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Effect of microthread presence and restoration design (screw versus cemented) in dental implant reliability and failure modes

Identifieur interne : 000026 ( Istex/Corpus ); précédent : 000025; suivant : 000027

Effect of microthread presence and restoration design (screw versus cemented) in dental implant reliability and failure modes

Auteurs : Erika O. Almeida ; Amilcar C. Freitas Júnior ; Estevam A. Bonfante ; Eduardo Passos Rocha ; Nelson R. F. A. Silva ; Paulo G. Coelho

Source :

RBID : ISTEX:091F6343233415B9186D3D1D76AE18492F0BED8B

English descriptors

Abstract

This study evaluated the reliability and failure modes of implants with a microthreaded or smooth design at the crestal region, restored with screwed or cemented crowns. The postulated null hypothesis was that the presence of microthreads in the implant cervical region would not result in different reliability and strength to failure than smooth design, regardless of fixation method, when subjected to step‐stress accelerated life‐testing (SSALT) in water.

Url:
DOI: 10.1111/j.1600-0501.2012.02437.x

Links to Exploration step

ISTEX:091F6343233415B9186D3D1D76AE18492F0BED8B

Le document en format XML

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<div type="abstract">This study evaluated the reliability and failure modes of implants with a microthreaded or smooth design at the crestal region, restored with screwed or cemented crowns. The postulated null hypothesis was that the presence of microthreads in the implant cervical region would not result in different reliability and strength to failure than smooth design, regardless of fixation method, when subjected to step‐stress accelerated life‐testing (SSALT) in water.</div>
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<affiliation>Corresponding author: Estevam A. Bonfante Rua Prof. José de Souza Herdy, 1.160 – 25 de Agosto, Duque de Caxias, RJ, Brazil 25071‐202 Tel.: +55(14) 3234 5805 Fax: +55(14) 3234 2566 e‐mail: estevamab@gmail.com</affiliation>
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<head>Abstract</head>
Objectives
<p>This study evaluated the reliability and failure modes of implants with a microthreaded or smooth design at the crestal region, restored with screwed or cemented crowns. The postulated null hypothesis was that the presence of microthreads in the implant cervical region would not result in different reliability and strength to failure than smooth design, regardless of fixation method, when subjected to step‐stress accelerated life‐testing (
<hi rend="fc">SSALT</hi>
) in water.</p>
Materials and methods
<p>Eighty four dental implants (3.3 × 10 mm) were divided into four groups (
<hi rend="italic"></hi>
= 21) according to implant macrogeometric design at the crestal region and crown fixation method: Microthreads Screwed (
<hi rend="fc">MS</hi>
); Smooth Screwed (
<hi rend="fc">SS</hi>
); Microthreads Cemented (
<hi rend="fc">MC</hi>
), and Smooth Cemented (
<hi rend="fc">SC</hi>
). The abutments were torqued to the implants and standardized maxillary central incisor metallic crowns were cemented (
<hi rend="fc">MC</hi>
,
<hi rend="fc"> SC</hi>
) or screwed (
<hi rend="fc">MS</hi>
,
<hi rend="fc"> SS</hi>
) and subjected to
<hi rend="fc">SSALT</hi>
in water. The probability of failure versus cycles (90% two‐sided confidence intervals) was calculated and plotted using a power law relationship for damage accumulation. Reliability for a mission of 50,000 cycles at 150 N (90% 2‐sided confidence intervals) was calculated. Differences between final failure loads during fatigue for each group were assessed by Kruskal–Wallis along with Benferroni's
<hi rend="italic">post hoc</hi>
tests. Polarized‐light and scanning electron microscopes were used for failure analyses.</p>
Results
<p>The Beta (β) value (confidence interval range) derived from use level probability Weibull calculation of 1.30 (0.76–2.22), 1.17 (0.70–1.96), 1.12 (0.71–1.76), and 0.52 (0.30–0.89) for groups
<hi rend="fc">MC</hi>
,
<hi rend="fc"> SC</hi>
,
<hi rend="fc"> MS</hi>
, and
<hi rend="fc">SS</hi>
respectively, indicated that fatigue was an accelerating factor for all groups, except for
<hi rend="fc">SS</hi>
. The calculated reliability was higher for
<hi rend="fc">SC</hi>
(99%) compared to
<hi rend="fc">MC</hi>
(87%). No difference was observed between screwed restorations (
<hi rend="fc">MS</hi>
– 29%,
<hi rend="fc">SS</hi>
– 43%). Failure involved abutment screw fracture for all groups. The cemented groups (
<hi rend="fc">MC</hi>
,
<hi rend="fc"> SC</hi>
) presented more abutment and implant fractures. Significantly higher load to fracture values were observed for
<hi rend="fc">SC</hi>
and
<hi rend="fc">MC</hi>
relative to
<hi rend="fc">MS</hi>
and
<hi rend="fc">SS</hi>
(
<hi rend="italic"></hi>
< 0.001).</p>
Conclusion
<p>Since reliability and strength to failure was higher for
<hi rend="fc">SC</hi>
than for
<hi rend="fc">MC</hi>
, our postulated null hypothesis was rejected.</p>
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<p>This study evaluated the reliability and failure modes of implants with a microthreaded or smooth design at the crestal region, restored with screwed or cemented crowns. The postulated null hypothesis was that the presence of microthreads in the implant cervical region would not result in different reliability and strength to failure than smooth design, regardless of fixation method, when subjected to step‐stress accelerated life‐testing (
<fc>SSALT</fc>
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<p>Eighty four dental implants (3.3 × 10 mm) were divided into four groups (
<i></i>
= 21) according to implant macrogeometric design at the crestal region and crown fixation method: Microthreads Screwed (
<fc>MS</fc>
); Smooth Screwed (
<fc>SS</fc>
); Microthreads Cemented (
<fc>MC</fc>
), and Smooth Cemented (
<fc>SC</fc>
). The abutments were torqued to the implants and standardized maxillary central incisor metallic crowns were cemented (
<fc>MC</fc>
,
<fc> SC</fc>
) or screwed (
<fc>MS</fc>
,
<fc> SS</fc>
) and subjected to
<fc>SSALT</fc>
in water. The probability of failure versus cycles (90% two‐sided confidence intervals) was calculated and plotted using a power law relationship for damage accumulation. Reliability for a mission of 50,000 cycles at 150 N (90% 2‐sided confidence intervals) was calculated. Differences between final failure loads during fatigue for each group were assessed by Kruskal–Wallis along with Benferroni's
<i>post hoc</i>
tests. Polarized‐light and scanning electron microscopes were used for failure analyses.</p>
</section>
<section xml:id="clr2437-sec-0003">
<title type="main">Results</title>
<p>The Beta (β) value (confidence interval range) derived from use level probability Weibull calculation of 1.30 (0.76–2.22), 1.17 (0.70–1.96), 1.12 (0.71–1.76), and 0.52 (0.30–0.89) for groups
<fc>MC</fc>
,
<fc> SC</fc>
,
<fc> MS</fc>
, and
<fc>SS</fc>
respectively, indicated that fatigue was an accelerating factor for all groups, except for
<fc>SS</fc>
. The calculated reliability was higher for
<fc>SC</fc>
(99%) compared to
<fc>MC</fc>
(87%). No difference was observed between screwed restorations (
<fc>MS</fc>
– 29%,
<fc>SS</fc>
– 43%). Failure involved abutment screw fracture for all groups. The cemented groups (
<fc>MC</fc>
,
<fc> SC</fc>
) presented more abutment and implant fractures. Significantly higher load to fracture values were observed for
<fc>SC</fc>
and
<fc>MC</fc>
relative to
<fc>MS</fc>
and
<fc>SS</fc>
(
<i></i>
< 0.001).</p>
</section>
<section xml:id="clr2437-sec-0004">
<title type="main">Conclusion</title>
<p>Since reliability and strength to failure was higher for
<fc>SC</fc>
than for
<fc>MC</fc>
, our postulated null hypothesis was rejected.</p>
</section>
</abstract>
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<title>Effect of microthread presence and restoration design (screw versus cemented) in dental implant reliability and failure modes</title>
</titleInfo>
<titleInfo type="alternative" contentType="CDATA" lang="en">
<title>Effect of microthread presence and restoration design (screw versus cemented) in dental implant reliability and failure modes</title>
</titleInfo>
<name type="personal">
<namePart type="given">Erika O.</namePart>
<namePart type="family">Almeida</namePart>
<affiliation>Department of Dental Material and Prosthodontics, Araçatuba School of Dentistry, Sao Paulo State University – UNESP, Sao Paulo, Brazil</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Amilcar C.</namePart>
<namePart type="family">Freitas Júnior</namePart>
<affiliation>Postgraduate Program in Dentistry, School of Dentistry – UnP, Potiguar University, RN, Natal, Brazil</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Estevam A.</namePart>
<namePart type="family">Bonfante</namePart>
<affiliation>Postgraduate Program in Dentistry, UNIGRANRIO University, RJ, Duque de Caxias, Brazil</affiliation>
<affiliation>Rua Prof. José de Souza Herdy, 1.160 – 25 de Agosto, Duque de Caxias, RJ, Brazil25071‐202Tel.: +55(14) 3234 5805Fax: +55(14) 3234 2566e‐mail:</affiliation>
<affiliation>E-mail: estevamab@gmail.com</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Eduardo Passos</namePart>
<namePart type="family">Rocha</namePart>
<affiliation>Department of Dental Material and Prosthodontics, Araçatuba School of Dentistry, Sao Paulo State University – UNESP, Sao Paulo, Brazil</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Nelson R. F. A.</namePart>
<namePart type="family">Silva</namePart>
<affiliation>Department of Prosthodontics, New York University College of Dentistry, NY, New York, USA</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Paulo G.</namePart>
<namePart type="family">Coelho</namePart>
<affiliation>Department of Biomaterials and Biomimetics, Director for Research, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, NY, New York, USA</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<typeOfResource>text</typeOfResource>
<genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre>
<originInfo>
<publisher>Blackwell Publishing Ltd</publisher>
<dateIssued encoding="w3cdtf">2013-02</dateIssued>
<dateCreated encoding="w3cdtf">2013-01-15</dateCreated>
<dateValid encoding="w3cdtf">2012-01-29</dateValid>
<edition>Almeida EO, Freitas Júnior AC, Bonfante EA, Rocha EP, Silva NRFA, Coelho PG. Effect of microthread presence and restoration design (screw versus cemented) in dental implant reliability and failure modes. Clin. Oral Impl. Res. 24, 2013, 191–196. doi: 10.1111/j.1600-0501.2012.02437.x</edition>
<copyrightDate encoding="w3cdtf">2013</copyrightDate>
</originInfo>
<language>
<languageTerm type="code" authority="rfc3066">en</languageTerm>
<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
</language>
<abstract>This study evaluated the reliability and failure modes of implants with a microthreaded or smooth design at the crestal region, restored with screwed or cemented crowns. The postulated null hypothesis was that the presence of microthreads in the implant cervical region would not result in different reliability and strength to failure than smooth design, regardless of fixation method, when subjected to step‐stress accelerated life‐testing (SSALT) in water.</abstract>
<abstract>Eighty four dental implants (3.3 × 10 mm) were divided into four groups (n = 21) according to implant macrogeometric design at the crestal region and crown fixation method: Microthreads Screwed (MS); Smooth Screwed (SS); Microthreads Cemented (MC), and Smooth Cemented (SC). The abutments were torqued to the implants and standardized maxillary central incisor metallic crowns were cemented (MC, SC) or screwed (MS, SS) and subjected to SSALT in water. The probability of failure versus cycles (90% two‐sided confidence intervals) was calculated and plotted using a power law relationship for damage accumulation. Reliability for a mission of 50,000 cycles at 150 N (90% 2‐sided confidence intervals) was calculated. Differences between final failure loads during fatigue for each group were assessed by Kruskal–Wallis along with Benferroni's post hoc tests. Polarized‐light and scanning electron microscopes were used for failure analyses.</abstract>
<abstract>The Beta (β) value (confidence interval range) derived from use level probability Weibull calculation of 1.30 (0.76–2.22), 1.17 (0.70–1.96), 1.12 (0.71–1.76), and 0.52 (0.30–0.89) for groups MC, SC, MS, and SS respectively, indicated that fatigue was an accelerating factor for all groups, except for SS. The calculated reliability was higher for SC (99%) compared to MC (87%). No difference was observed between screwed restorations (MS – 29%, SS – 43%). Failure involved abutment screw fracture for all groups. The cemented groups (MC, SC) presented more abutment and implant fractures. Significantly higher load to fracture values were observed for SC and MC relative to MS and SS (P < 0.001).</abstract>
<abstract>Since reliability and strength to failure was higher for SC than for MC, our postulated null hypothesis was rejected.</abstract>
<note type="funding">Emfils</note>
<note type="funding">Emfils, Colosso® Evolution system</note>
<note type="funding">Marotta Dental Studio</note>
<subject>
<genre>keywords</genre>
<topic>dental implant</topic>
<topic>fractography</topic>
<topic>reliability</topic>
<topic>step‐stress accelerated life‐testing</topic>
<topic>Weibull</topic>
</subject>
<relatedItem type="host">
<titleInfo>
<title>Clinical Oral Implants Research</title>
</titleInfo>
<titleInfo type="abbreviated">
<title>Clin. Oral Impl. Res.</title>
</titleInfo>
<genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre>
<subject>
<genre>article-category</genre>
<topic>Original Article</topic>
</subject>
<identifier type="ISSN">0905-7161</identifier>
<identifier type="eISSN">1600-0501</identifier>
<identifier type="DOI">10.1111/(ISSN)1600-0501</identifier>
<identifier type="PublisherID">CLR</identifier>
<part>
<date>2013</date>
<detail type="volume">
<caption>vol.</caption>
<number>24</number>
</detail>
<detail type="issue">
<caption>no.</caption>
<number>2</number>
</detail>
<extent unit="pages">
<start>191</start>
<end>196</end>
<total>6</total>
</extent>
</part>
</relatedItem>
<identifier type="istex">091F6343233415B9186D3D1D76AE18492F0BED8B</identifier>
<identifier type="ark">ark:/67375/WNG-PRZ7264L-6</identifier>
<identifier type="DOI">10.1111/j.1600-0501.2012.02437.x</identifier>
<identifier type="ArticleID">CLR2437</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2013 John Wiley & Sons A/S© 2012 John Wiley & Sons A/S</accessCondition>
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