Analysis of the stresses generated by short and conventional implants rehabilitated with splinted and non-splinted fixed prosthesis by digital image correlation method

Author(s)

Raniel Fernandes Peixoto

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Ribeirão Preto (PCARP/BC)
• Defense date: 2013-12-06

Examining board members

Maria da Gloria Chiarello de Mattos; Patrícia dos Santos Calderon; Renata Cristina Silveira Rodrigues Ferracioli

• Advisor: Maria da Gloria Chiarello de Mattos

Abstract

In cases of severe vertical bone loss, especially in the posterior region of the mandible, the use of short implants associated with splinted resin-veneered fixed dental prostheses (FDPs) can be an alternative to bone graft surgery and better force transmission to the adjacent bone, respectively. Among the methods to evaluate the stress distribution around the implants, the digital image correlation (DIC) has advantages as regards the possibility of evaluating the stress distribution continuously using images taken over time, during occlusal loading. Thus, this study evaluated qualitatively and quantitatively the biomechanical behavior of splinted and non-splinted resin-veneered FDPs, screw-retained on implants of different lengths positioned in the posterior region of the mandible with the aid of the DIC method. Four F16 polyurethane resin models were fabricated to simulate half of the mandibular arch containing tooth 44 in resin (Luxatemp) and teeth 45, 46 and 47 replaced by short (4 x 5 mm) and/or conventional (4 x 11 mm) implants. Groups (G) of this study were: G1 (two conventional implants [45 and 46] and one short implant [47]), G2 (one conventional implant [45] and two short implants [46 and 47]) G3 (three short implants) and G4 (three conventional implants). Splinted and non-splinted FDPs were screwed to the implant abutment and subjected to different oclusal loads of 250N: punctiform (45 mesial and 47 distal) and balanced occlusal load. Strains in the horizontal direction (&epsilon;xx) were calculated based on displacement and compared qualitatively and quantitatively by the DIC software (Davis 8.0, LaVision Inc.). In general, there was a stress concentration at higher intensity in those areas where short implants were placed. In punctiform load on the second molar, there was a compressive and tensile stresses predominance when splinted and non-splinted crowns were used, respectively, and the stresses of greater magnitude were found in the G2, G3 and G4 with non-splinted crowns (p>0.05), showing median values (&mu;S) equivalent to 396.08, 360.45 and 354.04, respectively. In punctiform load involving the second premolar, there was a compressive stress predominance in all planning with highest magnitudes in groups with splinted crowns (p<0.05). The oclusal load distributed simulations also revealed compressive stresses predominance in all planning, with greater magnitude in groups with splinted crowns, especially in G1 (-464.05 ± 106.43) and G3 (-474.39 ± 179.54), both with statistically significant differences when compared to the other groups (p<0.05). Within the limitations of this study, it can be concluded that splinting multiple adjacent implant supported provided a high stress concentration around the implants during punctiform (45 mesial) and balanced occlusal load, reinforcing the need for effective interproximal contact and oclusal adjustment to promote better stress distribution. Additionally, the combination of short and conventional implants seems to be a viable alternative in the rehabilitation of mandibular free end with reduced bone height. (AU)

• FAPESP's process: 12/09808-8 - Qualitative and quantitative analysis of the tensions generated by metaloplastic fixed crowns, splinted and non-splinted, in the posterior region of the mandible, rehabilitated with regular and short implants, by digital image correlation method.
• Grantee: Raniel Fernandes Peixoto
• Support Opportunities: Scholarships in Brazil - Master