Clinical application of lithium disilicate glass ceramic cantilever resin-bonded fixed partial denture in the restoration of single anterior tooth loss / 口腔疾病防治

Objective@#To investigate the clinical effect of lithium disilicate glass ceramic cantilever resin-bonded fixed partial dentures (CRBFPDs) on single anterior tooth loss to provide a reference for the selection of restoration methods for single anterior tooth loss.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Forty-two patients with less than two anterior teeth with monomaxillary loss were included in this study. After 6 months, 1 year, 2 years, and 3 years, the aesthetic and functional effects of the restorations and the periodontal health status were evaluated, and the visual analog scale (VAS) was used to assess patient satisfaction.@*Results@#During the observation period, the connector fractured in one case within 3 months. One case had debonded within 2 years. The aesthetic restoration effect of all lithium disilicate glass ceramic CRBFPDs was categorized as Class A. The periodontal health was good, there was no clinical absorption in the soft and hard tissues of the abutment or subbridge, periodontal status according to the evaluation indices was classified as class A, and the total satisfaction rate of the patient was 100%.@*Conclusion@#For single anterior tooth loss patients, lithium disilicate glass ceramic cantilever resin-bonded fixed partial denture can achieve the restoration effect of less invasion, better adhesion, aesthetics, comfort and good biocompatibility. With high patient satisfaction, it can be considered an ideal restoration method for replacing a single anterior tooth.

Replacement of maxillary lateral incisors with digitally manufactured single tooth retained all-ceramic pontics: a clinical report / Reabilitação da região de incisivo lateral superior ausente por pôntico modelo cantiléver em cerâmica pura fabricado digitalmente: relato de caso clínico

Several treatment options for replacement of anterior missing teeth exist, varying from no-prep (no preparation) adhesive restorations to implants. Patients' biological, psychological, economic conditions or age have an effect on the treatment choice. It is important to perform the most conservative and beneficial treatment option considering the patient based factors. The aim of this case report was to demonstrate a single session, minimally invasive, cantilevered 2-unit all-ceramic restorations replacing anterior missing teeth combined with the advantages of CAD/CAM technology and materials. (AU)

Existem várias opções de tratamento para reabilitação de dentes anteriores ausentes, variando de restaurações adesivas sem preparo (sem preparação) até implantes. As condições biológicas, psicológicas, econômicas ou a idade dos pacientes têm um efeito na escolha do tratamento. É importante realizar a opção de tratamento mais conservadora e benéfica, considerando os fatores baseados no paciente. O objetivo deste relato de caso foi demonstrar em sessão única, minimamente invasiva, um cantiléver de restaurações de cerâmica pura de 2 unidades, reabilitando a região de dentes anteriores ausentes combinadas com as vantagens da tecnologia CAD/CAM.(AU)

Effects of Locking Screws with Different Head Angles on Mechanical Properties of Screw-Plate System / 医用生物力学

Objective To investigate the effects from head angle and locking times of locking screws on mechanical properties of the screw-plate system, so as to provide a theoretical basis for doctors to select appropriate locking screws and master the locking times in clinical surgical procedure. Methods Locking screws with different head angles were selected to match with locking compression plates in the case of different locking times, and cantilever bending method was used to compare the differences of mechanical properties in each group. Results There were significant differences in failure load and bending stiffness between locking compression plate and locking screw with different head angles (P0-05). The failure modes of locking screw with different head angles and different locking times were different, and the failure mode of locking screw had a positive correlation with its head angle and locking times. Conclusions The differences in mechanical properties between locking screw with different head angles and locking compression plate cannot be neglected. It is suggested that doctors should choose locking screw and locking compression plate with the best locking degree in clinical procedure, and choose the right torque wrench to lock in multiple times if necessary, thus to prevent screw loosening from affecting recovery of the patients.

Prótese Parcial Fixa em Cantilever, uma opção de tratamento: Revisão da Literatura / Fixed Partial Denture with Cantilever an option for therapeutic: Literature Review

Hoje em dia no consultório a indicação de uma prótese fixa em cantilever, ainda gera muitas dúvidas, levando o clinico inseguro, muitas vezes a sua contra indicação. Com intuito de esclarecer as características relacionadas à prótese parcial fixa em cantilever realizou- -se uma revisão de literatura. Uma busca foi realizada nas bases de dados Scielo e Pubmed usando-se as palavras-chaves: Prótese fixa, cantilever, dentes suportes. Os artigos dentro do escopo do estudo foram selecionados e pode-se concluir que estas próteses são uma excelente alternativa conservadora para restabelecimento de dentes perdidos, porém para obtenção de resultados satisfatórios com boa longevidade, especial atenção deve ser desprendida aos princípios biomecânicos dos preparos e um controle rigoroso de placa bacteriana deve ser estabelecido.

Actuality the use of Fixed Partial Denture with Cantilever until causes many doubts, making de dentist do not indicate this treatment. To making clear the characteristics relation to this prosthesis, was done a literature review. A search was performed in the Scielo and Pubmed databases using the keywords: Fixed prosthesis, cantilever, supporting teeth. The articles within the scope of the study were selected and it can be concluded that these were an alternative excellent to reestablish the follow teeth, therefore to obtain the good results with respect long-term prosthetic appliances, special attention should be dispensed to the biomechanics principles and optimal hygiene with plaque control should be established.

Influence of the amount of tooth surface preparation on the shear bond strength of zirconia cantilever single-retainer resin-bonded fixed partial denture

PURPOSE: Conventional resin-bonded fixed partial dentures (RBFPDs) are usually made with a two-retainer design. Unlike conventional RBFPDs, cantilever resin-bonded fixed partial dentures (Cantilever RBFPDs) are, for their part, made with a single-retainer design. The aim of this study was to compare the effect of tooth surface preparation on the bond strength of zirconia cantilever single-retainer RBFPDs. The objective is to evaluate the shear bond strength of these single-retainer RBFPDs bonded on 3 different amount of tooth surface preparation. MATERIALS AND METHODS: Thirty extracted bovine incisors were categorized to 3 groups (n=10), with different amounts of tooth surface preparations. Teeth were restored with single-retainer RBFPDs with different retainer surfaces: large retainer of 32 mm²; medium retainer of 22 mm²; no retainer and only a proximal connecting box of 12 mm². All RBFPDs were made of zirconia and were bonded using an adhesive system without adhesive capacity. Shear forces were applied to these restorations until debonding. RESULTS: Mean shear bond strength values for the groups I, II, and II were 2.39±0.53 MPa, 3.13±0.69 MPa, and 5.40±0.96 MPa, respectively. Statistical analyses were performed using a one-way ANOVA test with Bonferroni post-hoc test, at a significance level of 0.001. Failure modes were observed and showed a 100% adhesive fracture. CONCLUSION: It can be concluded that the preparation of large tooth surface preparation might be irrelevant. For zirconia single-retainer RBFPD, only the preparation of a proximal connecting box seems to be a reliable and minimally invasive approach. The differences are statistically significant.

Implant supported prosthetic rehabilitation of severely atrophic mandible with fixed detachable prosthesis / 대한치과보철학회지

Implant supported prostheses have improved the quality of lives of totally edentulous patients. However, there are some limitations on the number of implants related to the residual bone level or the economic concern and so on. In this situation, applying fixed detachable prosthesis with bilateral cantilevers can be considered. This clinical report describes implant supported prosthetic rehabilitation of a patient with severe bone resorption. The patient was satisfied and felt comfortable with upper complete denture and lower fixed detachable prosthesis.

Using loop connectors as an interim mode of treatment: An interdisciplinary approach.

To tackle a large midline diastema and generalized spacing existing before extraction often poses a challenge to the treating prosthodontist. The situation becomes even more complicated if the patient is a teenager, with multiple missing teeth, associated deep bite and where the jaw bone growth has not yet been completed. Possible treatment options would include a removable prosthesis, a fixed partial denture or an implant supported prosthesis. Treating such cases with a simple removable prosthesis cannot be justified if a deep bite existed which would result in posterior disocclusion. Also a conventional fixed partial denture or closure of the diastema with light cure composite (LCC), would result in a seemingly large tooth, which would be unaesthetic in appearance. Implant supported prosthesis is a possibility, if the patient’s jaw bone growth has been completed. Another simple non-invasive solution to this problem would be to fabricate a non-rigid connector using loops. This presentation describes the procedure for fabrication of an interim loop connector for a 16 year old female patient who had lost one of her maxillary central incisors as a result of trauma. Patient also had multiple spacing in the maxillary anterior teeth and an associated deep bite. Her cephalogram revealed that she had a Class III skeletal pattern. A permanent treatment at this stage was not possible due to ontoward mandibular growth pattern as revealed on the cephalogram. Hence to dodge all these problems, a simple and non-invasive treatment using loop connectors was chosen till the growth period was completed.

Implant esthetic restoration with bone graft in the extended maxillary anterior area: A case report / 대한치과보철학회지

The maxillary anteriors play an important role in esthetics. Therefore after extraction, it is crucial to preserve the hard tissue and soft tissue in order to promote esthetics of restoration. There are several challenges when restoring the maxillary anteriors via implant. Some of the challenges are be maintaining consistency with neighboring teeth in terms of shade, form, and texture : as well as having harmonious emergency with the gingival margin. In this case, a traumatized patient with crown-root fracture of the maxillary central and lateral incisors is presented. The cracked teeth were extracted, and implants were inserted with bone grafts to compensate the volume of damaged area of the maxillary anterior. Cantilever implant prosthetics were planned while precise adjustments to the gingival area were made using customized impression coping to perform the esthetic restorations. The final outcome of the treatment was satisfying in both esthetic and utilitarian perspective.

Implant esthetic restoration with bone graft in the extended maxillary anterior area: A case report / 대한치과보철학회지

The maxillary anteriors play an important role in esthetics. Therefore after extraction, it is crucial to preserve the hard tissue and soft tissue in order to promote esthetics of restoration. There are several challenges when restoring the maxillary anteriors via implant. Some of the challenges are be maintaining consistency with neighboring teeth in terms of shade, form, and texture : as well as having harmonious emergency with the gingival margin. In this case, a traumatized patient with crown-root fracture of the maxillary central and lateral incisors is presented. The cracked teeth were extracted, and implants were inserted with bone grafts to compensate the volume of damaged area of the maxillary anterior. Cantilever implant prosthetics were planned while precise adjustments to the gingival area were made using customized impression coping to perform the esthetic restorations. The final outcome of the treatment was satisfying in both esthetic and utilitarian perspective.

Surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation.</p><p><b>METHODS</b>The clinical data of 12 patients with odontoid fracture associated with atlantoaxial dislocation from January 2008 to December 2013 were retrospectively analyzed. There were 8 males and 4 females, ranging in age from 21 to 53 years with an average of 37.2 years. Eleven cases were fresh fracture and 1 case was old fracture, all patients complicated with atlantoaxial anterior dislocation. According to Anderson-D' Alonzo typing method modified by Grauer, 3 cases were type IIA, 5 cases were type IIB, 3 cases were type IIC, and 1 case was type IIIA. All patients underwent surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach. JOA score and ADI method were respectively used to evaluate the nerve function and reductive condition of atlantoaxial dislocation.</p><p><b>RESULTS</b>All patients were followed up from 6 months to 2 years with an average of 1 year and 3 months. At 1 week, 6 months after operation, and final follow up, JOA scores were 13.2±1.3, 13.5±1.4, 14.3±1.5, respectively, and these data were obviously better than that of preoperative 8.3±1.4(<0.05). Postoperative X rays and CT showed satisfactory reduction of atlantoaxial dislocation. At 1 week, 6 months after operation, and final follow up, ADI were (2.2±0.4), (2.4±0.6), (2.3±0.5) mm, respectively, and these data were obviously better than that of preoperative.(5.8±1.2) mm(<0.05). All screws and cables had good location without looseness and breakage, and bone graft got fusion.</p><p><b>CONCLUSIONS</b>Surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation is a good method, with advantage of firm fixation and high safety. It could obtain good clinical effects.</p>

Use of Tilted Implants in Prosthetic Rehabilitation / Uso de Implantes Inclinados en la Rehabilitación Protésica

Biomechanical measurements show that tilted implants, when part of a prosthetic support, avoid the use of distal cantilever units. This study included 20 women (78%) and 12 men (22%), aged over 50 years old (89%), with a total of 156 implants. A delayed occlusal loading protocol was used and the average distal implant length and diameter were 10 mm and 4 mm respectively. Patients were followed up for 2 to 5 years after prosthesis connection. The aims of this study are to analyze the use of tilted implants in prosthetic rehabilitation of maxillae to reduce cantilevers length, and to study the biomechanical implications of implant-bone interface.

Mediciones biomecánicas demuestran que los implantes inclinados, cuando son parte de un soporte de prótesis, evitan el uso de unidades distales en voladizo. Se incluyeron 20 mujeres (78%) y 12 hombres (22%), mayores de 50 años (89%), con un total de 156 implantes. Se utilizó un protocolo de carga oclusal retardada, y la longitud y el diámetro promedios del implante a nivel distal distal, fue de 10 mm y 4 mm, respectivamente. Los pacientes fueron seguidos durante 2 a 5 años después de la conexión de la prótesis. El objetivo de este estudio consiste en analizar el uso de los implantes inclinados en la rehabilitación protésica de maxilares para reducir la longitud de los voladizos, y estudiar las implicaciones biomecánicas de la interfase hueso-implante.

Construction of three-dimensional finite element models of cantilever resin-bonded bridg with three differ-ent retainer designs / 实用口腔医学杂志

Objective:To construct three-dimensional(3D)finite element models with 3 different retainer designs.Methods:The intact maxillary first premolar was scanned using Micro-CT.CT images were reconstructed through Mimics 10.0 software and the prima-ry 3D models were gained after improvement in the Geomagic 7.0 software,The abutments and prosthesis of cantilever resin-bonded bridg that could be identified by the FEA software were accomplished.Results:The 3D models of cantilever resin-bonded bridg with 3 different retainer designs were constructed successfully using the maxillary first premolar as the abutment.The mesh number were 553 959,468 134,516 748,respectively.Conclusion:Using Micro-CT and finite element analysis the 3D reconstruction of the cantile-ver resin-bonded bridges may be more accurate for biomechanical analysis.

Three dimensional finite element analysis of the stress distribution around the mandibular posterior implant during non-working movement according to the amount of cantilever

PURPOSE: In case of large horizontal discrepancy of alveolar ridge due to severe resorption, cantilevered crown is usually an unavoidable treatment modality. The purpose of this study was to evaluate the clinical criteria for the placement of the aforementioned implant crown. MATERIALS AND METHODS: The mandible model with 2 mm thick cortical bone and cancellous bone was fabricated from CT cross-section image. An external connection type implant was installed and cantilevered crowns with increasing offset of 3, 4, 5, 6, and 7 mm were connected. Vertical load and 30degrees oblique load of 300 N was applied and stress around bone and implant component was analyzed. A total of 14 cases were modeled and finite element analysis was performed using COSMOS Works (Solid works Inc, USA). RESULTS: As for the location of the vertical load, the maximum stress generated on the lingual side of the implant became larger according to the increase of offset distance. When the oblique load was applied at 30degrees, the maximum stress was generated on the buccal side and its magnitude gradually decreased as the distance of the offset load increased to 5 mm. After that point, the magnitude of implant component's stress increased gradually. CONCLUSION: The results of this study suggest that for the patient with atrophied alveolar ridge following the loss of molar teeth, von-Mises stress on implant components was the lowest under the 30degrees oblique load at the 5 mm offset point. Further studies for the various crown height and numbers of occusal points are needed to generalize the conclusion of present study.

Resistência à fratura de infraestruturas implantossuportadas confeccionadas em zircônia e com cantiléver / Fracture strength of cantilevered, implant-supported zirconia frameworks

Com a consolidação e a popularização do uso de implantes osseointegrados na reabilitação de pacientes edêntulos, um dos aspectos que merece a atenção dos profissionais na Odontologia é o desenvolvimento de novos materiais para a confecção de infraestruturas para restaurações implantossuportadas. Este trabalho in vitro verificou a resistência à fratura de infraestruturas de zircônia com cantiléver a 9 mm e 18 mm do centro do último implante. Por meio de um gabarito em cobalto-cromo, simulando uma infraestrutura de prótese com cantiléver distal, foram confeccionados 20 corpos-de-prova, que foram divididos em dois grupos (n=10), de acordo com a localização da carga aplicada durante o teste de fratura. Em uma máquina de ensaio universal, aplicou-se uma força compressiva perpendicular à infraestrutura sobre o cantiléver a 9 mm e 18 mm do centro do último implante mais distal, até ocorrer fratura da mesma, quando se verificou a carga máxima. Os resultados foram submetidos ao teste t Student, que apontou que a resistência à fratura nas infraestruturas foi significativamente superior (p < 0,0001) no grupo em que a carga foi aplicada a 9 mm, que apresentou resistência média de 590,3 N (dp=99,1 N), enquanto o grupo onde a carga foi aplicada a 18 mm apresentou o valor médio de resistência à fratura de 181,2 N (dp=32,5 N). Concluiu-se que quanto maior a extensão do cantiléver menor é a força necessária para induzir uma fratura neste tipo de infraestrutura...

Due to consolidation and popularization of dental implants in the rehabilitation of edentulous patients, the development of new materials for framework fabrication on implant-supported restorations is one aspect that deserves professional attention in Dentistry. This in vitro study examined the fracture strength of yttria-stabilized zirconia infrastructures being the load applied at two different cantilever lengths. Twenty samples were made based on a Cobalt- Chrome pattern with a distal cantilever and divided into two groups (n=10). A compressive force was applied perpendicular to the infrastructure on the cantilever at 9 mm (G9) and 18 mm (G18) from the center of the last distal implant. The maximum load to failure was registered Mean fracture strength of the yttria-stabilized zirconia infrastructures was significantly higher (Student’s t test, p < 0.0001) for G9 (590.3 ± 99.1 N) than in the G18 (181.2 ± 32.5 N). It was concluded that the greater the length of the cantilever, the lower the force needed to induce fracture on yttria-stabilized zirconia frameworks...

Clinical outcomes of implant supported fixed-hybrid prostheses in the fully edentulous arches / 대한치과보철학회지

PURPOSE: The aim of this study was to evaluate clinical outcomes of implant supported fixed-hybrid prostheses (FHP) in the fully edentulous arches. MATERIALS AND METHODS: Patients in this retrospective study were restored with fixed-hybrid prostheses supported by 4 to 6 implants and functioned more than 1 year of loading. Outcome measures were marginal bone change of implant related with sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients, tilting of posterior implant by Mann-Whitney U test and cantilever length of superstructure by regression analysis, and complication rates. Significance level was set P.05), and cantilever length was not significantly related with a marginal bone loss of implant next to cantilever (P>.05). Complication was shown in 11 patients and veneer fracture and dislodging of artificial teeth were most prevalent. CONCLUSION: Within the limitations of this study, although marginal bone loss of FHP was very little, complication rates were high. Irrespective of tilting of most posterior implants, marginal bone loss of most posterior implants next to cantilever was less than those of the other implants positioned anteriorly. Cantilever length (<17 mm) did not affect a marginal bone loss of most posterior implants.

Uma revisão do conceito all-on-four / All-on-four concept: a literature review

Grandes avanços na história da Implantodontia vêm sendo documentados, porém, existem ainda algumas limitações no tratamento reabilitador com implantes dentários, o que desafia os profissionais a buscarem novas opções de tratamento. Pacientes que apresentam atrofia maxilar necessitam de procedimentos mais complexos, como enxertos ósseos extensos. Uma proposta de tratamento mais simplificada, com menor morbidade e menor tempo de tratamento, foi desenvolvida (Sistema all-on-four). Essa proposta de tratamento se baseia na redução do número de implantes compensada por um maior espaçamento entre eles, além da utilização dos implantes distais inclinados unidos por uma estrutura rígida que favorece a biomecânica e diminui a extensão do cantiléver.

Important progresses in the history of implants have been documented, but there are still some limitations in treatment rehabilitation with dental implants, challenging professionals to search for new treatment alternatives. Patients, with maxillary atrophy demand more complex procedures such as extensive bone grafts. A basic proposal for a treatment with lower morbidity and short-term duration has been developed (The All-on-Four Concept). This is based on reducing the number of implants compensated by an enlarged space between them, besides the use of tilted distal implants connected through a rigid structure that favors biomechanics and reduces cantilever extension.

Comparison of stress patterns and displacement in conventional cantilever fixed partial denture with resin bonded cantilever fixed partial denture: A finite element analysis.

Aim: This study aims to analyze the stress patterns and displacement in the cantilever resin bonded fixed partial denture (RBFPD) and compare it with the conventional cantilever fixed partial denture using 3-D finite element analysis. Also, the effect of cement on the displacement and stress patterns in conventional cantilever fixed partial denture was to be analyzed. Materials and Methods: Three-dimensional models were prepared layer wise to depict the conventional cantilever and the cantilever RBFPD. Once the models were made, the material properties were assigned and divided into three groups. (2-conventional cantilever with resin cement, 1- conventional cantilever with GIC cement and 3-resin bonded cantilever with resin cement). Load was applied in vertical as well as lateral directions and the stress patterns along with displacement were analyzed. Results: The results revealed that the von Mises stresses in all the three groups were found to be almost equal under vertical loading. Under lateral loading, the stress was more in cantilever RBFPD. Displacement in all the three axes was significantly less in the cantilever RBFPD. Conclusion: Stress concentration in the lateral direction in cantilever RBFPD was found to be higher than the cantilever conventional group. Displacement in X, Y and Z axes was less in cantilever RBFPD.

Early intervention following an unusual late complication of cantilever nasal costochondral grafts

The concept of the cantilever bone graft, popularised by Millard (1966), and its subsequent modification by Chait et al. (1980), led to the idea of the costochondral cantilever graft for nasal dorsum augmentation. Over 150 costochondral nasal grafts have been performed at the Australian Craniofacial Unit (ACFU) over the last 25 years, and the aim of this study was to review a cohort of fractured costochondral graft in patients treated at the ACFU. The notes of patients with nasal costochondral grafts were reviewed, those with a fractured graft forming the basis of this study. Patients with Binder Syndrome accounted for nearly 30% of the cohort. Other diagnoses included Opitz syndrome, frontonasal dysplasia and other craniofacial abnormalities. 3 patients were identified with late fractured costochondral grafts. The prominent position of the nose makes it easily susceptible to trauma, and very often, low energy impact can produce fractures of the nasal bones. To the best of our knowledge, this is the first reported series of fractures of costochondral nasal grafts and their subsequent management. We would advocate early surgical management of the fractured grafts when conservative treatment has failed. In our present series, all 3 patients still maintained a satisfactory cosmetic and functional result after a mean of 8.5 years following the reparative surgery.

Diseño y fabricación de una celda de carga para mediciones fisiológicas en distracción alveolar / Design and manufacturing of a load-cell for physiological measuring in alveolar distraction

Un factor de vital importancia para el diseño mecánico de distractor osteogénico alveolar es el conocimiento de las cargas fisiológicas para la simulación computacional, existe muy poca información o trabajos previos sobre este tema. Para obtener estas cargas, ha sido desarrollada una celda de carga constituida de una lámina de acero inoxidable en voladizo instrumentada con galgas extensométricas, la cual ha sido empotrada en una férula como la usada en tratamientos de ortodoncias. Luego de calibrar la celda de cargas fisiológicas, se realizó un ensayo in vivo sobre un paciente parcialmente edéntulo del maxilar inferior, obteniéndose registros digitales de cargas para diferentes condiciones de protrusión de la lengua, retracción del labio inferior y la combinación de ambas.

A key aspect involved in the mechanical design of alveolar distractor is the accurate evaluation of physiological loading for computer simulation. Very few information and previous work are available about this subject. A stainless steel load cell having strain gauges has been developed and manufactured. This cell was attached to a splint, like those used in orthodontia. The load cell was calibrated and then an “in vivo” test was carried out on a partially-edentulous patient. Digital registers of load were obtained for three cases: tongue protrusion, lower lips retraction and a combination of both.

Effect of cantilever length and inclined implants on axial force and bending moment in implant-supported fixed prostheses / Efeito do cantilever e de implantes inclinados na força axial e momento fletor em próteses fixas implantossuportadas

Purpose: To assess the magnitude and distribution of axial forces and bending moments in abutments as a function of cantilever length and inclination of implants. Methods: Ten metallic bars simulated frameworks of fixed implant-supported prosthesis over two master models with five implants: one with all implants straight and parallel (n=5) and one with the two distal implants tilted (n=5). Strain gauges were fixed on abutments to measure deformation when a 50N-load was applied on the cantilever at 10, 15, and 20mm-distance from the distal abutment. Deformation values were transformed into axial force and bending moment and analyzed by ANOVA and Tukey test (α = 5%). Results: Comparing 10mm- to 20mm-cantilever, there was an increase of approximately 50% for axial force and of 70% for saggital bending moment. On the abutment adjacent to the cantilever, the axial force in the inclined model was 70% lower than in the straight model, and bending moments did not vary. Conclusion: The results suggest that the inclination of distal implants does not have any deleterious biomechanical effect on abutments of the tested models and may reduce the cantilever effect on force magnitude.

Objetivo: Avaliar a magnitude e a distribuição de forças axiais e momentos fletores em pilares em função da extensão do cantilever e da inclinação dos implantes. Metodologia: Dez barras metálicas simularam infraestruturas de prótese fixa implantossuportada sobre dois modelos mestre com 5 implantes: um modelo com todos os implantes retos e paralelos (n=5) e um com os dois implantes distais inclinados (n=5). Extensômetros foram fixados nos pilares para medir sua deformação quando uma carga de 50N foi aplicada no cantilever a 10, 15 e 20 mm do implante distal. Os valores de deformação foram convertidos em força axial e momento fletor e analisados por ANOVA e teste de Tukey (α = 5%). Resultados: Comparando-se as distâncias de 10 e 20 mm, houve um aumento de aproximadamente 50% da força axial e de 70% do momento fletor sagital. No pilar adjacente ao cantilever, a força axial no modelo com implantes inclinados foi 70% menor que no modelo com implantes retos, e os momentos fletores não variaram. Conclusão: Os resultados sugerem que a inclinação dos implantes distais não promoveu nenhum efeito deletério sobre os pilares nos modelos testados e pode reduzir o efeito do cantilever na magnitude da força.