Does the prosthesis weight matter? 3D finite element analysis of a fixed implant-supported prosthesis at different weights and implant numbers

PURPOSE@#. This study evaluated the influence of prosthesis weight and number of implants on the bone tissue microstrain. @*MATERIALS AND METHODS@#. Fifteen (15) fixed full-arch implant-supported prosthesis designs were created using a modeling software with different numbers of implants (4, 6, or 8) and prosthesis weights (10, 15, 20, 40, or 60 g). Each solid was imported to the computer aided engineering software and tetrahedral elements formed the mesh. The material properties were assigned to each solid with isotropic and homogeneous behavior. The friction coefficient was set as 0.3 between all the metallic interfaces, 0.65 for the cortical bone-implant interface, and 0.77 for the cancellous bone-implant interface. The standard earth gravity was defined along the Z-axis and the bone was fixed. The resulting equivalent strain was assumed as failure criteria. @*RESULTS@#. The prosthesis weight was related to the bone strain. The more implants installed, the less the amount of strain generated in the bone. The most critical situation was the use of a 60 g prosthesis supported by 4 implants with the largest calculated magnitude of 39.9 mm/mm, thereby suggesting that there was no group able to induce bone remodeling simply due to the prosthesis weight. @*CONCLUSION@#. Heavier prostheses under the effect of gravity force are related to more strain being generated around the implants. Installing more implants to support the prosthesis enables attenuating the effects observed in the bone. The simulated prostheses were not able to generate harmful values of peri-implant bone strain.

Effect of the restorative technique on load-bearing capacity, cusp deflection, and stress distribution of endodontically-treated premolars with MOD restoration

OBJECTIVES: To evaluate the influence of the restorative technique on the mechanical response of endodontically-treated upper premolars with mesio-occluso-distal (MOD) cavity. MATERIALS AND METHODS: Forty-eight premolars received MOD preparation (4 groups, n = 12) with different restorative techniques: glass ionomer cement + composite resin (the GIC group), a metallic post + composite resin (the MP group), a fiberglass post + composite resin (the FGP group), or no endodontic treatment + restoration with composite resin (the CR group). Cusp strain and load-bearing capacity were evaluated. One-way analysis of variance and the Tukey test were used with α = 5%. Finite element analysis (FEA) was used to calculate displacement and tensile stress for the teeth and restorations. RESULTS: MP showed the highest cusp (p = 0.027) deflection (24.28 ± 5.09 µm/µm), followed by FGP (20.61 ± 5.05 µm/µm), CR (17.72 ± 6.32 µm/µm), and GIC (17.62 ± 7.00 µm/µm). For load-bearing, CR (38.89 ± 3.24 N) showed the highest, followed by GIC (37.51 ± 6.69 N), FGP (29.80 ± 10.03 N), and MP (18.41 ± 4.15 N) (p = 0.001) value. FEA showed similar behavior in the restorations in all groups, while MP showed the highest stress concentration in the tooth and post. CONCLUSIONS: There is no mechanical advantage in using intraradicular posts for endodontically-treated premolars requiring MOD restoration. Filling the pulp chamber with GIC and restoring the tooth with only CR showed the most promising results for cusp deflection, failure load, and stress distribution.

Influence of thickness and incisal extension of indirect veneers on the biomechanical behavior of maxillary canine teeth

OBJECTIVES: To analyze the influence of thickness and incisal extension of indirect veneers on the stress and strain generated in maxillary canine teeth. MATERIALS AND METHODS: A 3-dimensional maxillary canine model was validated with an in vitro strain gauge and exported to computer-assisted engineering software. Materials were considered homogeneous, isotropic, and elastic. Each canine tooth was then subjected to a 0.3 and 0.8 mm reduction on the facial surface, in preparations with and without incisal covering, and restored with a lithium disilicate veneer. A 50 N load was applied at 45° to the long axis of the tooth, on the incisal third of the palatal surface of the crown. RESULTS: The results showed a mean of 218.16 µstrain of stress in the in vitro experiment, and 210.63 µstrain in finite element analysis (FEA). The stress concentration on prepared teeth was higher at the palatal root surface, with a mean value of 11.02 MPa and varying less than 3% between the preparation designs. The veneers concentrated higher stresses at the incisal third of the facial surface, with a mean of 3.88 MPa and a 40% increase in less-thick veneers. The incisal cover generated a new stress concentration area, with values over 48.18 MPa. CONCLUSIONS: The mathematical model for a maxillary canine tooth was validated using FEA. The thickness (0.3 or 0.8 mm) and the incisal covering showed no difference for the tooth structure. However, the incisal covering was harmful for the veneer, of which the greatest thickness was beneficial.