Abstract
BackgroundThe aim of this study was to evaluate the biomechanical response of the peri-implant bone to standard, short-wide, and double mini implants replacing missing molar supporting either hybrid ceramic crowns (Lava Ultimate restorative) or full-metal crowns under two different loading conditions (axial and off-axial loading) using strain gauge analysis.MethodsThree single-molar implant designs, (1) single, 3.8-mm (regular) diameter implant, (2) single, 5.8-mm (wide) diameter implant, and (3) two 2.5-mm diameter (double) implants connected through a single-molar crown, were embedded in epoxy resin by the aid of a surveyor to ensure their parallelism. Each implant supported full-metal crowns made of Ni-Cr alloy and hybrid ceramic with standardized dimensions. Epoxy resin casts were prepared to receive 4 strain gauges around each implant design, on the buccal, lingual, mesial, and distal surfaces. Results were analyzed statistically.ResultsResults showed that implant design has statistically significant effect on peri-implant microstrains, where the standard implant showed the highest mean microstrain values followed by double mini implants, while the short-wide implant showed the lowest mean microstrain values. Concerning the superstructure material, implants supporting Lava Ultimate crowns had statistically significant higher mean microstrain values than those supporting full-metal crowns. Concerning the load direction, off-axial loading caused uneven distribution of load with statistically significant higher microstrain values on the site of off-axial loading (distal surface) than the axial loading.ConclusionsImplant design, superstructure material, and load direction significantly affect peri-implant microstrains.
Highlights
The aim of this study was to evaluate the biomechanical response of the peri-implant bone to standard, short-wide, and double mini implants replacing missing molar supporting either hybrid ceramic crowns (Lava Ultimate restorative) or full-metal crowns under two different loading conditions using strain gauge analysis
The recorded compressive and tensile microstrains for the tested designs were within the physiologic loading range, as they did not exceed the compressive or tensile strength of the bone-implant interface, which is more than 3000 microstrains except for the standard sized implant supporting Lava Ultimate crowns under both loading directions
Off-axial loading leads to uneven distribution of loads, in standard diameter implant, due to the cantilever effect, which caused microstrain values exceeding the physiologic limit, causing clinical failure over time
Summary
The aim of this study was to evaluate the biomechanical response of the peri-implant bone to standard, short-wide, and double mini implants replacing missing molar supporting either hybrid ceramic crowns (Lava Ultimate restorative) or full-metal crowns under two different loading conditions (axial and off-axial loading) using strain gauge analysis. The mandibular bone loss occurs as knife-edge residual ridge where there is marked narrowing of the labiolingual diameter of the crest of the ridge with a compensatory internal remodeling which sometimes leads to a sharp crest of the ridge which proceeds to low, well-rounded residual ridge [2]. The possibilities for patient’s rehabilitation in such limiting situations have involved advanced surgical techniques, such as autogenous bone augmentation and inferior alveolar nerve repositioning. These augmentation procedures have some drawbacks such as prolonged time until tooth reconstruction, patient morbidity, and expense. Side effects of bone augmentation include profound edema, pain, and discomfort and possible risks of nerve and blood vessel injury leading to nerve disturbance and hematoma [3, 4]
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