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Fracture analysis of randomized implant-supported fixed dental prostheses

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Fracture analysis of randomized implant-supported fixed dental prostheses

Auteurs : Josephine F. Esquivel-Upshaw [États-Unis] ; Alex Mehler [États-Unis] ; Arthur E. Clark [États-Unis] ; Dan Neal [États-Unis] ; Kenneth J. Anusavice [États-Unis]

Source :

Journal of dentistry [ 0300-5712 ] ; 2014.

RBID : PMC:4169735

Abstract

Objective

Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, and nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (1) presence of a tooth distal to the most distal retainer; (2) prosthesis loading either along the non-load bearing or load bearing areas; (3) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (4) magnitude of bite force on the occurrence of veneer ceramic fracture.

Methods

89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1 to 3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts.

Conclusion

No significant relationship exists between the occurrence of fracture and: (1) the magnitude of bite force; (2) a tooth distal to the most distal retainer; and (3) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only.

Clinical Significance

This clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses because of the absence of a periodontal ligament. Implant supported prostheses should have minimal occlusion and lighter contacts than ones supported by natural dentition.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4169735

DOI: 10.1016/j.jdent.2014.07.001
PubMed: 25016139
PubMed Central: 4169735

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PMC:4169735

Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, and nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (<xref rid="R1" ref-type="bibr">1</xref>
) presence of a tooth distal to the most distal retainer; (<xref rid="R2" ref-type="bibr">2</xref>
) prosthesis loading either along the non-load bearing or load bearing areas; (<xref rid="R3" ref-type="bibr">3</xref>
) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (<xref rid="R4" ref-type="bibr">4</xref>
) magnitude of bite force on the occurrence of veneer ceramic fracture.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1 to 3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts.</p>
</sec>
<sec id="S3"><title>Conclusion</title>
<p id="P3">No significant relationship exists between the occurrence of fracture and: (<xref rid="R1" ref-type="bibr">1</xref>
) the magnitude of bite force; (<xref rid="R2" ref-type="bibr">2</xref>
) a tooth distal to the most distal retainer; and (<xref rid="R3" ref-type="bibr">3</xref>
) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only.</p>
</sec>
<sec id="S4"><title>Clinical Significance</title>
<p id="P4">This clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses because of the absence of a periodontal ligament. Implant supported prostheses should have minimal occlusion and lighter contacts than ones supported by natural dentition.</p>
</sec>
</div>
</front>
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Fracture analysis of randomized implant-supported fixed dental prostheses

Fracture analysis of randomized implant-supported fixed dental prostheses

Source :

Abstract

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