilever length reduces depending on the quality of bone. At 30° angulation of distal implant a maximum cantilever length of 16 mm may be given if the quality of bone is D3 but only 8 mm cantilever may be recommended if bone quality is D4. At 40° angulation, 16 mm in D3 bone and 0 mm in D4 bone whereas at 45° angulation, it reduces to 12 mm in D3 bone and no cantilever is recommended with D4 bone.

Conclusion:

The 45° tilt induced higher stress values at the bone-implant interface, especially in the distal aspect, than the other 2 tilts analyzed. Stress values increased with increased cantilever length which was further influenced by the distal implant tilt and the quality of the bone.

Implant Bio-mechanics for Successful Implant Therapy: A Systematic Review

Background:

Dental implants are considered the best treatment option for replacement of missing teeth due to high survival rates and diverse applications. However, not all dental implant therapies are successful and some fail due to various biological and or/mechanical factors. The objective of this study was to systematically review primary studies that focus on the biomechanical properties of dental implants in order to determine which biomechanical properties are most important for success of dental implant therapy.

Materials and Methods:

An electronic database search was performed using MEDLINE (PubMed), EMBASE, Google Scholar, and CAB Abstracts. Six principal biomechanical properties were considered to prepare the search strategy for each database using key words and Boolean operators. Human and animal studies (observational studies, trials, and in vitro studies) were included in this review. Human studies that were considered eligible needed to have subjects above 18 years who received permanent restorations after implant surgery and followed up for at least 6 months after receiving permanent restorations. Studies with subjects who had absolute contraindications at the time of dental implant surgery were excluded.

Results:

In total, 28 studies were included in the review after application of the eligibility criteria; 18 in vitro studies, 5 cohort clinical studies, 3 animal studies, and 2 nonrandomized trials. Six in vitro studies assessed loss of preload, five in vitro studies assessed fatigue strength, four assessed implant abutment connection design, and one assessed implant diameter. Two nonrandomized trials assessed torque and six observational studies assessed the effect of cantilevers. Gold alloy coating of abutment screws resulted in higher preload values followed by titanium alloy coating and gold coating; there was a difference in preload values between coated and uncoated screws when tightened repeatedly. Preload values decreased as a function of time with majority of preload loss occurred within 10s of tightening. The 8-degree internal conical implant performed better than the internal hex design. Higher rate of complications (porcelain chipping, de-cementation) was observed in the cantilever groups in studies.

Conclusion:

Biomechanical properties of implants like preload, torque, cantilever design, implant abutment design have profound effects on the survival rates of dental implants. With limiations, this review provides some important parameters to consider for successful implant therapy.

Utility of measuring anterior-posterior spread to determine distal cantilever length off a fixed implant-supported full-arch prosthesis: A review of the literature

BACKGROUND

Historically, anterior-posterior (AP) spread assessments were often used to determine the length that a distal cantilever could be extended off an implant-supported fixed full-arch prosthesis.

TYPES OF STUDIES REVIEWED

The authors searched the literature for articles that used AP spread to calculate cantilever size to be constructed off implants bearing a fixed implant-supported full-arch rehabilitation.

RESULTS

The data indicate that the relationship between AP spread and cantilever length is not linear and many influences (such as beam theory, cantilever size differences in the mandible versus maxilla, number and distribution of placed implants, prosthetic materials, and framework design) need to be considered when computing cantilever length with respect to fixed implant-supported prostheses.

PRACTICAL IMPLICATIONS

Recommendations using AP spread assessments to compute cantilever lengths have not been validated by means of prospective scientific evaluations. Therefore, AP spread evaluation is just one of many issues that need to be considered when determining distal cantilever length associated with a fixed full-arch implant-bearing prosthesis.

Fabrication and Characterization of Roll-to-Roll-Coated Cantilever-Structured Touch Sensors

It is common in the field of printed electronics that polydimethylsiloxane (PDMS) be used as a dielectric layer for capacitive sensors because of its high elasticity and restoration force. However, capacitive sensors with the PDMS dielectric layer have a lower sensitivity than those with an air-gap structure that has been fabricated by the conventional micro-electromechanical system (MEMS) process. This paper presents a productive method for fabricating air-gap structures for touch sensors by roll-to-roll slot-die coating. The air-gap is formed by coating and removing a sacrificial layer. Cantilever-structured capacitive touch sensors with an air-gap are fabricated as follows: First, the bottom electrode, the dielectric layer, and the poly(vinyl alcohol) (PVA) sacrificial layer are roll-to-roll slot-die-coated on a flexible substrate. In addition, the spacer layer is spin-coated. On the sacrificial and spacer layers, the top electrode and structural layer are formed by spin-coating. Then, the air-gap and cantilever structure are made by removing the sacrificial layer in water. The cantilever-structured sensor samples are examined in terms of sensitivity, hysteresis, and repeatability. In particular, the electrical performance of the samples is compared to those with the PDMS dielectric layer. Experimental results show that the cantilever-structured sensor samples have significantly higher sensitivity compared to those with the PDMS dielectric layer.

Cantilever Type Acceleration Sensors Made by Roll-to-Roll Slot-Die Coating

This paper presents the fabrication by means of roll-to-roll slot-die coating and characterization of air gap-based cantilever type capacitive acceleration sensors. As the mass of the sensor moves in the opposite direction of the acceleration, a capacitance change occurs. The sensor is designed to have a six layers structure with an air gap. Fabrication of the air gap and cantilever was enabled by coating and removing water-soluble PVA. The bottom electrode, the dielectric layer, and the sacrificial layer were formed using the roll-to-roll slot-die coating technique. The spacer, the top electrode, and the structural layer were formed by spin coating. Several kinds of experiments were conducted for characterization of the fabricated sensor samples. Experimental results show that accelerations of up to 3.6 g can be sensed with an average sensitivity of 0.00856 %/g.

Design of a Tri-Axial Surface Micromachined MEMS Vibrating Gyroscope

Gyroscopes are one of the next killer applications for the MEMS (Micro-Electro-Mechanical-Systems) sensors industry. Many mature applications have already been developed and produced in limited volumes for the automotive, consumer, industrial, medical, and military markets. Plenty of high-volume applications, over 100 million per year, have been calling for low-cost gyroscopes. Bulk silicon is a promising candidate for low-cost gyroscopes due to its large scale availability and maturity of its manufacturing industry. Nevertheless, it is not suitable for a real monolithic IC integration and requires a dedicated packaging. New designs are supposed to eliminate the need for magnets and metal case package, and allow for a real monolithic MEMS-IC (Integrated Circuit) electronic system. In addition, a drastic cost reduction could be achieved by utilizing off-the-shelf plastic packaging with lead frames for the final assembly. The present paper puts forward the design of a novel tri-axial gyroscope based on rotating comb-drives acting as both capacitive sensors and actuators. The comb-drives are comprised of a single monolithic moving component (rotor) and fixed parts (stators). The former is made out of different concentrated masses connected by curved silicon beams in order to decouple the motion signals. The sensor was devised to be fabricated through the PolyMUMPs^® process and it is intended for working in air in order to semplify the MEMS-IC monolithic integration.

Label-free, chronological and selective detection of aggregation and fibrillization of amyloid β protein in serum by microcantilever sensor immobilizing cholesterol-incorporated liposome

To facilitate the early diagnosis of Alzheimer's disease and mild cognitive impairment patients, we developed a cantilever-based microsensor that immobilized liposomes of various phospholipids to detect a trace amount of amyloid β (Aβ) protein, and investigated its aggregation and fibrillization on model cell membranes in human serum. Three species of liposomes composed of different phospholipids of 1,2-dipalmtoyl-sn-glycero-3-phosphocholine (DPPC), DPPC/phosphatidyl ethanolamine and 1,2-dipalmitoyl-sn-glycero-3-phosphorylglycerol having varied hydrophilic groups were applied, which showed different chronological interactions with Aβ(1-40) protein and varied sensitivities of the cantilever sensor, depending on their specific electrostatic charged conditions, hydrophilicity, and membrane fluidity. 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) having short hydrophobic carbon chains confirmed to show a large interaction with Aβ(1-40) and a high sensitivity. Furthermore, the incorporation of cholesterol into DMPC was effective to selectively detect Aβ(1-40) in human serum, which effect was also checked by quartz crystal microbalance. Finally, Aβ detection of 100-pM order was expected selectively in the serum by using the developed biosensor.

MEMS-Based Pulse Wave Sensor Utilizing a Piezoresistive Cantilever

This paper reports on a microelectromechanical systems (MEMS)-based sensor for pulse wave measurement. The sensor consists of an air chamber with a thin membrane and a 300-nm thick piezoresistive cantilever placed inside the chamber. When the membrane of the chamber is in contact with the skin above a vessel of a subject, the pulse wave of the subject causes the membrane to deform, leading to a change in the chamber pressure. This pressure change results in bending of the cantilever and change in the resistance of the cantilever, hence the pulse wave of the subject can be measured by monitoring the resistance of the cantilever. In this paper, we report the sensor design and fabrication, and demonstrate the measurement of the pulse wave using the fabricated sensor. Finally, measurement of the pulse wave velocity (PWV) is demonstrated by simultaneously measuring pulse waves at two points using the two fabricated sensor devices. Furthermore, the effect of breath holding on PWV is investigated. We showed that the proposed sensor can be used to continuously measure the PWV for each pulse, which indicates the possibility of using the sensor for continuous blood pressure measurement.

Design and Fabrication of a Novel MEMS Relay with Low Actuation Voltage

Compared with conventional solid-state relays, micro-electro mechanical system (MEMS) relays have the advantages of high isolation, low contact resistance, low power consumption, and abrupt switching characteristics. Nevertheless, the widespread application of MEMS relays has been limited due to the issue of the conflict between low actuation voltages and high device performance. This article presents a novel cantilever MEMS relay with an embedded contact electrode which helps to achieve a low actuation voltage (below 8 V) and high restoring force simultaneously. Meanwhile, the contact resistance is as low as around 0.4 Ω and the reliability is verified. To thoroughly investigate and analyze the novel cantilever MEMS relay, a static theoretical model of the structure was developed. Based on the model, the cantilever MEMS relay was designed and optimized. Then, the relays were fabricated by the bulk-silicon micromachining process based on the silicon–glass anodic bonding technology. Finally, the switching performance of the novel cantilever MEMS relay was measured. Experimental results demonstrate that the proposed MEMS relay has a low actuation voltage below 8 V and high performance, which is in good agreement with the simulation results, and shows significant advantages when compared with previous reports. Therefore, the proposed MEMS relay with an embedded contact electrode is promising in practical applications.

In-Plane Vibration of Hammerhead Resonators for Chemical Sensing Applications

Thermally excited and piezoresistively detected in-plane cantilever resonators have been previously demonstrated for gas- and liquid-phase chemical and biosensing applications. In this work, the hammerhead resonator geometry, consisting of a cantilever beam supporting a wider semicircular "head", vibrating in an in-plane vibration mode, is shown to be particularly effective for gas-phase sensing with estimated limits of detection in the sub-ppm range for volatile organic compounds. This paper discusses the hammerhead resonator design and the particular advantages of the hammerhead geometry, while also presenting mechanical characterization, optical characterization, and chemical sensing results. These data highlight the distinct advantages of the hammerhead geometry over other cantilever designs.

MEMS-Based Sensor for Simultaneous Measurement of Pulse Wave and Respiration Rate

The continuous measurements of vital signs (body temperature, blood pressure, pulse wave, and respiration rate) are important in many applications across various fields, including healthcare and sports. To realize such measurements, wearable devices that cause minimal discomfort to the wearers are highly desired. Accordingly, a device that can measure multiple vital signs simultaneously using a single sensing element is important in order to reduce the number of devices attached to the wearer's body, thereby reducing user discomfort. Thus, in this study, we propose a device with a microelectromechanical systems (MEMS)-based pressure sensor that can simultaneously measure the blood pulse wave and respiration rate using only one sensing element. In particular, in the proposed device, a thin silicone tube, whose inner pressure can be measured via a piezoresistive cantilever, is attached to the nose pad of a pair of eyeglasses. On wearing the eyeglasses, the tube of sensor device is in contact with the area above the angular artery and nasal cavity of the subject, and thus, both pulse wave and breath of the subject cause the tube's inner pressure to change. We experimentally show that it is possible to extract information related to pulse wave and respiration as the low-frequency and high-frequency components of the sensor signal, respectively.

Micro-Cantilever Displacement Detection Based in Optical Fiber Tip

This work demonstrates the potential of combining a microsphere with a tip for the functionality of the contact sensor. This sensor consists of a tip aligned with the fiber core and a microsphere, which appears during tip formation. This new structure was produced using the electric arc machine. The sensor operation consists of the variation of the tip curvature, which causes a variation of the optical paths and, consequently, a change in the output signal. The study of this micro-cantilever consisted of an exploration of the contact mode. In addition, the sensor was characterized by temperature, which shows very low sensitivity and vibration. This last characterization was performed with two configurations parallel and perpendicular to the oscillating surface. The perpendicular case showed higher sensitivity and has an operating band of 0 Hz to 20 kHz. In this configuration, for frequencies up to 2 Hz, the intensity varies linearly with the frequencies and with a sensitivity of 0.032 ± 0.001 (Hz^-1). For the parallel case, the operating band was from 1.5 kHz to 7 kHz.

Tunable Coupling of a Double Quantum Dot Spin System to a Mechanical Resonator

The interaction of quantum systems with mechanical resonators is of practical interest for applications in quantum information and sensing and also of fundamental interest as hybrid quantum systems. Achieving a large and tunable interaction strength is of great importance in this field as it enables controlled access to the quantum limit of motion and coherent interactions between different quantum systems. This has been challenging with solid state spins, where typically the coupling is weak and cannot be tuned. Here we use pairs of coupled quantum dots embedded within cantilevers to achieve a high coupling strength of the singlet-triplet spin system to mechanical motion through strain. Two methods of achieving strong, tunable coupling are demonstrated. The first is through different strain-induced energy shifts for the two QDs when the cantilever vibrates, resulting in changes to the exchange interaction. The second is through a laser-driven AC Stark shift that is sensitive to strain-induced shifts of the optical transitions. Both of these mechanisms can be tuned to zero with electrical bias or laser power, respectively, and give large spin-mechanical coupling strengths.

Piezoelectric matrix-assisted ionization

We have developed a new actuation method for matrix-assisted ionization with good temporal and spatial resolution using piezoelectric cantilever. A strike from the piezoelectric bimorph cantilever on a thin metal foil was used to remove materials deposited on the opposite side facing the mass spectrometer inlet. Highly charged ions of peptides and proteins were generated from dried droplet deposits and sampled into the inlet of the mass spectrometer. A lateral resolution of 1 mm was obtained with the piezoelectric sampling configuration. Singly charged lipids and gangliosides were detected from tissue with piezoelectric matrix-assisted ionization using a silica nanoparticle co-matrix.