Evaluation of bite force, quality of life, and patients' satisfaction in elderly edentulous patients using implant overdentures

Purpose@#This study aimed to compare the bite force (BF) between complete dentures and implant overdentures (IODs) retained by two mandibular implants. Additionally, we evaluated the quality of life (QoL) and patient satisfaction among individuals using IODs. In addition, the effects of demographic parameters such as age and sex, and clinical parameters such as implant length, implant diameter, attachment height, attachment color, and interimplant distance on BF, QoL, and patient satisfaction were evaluated. @*Materials and methods@#A total of 51 edentulous patients rehabilitated with the maxillary complete dentures and mandibular IODs retained by two implants were included in this study. BF was measured using a force meter pre- and post-implant in the same patients. Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP-14) and patient satisfaction was assessed with the Visual Analog Scale (VAS) questionnaires. @*Results@#It was found that BF values were statistically higher for IODs than complete dentures (P < .001). In terms of attachment height of the OHIP scores, there was a significant difference in the psychological disability and social disability domains (P < .05). When examining the change in patient satisfaction as a function of sex, it was found that mandibular retention satisfaction differed significantly by sex (P < .05), but there was no significant difference in the other domains. @*Conclusion@#Within the limitations of this study, it was observed that the BF increased after the use of IODs. Several factors, including age, interimplant distance, attachment height, and attachment color, were found to impact OHRQoL. Sex and implant diameter were identified as factors affecting patient satisfaction.

Biomechanical investigation of maxillary implant-supported full-arch prostheses produced with different framework materials: a finite elements study

PURPOSE@#. Four and six implant-supported fixed full-arch prostheses with various framework materials were assessed under different loading conditions. @*MATERIALS AND METHODS@#. In the edentulous maxilla, the implants were positioned in a configuration of four to six implant modalities. CoCr, Ti, ZrO2 , and PEEK materials were used to produce the prosthetic structure. Using finite element stress analysis, the first molar was subjected to a 200 N axial and 45° oblique force. Stresses were measured on the bone, implants, abutment screw, abutment, and prosthetic screw. The Von Mises, maximum, and minimum principal stress values were calculated and compared. RESULTS. The maximum and minimum principal stresses in bone were determined as CoCr < ZrO2 < Ti < PEEK. The Von Mises stresses on the implant, implant screw, abutment, and prosthetic screws were determined as CoCr < ZrO2 < Ti < PEEK. The highest Von Mises stress was 9584.4 Mpa in PEEK material on the prosthetic screw under 4 implant-oblique loading. The highest maximum principal stress value in bone was found to be 120.89 Mpa, for PEEK in 4 implant-oblique loading. CONCLUSION.For four and six implant-supported structures, and depending on the loading condition, the system accumulated different stresses. The distribution of stress was reduced in materials with a high elastic modulus. When choosing materials for implant-supported fixed prostheses, it is essential to consider both the number of implants and the mechanical and physical attributes of the framework material.

Influence of nano alumina coating on the flexural bond strength between zirconia and resin cement

PURPOSE: The purpose of this in vitro study is to examine the effects of a nano-structured alumina coating on the adhesion between resin cements and zirconia ceramics using a four-point bending test. MATERIALS AND METHODS: 100 pairs of zirconium bar specimens were prepared with dimensions of 25 mm × 2 mm × 5 mm and cementation surfaces of 5 mm × 2 mm. The samples were divided into 5 groups of 20 pairs each. The groups are as follows: Group I (C) – Control with no surface modification, Group II (APA) – airborne-particle-abrasion with 110 µm high-purity aluminum oxide (Al2O3) particles, Group III (ROC) – airborne-particle-abrasion with 110 µm silica modified aluminum oxide (Al₂O₃ + SiO2) particles, Group IV (TCS) – tribochemical silica coated with Al2O3 particles, and Group V (AlC) – nano alumina coating. The surface modifications were assessed on two samples selected from each group by atomic force microscopy and scanning electron microscopy. The samples were cemented with two different self-adhesive resin cements. The bending bond strength was evaluated by mechanical testing. RESULTS: According to the ANOVA results, surface treatments, different cement types, and their interactions were statistically significant (P < .05). The highest flexural bond strengths were obtained in nanostructured alumina coated zirconia surfaces (50.4 MPa) and the lowest values were obtained in the control group (12.00 MPa), both of which were cemented using a self-adhesive resin cement. CONCLUSION: The surface modifications tested in the current study affected the surface roughness and flexural bond strength of zirconia. The nano alumina coating method significantly increased the flexural bond strength of zirconia ceramics.

Effect of atmospheric plasma versus conventional surface treatments on the adhesion capability between self-adhesive resin cement and titanium surface

PURPOSE: The aim of this study was to evaluate the effects of atmospheric plasma (APL) versus conventional surface treatments on the adhesion of self-adhesive resin cement to Ti-6Al-4V alloy. MATERIALS AND METHODS: Sixty plates of machined titanium (Ti) discs were divided into five groups (n=12): 1) Untreated (CNT); 2) Sandblasted (SAB); 3) Tribochemically treated (ROC); 4) Tungsten CarbideBur (TCB); 5) APL treated (APL). SEM analysis and surface roughness (Ra) measurements were performed. Self-adhesive resin cement was bonded to the Ti surfaces and shear bond strength (SBS) tests, Ra and failure mode examinations were carried out. Data were analyzed by one-way analysis of variance and chi-squared test. RESULTS: The lowest SBS value was obtained with CNT and was significantly different from all other groups except for APL. The ROC showed the highest SBS and Ra values of all the groups. CONCLUSION: It was concluded that the effect of APL on SBS and Ra was not sufficient and it may not be a potential for promoting adhesion to titanium.

The use of definitive implant abutments for the fabrication of provisional crowns: a case series

PURPOSE: The anterior region is a challenge for most clinicians to achieve optimal esthetics with dental implants. The provisional crown is a key factor in the success of obtaining pink esthetics around restorations with single implants, by soft tissue and inter-proximal papilla shaping. Provisional abutments bring additional costs and make the treatment more expensive. Since one of the aims of the clinician is to reduce costs and find more economic ways to raise patient satisfaction, this paper describes a practical method for chair-side fabrication of non-occlusal loaded provisional crowns used by the authors for several years successfully. METHODS: Twenty two patients (9 males, 13 females; mean age, 36,72 years) with one missing anterior tooth were treated by using the presented method. Metal definitive abutments instead of provisional abutments were used and provisional crowns were fabricated on the definitive abutments for all of the patients. The marginal fit was finished on a laboratory analogue and temporarily cemented to the abutments. The marginal adaptation of the crowns was evaluated radiographically. RESULTS: The patients were all satisfied with the final appearance and no complications occurred until the implants were loaded with permanent restorations. CONCLUSIONS: The use of the definitive abutments for provisional crowns instead of provisional abutments reduces the costs and the same results can be obtained.

Flexural properties of a light-cure and a self-cure denture base materials compared to conventional alternatives

PURPOSE: A new light curing urethane dimethacrylate and a cold curing resin with simpler and faster laboratory procedures may have even improved flexural properties. This study investigated the 3-point flexural strengths and flexural moduli of two alternate base materials. MATERIALS AND METHODS: A cold curing resin (Weropress) and a light curing urethane dimethacrylate base material (Eclipse). Along with Eclipse and Weropress, a high impact resin (Lucitone199) and three conventional base materials (QC 20, Meliodent and Paladent 20) were tested. A 3-point bending test was used to determine the flexural strengths and flexural moduli. The mean displacement, maximum load, flexural modulus and flexural strength values and standard deviations for each group were analyzed by means of one-way analysis of variance (ANOVA) (with mean difference significant at the 0.05 level). Post hoc analyses (Scheffe test) were carried out to determine the differences between the groups at a confidence level of 95%. RESULTS: Flexural strength, displacement and force maximum load values of Eclipse were significantly different from other base materials. Displacement values of QC 20 were significantly different from Lucitone 199 and Weropress. CONCLUSION: The flexural properties and simpler processing technique of Eclipse system presents an advantageous alternative to conventional base resins and Weropress offers another simple laboratory technique.