EVALUATION OF STRESS DISTRIBUTIONS OF ZIRCONIA CONNECTING SCREW IN BRUXISM: A FINITE ELEMENT ANALYSIS

Abstract

Abstract Background: The purpose of the present study was to evaluate the stress distributions of zirconia or titanium connecting screws under different loads (vertical and oblique) in bruxism patients and to indicate its applicability by comparing with physiological stress limit values.. Methods: Four different models were created in which the implants were the same size and design, with dental implant, abutment and connection screws made of zirconia or Ti (only screw). 3D-Finite element analysis (3D-FEA) was applied to study the effect of a vertical load (1000 N) and oblique load (an angle of 30°) on abutments in the models. The placement of implants are mandibular right first molar. Computerized tomography imaging of cadaver mandibles was used. Von Mises stresses of the different screw materials were compared with each other and the physiological stress limit values for zirconia. Results: Von Mises stress values increased in oblique loading in all models. The von Mises stress values were significantly reduced in the titanium screw than zirconium under both loading simulations. Conclusion: In patients with a high biting force physiological stress limit values for zirconia were not exceeded. Zircon connection screw may be used in patients with bruxism.

Keywords

• Bruxism
• Finite element analysis
• Mandible
• Zirconia material

BRUKSiZM HASTALARINDA ZiRKON BAĞLANTI ViDASININ STRES DAĞILIMLARININ SONLU ELEMANLAR ANALiZi İLE DEĞERLENDiRiLMESi

Abstract

Amaç: Çalışmanın amacı, bruksizm hastalarında farklı materyallerdeki implant-abutment bağlantı vidasında meydana gelen stress dağılımının değerlendirilmesidir. Ayrıca fizyolojik stress limit değerleri ile karşılaştırılarak uygulanabilirliğini belirtmektir. Gereç ve Yöntemler: İmplantların, abutmentlerin ve bağlantı vidalarının aynı dizayn ve boyutta olduğu 4 model oluşturuldu. Bağlantı vidası titanium veya zircon olarak modellendi, diğer materyaller ise titanium olarak modellendi. Bruksizmli hastaların ısırma kuvvetinin taklidi için 1000 N dikey veya 30° açılı yükleme abutmentlerin orta noktalarına uygulandı. Modellenen implant sağ mandibular birinci molar hizasındadır. Mandibulanın modellenmesinde kadavranın bilgisayarlı tomografi görüntüleri kullanıldı. Farklı bağlantı vidası materyallerinde meydana gelen (zircon veya titanium) von Mises stress değerleri karşılaştırıldı. Ayrıca zirkonyum bağlantı vidasındaki von Mises stress değerleri zirkonyumun fizyolojik stress limit değeri ile karşılaştırıldı. Bulgular: Von Mises stres değerleri tüm modellerde 30° açılı yüklemede artmıştır. Von Mises stres değerleri, her iki yükleme simülasyonunda titanyum vidada zirkonyuma göre önemli ölçüde azaldı. Sonuç: Isırma kuvveti yüksek olan hastalarda zirkonyum fizyolojik stres limit değerleri aşılmamıştır. Bruksizm hastalarında zirkon bağlantı vidası kullanılmasında sakınca yoktur.

Keywords

• Bruksizm
• Mandibula
• Sonlu elemanlar analizi
• Zirkon

References

1. 1. Villabona CA, Amorin Vasco MA, Ruales E, Bedoya KA, Benfatti CM, Bezzon OL, et al. Three-Dimensional Finite Element Analisys of Stress Distribution in Zirconia and Titanium Dental Implants. The Journal of oral implantology. 2018.
2. 2. Ozkurt Z, Kazazoglu E. Zirconia dental implants: a literature review. The Journal of oral implantology. 2011;37(3):367-76.
3. 3. Borgonovo AE, Censi R, Vavassori V, Dolci M, Calvo-Guirado JL, Delgado Ruiz RA, et al. Evaluation of the success criteria for zirconia dental implants: a four-year clinical and radiological study. International journal of dentistry. 2013;2013:463073.
4. 4. Pieralli S, Kohal RJ, Jung RE, Vach K, Spies BC. Clinical Outcomes of Zirconia Dental Implants: A Systematic Review. Journal of dental research. 2017;96(1):38-46.
5. 5. Bankoglu Gungor M, Yilmaz H. Evaluation of stress distributions occurring on zirconia and titanium implant-supported prostheses: A three-dimensional finite element analysis. The Journal of prosthetic dentistry. 2016;116(3):346-55.
6. 6. Choi AH, Matinlinna JP, Ben-Nissan B. Finite element stress analysis of Ti-6Al-4V and partially stabilized zirconia dental implant during clenching. Acta odontologica Scandinavica. 2012;70(5):353-61.
7. 7. Kohal RJ, Att W, Bachle M, Butz F. Ceramic abutments and ceramic oral implants. An update. Periodontology 2000. 2008;47:224-43.
8. 8. Rodriguez AE, Monzavi M, Yokoyama CL, Nowzari H. Zirconia dental implants: A clinical and radiographic evaluation. Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry [et al]. 2018.

9. 9. Ayranci F, Sivrikaya EC, Omezli MM. Is bone density or implant design more important in implant stress formation in patients with bruxism? Biotechnol Biotec Eq. 2017;31(6):1221-5.
10. 10. Van der Zaag J, Lobbezoo F, Van der Avoort PG, Wicks DJ, Hamburger HL, Naeije M. Effects of pergolide on severe sleep bruxism in a patient experiencing oral implant failure. Journal of oral rehabilitation. 2007;34(5):317-22.
11. 11. Sivrikaya EC, Omezli MM. The Effect Of Tapered And Cylindrical Implants On Stress Distribution In Different Bone Qualities: A Finite Element Analysis. The International journal of oral & maxillofacial implants. 2019;34(6):e99-e105.
12. 12. Osman RB, Elkhadem AH, Ma S, Swain MV. Titanium versus zirconia implants supporting maxillary overdentures: three-dimensional finite element analysis. The International journal of oral & maxillofacial implants. 2013;28(5):e198-208.
13. 13. Kourtis S, Damanaki M, Kaitatzidou S, Kaitatzidou A, Roussou V. Loosening of the fixing screw in single implant crowns: predisposing factors, prevention and treatment options. Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry [et al]. 2017;29(4):233-46.
14. 14. da Silva LH, Ribeiro S, Borges AL, Cesar PF, Tango RN. FEA and microstructure characterization of a one-piece Y-TZP abutment. Dental materials : official publication of the Academy of Dental Materials. 2014;30(11):e283-8.
15. 15. Macedo JP, Pereira J, Vahey BR, Henriques B, Benfatti CA, Magini RS, et al. Morse taper dental implants and platform switching: The new paradigm in oral implantology. European journal of dentistry. 2016;10(1):148-54.
16. 16. Hisbergues M, Vendeville S, Vendeville P. Zirconia: Established facts and perspectives for a biomaterial in dental implantology. Journal of biomedical materials research Part B, Applied biomaterials. 2009;88(2):519-29.
17. 17. Datte CE, Tribst JP, Dal Piva AO, Nishioka RS, Bottino MA, Evangelhista AM, et al. Influence of different restorative materials on the stress distribution in dental implants. Journal of clinical and experimental dentistry. 2018;10(5):e439-e44.
18. 18. Gore E, Evlioglu G. Assessment of the effect of two occlusal concepts for implant-supported fixed prostheses by finite element analysis in patients with bruxism. The Journal of oral implantology. 2014;40(1):68-75.
19. 19. Bozkaya D, Muftu S, Muftu A. Evaluation of load transfer characteristics of five different implants in compact bone at different load levels by finite elements analysis. The Journal of prosthetic dentistry. 2004;92(6):523-30.
20. 20. Goiato MC, dos Santos DM, Santiago JF, Jr., Moreno A, Pellizzer EP. Longevity of dental implants in type IV bone: a systematic review. International journal of oral and maxillofacial surgery. 2014;43(9):1108-16.
21. 21. Akca K, Iplikcioglu H. Finite element stress analysis of the influence of staggered versus straight placement of dental implants. The International journal of oral & maxillofacial implants. 2001;16(5):722-30.
22. 22. Ciftci Y, Canay S. The effect of veneering materials on stress distribution in implant-supported fixed prosthetic restorations. The International journal of oral & maxillofacial implants. 2000;15(4):571-82.
23. 23. Gharechahi J, Sharifi E, Aghdaee NA, Nosohian S. Finite element method analysis of the stress distribution to supporting tissues in a Class IV Aramany removable partial denture (Part I: the teeth and periodontal ligament). The journal of contemporary dental practice. 2008;9(6):65-72.
24. 24. Koca OL, Eskitascioglu G, Usumez A. Three-dimensional finite-element analysis of functional stresses in different bone locations produced by implants placed in the maxillary posterior region of the sinus floor. The Journal of prosthetic dentistry. 2005;93(1):38-44.
25. 25. O'Brien WJ. Dental materials and their selection. 2nd ed. Chicago: Quintessence Pub. Co.; 1997. xii, 421 p. p.
26. 26. Geng JP, Tan KB, Liu GR. Application of finite element analysis in implant dentistry: a review of the literature. The Journal of prosthetic dentistry. 2001;85(6):585-98.
27. 27. Sevimay M, Turhan F, Kilicarslan MA, Eskitascioglu G. Three-dimensional finite element analysis of the effect of different bone quality on stress distribution in an implant-supported crown. The Journal of prosthetic dentistry. 2005;93(3):227-34.
28. 28. Raimondi MT, Vena P, Pietrabissa R. Quantitative evaluation of the prosthetic head damage induced by microscopic third-body particles in total hip replacement. Journal of biomedical materials research. 2001;58(4):436-48.