氧化锆基台的制作及其与钛基台抗折强度的比较

目的：制作氧化锆基台并将其与钛基台的抗折强度相比较,从而探讨其临床应用的可行性。方法：选用纳米氧化锆粉,采用冷等静压成型和二次烧结工艺制作0sstem USⅡ系统氧化锆基台;选取氧化锆基台和成品钛基台（OSSTEM公司,韩国）各10枚,分别与0sstem USⅡ种植体装配,然后固定于不锈钢夹具中置于万能试验机,将万能试验机压头与种植体长轴成90°角施加压力,记录基台损坏时的加载力值,比较分析两组试件的强度差异。结果：氧化锆基台和钛基台的平均抗折强度分别为（540.5±84.6）N和（753.9±160.8）N,差别有统计学意义（P〈0.05）。氧化锆基台组10枚基台全部颈部折裂;钛基台组2枚种植体损坏,6枚中央固位螺钉损坏,2枚基台颈部折裂。结论：本研究制作的0sstem USⅡ系统的氧化锆基台的抗折强度虽然低于钛基台,但尚能满足临床应用要求。     

Fracture resistance and analysis of stress distribution of implant-supported single zirconium ceramic coping combination with abutments made of different materials

The purpose of this study was to compare the fracture resistance and fracture mode of single implant-zirconium coping combinations using zirconium and titanium abutments and to analyze the stress distribution pattern using three-dimensional finite elements analysis. Twenty implants with titanium and zirconium abutments were randomly divided into two groups (n = 10) and into resin blocks. Zirconium copings were cemented onto the abutments. The specimens were loaded with 135° angles to the long axis and the load values at the moment of failure were recorded using a universal test machine. Stress levels were calculated according to the maximum Von Mises criteria. The fracture resistances for titanium and zirconium abutment groups were 525.65 N and 514.05 N, respectively. No significant differences were observed between two groups regarding the fracture resistance levels. The maximum Von Mises equivalent stress concentrated on zirconium copings in both of the groups. Implant-abutment-ZrO2 coping combination has the potential to withstand physiological occlusal forces in the anterior region. Three-dimensional finite elements analysis results of the implant-abutment-ZrO2 coping combination is compatible with the results of fracture resistance.     

Radiologic Evaluation of Bone Loss at Implants with Biocide Coated Titanium Abutments: A Study in the Dog

The objective of the present study is to evaluate bone loss at implant abutments coated with a soda-lime glass containing silver nanoparticles subjected to experimental peri-implantitis. Five beagle dogs were used in the experiments, 3 implants were installed in each quadrant of the mandibles. Glass/n-Ag coted abutments were connected to implant platform. Cotton floss ligatures were placed in a submarginal position around the abutment necks and the animals were subject to a diet which allowed plaque accumulation, and after 15 weeks the dogs were sacrificed. Radiographs of all implant sites were obtained at the beginning and at the end of the experimentally induced peri-implantitis. The radiographic examination indicated that significant amounts of additional bone loss occurred in implants without biocide coating, considering both absolute and relative values of bone loss. Percentages of additional bone loss observed in implants dressed with a biocide coated abutment were about 3 times lower (p<0.006 distal aspect; and p<0.031 at mesial aspect) than the control ones. Within the limits of the present study it seems promising the use of soda-lime glass/nAg coatings on abutments to prevent peri-implant diseases.     

Finite element investigation of implant-supported fixed partial prosthesis in the premaxilla in immediately loaded and osseointegrated states

The aim of this study was to gain insight into the behaviour of the stresses and strains at the bone–implant interface of an implant-supported fixed partial prosthesis (FPP) in the premaxilla under immediate loading and osseointegrated conditions. Finite element models of a four-unit FPP were generated. An extreme condition was simulated, using only two immediately loaded implants in order to derive recommendations for possible clinical application. Straight and 20°-angled abutments and bonded or sliding contact between the bridge and abutment were simulated. In addition, two models were generated with two completely osseointegrated implants. A 150 N load to the prosthesis at a 45° angle to the long axis of each implant was applied. Minor differences were observed in implant displacements, stress and strain distributions of the two abutment designs. However, bone loading exceeded the physiological limits, including a risk of bone atrophy. A considerable decrease in implant displacements and bone loading was observed in the osseointegrated cases. An FPP supported by only two implants cannot be recommended for immediate loading.     

Design of a custom angled abutment for dental implants using computer-aided design and nonlinear finite element analysis

Computer-aided design/computer-aided manufacturing (CAD/CAM) custom abutments have been attracting more and more attention due to their advantages of accuracy fit and esthetic emergence profile. However, the CAD key technology for custom abutments has been seldom studied as well as their biomechanical behavior. This paper explored a novel method to design a CAD/CAM custom angled abutment, evaluated the biomechanical performance of the whole system and compared the difference between the custom and the conventional abutment through 3D nonlinear finite element analysis (FEA). Firstly, the digital data of the dental casts at the healing abutment level was acquired by optical scanner. Thus the position of the healing abutment and the implant can be determined by CAD technology. The custom angled abutment was then designed according to the need of restoration and esthetics with CAD software. The described system can eliminate wax and cast, create an esthetic anatomical emergence profile and provide a satisfactory angle correction. Simulation results indicate that there was no distinct difference in the stress distribution and magnitude of implant-bone interface and screw using the custom or the conventional angled abutment.     

Influence of Different Abutment Designs on the Biomechanical Behavior of One-Piece Zirconia Dental Implants and Their Surrounding Bone: A 3D-FEA

BackgroundIn a dental implant/bone system, the design factors affect the value and distributions of stress and deformations that plays a pivotal role on the stability, durability and lifespan of the implant/bone system.ObjectiveThe aim of this study was to compare the influence of different abutment designs on the biomechanical behavior of one-piece zirconia dental implants and their surrounding bone tissues using three-dimensional finite element analysis.MethodsA three-dimensional geometrical model of a zirconia dental implant and its surrounding bone tissue were created. The occlusal loading force applied to the prosthetic abutments was a combination of 114.6 N in the axial direction, 17.1 N in the lingual direction and 23.4 N toward the mesial direction where these components represent masticatory force of 118.2 N in the angle of approximately 75° to the occlusal plane.ResultsThe system included implant abutment Model 01 showed a decrease of 9.58%, 9.92% and 3.62% at least in the average value of maximum von Mises stress compared to Model 02, Model 03 and Model 04 respectively. The results also showed that the system included implant abutment Model 01 decreases the average value of maximum deformation of 16.96%, 7.17% and 9.47% at least compared to Model 02, Model 03 and Model 04 respectively.ConclusionThe one-piece zirconia dental implant abutment Model 01 presents a better biomechanical behavior in the peri-implant bone than others. It can efficiently distribute the applied load and present more homogeneous behavior of stress distribution and has less deformation than others, which will enhance the stability of implant/bone system and prolong its lifespan.     

Evaluation of the assembling and retention forces of constraint liners for total hip replacement]

Dislocation is a severe complication after total hip replacement which may cause revision surgery in some cases. The use of constraint inserts that are coupled to the femoral head by a snapping mechanism provides an opportunity for treatment of recurrent dislocations. This study was aimed to investigate the assembling and retention forces of a specific constraint liner. Using a universal testing machine the assembling forces were determined for head sizes of 28 and 32 mm and the clinically mostly used as well as the maximum cup size. Subsequently, under variation of load direction and pull-out velocity the retention forces were investigated. For primary assembly of the head the required compressive forces were in a range from 197 N and 283 N depending on head and cup size (each size n = 3). Repeated assembly led to a decrease of these forces up to 29%. The retention forces always were slightly below the assembling forces, i. e. forces to remove the heads from the inserts were between 183 N and 230 N (each size n = 3). Repeated disconnection caused a decrease of the retention forces up to 16%. An increase of load velocity as well as an oblique load direction resulted in an enhancement of the retention forces. For all investigated implant sizes the retention force for the femoral head was approximately ten-times less than the interface strength between the insert and the metal-back. In case of correct implant handling the risk of disconnection between the tested constraint insert and the corresponding metal-back has not to be considered in clinical practice.     

Influence of transmucosal height in abutments of single and multiple implant-supported prostheses: a non-linear three-dimensional finite element analysis

The aim of this study was to analyze the influence of three different transmucosal heights of the abutments in single and multiple implant-supported prostheses through the finite element method. External hexagon implants, MicroUnit, and EsthetiCone abutments were scanned and placed in an edentulous maxillary model obtained from a tomography database. The simulations were divided into two groups: (1) one implant with 3.75 × 10 mm placed in the upper central incisor, simulating a single implant-supported fixed prosthesis with an EsthetiCone abutment; and (2) two implants with 3.75 × 10 mm placed in the upper lateral incisors with MicroUnit abutments, simulating a multiple implant-supported prosthesis. Subsequently, each group was subdivided into three models according to the transmucosal height (1, 2, and 3 mm). A static oblique load at an angle of 45 degrees to the long axis of the implant in palatal-buccal direction of 150 and 75 N was applied for multiple and single implant-supported prosthesis, respectively. The implants and abutments were assessed according to the equivalent Von Mises stress analyses while the bone and ceramics were analyzed through maximum and minimum principal stresses. The total deformation values increased in all models, while the transmucosal height was augmented. The transmucosal height of the abutments influences the stress values at the bone, ceramics, implants, and abutments of both the single and multiple implant-supported prostheses, with the transmucosal height of 1 mm showing the lowest stress values.     

Bone Loss at Implant with Titanium Abutments Coated by Soda Lime Glass Containing Silver Nanoparticles: A Histological Study in the Dog

The aim of the present study was to evaluate bone loss at implants connected to abutments coated with a soda-lime glass containing silver nanoparticles, subjected to experimental peri-implantitis. Also the aging and erosion of the coating in mouth was studied. Five beagle dogs were used in the experiments. Three implants were placed in each mandible quadrant: in 2 of them, Glass/n-Ag coated abutments were connected to implant platform, 1 was covered with a Ti-mechanized abutment. Experimental peri-implantitis was induced in all implants after the submarginal placement of cotton ligatures, and three months after animals were euthanatized. Thickness and morphology of coating was studied in abutment cross-sections by SEM. Histology and histo-morphometric studies were carried on in undecalfied ground slides. After the induced peri-implantitis: 1.The abutment coating shown losing of thickness and cracking. 2. The histometry showed a significant less bone loss in the implants with glass/n-Ag coated abutments. A more symmetric cone of bone resorption was observed in the coated group. There were no significant differences in the peri-implantitis histological characteristics between both groups of implants. Within the limits of this in-vivo study, it could be affirmed that abutments coated with biocide soda-lime-glass-silver nanoparticles can reduce bone loss in experimental peri-implantitis. This achievement makes this coating a suggestive material to control peri-implantitis development and progression.     

Efficiency considerations for the purely tapered interference fit (TIF) abutments used in dental implants

A tapered interference fit provides a mechanically reliable retention mechanism for the implant-abutment interface in a dental implant. Understanding the mechanical properties of the tapered interface with or without a screw at the bottom has been the subject of a considerable amount of studies involving experiments and finite element (FE) analysis. In this paper, approximate closed-form formulas are developed to analyze the mechanics of a tapered interference fit. In particular, the insertion force, the efficiency, defined as the ratio of the pull-out force to insertion force, and the critical insertion depth, which causes the onset of plastic deformation, are analyzed. It is shown that the insertion force is a function of the taper angle, the contact length, the inner and outer radii of the implant, the static and the kinetic coefficients of friction, and the elastic modulii of the implant/abutment materials. The efficiency of the tapered interference fit, which is defined as the ratio of the pull-out force to insertion force, is found to be greater than one, for taper angles that are less than 6 deg when the friction coefficient is 0.3. A safe range of insertion forces has been shown to exist. The lower end of this range depends on the maximum pull-out force that may occur due to occlusion in the multiple tooth restorations and the efficiency of the system; and the upper end of this range depends on the plastic deformation of the abutment and the implant due to interference fit. It has been shown that using a small taper angle and a long contact length widens the safe range of insertion forces.     

Telescopic crowns: extra-oral and intra-oral retention force measurement--in vitro/in vivo correlation

doi: 10.1111/j.1741‐2358.2011.00477.x
Telescopic crowns: extra‐oral and intra‐oral retention force measurement –in vitro/in vivo correlation Objective: This study deals with the determination of the retentive forces of telescopic crowns measured extra‐ and intra‐orally and the correlation of these values. Background: The telescopic denture is a well‐documented solution for prosthetic rehabilitation for a partially edentulous jaw. Acceptable retention forces are needed to avoid inadvertent removal of the denture during movement of the jaws. Recent literature suggests 3–7 N per attachment to be acceptable. These values are only supported by in vitro studies. In vivo data are scarce, and a correlation of the in vitro and in vivo values is lacking. Material and Methods: Twenty‐five combined fixed‐removable prostheses with a total of 72 double crowns were used for extra‐oral retention force measurement prior to cementation (in vitro). The intra‐oral measurement was performed at 72 defined measuring points of the dentures 4–6 weeks after prosthetic rehabilitation (in vivo). A specifically designed measuring device was used. Results: The rank correlation showed that the in vitro and in vivo values correlate with each other (Spearman’s ρ = 0.5052). Additionally, it was found that the median values measured before (1.97N) insertion of the dentures were significantly lower than after (4.70N) insertion (Mann–Whitney test, p ≤ 0.0001). Conclusion: The retention forces measured before and after insertion of the denture correlate with each other although their dimension is significantly higher after insertion. The reason for this behaviour might be some tilting during removal. Nevertheless, the correlation allows a prediction of the clinically relevant forces by a measurement of the extra‐orally measured retentive values.     

Accurate detection of protein:ligand binding sites using molecular dynamics simulations

Accurate prediction of location of cavities and surface grooves in proteins is important, as these are potential sites for ligand binding. Several currently available programs for cavity detection are unable to detect cavities near the surface or surface grooves. In the present study, an optimized molecular dynamics based procedure is described for detection and quantification of interior cavities as well as surface pockets. This is based on the observation that the mobility of water in such pockets is significantly lower than that of bulk water. The algorithm efficiently detects surface grooves that are sites of protein-ligand and protein-protein interaction. The algorithm was also used to substantially improve the performance of an automated docking procedure for docking monomers of nonobligate protein-protein complexes. In addition, it was applied to predict key residues involved in the binding of the E. coli toxin CcdB with its inhibitor. Predictions were subsequently validated by mutagenesis experiments.     

Simulation of bone strain by orthodontic implants using the finite element method]

Load direction of applied forces, implant geometry and other biomechanical parameters lead to varying reactions in the surrounding bone structure. Three types of endosseous implant measuring 9 mm in length and 3.3 mm in diameter with and without superperiosteal step, and a threaded surface were investigated with the aid of a finite element method using the COSMOS/M 2.5 program. The load on the implant was investigated under vertical, horizontal, and diagonal forces of between 0.01 N and 100 N. Vertical loading of simple implants caused bone deformation of more than 600 mu eps. The application of the superperiosteal step clearly reduced the deformation. The largest deformations under vertical loading were observed in the trabecular bone with all 3 implant geometries. On horizontal loading the deformation shifted from the trabecular to the cortical bone and was particularly marked at the transition between the two. The smallest deformations, less than 300 mu eps, were measured at implants with a superperiosteal step under diagonal loading. The thread did not improve loading capacity. Implants with a superperiosteal step are recommended since they contribute to more rapid healing and strengthening of the bone.     

INVESTIGATION OF THE STRUCTURE OF THE CORNIFIED EPITHELIUM OF THE HUMAN SKIN

To explore the submicroscopic structure of the human callus by the polarization optical method, serial sections were prepared in three principal planes and the sign of double refraction as well as optic axes of various regions of the sections was determined. It was concluded that in areas under the grooves keratin is oriented parallel to the surface plane of the callus and to the direction of the grooves. In component structures of ridge areas such as in sweat duct areas a circumferential, in cross-band areas a linear, and in other parts a random structure was seen. The cross-bands of ridge areas in association with groove areas revealed a regular lattice-like submicroscopic pattern which was considered as an important mechanical system of the cornified epithelium.     

Genome analysis and clinical implications of the bacterial communities in early biofilm formation on dental implants restored with titanium or zirconia abutments

This cross-sectional study aimed to identify and quantify up to 42 target species colonizing the early biofilm of dental implants restored with titanium or zirconia abutments. A total of 720 samples from 20 healthy individuals were investigated. Biofilm samples were collected from the peri-implant sulci, inner parts of implants, abutment surfaces and prosthetic crowns over a functioning period of 30 days. Checkerboard DNA–DNA hybridization was used for microbial detection and quantitation. Clinical characteristics (probing depth, bleeding on probing, clinical attachment level and marginal bone loss) were also investigated during the monitoring period. Genome counts were low at the implant loading time point for both the abutment materials, and increased over time. Both the titanium and the zirconia groups presented similar microbial counts and diversity over time, and the microbiota was very similar to that colonizing the remaining teeth. Clinical findings were consistent with a healthy condition with no significant difference regarding marginal bone loss between the two materials.     

The stress model of abutment tooth and periodontal tissues with unilateral mandibular dissociation and loss by precision extracoronal attachment

In order to explore the application of the precision extracoronal attachment based on three-dimensional finite element stress model in the repair of unilateral mandibular dissociation and loss, the stress distribution of the butment and periodontal tissues when the precision extracoronal attachment was used in unilateral mandibular dissociation and loss was analyzed, so as to provide reference for the application of materials in clinical repair. In this study, the biomechanics of oral cavity and its attachment were analyzed to provide theoretical basis for model construction. Because the degree of periodontal tissue absorption and the number of abutment teeth affected the restoration effect of the coronal precision attachment, the models were established from these two perspectives. The results showed that when the periodontal tissue absorption of both abutment teeth exceeded 1/3, the method of double abutment restoration was not recommended. When three abutments were used, there was a significant decrease compared with the absorption of the periodontal tissue of the double abutment. In clinic, the stress distribution of the distal abutment teeth and its periodontal tissues can be improved by increasing the number of abutment tooth. However, since increasing the number of abutments required an increase in the amount of healthy tooth tissue, it couldn’t be blindly selected in the clinic. After comprehensive consideration, it is appropriate to choose two abutment teeth for restoration.     

Retention of telescopic denture in elderly patients with maximum partially edentulous arch

The telescopic denture is one possible solution for prosthetic rehabilitation for a partially dentate arch with few remaining teeth, which is the reason why it is usually considered in elderly patients. The system of double crowns consists of the male component of attachment or patrix, which is cemented to the abutment tooth, and the female component of attachment or matrix, which is the removable part of the restoration. Retention force represents resistance to those forces which tend to separate the partial denture and supporting tissue in the occlusal direction. Its optimal value is 5–9 N per each patrix and it should strictly be between these limits as a stronger or weaker force will endanger the functionality of the denture or damage the supporting tissue of the abutment teeth. Objective: The goal of this study was to establish the exact value of the individual and total retention force of the completed telescopic system. Method: The Bredent dynamometer was used for measuring these values. The study involved measuring the individual force of separation of 50 patrix–matrix components, and total force of 20 partial dentures of various designs retained by double crowns made in the Dental Laboratory of the Clinic for Prosthetic Dentistry, Faculty of Stomatology, Belgrade University. The research was carried out in the period from January 2006 to October 2006. Results and conclusion: The results showed different values of separation force – from very low values to those exceeding optimal limits. A reduction in the force of separation is necessary in the case of excessive tightness. If there was looseness between patrix and matrix, the cylindrical components of double crowns need to be lined by a suitable composite material.     

Estimation of trunk muscle forces using the finite element method and in vivo loads measured by telemeterized internal spinal fixation devices.

Direct quantitative measurement of muscle forces is not possible. Forces in the trunk muscles were estimated for standing and flexion of the upper body using three-dimensional, nonlinear finite element models of the lumbar spine with and without an internal spinal fixation device. Muscle forces assumed were two pairs dorsally and one ventrally, each representing several muscles. Muscle forces in the model with internal fixators were varied in discrete steps until the implant loads calculated closely corresponded to those measured in a patient with an instrumented implant. The calculated angles between adjacent lumbar vertebrae were compared with corresponding values measured on X-ray films of a patient as well as with literature values and served as a second criterion for predicting muscle forces. For the model without an implant, the muscle forces of the first model were slightly varied until the lumbar spine shape and the intradiscal pressure were physiological. The abdomen was shown to have a considerable supporting function for flexion.     

年轻恒牙作为基牙制备后脱敏处理临床效果评价

目的：观察年轻活髓牙牙体制备后脱敏处理的临床效果;材料与方法：随机选择23例双端固定桥义齿以两侧活髓牙为基牙中的23颗活髓牙作实验牙,临床虎体制备后给以脱敏处理,于制备后24小时、一周及二周进行随访统计,并与另外23颗牙作对比;结果：经脱敏剂脱敏处理的年轻活髓牙牙本质过敏症状明显低于不做脱敏处理的活髓牙。     

Evaluation in a Dog Model of Three Antimicrobial Glassy Coatings: Prevention of Bone Loss around Implants and Microbial Assessments

ObjectivesThe aim of the present study is to evaluate, in a ligature-induced peri-implantitis model, the efficacy of three antimicrobial glassy coatings in the prevention of biofilm formation, intrasulcular bacterial growth and the resulting peri-implant bone loss.MethodsMandibular premolars were bilaterally extracted from five beagle dogs. Four dental implants were inserted on each hemiarch. Eight weeks after, one control zirconia abutment and three with different bactericidal coatings (G1n-Ag, ZnO35, G3) were connected. After a plaque control period, bacterial accumulation was allowed and biofilm formation on abutments was observed by Scanning Electron Microscopy (SEM). Peri-implantitis was induced by cotton ligatures. Microbial samples and peri-implant crestal bone levels of all implant sites were obtained before, during and after the breakdown period.ResultsDuring experimental induce peri-implantitis: colony forming units counts from intrasulcular microbial samples at implants with G1n-Ag coated abutment remained close to the basal inoculum; G3 and ZnO35 coatings showed similar low counts; and anaerobic bacterias counts at control abutments exhibited a logarithmic increase by more than 2. Bone loss during passive breakdown period was no statistically significant. Additional bone loss occurred during ligature-induce breakdown: 0.71 (SD 0.48) at G3 coating, 0.57 (SD 0.36) at ZnO35 coating, 0.74 (SD 0.47) at G1n-Ag coating, and 1.29 (SD 0.45) at control abutments; and statistically significant differences (p<0.001) were found. The lowest bone loss at the end of the experiment was exhibited by implants dressing G3 coated abutments (mean 2.1; SD 0.42).SignificanceAntimicrobial glassy coatings could be a useful tool to ward off, diminish or delay peri-implantitis progression.