Three-dimensional stress analysis of tooth/lmplant-retained long-span fixed dentures.

PURPOSE The aim was to assess the influence of connection of the canine teeth to implant-retained long-span fixed dentures on stress in mandibular bone using finite element analysis. MATERIALS AND METHODS Each 3-dimensional model included bone, 6 implants, both natural canines, and superstructures. Each model simulated 1 of 4 prosthetic designs: a tooth/implant-retained 1-piece superstructure (One-piece), 3-piece superstructures with an anterior and 2 posterior segments with unconnected teeth (UnConnect), 3-piece superstructures with the teeth connected to the posterior segments (PostConnect), and 3-piece superstructures with the teeth connected to the anterior segment (AntConnect). A nonlinear elastic modulus was applied to the periodontal ligament (PDL). Maximum intercuspal (IP), canine-protected (CP), and group-function (GF) occlusions were simulated. RESULTS The maximum stresses in the peri-implant regions of the bone were lower for the One-piece than for the other superstructures. In PostConnect and AntConnect, the maximum stress in the PDL was lower than that in UnConnect, but the stress in the peri-implant bone was comparable in those 3 models. The stresses were lower in the GF model than in the CP model. The stress created in the peri-implant bone was insensitive to the modes of the teeth/implant connection in long-span fixed dentures. CONCLUSION Within the limitation of the mechanical analysis, it is suggested that the connection of the canine tooth to the implant-retained long-span superstructures is an acceptable option in partially edentulous patients.

[1]  J. Kent,et al.  Prospective evaluation of implants connected to teeth. , 2002, The International journal of oral & maxillofacial implants.

[2]  Rieder Ce,et al.  A survey of natural tooth abutment intrusion with implant-connected fixed partial dentures. , 1993 .

[3]  L. T. García,et al.  Natural tooth intrusion phenomenon with implants: a survey. , 1998, The International journal of oral & maxillofacial implants.

[4]  C. Rieder,et al.  A survey of natural tooth abutment intrusion with implant-connected fixed partial dentures. , 1993, The International journal of periodontics & restorative dentistry.

[5]  D Lundgren,et al.  Occlusal force pattern during chewing and biting in dentitions restored with fixed bridges of cross-arch extension. II. Unilateral posterior two-unit cantilevers. , 1986, Journal of oral rehabilitation.

[6]  C Bourauel,et al.  Experimental and numerical determination of initial tooth mobility and material properties of the periodontal ligament in rat molar specimens. , 2003, European journal of orthodontics.

[7]  M. Quirynen,et al.  Freestanding and tooth-implant connected prostheses in the treatment of partially edentulous patients Part II: An up to 15-years radiographic evaluation. , 2001, Clinical oral implants research.

[8]  U. Belser,et al.  Mechanical characterization of bovine periodontal ligament. , 2002, Journal of periodontal research.

[9]  Hisao Oka,et al.  Tooth Mobility Measurement of Dental Implants , 1993 .

[10]  J. Gunne,et al.  Bridges supported by free-standing implants versus bridges supported by tooth and implant. A five-year prospective study. , 1995, Clinical oral implants research.

[11]  N. Lang,et al.  Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after four to five years of function. , 2001, Clinical oral implants research.

[12]  T. Josefsson,et al.  Tooth-implant supported fixed prostheses: a retrospective multicenter study. , 2001, The International journal of prosthodontics.

[13]  C G Sheets,et al.  Tooth intrusion in implant-assisted prostheses. , 1997, The Journal of prosthetic dentistry.

[14]  Chun-Li Lin,et al.  Nonlinear finite element analysis of a splinted implant with various connectors and occlusal forces. , 2003, The International journal of oral & maxillofacial implants.

[15]  D. R. F. West,et al.  Encyclopedia of materials science and engineering , 1989 .

[16]  R L Mullen,et al.  Theoretical study of the effects of tooth and implant mobility differences on occlusal force transmission in tooth/implant-supported partial prostheses. , 1997, The Journal of prosthetic dentistry.

[17]  T. Takamizawa Studies on the Co-relative and Individual Biting Forces of Normal Permanent Teeth , 1965 .

[18]  Alexei Mossolov,et al.  Tooth-implant connection: some biomechanical aspects based on finite element analyses. , 2002, Clinical oral implants research.

[19]  Makoto Shiota,et al.  The influence of implant location and length on stress distribution for three-unit implant-supported posterior cantilever fixed partial dentures. , 2004, The Journal of prosthetic dentistry.

[20]  R. Palmer,et al.  A prospective 3‐year study of fixed bridges linking Astra Tech ST implants to natural teeth , 2005 .

[21]  Hans R. Mühlemann,et al.  10 Years of Tooth‐Mobility Measurements , 1960 .

[22]  A. Biewener Safety factors in bone strength , 2005, Calcified Tissue International.

[23]  S. Wang,et al.  In vivo measurement of the elastic modulus of the human periodontal ligament. , 2003, Medical engineering & physics.

[24]  H. B. Kay Free-standing versus implant-tooth-interconnected restorations: understanding the prosthodontic perspective. , 1993, The International journal of periodontics & restorative dentistry.

[25]  R G Craig,et al.  Finite element analysis of three- and four-unit bridges. , 1989, Journal of oral rehabilitation.

[26]  J. Gunne,et al.  Tooth-implant and implant supported fixed partial dentures: a 10-year report. , 1999, The International journal of prosthodontics.

[27]  D. van Steenberghe,et al.  Freestanding and tooth-implant connected prostheses in the treatment of partially edentulous patients. Part I: An up to 15-years clinical evaluation. , 2001, Clinical oral implants research.

[28]  N. Wakabayashi,et al.  Finite element contact stress analysis of the RPD abutment tooth and periodontal ligament. , 2004, Journal of dentistry.

[29]  E. Motegi,et al.  A study of occlusion in elderly Japanese over 80 years with at least 20 teeth. , 2005, Gerodontology.

[30]  J O Katz,et al.  Anisotropic elastic properties of cancellous bone from a human edentulous mandible. , 2000, Clinical oral implants research.

[31]  N. Wakabayashi,et al.  Stress analysis in edentulous mandibular bone supporting implant-retained 1-piece or multiple superstructures. , 2005, The International journal of oral & maxillofacial implants.

[32]  Kay Hb Free-standing versus implant-tooth-interconnected restorations: understanding the prosthodontic perspective. , 1993 .

[33]  B Z Laufer,et al.  Splinting osseointegrated implants and natural teeth in rehabilitation of partially edentulous patients. Part I: laboratory and clinical studies. , 1997, Journal of oral rehabilitation.

[34]  B. Melsen,et al.  The Finite Element Method: a Tool to Study Orthodontic Tooth Movement , 2005, Journal of dental research.

[35]  D. Lundgren,et al.  Occlusal force pattern during chewing and biting in dentitions restored with fixed bridges of cross-arch extension. I. Bilateral end abutments. , 1986, Journal of oral rehabilitation.

[36]  W. G. Matthews,et al.  Tensile Properties of Mineralized and Demineralized Human and Bovine Dentin , 1994, Journal of dental research.

[37]  O. Miyakawa,et al.  Peri-implant stress analysis in simulation models with or without trabecular bone structure. , 2006, The International journal of prosthodontics.