Abutment Design Research Articles

Rehabilitating Amputated Hallux with Dental Implant–Supported Double Magnet in Y-Bar–Retained Prosthesis

ABSTRACT Introduction Loss of hallux leads to aesthetic deficit and functional loss, with active push-off, weight-bearing ability, and pronation all being affected. Rehabilitation can be surgical or prosthetic; however, surgical alternatives can be unpredictable in terms of aesthetics and is not cost-effective. Therefore, prosthetic rehabilitation is often favored. However, loss of all 3 phalanges makes prosthetic rehabilitation challenging due to minimal scope of retention from the residual limb. Materials and Methods This technique presents a solution to this challenge, with an implant-supported, magnet-retained silicone prosthesis, having a novel abutment design, to provide dual (magnetic and frictional) retention. Conclusions The prosthetic design improved retention, facilitated easy handling by the patient, and prevented stress concentration on implant-bone interface. Clinical Relevance The prosthetic innovation improved retention during standing and walking, and increased the patient’s confidence to perform daily activities without fear of dislodgement.

Utilizing Building Information Modelling Technology To Modelling Abutment: Revit

Building Information Modeling (BIM) has transformed the construction industry by offering a robust platform that integrates design, analysis, and construction processes within a single digital environment. This research explores the application of BIM technology, explicitly using Autodesk Revit, in modeling bridge abutments—an essential component in bridge construction that supports and distributes loads from the superstructure to the foundation. The study aims to demonstrate how BIM enhances the efficiency, accuracy, and sustainability of abutment design and construction. The methodology involves a comprehensive review of existing literature on BIM and bridge abutment design, focusing on technological advancements, case studies, and best practices. Additionally, practical implementation of BIM using Revit is conducted to develop detailed 3D models of abutments, incorporating architectural, structural, and geotechnical elements. The benefits of BIM in this context include improved collaboration among multidisciplinary teams, enhanced visualization capabilities for design optimization, and early detection of clashes and constructability issues. The research investigates the integration of Geographic Information Systems (GIS) with BIM to enhance site selection and environmental assessment phases, ensuring informed decision-making throughout the project lifecycle. Innovations in materials science, such as the use of fiber-reinforced polymers (FRP) and ultra-high-performance concrete (UHPC), are also considered for their potential to enhance the durability and longevity of bridge abutments. Ultimately, this study contributes to advancing the application of BIM in civil engineering, particularly in bridge construction, by showcasing Revit's capabilities in creating accurate, data-rich models that improve project outcomes.

Biomechanical analysis of partial mandibular implants with various lattice designs of different material properties: In vitro study and finite element analysis

For patients with mandibular bone defects, although reconstruction plates can be used for repair, achieving both occlusal function and facial aesthetics is challenging. In the present study, in vitro experiments and finite element analysis (FEA) were conducted to determine the biomechanical characteristics of multiple porous lattice structures of varying shapes and diameters that were used for mandibular implants. Additionally, an abutment designed to carry occlusal forces was added to the top of the implants. The stress distribution of four lattice designs (tetrahedron, quad-diametral-cross, hex-star, and hex-vase) of three sizes (2.5, 3.0, and 3.5 mm) in cubic porous models were analyzed by FEA. Subsequently, two optimal designs for 3D-printed titanium alloy were selected. These designs, featuring different lattice diameters (0.5, 0.7, and 0.9 mm), were tested to determine their elastic modulus, which was used in another FEA of a mandibular implant designed for a patient with a malignant tumor in the right mandible. This model, which included an abutment design, was subjected to a vertical force of 100 N and muscle forces generated by biting. This analysis was conducted to determine the elastic modulus of the implant and the values of stress and strain on the implant and surrounding bone. The lattice designs of quad-diametral-cross and hex-vase exhibited smaller high-stress regions than those of tetrahedron and hex-star. In vitro tests revealed that the elastic modulus of the lattices increased with the rod diameter. When these values were applied to mandibular implants, Young’s modulus decreased, which in turn increased the frictional stress observed at the interface between the abutment and the implant. However, the implant’s maximum stress remained below its yield strength (910 MPa), and the strain on the surrounding bone varied between 1500 and 3000 μstrain. As indicated by Frost’s theory, these implants are unlikely to damage the surrounding bone tissue and are likely to support bone growth.  

Examination of Various Abutment Designs Behavior Depending on Load Using Finite Element Analysis.

Studies on dental implant abutments' geometric design and material selection offer significant innovations and results. These studies aim to improve the abutments' functionality and aesthetic performance, minimize microcavities' formation, and ensure implant-supported prostheses' longevity. For example, CAD-CAM fabricated custom abutments have been found to produce a better marginal fit and fewer microgaps than standard abutments. In an in vitro study, transepithelial abutments offered lower microgap values than titanium-based abutments and provided a better fit at the implant-abutment interface. It is known that studies to improve mechanical and biological performance with Polyether Ether Ketone (PEEK) material have been addressed. New materials such as PEEK and zirconia have offered significant advantages in biocompatibility and aesthetics. Along with those studies, different abutment designs are also important. Abutment geometry is optimized to improve stress distribution and minimize peri-implant bone loss. In implant and abutment connections with different angles, mechanical life performances may vary depending on static and dynamic load. These studies emphasize the importance of material research on different types of connections to improve dental implants' durability, homogeneous load distribution, and reliability. The abutment parts used in implant treatment are insufficient to distribute the load homogeneously against chewing pressure due to their materials and geometry. Non-uniform load distribution damages the abutment and the prosthetic crown, accelerating the wear process. This study aimed to create different abutment designs to improve dental implants' biomechanical performance and longevity. This study aimed to increase the mechanical durability of the implant-abutment connection by reducing stress concentrations in response to masticatory compression on the abutment in different directions and forces and to guarantee the long-term success of the implant system by providing a more homogeneous stress distribution. It aimed to apply different forces in the axial direction to these models in a simulation environment and to calculate and compare the deformation and stress load distribution. As a method, three-dimensional models of the parts used in implant treatments and forming the implant system were designed. Different abutment designs were created with these models. Taking the current material values used in implant treatments as a reference, finite element analysis (FEA) was performed by applying different axial loads to each implant system model in the ANSYS software (version 24.1). Comparative analysis graphs were prepared and interpreted for the stress values obtained after the applied load. This study evaluated the mechanical performance of different abutment models (A, B, C, D, and E) under a 100 N load using the Kruskal-Wallis test. The Kruskal-Wallis test showed significant differences between the groups (p < 0.001). The greatest difference was observed between models E and A (q' = 6.215), with a significant difference also found between models C and A (q' = 3.219, p < 0.005). Regarding stress values, the highest stress on the abutment was observed in Model B (97.4 MPa), while the lowest stress was observed in Model E (9.6 MPa). The crown exhibited the highest stress in Model B (22.7 MPa) and the lowest in Model E (17.3 MPa). The implant stress was highest in Model C (14.8 MPa) and lowest in Model B (11.3 MPa). The stress values for the cortical bone and cancellous bone were quite similar across the models, showing no significant differences. These findings indicate that the abutment design and material selection significantly impact mechanical performance. Among the implant systems created with five different abutment models, in which the existing abutment geometry was also compared, homogeneous and axial distribution of the load on the abutment was achieved, especially with viscoelastic and surface area increased abutment designs. Clinically, the inadequacy and limited mounting surface or geometry of the abutments used in today's implant treatment applications have led to different design searches. It was concluded that the designs in this study, which are considered alternatives to existing abutment models, contribute positively to the mechanical life of the abutment material, considering the von Mises stresses and directions. This study brings a new perspective to today's practices and offers an alternative to treatment practices.

Multi-objective optimization of custom implant abutment design for enhanced bone remodeling in single-crown implants using 3D finite element analysis

The optimal configuration of a customized implant abutment is crucial for bone remodeling and is influenced by various design parameters. This study introduces an optimization process for designing two-piece zirconia dental implant abutments. The aim is to enhance bone remodeling, increase bone density in the peri-implant region, and reduce the risk of late implant failure. A 12-month bone remodeling algorithm subroutine in finite element analysis to optimize three parameters: implant placement depth, abutment taper degree, and gingival height of the titanium base abutment. The response surface analysis shows that implant placement depth and gingival height significantly impact bone density and uniformity. The taper degree has a smaller effect on bone remodeling. The optimization identified optimal values of 1.5 mm for depth, 35° for taper, and 0.5 mm for gingival height. The optimum model significantly increased cortical bone density from 1.2 to 1.937 g/cm3 in 2 months, while the original model reached 1.91 g/cm3 in 11 months. The standard deviation of density showed more uniform bone apposition, with the optimum model showing values 2 to 6 times lower than the original over 12 months. The cancellous bone showed a similar trend. In conclusion, the depth and taper have a significant effect on bone remodeling. This optimized model significantly improves bone density uniformity.

Design and Biomechanical Analysis of Customized Angled Abutment Based on Tooth Inclination Angle for Immediate Implant Placement on Maxillary Anterior Region.

Finite element analysis and an in vitro experiment were employed to investigate the loading effects of angled abutments, comparing various customized angled abutments derived from the average angle of incisors in patients with a commercial 15°∆ angled abutment, on both the implant and surrounding bone. Four customized angled abutment models (21.9°∆, 24.15°∆, 20.22°∆, 33°∆) were developed using cone-beam computed tomography (CBCT) images of incisor inclination from various age groups of patients. 3D maxillary bone models were created from CBCT images of four individual patients. Finite element analysis and in-vitro strain gauge experiments were conducted, applying 100N or 50N of axial or oblique force, to assess the differences in stress/strain between the customized and the commercial 15°∆ angled abutments in both the implants and surrounding bone. Under axial loading, the stress values in the dental implant and surrounding bone were elevated due to the relatively higher angles of the customized angled abutments (21.9°∆, 24.15°∆, 20.22°∆, 33°∆) when compared to the commercial 15°∆ angled abutment; however, under oblique loading the commercial 15°∆angled abutment exhibited higher stress values in both the implant and surrounding bone. For in vitro experiment, there is no statically difference in bone strain between the customized (21.9°∆) and the commercial 15°∆ angled abutments in axial loading. Nevertheless, in oblique loading using a commercial 15°∆ angled abutment induced the higher bone strains. Customized angled abutments offer lower stress/strain under oblique loads but higher stress/strain under axial loads compared to commercial ones. Therefore, in the design and application of angled abutments, careful consideration of the occlusal load direction is paramount for achieving biomechanical success of dental implant.

Centrifuge model tests on vertical stress distribution of geosynthetics reinforced soil (GRS) abutment

Geosynthetics reinforced soil (GRS) abutment has been widely used in the construction of small to medium single-span bridges and shows good service performance in engineering projects. Vertical stress distribution plays an important role for engineering design of the GRS abutments. Three centrifugal model tests of GRS abutments were carried out to investigate the vertical stress distribution underneath the centreline of beam seat, considering the setback distance (i.e., the distance from the beam seat to the inner of the facing) and beam seat width as influencing factors. Test results indicated the measured incremental vertical stresses under the beam seat increased with increasing loads uniformly and presented “larger on the upside and smaller on the downside” along the elevation. There existed the phenomenon of stress concentration near the top of the abutment and with the increasing beam seat width, the phenomenon of stress concentration presented more obvious. However, the setback distance had little effect on the vertical stress distribution. A comparison between measured and theoretical vertical stress showed that the AASHTO method provided a better prediction of the incremental vertical stress distribution than the FHWA method under the load of 200 kPa, but with the increasing loads, these two methods significantly underestimated the incremental vertical stress.

Ultimate bearing capacity of geosynthetic reinforced soil abutment centrifuge model tests

Five centrifuge models of geosynthetic reinforced soil (GRS) abutments with segmental block facing were loaded in the acceleration field under plane strain condition. Influencing factors including reinforcement tensile strength, setback and bearing area width were considered and analysed. Results show that the abutment with stronger reinforcement remained stable under the maximum loading capacity. However, abutments with weaker reinforcement showed excessive vertical strain, local deformation or even collapse. The ultimate bearing capacity increased with the lengthening of setback but decreased due to a larger bearing area. The rupture of reinforcements was observed and considered as the cause of the failures. Compared with the measured ultimate bearing capacity, the values calculated by the semi-empirical formula of design guidelines were significantly conservative. The failure surface of failed abutment developed from the rear edge of the bearing area to the middle height of the abutment at an angle of nearly 45° + φ/2. The setback and the bearing area width affected the form and position of the failure surface. The difference between the potential failure surface predicted by available methods and the measured failure surfaces has been discussed, and suggestions for the design and ultimate bearing capacity prediction of GRS abutments with segmental block facing are provided.

The Influence of Hydroxyapatite, Titanium, and Yttria-Stabilized Zirconia Oxide on Diversity of Bacterial Cultures Grown from Human Dental Biofilm Specimens in an In Vitro Model

Background: Titanium (TI) and yttria stabilized-zirconia oxide (YSZ) are dental materials commonly utilized at the soft-tissue interface surrounding dental implants. The influence of these surfaces on bacterial adhesion and biofilm development may affect clinical performance and patient susceptibility to inflammatory peri-implant disease. The purpose of this study was to evaluate the influence of the substrate material on biofilm diversity. Methods: Biofilms were cultured on TI, YSZ, and hydroxyapatite (HA) surfaces (control) using plaque specimens obtained from three human donors. Duplicate cultures grew for one, two, three, six or nine days. Biofilm diversity was then analyzed using 16S rRNA sequencing. The Shannon Diversity Index (SDI) was calculated for each experimental group. Microbial profiles were intercompared in a pairwise fashion to establish dissimilarity scores, which were recorded in a distance dissimilarity matrix. Results: A total of 16 taxa were identified, and relative abundances of the predominant phyla and genera did not appear statistically different across experimental groups. Biofilms grown on HA surfaces exhibited significantly higher alpha diversity compared with those formed on TI or YSZ (p&lt;0.0001), although biofilms cultured on TI and YSG surfaces exhibited comparable diversity. Statistically significant differences in beta diversity associated with substrate (p=0.012) and growth period (p=0.001) were detected. Conclusions: Under the conditions described, biofilms grown on TI or YSZ appeared significantly less complex than those formed on HA. Transmucosal implant abutment surface characteristics represent one modifiable factor potentially influencing risk of peri-implant disease. Among risk of peri-implant disease. Among multiple considerations in abutment design, biofilm diversity performance may represent a clinically relevant benchmark.

The Impact of Implant Abutment Angle and Height on Peri-implant Tissue Health: Retrospective Analyses from a Randomized Controlled Clinical Trial.

To examine the influence of abutment emergence angle and abutment height on marginal peri-implant bone stability in patients not considered susceptible to peri-implantitis. Furthermore, it was analyzed whether titanium-base (Ti-base) abutments lead to wider abutment emergence angles compared to one-piece abutments. A total of 48 abutments (ie, 24 Ti-base and 24 one-piece abutments in 24 patients) were evaluated at abutment installation, after 1 year, and thereafter on a yearly basis for up to 5 years. Clinical and radiographic outcome variables were assessed. With regard to peri-implant marginal bone stability, only moderately negative, albeit significant, correlations were found on the mesial sides of the one-piece abutments after 4 and 5 years for an abutment emergence angle > 30 degrees. No statistically significant negative correlations were found for distances of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level for either Ti-base or for one-piece abutments. Furthermore, abutments bonded to Ti-bases were not associated with larger emergence angles than one-piece abutments. For patients at low risk of developing peri-implantitis, it can be concluded that neither a larger abutment emergence angle (> 30 degrees) nor a distance of ≤ 1.5 mm between the restoration margin and the crestal peri-implant bone level are associated with marginal peri-implant bone loss. Furthermore, abutments bonded to Ti-bases are not associated with wider emergence angles than one-piece abutments.

Investigation of the Fracture Strength Between Dental Implant And Ti-Base Abutment Produced with Different Heights and Grades of Titanium Material

New prosthetic designs were developed to provide a balanced transmission of the stress caused by the chewing function to other mechanical and anatomical structures, and these designs revealed new research areas. An example of this is screw-retained implant-supported prostheses. With screw-retained prostheses, the residual cement problem is eliminated. However, abutment material and abutment design may adversely affect the mechanical and aesthetic properties of prostheses. Ti-base abutments have been developed to solve these problems. However, studies on clinical succes, material content and abutment height of ti-base abutments remain up-to-date. In our study, the effect or abutment heights on the bond strength and stress distribution with monolithic zirconia crowns in ti-base abutments manufactured from different titanium Gr types will be tested. Titanium Gr 4, Gr 5 and Gr 23 ELI materials will be used in our study. A total of 7 groups are planned with ti-base abutments with a abutment length of 3.5 mm, 5.5 mm for Gr 4 and Gr 5, abutment length of 3.5 mm, 5.5 mm and 7 mm for Gr 23. In the in vitro experiment, the fracture strength of the samples will be tested with the universal testing device. total of 77 implants, ti-base abutments and monolithic zirconia crowns will be used by creating 11 samples for each study group. The obtained values will be recorded in Newtons and Megapascals. The data will be analysed using the SPSS 22.0 programme. As a result, while the lowest fracture strength values were observed in Gr 4 Ti material in all ti-base abutment lengths in the samples for which the fracture strength test was performed, similar values were observed in the ti-base abutments produced from Gr 5 and Gr 23 ELİ alloys. When the relationship of bonding strengths with Ti alloys was evaluated, it was seen that there was no significant difference between Ti alloys.

Digital Workflow for Designing CAD-CAM Custom Abutments of Immediate Implants Based on the Natural Emergence Profile of the Tooth to be Extracted.

The aim of this report is to present a digital workflow technique to design a customized abutment for provisionalization of an implant immediately placed based on the natural emergence profile of the tooth to be extracted. The workflow involves the combination of intraoral and cone beam computerized tomography scans, from which 3-dimensional reconstructions of soft tissue and alveolar bone, as well as reconstructions of the tooth to be extracted, are obtained and exported as standard tessellation language files. The files are imported to a computer-aided design software, in which a virtual wax-up and custom abutment design are performed considering the natural emergence profile of the patient's tooth prior to extraction. Since the customized abutment is digitally designed, it can also be used as a scan body, to be directly scanned intraorally after soft tissue healing around an interim implant restoration. The custom abutment digitally designed then can be produced by milling zirconia with an optimally chosen color, in accordance with the esthetic needs of the patient.

Trans-mucosal platforms for dental implants: Strategies to induce muco-integration and shield peri-implant diseases.

Trans-mucosal platforms connecting the bone-anchored implants to the prosthetic teeth are essential for the success of oral rehabilitation in implant dentistry. This region promotes a challenging environment for the successfulness of dental components due to the transitional characteristics between soft and hard tissues, the presence of bacteria, and mechanical forces. This review explored the most current approaches to modify trans-mucosal components in terms of macro-design and surface properties. This critical review article revised intensely the literature until July 2023 to demonstrate, discuss, and summarize the current knowledge about marketable and innovative trans-mucosal components for dental implants. A large number of dental implant brands have promoted the development of several implant-abutment designs in the clinical market. The progress of abutment designs shows an optimistic reduction of bacteria colonization underlying the implant-abutment gap, although, not completely inhibited. Fundamental and preclinical studies have demonstrated promising outcomes for altered-surface properties targeting antibacterial properties and soft tissue sealing. Nanotopographies, biomimetic coatings, and antibiotic-release properties have been shown to be able to modulate, align, orient soft tissue cells, and induce a reduction in biofilm formation, suggesting superior abilities compared to the current trans-mucosal platforms available on the market. Future clinical implant-abutments show the possibility to reduce peri-implant diseases and fortify soft tissue interaction with the implant-substrate, defending the implant system from bacteria invasion. However, the absence of technologies translated to commercial stages reveals the need for findings to "bridge the gap" between scientific evidences published and applied science in the industry.

Electron Microscopy (EM) Analysis of Collagen Fibers in the Peri-Implant Soft Tissues around Two Different Abutments.

The design of the implant prosthesis-abutment complex appears crucial for shaping healthy and stable peri-implant soft tissues. The aim of the present animal study was to compare two implants with different healing abutment geometries: a concave design (TEST) and a straight one (CTRL). Transmission electron microscopy (TEM) was used to quantify the three-dimensional topography and morphological properties of collagen at nanoscale resolution. 2 swine were included in the experiment and 6 implants per animal were randomly placed in the left or right hemimandible in either the physiologically mature bone present between the lower canine and first premolar or in the mandibular premolar area, within tooth extraction sites. Each CTRL implant was positioned across from its respective TEST implant on the other side of the jaw. After 12 weeks of healing, 8 specimens (4 CTRL and 4 TEST) were retrieved and prepared for histological and TEM analysis. The results showed a significantly higher percentage of area covered by collagen bundles and average bundle size in TEST implants, as well as a significant decrease in the number of longitudinally oriented bundles with respect to CTRL implants, which is potentially due to the larger size of TEST bundles. These data suggest that a concave transmucosal abutment design serves as a scaffold, favoring the deposition and growth of a well-organized peri-implant collagen structure over the implant platform in the early healing phase, also promoting the convergence of collagen fibers toward the abutment collar.

Risk factors associated with screw loosening in CAD-CAM custom abutments: A 6-year retrospective study

Statement of ProblemCustom abutments made by using computer-aided design and computer-aided manufacturing (CAD-CAM) are often used for implant-supported prostheses. However, studies on screw loosening of implant prostheses using custom abutments are lacking. PurposeThe purpose of this retrospective study was to investigate the risk factors of screw loosening in implant-supported prostheses using custom abutments made with CAD-CAM. Material and methodsClinical charts, radiographic images, and CAD custom abutment design file data were collected and analyzed retrospectively. The study included 255 patients with 401 dental implants, and the follow-up duration was 6 years. Age, sex (male/female), type of unit (single-unit or multiunit), location of the implant (maxilla or mandible and anterior, premolar, or molar tooth), type of antagonist, and experience of the prosthodontist were reviewed, and implant angulation (mesiodistal and buccolingual), location of the screw access hole (mesiodistal and buccolingual distances from center), and attrition status (none, localized, or generalized) were measured by using a CAD file. The frequencies and percentages of risk factors were evaluated with the Fisher exact test, and the Bonferroni correction was used as a post hoc test. Multiple logistic regression with the Firth method was performed to calculate the odds ratios and their confidence intervals (α=.05). ResultsScrew loosening showed a correlation with the severity of attrition (P<.001). Single-unit prostheses had a higher risk of screw loosening than multiunit prostheses (P<.001). Experience of the prosthodontist (P<.001). Buccolingual angulation of the implant and abutment significantly influenced the incidence of screw loosening (P<.05). Age, sex, location of the implant, type of antagonist, mesiodistal implant angulation, and buccolingual and mesiodistal location of the screw access hole did not significantly influence the incidence of screw loosening (P>.05). ConclusionsThe degree of attrition, buccolingual angulation of the implant and abutment, type of unit, and experience of the prosthodontist (>3 years or <3 years) were risk factors in the incidence of screw loosening.

COMPARATIVE EVALUATION OF CRESTAL BONE LOSS AROUND SUBMERGED AND NON-SUBMERGED IMPLANTS WITH DIFFERENT TYPES OF HEALING ABUTMENT DESIGNS - AN IN VIVO STUDY

Successful osseointegration is observed predictably for submerged implants requiring a two-stage procedure as well as for non-submerged implants characterized by one-stage surgical procedure. This study was aimed at evaluating and comparing crestal bone alterations around submerged and non-submerged implant radiographically. Total 45 patients aged between 20 to 50 years with missing mandibular posterior teeth were divided into 3 groups [Submerged implants (n=15), Non-submerged implants with anatomic healing abutment (n=15) and Non-submerged implants with esthetic healing abutment (n=15)]. Radiographic evaluation of mesial and distal marginal bone loss was done at 1 month and 3 months. Statistically significant differences were found between submerged dental implants and non-submerged dental implants with anatomical type of healing abutment designs (P &lt; 0.001) and between the two non-submerged dental implant groups with different types of healing abutments (P &lt; 0.001) at 1 month and 3 months. But there was no statistically significant difference between submerged dental implants and non-submerged dental implants with esthetic type of healing abutments (P &gt; 0.05) at 1 month and 3 months. It was concluded from this study that bone resorption during the osseointegration period using the non-submerged technique varied significantly depending on the morphology of the healing abutment used. The non-submerged technique with an esthetic healing abutment produced an equally predictable outcome compared with the submerged technique.

Scaled Model Tests Investigating Deformation Characteristics of Geosynthetic Reinforced Soil (GRS) Abutments under Vertical Loads.

This study conducted plane-strain scaled model tests to investigate the deformation characteristics of geosynthetic reinforced soil (GRS) abutments subjected to vertical loads. Setback distance, i.e., the distance between the back of the abutment facing and the front of the loading plate, was chosen as the investigated influencing factor since it is one of the most frequently used variables by engineers for the design of GRS abutments. This study analyzed the settlements at the top of the abutment, the lateral displacements of the abutment facing, and the volumetric deformations of the abutment under the applied vertical loads. Test results showed that increasing the setback distance could effectively reduce the deformations of the GRS abutment. There existed an optimum setback distance and further increasing the setback distance beyond this optimum value did not have a significant effect on reducing the abutment deformations. The vertical, lateral, and total volumetric deformations of the GRS abutment showed an approximately linear increase with the increase of the applied vertical loads. The lateral volumetric deformations of the GRS abutment were larger than its vertical volumetric deformations and therefore the total volumetric strains of the GRS abutment were not zero based on the test results. However, the theory of zero volume change may still be suitable for the deformation calculation of the GRS abutment since the values of the volumetric strains were minimal. The measured maximum lateral facing displacements were compared with the calculated values using the US Federal Highway Administration (FHWA) method, which assumes zero volume change of the GRS abutment under vertical loads. Comparison results indicated that the FHWA method overestimated the maximum lateral facing displacements of the GRS abutment under vertical loads. An improved method was proposed in this study to calculate the maximum lateral facing displacements under vertical loads based on the theory of zero volume change and a revised distribution of the settlements at the top of the GRS abutment. Results showed that the improved method could better predict the maximum lateral facing displacements as compared to the FHWA method.

Effect of abutment design on fracture resistance of resin-matrix ceramic crowns for dental implant restoration: an in vitro study

BackgroundThe purpose of this study is to investigate the performance and fracture resistance of different resin-matrix ceramic materials for use in implant-supported single crowns with respect to the abutment design (crown thickness: 1 mm, 2 and 3 mm).MethodsForty-eight abutments and crowns were fabricated on implants in the right lower first molar. Two resin-matrix ceramic materials for dental crowns were selected for study: (1) a glass-ceramic in a resin interpenetrating matrix (Vita Enamic, Vita, Germany) and (2) a resin-based composite with nanoparticle ceramic filler (Lava Ultimate, 3 M ESPE, USA). Three types of abutments were designed: 1 mm thick crown + custom titanium abutment, 2 mm thick crown + custom titanium abutment and 3 mm thick crown + prefabricated titanium abutment. The experiment was divided into 6 groups (n = 8) according to the crown materials and abutment designs. After 10,000 thermocycles, fracture resistance was measured using a universal testing machine. The statistical significance of differences between various groups were analysed with ANOVA followed by a post hoc Tukey’s honestly significant difference test. The surfaces of the fractured specimens were examined with scanning electron microscopy (SEM).ResultsTwo-way ANOVA revealed that the abutment design (F = 28.44, P = 1.52 × 10− 8<0.001) and the crown materials (F = 4.37, P = 0.043 < 0.05) had a significant effect on the fracture resistance of implant crown restoration. The Lava Ultimate-2 mm group showed the highest fracture resistance of 2222.74 ± 320.36 N, and the Vita Enamic-3 mm group showed the lowest fracture resistance of 1204.96 ± 130.50 N. Most of the 1 and 2 mm groups had partial crown fractures that could be repaired directly with resin, while the 3 mm group had longitudinal fracture of the crown, and the crowns were detached from the abutments.ConclusionBased on the in vitro data of this study, the fracture resistance of the 2 mm thick resin-matrix ceramic crown design was higher than that of the 1 and 3 mm groups. The 2 mm thick resin-matrix ceramic crown and personalized abutment are an option to replace zirconia for implant crown restoration.

Failed Dental Implant: When Titanium Fractures.

Despite the widespread use of titanium implants in orthopedic and dental surgeries, concerns have recently emerged regarding potential deformations and fractures after osseointegration. In a recent clinical case, a titanium implant fractured after successful osseointegration. This fracture occurred despite the absence of any significant trauma or excessive external force applied to the area. The fracture was attributed to a combination of factors, including abutment design flaws, material fatigue, and biomechanical stress imposed on the implant during functional loading. This raises concerns about the long-term durability and reliability of titanium implants, particularly in high-stress areas such as the posterior region or weight-bearing bones. An image was made with scanning electron microscopy showing the fracture region near the prosthetic platform and highlighting the knowledge that despite their ductility, titanium implants can fracture.

Evaluation of two implant-supported fixed partial denture abutment designs: Influence on screw surface characteristics.

To compare screw surface characteristics between hemi-engaging and non-engaging implant-supported fixed partial denture (FPD) designs after cyclic loading. Twenty-four implants measuring 4.3 × 10mm were mounted on acrylic resin blocks. Specimens were divided into two groups. An experimental group included twelve 3-unit FPD with a hemi-engaging design; a control group included twelve 3-unit FPDs with the conventional design of two non-engaging abutments. Both groups were subjected to two types of cycling loading (CL), first axial loading, and then lateral loading at 30°. Load was applied to the units one million times (1.0 × 106 cycles) for each loading axis. Data on screw surface roughness in three locations and screw thread depth were collected before (BL) and after (AL) each loading type. Screw surface roughness was measured in μm using a mechanical digital surface profilometer and optical profiler. To evaluate screw thread depth in μm, an upright optical microscope Axio-imager 2 was used. To confirm readings made from the optical microscope, four random samples were selected from each group for scanning electron microscopy (SEM) analysis. The effect of cyclic loading was evaluated by averaging values across the two screws within each specimen, then calculating difference scores (DL) between BL and AL (DL = AL - BL). Additional difference scores were computed between the non-engaging screws in each experimental group specimen, and one randomly selected non-engaging screw in each control specimen. This difference was referred to as the non-engaging DL. Statistical significance was assessed using Mann-Whitney U tests (α = 0.05). Comparisons of DL and non-engaging DL by loading type revealed one significant difference regarding surface roughness at the screw thread. Significantly greater mean changes were observed after axial loading compared to lateral loading regarding both DL (axial M = -0.36 ± 0.08; lateral M = -0.21 ± 0.09; U = 20; p = 0.003) and non-engaging DL (axial M = -0.40 ± 0.22; lateral M = -0.21 ± 0.11; U = 29; p = 0.013). No significant differences in screw surface roughness in other sites or thread depth were found between the experimental and control abutment designs in DL or in non-engaging DL. No significant differences were found for DL (axial U = 13, p = 0.423; lateral U = 9, p = 0.150;) or non-engaging DL (axial U = 13, p = 0.423; lateral U = 18, p = 1.00). Results suggest that overall, changes in screw surface physical characteristics did not differ between hemi-engaging and non-engaging designs after evaluating screw surface roughness and thread depth before and after axial and lateral cyclic loading.