An up to 14-years split-mouth comparative study of two screw-shaped titanium implant systems
Reinhilde JacobsPisha PittayapatGreet De MarsF GijbelsAnnelies Van der DonckXin LiangMarc QuirynenDaniël van SteenbergheIgnace Naert
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As an alternative to atrophic ridges of maxillectomized patients, the installation of implants with distal inclination in greatest bone density areas has been indicated in order to improve the geometric arrangement of the joint prosthesis/implant. However, the biomechanical function of the implant is still uncertain. This study aimed to evaluate the stress distribution of implant retained palatal obturator prosthesis with tilted implant and different attachment systems by using the photoelastic analysis images. Two photoelastic models of the maxilla with oral-sinus nasal communication were fabricated. One model received three implants on the left side of the alveolar ridge with two parallel implants (incisive, canine) and one tilted implant (distal angulation of 17° in first molar region) and the other model did not receive implants. Afterwards, a conventional palatal obturator prosthesis (control) and four implant-retained palatal obturator prostheses with different attachment systems (o’ring; two o’rings placed over the bar, bar-clip and bar-clip with two distally placed o’rings) were constructed. Models were placed in a circular polariscope and a 100-N axial load was applied in three different regions (incisive, canine and first molar regions) by using a universal testing machine. The results were photographed and analyzed qualitatively using software (AdobePhotoshop). The bar-clip system exhibited the highest stress concentration followed by the bar-clip system with two-distally placed o’rings, bar with two o’rings placed over the bar, o’ring system and conventional denture. The greatest stress concentration was observed on the apex of the implants. The attachment system affected the stress distribution of implant-retained palatal obturator prosthesis. The tilted implant exhibited a biomechanical behavior similar to the parallel implants. jovechiato@hotmail.com
Palatal obturator
Bar (unit)
Sinus (botany)
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Abstract The mandibular staple is an endosseous implant that will permit the attachment of a lower deture in cases of severe alveolar bone atrophy. It is placed through a submental incision and inserted into seven parallel holes drilled into the mandible. A curved bar containing seven pins is inserted in the holes and is place against the inferior border of the mandibular symphysis. The two lateral most pins project into the mouth and the five retentive pins remain completely buried in bone. Two fasteners are screwed down on the threading of the intraoral pins. Later a bridge containing Dalbo attachments is cemented to the fasteners which allow attachment to a lower denture. A series of 25 patients have been completed with 20 successful patients for survival rate of 80%. The longest case has been in for five years and the average case has been in for 3 years. Stainless steel, titanium and ceramic coated titanium has been with apparently equal success. Patient acceptance has been excellent.
Mandibular symphysis
Bridge (graph theory)
Mandible (arthropod mouthpart)
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During the past few decades, unalloyed titanium has been extensively used as a material of dental implant-supported restorations but it cause gingival discoloration and unnatural appearance of the surrounding soft tissue. Currently, yttrium oxide partially-stabilized zirconia (Y-TZP) is a ceramic of special interest because of its superior mechanical properties. This study was carried out with four one piece zirconium implants embedded on a standard acrylic resin mandibular edentulous model, the abutment of zirconium implant was classified into two designs and then laboratory test was applied with proposed biting force (sensor (BS) and a bidirectional transmit-receive module. Our study concluded that the use of one piece Zirconium implant with box or parallel shape abutment head in implant supported over-denture without a need of cement, screws or plastics or metal housing for attachment in other types of implant had a superior results and easier maintenance and repair of the prosthesis if any complications occur.
Abutment
Zirconium oxide
Dental Abutments
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The objective of this study was to observe what influences the differences in implant systems and their configuration and conditions at insertion of implant would cause in change of soft tissue over time after setting of crown, and consequently to clarify what type of clinical treatment should be applied in order to minimize invasion to patients as well as achieve maximum results. This study was conducted through implant-prosthetic treatments with the cases of single tooth loss in maxillary anterior area. The lengths of clinical crown were measured both at the time of setting crown and after follow-up of 4.5 years in average. Used were 60 implants, composed of 26 of Tapered Screw-Vent, 22 of Straumann and 12 of Ankylos. In the cases with Ankylos, whose configuration is of platform switching, the clinical crowns turned out to have got longer only by 0.3mm, while that with Tapered Screw-Vent by 1.1mm and that with Straumann by 1.3mm.Furthermore, the cases with Tapered Screw-Vent were divided into 2 groups according to the conditions of insertion. One group was that the implants were inserted at an angle to the axis of natural teeth and on the labial side, and the other was that the implants were inserted vertically and on the palatal side. The variations were 1.9mm longer in the former group and 0.3mm in the latter respectively. The results obtained, in spite of the use of one implant system, varied according to the seating conditions, and with the cases with Tapered Screw-Vent seated vertically, the variation of soft tissue was as quite small as the cases with Ankylos. It indicates that a choice of appropriate implant system and the consideration about the conditions of implant insertion are significant in order to maintain satisfactory long-term esthetic results.
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