Load-bearing capacity of screw-retained CAD/CAM-produced titanium implant frameworks (I-Bridge®2) before and after cyclic mechanical loading
Identifieur interne : 002398 ( Main/Exploration ); précédent : 002397; suivant : 002399Load-bearing capacity of screw-retained CAD/CAM-produced titanium implant frameworks (I-Bridge®2) before and after cyclic mechanical loading
Auteurs : Marc Philipp Dittmer [Allemagne] ; Moritz Nensa [Allemagne] ; Meike Stiesch [Allemagne] ; Philipp Kohorst [Allemagne]Source :
- Journal of Applied Oral Science [ 1678-7757 ] ; 2013.
Abstract
Implant-supported screw-retained fixed dental prostheses (FDPs) produced by CAD/ CAM have been introduced in recent years for the rehabilitation of partial or total endentulous jaws. However, there is a lack of data about the long-term mechanical characteristics.
The aim of this study was to investigate the failure mode and the influence of extended cyclic mechanical loading on the load-bearing capacity of these frameworks.
Ten five-unit FDP frameworks simulating a free-end situation in the mandibular jaw were manufactured according to the I-Bridge®2-concept (I-Bridge®2, Biomain AB, Helsingborg, Sweden) and each was screw-retained on three differently angulated Astra Tech implants (30º buccal angulation/0º angulation/30º lingual angulation). One half of the specimens was tested for static load-bearing capacity without any further treatment (control), whereas the other half underwent five million cycles of mechanical loading with 100 N as the upper load limit (test). All specimens were loaded until failure in a universal testing machine with an occlusal force applied at the pontics. Load-displacement curves were recorded and the failure mode was macro- and microscopically analyzed. The statistical analysis was performed using a t-test (p=0.05).
All the specimens survived cyclic mechanical loading and no obvious failure could be observed. Due to the cyclic mechanical loading, the load-bearing capacity decreased from 8,496 N±196 N (control) to 7,592 N±901 N (test). The cyclic mechanical loading did not significantly influence the load-bearing capacity (p=0.060). The failure mode was almost identical in all specimens: large deformations of the framework at the implant connection area were obvious.
The load-bearing capacity of the I-Bridge®2 frameworks is much higher
than the clinically relevant occlusal forces, even with considerably angulated
implants. However, the performance under functional loading
Url:
DOI: 10.1590/1679-775720130077
PubMed: 24037068
PubMed Central: 3881892
Affiliations:
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frameworks (I-Bridge<sup>®</sup>2) before and after cyclic mechanical
loading</title><author><name sortKey="Dittmer, Marc Philipp" sort="Dittmer, Marc Philipp" uniqKey="Dittmer M" first="Marc Philipp" last="Dittmer">Marc Philipp Dittmer</name><affiliation wicri:level="3"><nlm:aff id="aff01"> PD Dr, Private Practice, Hannover, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> PD Dr, Private Practice, Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Nensa, Moritz" sort="Nensa, Moritz" uniqKey="Nensa M" first="Moritz" last="Nensa">Moritz Nensa</name><affiliation wicri:level="3"><nlm:aff id="aff02"> Clinic for Maxillofacial Surgery, Plastic Surgery, Implant Center, Stuttgart, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> Clinic for Maxillofacial Surgery, Plastic Surgery, Implant Center, Stuttgart</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Stuttgart</region><settlement type="city">Stuttgart</settlement></placeName></affiliation></author><author><name sortKey="Stiesch, Meike" sort="Stiesch, Meike" uniqKey="Stiesch M" first="Meike" last="Stiesch">Meike Stiesch</name><affiliation wicri:level="3"><nlm:aff id="aff03"> Professor Dr., Head of the Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> Professor Dr., Head of the Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Kohorst, Philipp" sort="Kohorst, Philipp" uniqKey="Kohorst P" first="Philipp" last="Kohorst">Philipp Kohorst</name><affiliation wicri:level="3"><nlm:aff id="aff04"> PD Dr., Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> PD Dr., Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24037068</idno><idno type="pmc">3881892</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881892</idno><idno type="RBID">PMC:3881892</idno><idno type="doi">10.1590/1679-775720130077</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002F75</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002F75</idno><idno type="wicri:Area/Pmc/Curation">002F75</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002F75</idno><idno type="wicri:Area/Pmc/Checkpoint">001939</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001939</idno><idno type="wicri:Area/Ncbi/Merge">004985</idno><idno type="wicri:Area/Ncbi/Curation">004985</idno><idno type="wicri:Area/Ncbi/Checkpoint">004985</idno><idno type="wicri:doubleKey">1678-7757:2013:Dittmer M:load:bearing:capacity</idno><idno type="wicri:Area/Main/Merge">002409</idno><idno type="wicri:Area/Main/Curation">002398</idno><idno type="wicri:Area/Main/Exploration">002398</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Load-bearing capacity of screw-retained CAD/CAM-produced titanium implant
frameworks (I-Bridge<sup>®</sup>2) before and after cyclic mechanical
loading</title><author><name sortKey="Dittmer, Marc Philipp" sort="Dittmer, Marc Philipp" uniqKey="Dittmer M" first="Marc Philipp" last="Dittmer">Marc Philipp Dittmer</name><affiliation wicri:level="3"><nlm:aff id="aff01"> PD Dr, Private Practice, Hannover, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> PD Dr, Private Practice, Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Nensa, Moritz" sort="Nensa, Moritz" uniqKey="Nensa M" first="Moritz" last="Nensa">Moritz Nensa</name><affiliation wicri:level="3"><nlm:aff id="aff02"> Clinic for Maxillofacial Surgery, Plastic Surgery, Implant Center, Stuttgart, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> Clinic for Maxillofacial Surgery, Plastic Surgery, Implant Center, Stuttgart</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Stuttgart</region><settlement type="city">Stuttgart</settlement></placeName></affiliation></author><author><name sortKey="Stiesch, Meike" sort="Stiesch, Meike" uniqKey="Stiesch M" first="Meike" last="Stiesch">Meike Stiesch</name><affiliation wicri:level="3"><nlm:aff id="aff03"> Professor Dr., Head of the Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> Professor Dr., Head of the Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Kohorst, Philipp" sort="Kohorst, Philipp" uniqKey="Kohorst P" first="Philipp" last="Kohorst">Philipp Kohorst</name><affiliation wicri:level="3"><nlm:aff id="aff04"> PD Dr., Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea> PD Dr., Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author></analytic><series><title level="j">Journal of Applied Oral Science</title><idno type="ISSN">1678-7757</idno><idno type="eISSN">1678-7765</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Implant-supported screw-retained fixed dental prostheses (FDPs) produced by CAD/ CAM
have been introduced in recent years for the rehabilitation of partial or total
endentulous jaws. However, there is a lack of data about the long-term mechanical
characteristics.</p><sec><title>Objective</title><p>The aim of this study was to investigate the failure mode and the influence of
extended cyclic mechanical loading on the load-bearing capacity of these
frameworks.</p></sec><sec><title>Material and Methods</title><p>Ten five-unit FDP frameworks simulating a free-end situation in the mandibular jaw
were manufactured according to the I-Bridge<sup>®</sup>2-concept
(I-Bridge<sup>®</sup>2, Biomain AB, Helsingborg, Sweden) and each was
screw-retained on three differently angulated Astra Tech implants (30º buccal
angulation/0º angulation/30º lingual angulation). One half of the specimens was
tested for static load-bearing capacity without any further treatment (control),
whereas the other half underwent five million cycles of mechanical loading with
100 N as the upper load limit (test). All specimens were loaded until failure in a
universal testing machine with an occlusal force applied at the pontics.
Load-displacement curves were recorded and the failure mode was macro- and
microscopically analyzed. The statistical analysis was performed using a t-test
(p=0.05). </p></sec><sec><title>Results</title><p>All the specimens survived cyclic mechanical loading and no obvious failure could
be observed. Due to the cyclic mechanical loading, the load-bearing capacity
decreased from 8,496 N±196 N (control) to 7,592 N±901 N (test). The cyclic
mechanical loading did not significantly influence the load-bearing capacity
(p=0.060). The failure mode was almost identical in all specimens: large
deformations of the framework at the implant connection area were obvious. </p></sec><sec><title>Conclusion</title><p>The load-bearing capacity of the I-Bridge<sup>®</sup>2 frameworks is much higher
than the clinically relevant occlusal forces, even with considerably angulated
implants. However, the performance under functional loading <italic>in
vivo</italic> depends on additional aspects. Further studies are needed to
address these aspects.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Amin, Wm" uniqKey="Amin W">WM Amin</name></author><author><name sortKey="Fletcher, Am" uniqKey="Fletcher A">AM Fletcher</name></author><author><name sortKey="Ritchie, Gm" uniqKey="Ritchie G">GM Ritchie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Atsu, Ss" uniqKey="Atsu S">SS Atsü</name></author><author><name sortKey="Gelgor, Ie" uniqKey="Gelgor I">IE Gelgör</name></author><author><name sortKey="Sahin, V" uniqKey="Sahin V">V Sahin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Atsu, Ss" uniqKey="Atsu S">SS Atsü</name></author><author><name sortKey="Kilicarslan, Ma" uniqKey="Kilicarslan M">MA Kilicarslan</name></author><author><name sortKey="Kucukesmen, Hc" uniqKey="Kucukesmen H">HC Kucukesmen</name></author><author><name sortKey="Aka, Ps" uniqKey="Aka P">PS 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