Comparative analysis of stress distribution around CFR‑PEEK implants and titanium implants with different prosthetic crowns: A finite element analysis.

Swapnil Tamrakar,Sunil Mishra,Srinivas Rao,Ramesh Chowdhary

doi:10.17219/dmp/133234

Abstract

Polyetheretherketone (PEEK) is a new material that was introduced for the fabrication of implants and their superstructure along with other available materials. It is not yet known whether the carbon fiber-reinforced polyetheretherketone (CFR‑PEEK) material can be used as an implant and its superstructure in place of titanium (Ti). The study evaluated stress distribution around CFR‑PEEK implants and Ti implants with 5 different prosthetic crowns. A three-dimensional (3D) model of a bone block was created to represent the right maxillary premolar area with a bone-level implant system with 100% osseointegration, using the Ansys Workbench software, v. 15.0. In total, 10 3D finite element analysis (FEA) models were created. The models were divided into 2 groups according to the type of implant: the CFR‑PEEK group (n = 5); and the Ti group (n = 5). Each group was subdivided to imitate 5 different restorative crown materials (PEEK, zirconia, porcelain fused to metal (PFM), metal, and acrylic resin). Each implant model was loaded vertically (200 N) and obliquely (100 N). Stress distribution in the implants, the abutments, the cement layers, and the crowns was evaluated using the von Mises stress analysis. Maximum and minimum principal stress analyses were used to determine the stress generated in the bone. The CFR‑PEEK implants bore more stress in vertical and oblique loading as compared to the Ti implants. The stress generated in the bone with the CFR‑PEEK implants was similar to that generated with the Ti implants under vertical loading. Under oblique loading, less stress was transferred to the bone with the CFR‑PEEK implants as compared to the Ti implants, showing better adaptation of the CFR‑PEEK implants to lateral stress. In this FEA study, the amount of stress generated within the bone in the case of the CFR‑PEEK implants with different restorative crowns was smaller in comparison with the Ti implants in oblique loading. This could help reduce lateral stress on implants as well as crestal bone loss.

Highlights

Dental implant-supported prostheses are becoming the preferred treatment option in dentistry to replace missing teeth due to their long-term survivability and proven advantages.[1,2] The pattern of stress distribution during mastication differs in implants, as the forces are directly transferred to the adjacent surrounding bone, which plays a vital role in the success of implants.[3,4] The lack of the periodontal ligament in dental implants causes decreased proprioception at the implant–bone interface
In this finite element analysis (FEA) study, the amount of stress generated within the bone in the case of the CFR‐PEEK implants with different restorative crowns was smaller in comparison with the Ti implants in oblique loading
The maximum principal stress generated in the bone with the CFR‐PEEK implants and the PEEK crown (5.888 MPa), the zirconia crown (5.889 MPa), the porcelain fused to metal (PFM) crown (5.888 MPa), the metal crown (5.889 MPa), and the acrylic resin crown (5.888 MPa) was slightly greater as compared to the Ti implants and the PEEK crown (5.645 MPa),the zirconia crown (5.649 MPa), the PFM crown (5.645 MPa), the metal crown (5.649 MPa), and the acrylic resin crown (5.648 MPa)

Summary

Introduction

Dental implant-supported prostheses are becoming the preferred treatment option in dentistry to replace missing teeth due to their long-term survivability and proven advantages.[1,2] The pattern of stress distribution during mastication differs in implants, as the forces are directly transferred to the adjacent surrounding bone, which plays a vital role in the success of implants.[3,4] The lack of the periodontal ligament in dental implants causes decreased proprioception at the implant–bone interface. Titanium (Ti) is the material of choice for dental implants; it was introduced by Brånemark in 1978.7 certain drawbacks with regard to the use of Ti have been reported in the literature, such as its tendency to cause hypersensitivity and allergic reactions.[8–10]. Another drawback is that its modulus of elasticity differs from that of the surrounding bone. This causes stress concentration at the implant–bone interface during load transfer, resulting in peri-implant bone loss.[11]. It is not yet known whether the carbon fiber-reinforced polyetheretherketone (CFR‐PEEK) material can be used as an implant and its superstructure in place of titanium (Ti)

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