Investigation of the effect of implant crown ratio and material type on the force transmitted to the implant in implant-supported restorations: a finite element analysis study

Yıl 2024, Cilt: 7 Sayı: 6, 604 - 609, 27.10.2024

Burcu Kızılırmak , Neslihan Güntekin , Reza Mohammadi , Meryem Erdoğdu , Ali Rıza Tunçdemir

Öz

Aims: The crown implant ratio may pose a problem, especially when short implants are used. This condition is associated with marginal bone loss. Therefore, in this study, it was aimed to evaluate the stresses arising from the bone, implant and its parts and the restoration by finite element analysis (FEA), as a result of comparing a situation with ideal bone support and a similar situation with vertical bone loss. The null hypothesis is that the type of material and crown length chosen for implant-supported restorations will not make a difference in terms of stress on implants of different sizes.
Methods: For this study, 8 mm implants were placed in the 44-46 region and a group with a 3-unit 12 mm length fixed prosthesis and a group with 12 mm implants and a 3-unit 8 mm length fixed restoration were designed. The data of the implant parts were obtained from a implant company (Bilimplant, İstanbul, Turkiye) and placed in the appropriate position within a bone data drawn in the Solidworks 2013 software (Solidworks Corp., USA). Appropriate multi-unit parts were then added and 3-unit restorations were designed with exocad. Necessary arrangements were made in the Geomagic Design X 2020 (3D systems, Morrisville, NC, USA) program, the restorations were given the characteristics of 2 different materials (lithium disilicate and zirconia). Applying a force of 200 N on the occlusal direction, the maximum principal stress values ​​​​occurring in the bone, implant, multi-unit, restoration and occlusal screw were recorded.
Results: Principal stress (Pmax) values recorded on the implant for the 1st premolar were higher on the 12 mm implant (B1 and B2 groups) and lower on the 8 mm implant. For the implant applied to the 1st molar region, higher stress values were observed in the groups with 8 mm implants (A1 and A2 groups), while lower values were observed with 12 mm implants (B1 and B2 groups).
Conclusion: As the crown/implant ratio increases in favour of the implant, the survival of the unit decreases. In addition, it is more appropriate to prefer rigid materials in implant restorations.

Anahtar Kelimeler

CAD/CAM, finite element analysis, implant

Kaynakça

• Wu HC, Huang HL, Fuh LJ, Tsai MT, Hsu JT. Effect of implant length and insertion depth on primary stability of short dental implant. Int J Oral Maxillofac Implants. 2023;38(1):62-70. doi:10.11607/jomi.9769
• Robau-Porrua A, Pérez-Rodríguez Y, Soris-Rodríguez LM, Pérez-Acosta O, González JE. The effect of diameter, length and elastic modulus of a dental implant on stress and strain levels in peri-implant bone: a 3D finite element analysis. Biomed Mater Eng. 2020;30(5-6):541-558. doi:10.3233/BME-191073
• Lemos CAA, Ferro-Alves ML, Okamoto R, Mendonça MR, Pellizzer EP. Short dental implants versus standard dental implants placed in the posterior jaws: a systematic review and meta-analysis. J Dent. 2016;47:8-17. doi:10.1016/j.jdent.2016.01.005
• Oswal MM, Amasi UN, Oswal MS, Bhagat AS. Influence of three different implant thread designs on stress distribution: a three-dimensional finite element analysis. J Indian Prosthodont Soc. 2016;16(4):359-365. doi:10.4103/0972-4052.191283
• Kim W, Li XC, Bidra AS. Clinical outcomes of implant-supported monolithic zirconia crowns and fixed partial dentures: a systematic review. J Prosthodont. 2023;32(2):102-107. doi:10.1111/jopr.13575
• Borie E, Orsi IA, de Araujo CP. The influence of the connection, length and diameter of an implant on bone biomechanics. Acta Odontol Scand. 2015;73(5):321-329. doi:10.3109/00016357.2014.961957
• Monje A, Fu JH, Chan HL, et al. Do implant length and width matter for short dental implants (<10 mm)? A meta-analysis of prospective studies. J Periodontol. 2013;84(12):1783-1791. doi:10.1902/jop.2013.120745
• Birdi H, Schulte J, Kovacs A, Weed M, Chuang SK. Crown-to-implant ratios of short-length implants. J Oral Implantol. 2010;36(6):425-433. doi:10.1563/AAID-JOI-D-09-00071
• Robau-Porrua A, Pérez-Rodríguez Y, Soris-Rodríguez LM, Pérez-Acosta O, González JE. The effect of diameter, length and elastic modulus of a dental implant on stress and strain levels in peri-implant bone: a 3D finite element analysis. Biomed Mater Eng. 2020;30(5-6):541-558. doi:10.3233/BME-191073
• Sun SP, Moon IS, Park KH, Lee DW. Effect of crown to implant ratio and anatomical crown length on clinical conditions in a single implant: a retrospective cohort study. Clin Implant Dent Relat Res. 2015;17(4):724-731. doi:10.1111/cid.12175
• Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res. 2012;23(Suppl 6):2-21. doi:10.1111/j.1600-0501.2012.02547.x
• Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CH, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res. 2009;20(Suppl 4):4-31. doi:10.1111/j.1600-0501.2009.01787.x
• Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res. 2018;29(Suppl 16):199-214. doi:10.1111/clr.13306
• De Angelis P, Passarelli PC, Gasparini G, et al. Monolithic CAD-CAM lithium disilicate versus monolithic CAD-CAM zirconia for single implant-supported posterior crowns using a digital workflow: a 3-year cross-sectional retrospective study. J Prosthet Dent. 2020;123(2):252-256. doi:10.1016/j.prosdent.2018.11.016
• Zarone F, Di Mauro MI, Ausiello P, Ruggiero G, Sorrentino R. Current status on lithium disilicate and zirconia: a narrative review. BMC Oral Health. 2019;19(1):134. doi:10.1186/s12903-019-0838-x
• Sadowsky SJ. Has zirconia made a material difference in implant prosthodontics? A review. Dent Mater. 2020;36(1):1-8. doi:10.1016/j.dental.2019.08.100
• Roberts EE, Bailey CW, Ashcraft-Olmscheid DL, Vandewalle KS. Fracture resistance of titanium-based lithium disilicate and zirconia implant restorations. J Prosthodont. 2018;27(7):644-650. doi:10.1111/jopr.12765
• Welch Phillips A, Gibbons D, Ahern DP, Butler JS. What is finite element analysis?. Clin Spine Surg. 2020;33(8):323-324. doi:10.1097/BSD.0000000000001050
• Tatarciuc M, Maftei GA, Vitalariu A, Luchian I, Martu I, Diaconu-Popa D. Inlay-retained dental bridges-a finite element analysis. Appl Sci. 2021;11(9):3770. doi:10.3390/app11093770
• Lagravère M. Finite element analysis: is it justifiable? Am J Orthod Dentofacial Orthop. 2021;159:255-256. doi:10.1016/j.ajodo.2020.10.017
• Kwon SJ, Lawson NC, McLaren EE, Nejat AH, Burgess JO. Comparison of the mechanical properties of translucent zirconia and lithium disilicate. J Prosthet Dent. 2018;120(1):132-137. doi:10.1016/j.prosdent.2017.08.004
• Yilmaz B, Gouveia D, Seghi RR, Johnston WM, Lang LA. Effect of crown height on the screw joint stability of zirconia screw-retained crowns. J Prosthet Dent. 2021;128(6):1328-1334. doi:10.1016/j.prosdent.2021.02.027
• Malchiodi L, Cucchi A, Ghensi P, Consonni D, Nocini PF. Influence of crown-implant ratio on implant success rates and crestal bone levels: a 36-month follow-up prospective study. Clin Oral Implants Res. 2014;25(2):240-251. doi:10.1111/clr.12105
• Hoshaw SJ, Brunski JB, Cochran GV. Mechanical loading of Brånemark implants effects interfacial bone modeling and remodeling. Int J Oral Maxillofac Implants. 1994;9:3. doi:10.1038/sj.bdj.4808259
• Brunski JB. In vivo bone response to biomechanical loading at the bone/dental-implant interface. Adv Dent Res. 1999;13(1):99-119. doi:10.1177/08959374990130012301
• Blanes RJ. To what extent does the crown–implant ratio effect the survival and complications of implant-supported reconstructions? A systematic review. Clin Oral Implants Res. 2002;20(Suppl 4):67-72. doi: 10.1111/j.1600-0501.2009.01762.x
• Nissan J, Ghelfan O, Gross O, et al. The effect of crown/implant ratio and crown height space on stress distribution in unsplinted implant supporting restorations. J Oral Maxillofac Surg. 2011;69(7):1934-1939. doi: 10.1016/j.joms.2011.01.036
• Huang Y, Wang J. Mechanism of and factors associated with the loosening of the implant abutment screw: a review. J Esthet Restor Dent. 2019;31(4):338-345. doi: 10.1111/jerd.12494
• Ibrahim CRM, Sameh A, Askar O. A finite element analysis study on different angle correction designs for inclined implants in All-on-Four protocol. BMC Oral Health. 2024;24(1):331. doi: 10.1186/s12903-024-04091-2
• Huang H, Zhang Z, Lin P, Xiang Y, Xu Y, Chen Y, Yin L. Removal of broken screws on implant abutment by digital guide plate: a case report and literature review. J Appl Biomater Funct Mater. 2023;21:22808000231186226. doi:10.1177/22808000231186226