Although short implants are seen as alternative treatments that require additional surgical techniques in posterior region, they can be applied to anterior maxilla and various studies are required on this subject. The purpose of this study was to examine and compare the peak von Mises stress distributions in the crown, implant and abutment by using finite element analysis (FEA). Besides, a comparison of the implant-abutment connection types in the short implant with the FEA method was established. A short implant (4 × 5 mm) with a taper-lock connection and a regular implant (4 × 9 mm) with a screw connection were used in maxillary central incisor tooth area. Three different titanium abutments with 0?, 15? and 25? angles were used for abutments. In addition, in order to determine whether the stress change in short implants is due to the length of the implant-abutment connection, a screw was designed for a short implant and it was also evaluated in the same three angles. A total of three groups and nine models were generated. 114.6N load was applied to the cingulum area of the crown at an angle of 135? to the long axis of the crowns. A torque load of 25 Ncm was applied to the regular and short implant screw. Von Mises stress distributions of implants, abutments and crowns were evaluated by using FEA. Increased angle in implants increased von Mises stress values of implant, abutment and crown. Screw connection was found higher at all angles in short implants. Close values were found at different angles in taper-lock short implant crowns. The length and the angle in the bone of implant with the type of implant-abutment connection results in the accumulated stress values. Clinical Implications Taper implant-abutment connection system was found to be more promising in terms of stress accumulation in crowns. Although the amount of stress on the abutment increased due to the length of the implant in short implants, taper implant-abutment connection system slightly reduced related to this increase.
References
[1]
Esposito, M., Murray-Curtis, L., Grusovin, M.G., et al. (2007) Interventions for Replacing Missing Teeth: Different Types of Dental Implants. Cochrane Database of Systematic Reviews, 4, Cd003815. https://doi.org/10.1002/14651858.CD003815.pub3
[2]
Jokstad, A., Braegger, U., Brunski, J.B., et al. (2003) Quality of Dental Implants. International Dental Journal, 53, 409-443. https://doi.org/10.1111/j.1875-595X.2003.tb00918.x
[3]
Wical, K.E. and Swoope, C.C. (1974) Studies of Residual Ridge Resorption. Part I. Use of Panoramic Radiographs for Evaluation and Classification of Mandibular Resorption. Journal of Prosthetic Dentistry, 32, 7-12. https://doi.org/10.1016/0022-3913(74)90093-6
[4]
Pietrokovski, J., Sorin, S. and Hirschfeld, Z. (1976) The Residual Ridge in Partially Edentulous Patients. Journal of Prosthetic Dentistry, 36, 150-158. https://doi.org/10.1016/0022-3913(76)90136-0
[5]
Pietrokovski, J. and Massler, M. (1967) Alveolar Ridge Resorption Following Tooth Extraction. Journal of Prosthetic Dentistry, 17, 21-27. https://doi.org/10.1016/0022-3913(67)90046-7
[6]
Pietrokovski, J. (1975) The Bony Residual Ridge in Man. Journal of Prosthetic Dentistry, 34, 456-462. https://doi.org/10.1016/0022-3913(75)90166-3
[7]
Parkinson, C.F. (1978) Similarities in Resorption Patterns of Maxillary and Mandibular Ridges. Journal of Prosthetic Dentistry, 39, 598-602. https://doi.org/10.1016/S0022-3913(78)80066-3
[8]
Lazarescu, F. (2019) Comprehensive Esthetic Dentistry. Quintessence Publishing Co. Ltd., New Malden, 530-556.
[9]
Saadoun, A.P., LeGall, M. and Touati, B. (1999) Selection and Ideal Tridimensional Implant Position for Soft Tissue Aesthetics. Practical Periodontics and Aesthetic Dentistry, 11, 1063-1072.
Misch, C. and Bidez, M. (1997) Occlusion and Crestal Bone Resorption: Etiology and Treatment Planning Strategies for Implants. In: McNeill, C., Ed., Science and Practice of Occlusion, Quintessence Publishing Co Inc., Chicago, 473-486.
[12]
Ha, C.-Y., Lim, Y.-J., Kim, M.-J. and Choi, J.-H. (2011) The Influence of Abutment Angulation on Screw Loosening of Implants in the Anterior Maxilla. The International Journal of Oral & Maxillofacial Implants, 26, 45-55.
[13]
Geng, J.P., Tan, K.B. and Liu, G.R. (2001) Application of Finite Element Analysis in Implant Dentistry: A Review of the Literature. Journal of Prosthetic Dentistry, 85, 585-598. https://doi.org/10.1067/mpr.2001.115251
Trivedi, S. (2014) Finite Element Analysis: A Boon to Dentistry. Journal of Oral Biology and Craniofacial Research, 4, 200-203. https://doi.org/10.1016/j.jobcr.2014.11.008
[16]
Rubin, C., Krishnamurthy, N., Capilouto, E. and Yi, H. (1983) Stress Analysis of the Human Tooth Using a Three-Dimensional Finite Element Model. Journal of Dental Research, 62, 82-86. https://doi.org/10.1177/00220345830620021701
[17]
Ho, M.H., Lee, S.Y., Chen, H.H. and Lee, M.C. (1994) Three-Dimensional Finite Element Analysis of the Effects of Posts on Stress Distribution in Dentin. Journal of Prosthetic Dentistry, 72, 367-372. https://doi.org/10.1016/0022-3913(94)90555-X
[18]
Karabudak, F., Zamanlou, H., Yesildal, R., et al. (2014) Comparison of Titanium and Zirconia Dental Implants of Straight and Angled Abutments’ Stress Analysis. Engineer & the Machinery Magazine, 55, 35-42.
[19]
Bayraktar, M., Gultekin, B.A., Yalcin, S. and Mijiritsky, E. (2013) Effect of Crown to Implant Ratio and Implant Dimensions on Periimplant Stress of Splinted Implant-Supported Crowns: A Finite Element Analysis. Implant Dentistry, 22, 406-413. https://doi.org/10.1097/ID.0b013e31829c224d
[20]
Kaleli, N., Sarac, D., Külünk, S. and Oztürk, O. (2018) Effect of Different Restorative Crown and Customized Abutment Materials on Stress Distribution in Single Implants and Peripheral Bone: A Three-Dimensional Finite Element Analysis Study. Journal of Prosthetic Dentistry, 119, 437-445. https://doi.org/10.1016/j.prosdent.2017.03.008
[21]
Nelson, S.J. (2010) Wheeler’s Dental Anatomy, Physiology, and Occlusion. 9th Edition, Saunders Elsevier, St Louis, 99-106.
[22]
Lee, H., Park, S. and Noh, G. (2019) Biomechanical Analysis of 4 Types of Short Dental Implants in a Resorbed Mandible. Journal of Prosthetic Dentistry, 121, 659-670. https://doi.org/10.1016/j.prosdent.2018.07.013
[23]
Esposito, M., Grusovin, M.G., Rees, J., et al. (2010) Interventions for Replacing Missing Teeth: Augmentation Procedures of the Maxillary Sinus. Cochrane Database of Systematic Reviews, 3, Cd008397. https://doi.org/10.1002/14651858.CD008397
[24]
Esposito, M., Grusovin, M.G., Felice, P., et al. (2009) Interventions for Replacing Missing Teeth: Horizontal and Vertical Bone Augmentation Techniques for Dental Implant Treatment. Cochrane Database of Systematic Reviews, 4, Cd003607. https://doi.org/10.1002/14651858.CD003607.pub4
[25]
Griffin, T.J. and Cheung, W.S. (2004) The Use of Short, Wide Implants in Posterior Areas with Reduced Bone Height: A Retrospective Investigation. Journal of Prosthetic Dentistry, 92, 139-144. https://doi.org/10.1016/j.prosdent.2004.05.010
[26]
Misch, C.E., Steignga, J., Barboza, E., et al. (2006) Short Dental Implants in Posterior Partial Edentulism: A Multicenter Retrospective 6-Year Case Series Study. Journal of Periodontology, 77, 1340-1347. https://doi.org/10.1902/jop.2006.050402
[27]
Ravidà, A., Barootchi, S., Askar, H., et al. (2019) Long-Term Effectiveness of Extra-Short (≤ 6 mm) Dental Implants: A Systematic Review. The International Journal of Oral & Maxillofacial Implants, 34, 68-84. https://doi.org/10.11607/jomi.6893
[28]
Gujjarlapudi, M.C., Nunna, N.V., Manne, S.D., et al. (2013) Predicting Peri-Implant Stresses around Titanium and Zirconium Dental Implants—A Finite Element Analysis. The Journal of the Indian Prosthodontic Society, 13, 196-204. https://doi.org/10.1007/s13191-013-0257-7
[29]
Sato, Y., Teixeira, E.R., Tsuga, K. and Shindoi, N. (1999) The Effectiveness of a New Algorithm on a Three-Dimensional Finite Element Model Construction of Bone Trabeculae in Implant Biomechanics. Journal of Oral Rehabilitation, 26, 640-643. https://doi.org/10.1046/j.1365-2842.1999.00442.x
[30]
Bal, B.T., Caglar, A., Aydin, C., et al. (2013) Finite Element Analysis of Stress Distribution with Splinted and Nonsplinted Maxillary Anterior Fixed Prostheses Supported by Zirconia or Titanium Implants. The International Journal of Oral & Maxillofacial Implants, 28, e27-e38. https://doi.org/10.11607/jomi.2442
[31]
Caglar, A., Bal, B.T., Aydin, C., et al. (2010) Evaluation of Stresses Occurring on Three Different Zirconia Dental Implants: Three-Dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 25, 95-103.
[32]
Caglar, A., Bal, B.T., Karakoca, S., et al. (2011) Three-Dimensional Finite Element Analysis of Titanium and Yttrium-Stabilized Zirconium Dioxide Abutments and Implants. The International Journal of Oral & Maxillofacial Implants, 26, 961-969.
[33]
Sahin, S., Cehreli, M.C. and Yalcin, E. (2002) The Influence of Functional Forces on the Biomechanics of Implant-Supported Prostheses—A Review. Journal of Dentistry, 30, 271-282. https://doi.org/10.1016/S0300-5712(02)00065-9
[34]
Lin, D., Li, Q., Li, W. and Swain, M. (2009) Dental Implant Induced Bone Remodeling and Associated Algorithms. Journal of the Mechanical Behavior of Biomedical Materials, 2, 410-432. https://doi.org/10.1016/j.jmbbm.2008.11.007
[35]
Sannino, G., Pozzi, A., Schiavetti, R. and Barlattani, A. (2012) Stress Distribution on a Three-Unit Implant-Supported Zirconia Framework. A 3D Finite Element Analysis and Fatigue Test. Oral & Implantology (Rome), 5, 11-20.
[36]
Meijer, H.J., Starmans, F.J., Bosman, F. and Steen, W.H. (1993) A Comparison of Three Finite Element Models of an Edentulous Mandible Provided with Implants. Journal of Oral Rehabilitation, 20, 147-157. https://doi.org/10.1111/j.1365-2842.1993.tb01598.x
[37]
Teixeira, E.R., Sato, Y., Akagawa, Y. and Shindoi, N. (1998) A Comparative Evaluation of Mandibular Finite Element Models with Different Lengths and Elements for Implant Biomechanics. Journal of Oral Rehabilitation, 25, 299-303. https://doi.org/10.1111/j.1365-2842.1998.00244.x
[38]
Tada, S., Stegaroiu, R., Kitamura, E., Miyakawa, O. and Kusakari, H. (2003) Influence of Implant Design and Bone Quality on Stress/Strain Distribution in Bone around Implants: A 3-Dimensional Finite Element Analysis. The International Journal of Oral & Maxillofacial Implants, 18, 357-368.
[39]
Saab, X.E., Griggs, J.A., Powers, J.M. and Engelmeier, R.L. (2007) Effect of Abutment Angulation on the Strain on the Bone around an Implant in the Anterior Maxilla: A Finite Element Study. Journal of Prosthetic Dentistry, 97, 85-92. https://doi.org/10.1016/j.prosdent.2006.12.002
[40]
Paul, S., Padmanabhan, T.V. and Swarup, S. (2013) Comparison of Strain Generated in Bone by “Platform-Switched” and “Non-Platform-Switched” Implants with Straight and Angulated Abutments under Vertical and Angulated Load: A Finite Element Analysis Study. Indian Journal of Dental Research, 24, 8-13. https://doi.org/10.4103/0970-9290.114913
[41]
Sadrimanesh, R., Siadat, H., Sadr-Eshkevari, P., et al. (2012) Alveolar Bone Stress around Implants with Different Abutment Angulation: An FE-Analysis of Anterior Maxilla. Implant Dentistry, 21, 196-201. https://doi.org/10.1097/ID.0b013e31824c302e
[42]
Hasan, I., Bourauel, C., Keilig, L., Reimann, S. and Heinemann, F. (2011) The Influence of Implant Number and Abutment Design on the Biomechanical Behaviour of Bone for an Implant-Supported Fixed Prosthesis: A Finite Element Study in the Upper Anterior Region. Computer Methods in Biomechanics and Biomedical Engineering, 14, 1113-1116. https://doi.org/10.1080/10255842.2010.515212
[43]
Clelland, N.L., Lee, J.K., Bimbenet, O.C. and Brantley, W.A. (1995) A Three-Dimensional Finite Element Stress Analysis of Angled Abutments for an Implant Placed in the Anterior Maxilla. Journal of Prosthodontics, 4, 95-100. https://doi.org/10.1111/j.1532-849X.1995.tb00323.x
[44]
Tian, K., Chen, J., Han, L., et al. (2012) Angled Abutments Result in Increased or Decreased Stress on Surrounding Bone of Single-Unit Dental Implants: A Finite Element Analysis. Medical Engineering & Physics, 34, 1526-1531. https://doi.org/10.1016/j.medengphy.2012.10.003
[45]
Arun Kumar, G., Mahesh, B. and George, D. (2013) Three Dimensional Finite Element Analysis of Stress Distribution around Implant with Straight and Angled Abutments in Different Bone Qualities. The Journal of the Indian Prosthodontic Society, 13, 466-472. https://doi.org/10.1007/s13191-012-0242-6
[46]
Miura, S., Kasahara, S., Yamauchi, S. and Egusa, H. (2018) Effect of Finish Line Design on Stress Distribution in Bilayer and Monolithic Zirconia Crowns: A Three-Dimensional Finite Element Analysis Study. European Journal of Oral Sciences, 126, 159-165. https://doi.org/10.1111/eos.12402
[47]
Yu, H., Chen, Y.H., Cheng, H. and Sawase, T. (2019) Finish-Line Designs for Ceramic Crowns: A Systematic Review and Meta-Analysis. Journal of Prosthetic Dentistry, 122, 22-30. https://doi.org/10.1016/j.prosdent.2018.10.002
[48]
Shillingburg, H.T., Hobo, S., Whitsett, L.D., et al. (1997) Fundamentals of Fixed Prosthodontics. 3rd Edition, Quintessence Publishing Co Inc., Carol Stream, 433-454.
[49]
Dykema, R.W., Goodacre, C.J. and Phillips, R.W. (1986) Johnston’s Modern Practice in Fixed Prosthodontics. 4th Edition, WB Saunders, Philadelphia, 24, 36-39, 249-255, 277-284.
[50]
Malone, W.F.P. and Koth, D.L. (1989) Tylman’s Theory and Practice of Fixed Prosthodontics. 8th Edition, Ishiyaku EuroAmerica Inc., St. Louis, 120.
[51]
Rosenstiel, S.F., Land, M. and Fujimoto, J. (2016) Contemporary Fixed Prosthodontics. 5th Edition, Elsevier, St. Louis, 264-267.
[52]
Chiche, G.J. and Pinault, A. (1994) All-Ceramic Crowns and Foil Crowns. In: Mclean, J.W., Jeansonne, E.E., Chiche, G.J. and Pinault, A., Eds., Esthetics of Anterior Fixed Prosthodontics, Quintessence Publishing Co Inc., Chicago, 102-103.
[53]
Goodacre, C.J., Campagni, W.V. and Aquilino, S.A. (2001) Tooth Preparations for Complete Crowns: An Art Form Based on Scientific Principles. Journal of Prosthetic Dentistry, 85, 363-376. https://doi.org/10.1067/mpr.2001.114685
[54]
Wilson, A.H. and Chan, D.C. (1994) The Relationship between Preparation Convergence and Retention of Extracoronal Retainers. Journal of Prosthodontics, 3, 74-78. https://doi.org/10.1111/j.1532-849X.1994.tb00132.x
[55]
Tiu, J., Al-Amleh, B., Waddell, J.N. and Duncan, W.J. (2015) Clinical Tooth Preparations and Associated Measuring Methods: A Systematic Review. Journal of Prosthetic Dentistry, 113, 175-184. https://doi.org/10.1016/j.prosdent.2014.09.007
[56]
Maxwell, A.W., Blank, L.W. and Pelleu, G.B. (1990) Effect of Crown Preparation Height on the Retention and Resistance of Gold Castings. General Dentistry, 38, 200-202.
[57]
Woolsey, G.D. and Matich, J.A. (1978) The Effect of Axial Grooves on the Resistance form of Cast Restorations. The Journal of the American Dental Association, 97, 978-980. https://doi.org/10.14219/jada.archive.1978.0429
[58]
Lekholm, U., Gunne, J., Henry, P., et al. (1999) Survival of the Branemark Implant in Partially Edentulous Jaws: A 10-Year Prospective Multicenter Study. The International Journal of Oral & Maxillofacial Implants, 14, 639-645.
[59]
Niinomi, M. (1998) Mechanical Properties of Biomedical Titanium Alloys. Materials Science and Engineering: A, 243, 231-236. https://doi.org/10.1016/S0921-5093(97)00806-X
[60]
Bourauel, C., Aitlahrach, M., Heinemann, F. and Hasan, I. (2012) Biomechanical Finite Element Analysis of Small Diameter and Short Dental Implants: Extensive Study of Commercial Implants. Biomedical Technician (Berl), 57, 21-32. https://doi.org/10.1515/bmt-2011-0047
[61]
Bozkaya, D., Muftu, S. and Muftu, A. (2004) Evaluation of Load Transfer Characteristics of Five Different Implants in Compact Bone at Different Load Levels by Finite Elements Analysis. Journal of Prosthetic Dentistry, 92, 523-530. https://doi.org/10.1016/j.prosdent.2004.07.024
[62]
Guguloth, H., Duggineni, C.R., Chitturi, R.K., et al. (2019) Correlation between Abutment Angulation and Off-Axial Stresses on Biomechanical Behavior of Titanium and Zirconium Implants in the Anterior Maxilla: A Three-Dimensional Finite Element Analysis Study. The Journal of the Indian Prosthodontic Society, 19, 353-361. https://doi.org/10.4103/jips.jips_268_19
[63]
de Souza Rendohl, E. and Brandt, W.C. (2020) Stress Distribution with Extra-Short Implants in an Angled Frictional System: A Finite Element Analysis Study. Journal of Prosthetic Dentistry, 124, 728.e1-728.e9. https://doi.org/10.1016/j.prosdent.2020.04.022
[64]
García-Braz, S.H., Prados-Privado, M., Zanatta, L.C.S., et al. (2019) A Finite Element Analysis to Compare Stress Distribution on Extra-Short Implants with Two Different Internal Connections. Journal of Clinical Medicine, 8, 1103. https://doi.org/10.3390/jcm8081103
[65]
Wu, D., Tian, K., Chen, J., et al. (2015) A Further Finite Element Stress Analysis of Angled Abutments for an Implant Placed in the Anterior Maxilla. Computational and Mathematical Methods in Medicine, 2015, 560-645. https://doi.org/10.1155/2015/560645
[66]
Yu, S.-H., Park, W.-H., Park, J.-J. and Lee, Y.-S. (2006) A Study on the Various Implant Systems Using the Finite Element Stress Analysis. The Journal of Korean Academy of Prosthodontics, 44, 207-216.
[67]
Franco-Tabares, S., Stenport, V.F., Hjalmarsson, L. and Johansson, C.B. (2018) Limited Effect of Cement Material on Stress Distribution of a Monolithic Translucent Zirconia Crown: A Three-Dimensional Finite Element Analysis. The International Journal of Prosthodontics, 31, 67-70. https://doi.org/10.11607/ijp.5469
[68]
Sertg, A. (1997) Finite Element Analysis Study of the Effect of Superstructure Material on Stress Distribution in an Implant-Supported Fixed Prosthesis. The International Journal of Prosthodontics, 10, 19-27.
[69]
Sevimay, M., Turhan, F., Kiliarslan, M.A. and Eskitascioglu, G. (2005) Three-Dimensional Finite Element Analysis of the Effect of Different Bone Quality on Stress Distribution in an Implant-Supported Crown. Journal of Prosthetic Dentistry, 93, 227-234. https://doi.org/10.1016/j.prosdent.2004.12.019