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Strains around distally inclined implants retaining mandibular overdentures with Locator attachments: an in vitro study

Identifieur interne : 006687 ( Ncbi/Merge ); précédent : 006686; suivant : 006688

Strains around distally inclined implants retaining mandibular overdentures with Locator attachments: an in vitro study

Auteurs : Moustafa Abdou Elsyad [Égypte] ; Fathi Abo Setta [Libye] ; Ahmed Samir Khirallah [Égypte]

Source :

RBID : PMC:4852263

Abstract

PURPOSE

The aim of the present study was to evaluate, by means of strain gauge analysis, the effect of different implant angulations on strains around two implants retaining mandibular overdenture with Locator attachments.

MATERIALS AND METHODS

Four duplicate mandibular acrylic models were constructed. Two implants were inserted in the canine regions using the following degrees of distal inclinations: group I (control); 0°, group II; 10°, group III; 20°, and group IV; 30°. Locator pink attachments were used to connect the overdenture to the implants and Locator red (designed for severely angled implants) was used for group IV (group IVred). For each group, two linear strain gauges were attached at the mesial and distal surfaces of the acrylic resin around each implant. Peri-implant strain was measured on loading and non-loading sides during bilateral and unilateral loading.

RESULTS

For all groups, the mesial surfaces of the implants at loading and non-loading sides experienced compressive (negative) strains, while the distal implant surfaces showed tensile (positive) strains. Group IV showed the highest strain, followed by group III, group II. Both group I and group IVred showed the lowest strain. The strain gauges at the mesial surface of the loading side recorded the highest strain, and the distal surface at non-loading side showed the lowest strain. Unilateral loading recorded significantly higher strain than bilateral loading.

CONCLUSION

Peri-implant strains around two implants used to retain mandibular overdentures with Locator attachments increase as distal implant inclination increases, except when red nylon inserts were used.


Url:
DOI: 10.4047/jap.2016.8.2.116
PubMed: 27141255
PubMed Central: 4852263

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PMC:4852263

Le document en format XML

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<name sortKey="Elsyad, Moustafa Abdou" sort="Elsyad, Moustafa Abdou" uniqKey="Elsyad M" first="Moustafa Abdou" last="Elsyad">Moustafa Abdou Elsyad</name>
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<name sortKey="Setta, Fathi Abo" sort="Setta, Fathi Abo" uniqKey="Setta F" first="Fathi Abo" last="Setta">Fathi Abo Setta</name>
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<name sortKey="Khirallah, Ahmed Samir" sort="Khirallah, Ahmed Samir" uniqKey="Khirallah A" first="Ahmed Samir" last="Khirallah">Ahmed Samir Khirallah</name>
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<title level="j">The Journal of Advanced Prosthodontics</title>
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<title>PURPOSE</title>
<p>The aim of the present study was to evaluate, by means of strain gauge analysis, the effect of different implant angulations on strains around two implants retaining mandibular overdenture with Locator attachments.</p>
</sec>
<sec>
<title>MATERIALS AND METHODS</title>
<p>Four duplicate mandibular acrylic models were constructed. Two implants were inserted in the canine regions using the following degrees of distal inclinations: group I (control); 0°, group II; 10°, group III; 20°, and group IV; 30°. Locator pink attachments were used to connect the overdenture to the implants and Locator red (designed for severely angled implants) was used for group IV (group IV
<sub>red</sub>
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</sec>
<sec>
<title>RESULTS</title>
<p>For all groups, the mesial surfaces of the implants at loading and non-loading sides experienced compressive (negative) strains, while the distal implant surfaces showed tensile (positive) strains. Group IV showed the highest strain, followed by group III, group II. Both group I and group IV
<sub>red</sub>
showed the lowest strain. The strain gauges at the mesial surface of the loading side recorded the highest strain, and the distal surface at non-loading side showed the lowest strain. Unilateral loading recorded significantly higher strain than bilateral loading.</p>
</sec>
<sec>
<title>CONCLUSION</title>
<p>Peri-implant strains around two implants used to retain mandibular overdentures with Locator attachments increase as distal implant inclination increases, except when red nylon inserts were used.</p>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Adv Prosthodont</journal-id>
<journal-id journal-id-type="iso-abbrev">J Adv Prosthodont</journal-id>
<journal-id journal-id-type="publisher-id">JAP</journal-id>
<journal-title-group>
<journal-title>The Journal of Advanced Prosthodontics</journal-title>
</journal-title-group>
<issn pub-type="ppub">2005-7806</issn>
<issn pub-type="epub">2005-7814</issn>
<publisher>
<publisher-name>The Korean Academy of Prosthodontics</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">27141255</article-id>
<article-id pub-id-type="pmc">4852263</article-id>
<article-id pub-id-type="doi">10.4047/jap.2016.8.2.116</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Strains around distally inclined implants retaining mandibular overdentures with Locator attachments: an
<italic>in vitro</italic>
study</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<contrib-id contrib-id-type="orcid" authenticated="true">http://orcid.org/0000-0001-9514-6931</contrib-id>
<name>
<surname>Elsyad</surname>
<given-names>Moustafa Abdou</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Setta</surname>
<given-names>Fathi Abo</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Khirallah</surname>
<given-names>Ahmed Samir</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Removable Prosthodontics, Faculty of Dentistry, Mansoura University, Egypt.</aff>
<aff id="A2">
<label>2</label>
Bachelor degree student, Faculty of Dentistry, Tripoli University, Libya.</aff>
<author-notes>
<corresp>Corresponding author: Moustafa Abdou Elsyad. Department of Removable Prosthodontic, Faculty of Dentistry, Mansoura University, #68 ElGomhoria Street, ElMansoura 35516, Egypt. Tel. 20 0572353238,
<email>M_syad@mans.edu.eg</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>4</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>21</day>
<month>4</month>
<year>2016</year>
</pub-date>
<volume>8</volume>
<issue>2</issue>
<fpage>116</fpage>
<lpage>124</lpage>
<history>
<date date-type="received">
<day>10</day>
<month>9</month>
<year>2015</year>
</date>
<date date-type="rev-recd">
<day>02</day>
<month>11</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>12</day>
<month>1</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>© 2016 The Korean Academy of Prosthodontics</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>PURPOSE</title>
<p>The aim of the present study was to evaluate, by means of strain gauge analysis, the effect of different implant angulations on strains around two implants retaining mandibular overdenture with Locator attachments.</p>
</sec>
<sec>
<title>MATERIALS AND METHODS</title>
<p>Four duplicate mandibular acrylic models were constructed. Two implants were inserted in the canine regions using the following degrees of distal inclinations: group I (control); 0°, group II; 10°, group III; 20°, and group IV; 30°. Locator pink attachments were used to connect the overdenture to the implants and Locator red (designed for severely angled implants) was used for group IV (group IV
<sub>red</sub>
). For each group, two linear strain gauges were attached at the mesial and distal surfaces of the acrylic resin around each implant. Peri-implant strain was measured on loading and non-loading sides during bilateral and unilateral loading.</p>
</sec>
<sec>
<title>RESULTS</title>
<p>For all groups, the mesial surfaces of the implants at loading and non-loading sides experienced compressive (negative) strains, while the distal implant surfaces showed tensile (positive) strains. Group IV showed the highest strain, followed by group III, group II. Both group I and group IV
<sub>red</sub>
showed the lowest strain. The strain gauges at the mesial surface of the loading side recorded the highest strain, and the distal surface at non-loading side showed the lowest strain. Unilateral loading recorded significantly higher strain than bilateral loading.</p>
</sec>
<sec>
<title>CONCLUSION</title>
<p>Peri-implant strains around two implants used to retain mandibular overdentures with Locator attachments increase as distal implant inclination increases, except when red nylon inserts were used.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Strain</kwd>
<kwd>Inclined implants</kwd>
<kwd>Locator</kwd>
<kwd>Overdentures</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="F1" orientation="portrait" position="float">
<label>Fig. 1</label>
<caption>
<title>Controlling the degree of distal implant inclination using a conventional transparent plastic semicircular protractor.</title>
</caption>
<graphic xlink:href="jap-8-116-g001"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float">
<label>Fig. 2</label>
<caption>
<title>(A) Group I (0°) implant inclination, (B) Group II (10°) implant inclination, (C) Group III (20°) implant inclination, (D) Group IV (30°) implant inclination.</title>
</caption>
<graphic xlink:href="jap-8-116-g002"></graphic>
</fig>
<fig id="F3" orientation="portrait" position="float">
<label>Fig. 3</label>
<caption>
<title>The strain gauge positions around the implants.</title>
</caption>
<graphic xlink:href="jap-8-116-g003"></graphic>
</fig>
<fig id="F4" orientation="portrait" position="float">
<label>Fig. 4</label>
<caption>
<title>Bilateral load application.</title>
</caption>
<graphic xlink:href="jap-8-116-g004"></graphic>
</fig>
<fig id="F5" orientation="portrait" position="float">
<label>Fig. 5</label>
<caption>
<title>Unilateral load application.</title>
</caption>
<graphic xlink:href="jap-8-116-g005"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<title>Comparison of total microstrains between groups</title>
</caption>
<alternatives>
<graphic xlink:href="jap-8-116-i001"></graphic>
<table frame="hsides" rules="rows">
<col width="18.22%" span="1"></col>
<col width="19.38%" span="1"></col>
<col width="21.71%" span="1"></col>
<col width="18.22%" span="1"></col>
<col width="22.48%" span="1"></col>
<thead>
<tr>
<th valign="middle" align="center" rowspan="1" colspan="1">Group</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Mean</th>
<th valign="middle" align="center" rowspan="1" colspan="1">St. error</th>
<th valign="middle" align="center" rowspan="1" colspan="1">ANOVA
<break></break>
<italic>P</italic>
value</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Post hoc test
<break></break>
(Bonferroni)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">I</td>
<td valign="top" align="right" rowspan="1" colspan="1">-31.875</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.685</td>
<td valign="middle" align="center" rowspan="5" colspan="1">.00
<sup>*</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">A</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">II</td>
<td valign="top" align="right" rowspan="1" colspan="1">-105.250</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.685</td>
<td valign="top" align="center" rowspan="1" colspan="1">B</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">III</td>
<td valign="top" align="right" rowspan="1" colspan="1">-147.925</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.685</td>
<td valign="top" align="center" rowspan="1" colspan="1">C</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">IV</td>
<td valign="top" align="right" rowspan="1" colspan="1">-220.750</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.685</td>
<td valign="top" align="center" rowspan="1" colspan="1">D</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">IV
<sub>red</sub>
</td>
<td valign="top" align="right" rowspan="1" colspan="1">-30.375</td>
<td valign="top" align="center" rowspan="1" colspan="1">6.685</td>
<td valign="top" align="center" rowspan="1" colspan="1">A</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn>
<p>
<sup>*</sup>
<italic>P</italic>
is significant at 0.05 level of significance. The different upper case letters indicate significant differences between groups.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" orientation="portrait" position="float">
<label>Table 2</label>
<caption>
<title>Comparison of total microstrains between sites of strain gauges</title>
</caption>
<alternatives>
<graphic xlink:href="jap-8-116-i002"></graphic>
<table frame="hsides" rules="rows">
<col width="26.93%" span="1"></col>
<col width="18.27%" span="1"></col>
<col width="18.27%" span="1"></col>
<col width="18.27%" span="1"></col>
<col width="18.27%" span="1"></col>
<thead>
<tr>
<th valign="middle" align="center" rowspan="1" colspan="1">Group</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Mean</th>
<th valign="middle" align="center" rowspan="1" colspan="1">St. error</th>
<th valign="middle" align="center" rowspan="1" colspan="1">ANOVA
<break></break>
<italic>P</italic>
value</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Post hoc test
<break></break>
(Bonferroni)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">RD (right distal)</td>
<td valign="top" align="right" rowspan="1" colspan="1">472.100</td>
<td valign="top" align="center" rowspan="1" colspan="1">5.979</td>
<td valign="middle" align="center" rowspan="4" colspan="1">.00
<sup>*</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">A</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">RM (right mesial)</td>
<td valign="top" align="right" rowspan="1" colspan="1">-784.400</td>
<td valign="top" align="center" rowspan="1" colspan="1">5.979</td>
<td valign="top" align="center" rowspan="1" colspan="1">B</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">LM (left mesial)</td>
<td valign="top" align="right" rowspan="1" colspan="1">-299.400</td>
<td valign="top" align="center" rowspan="1" colspan="1">5.979</td>
<td valign="top" align="center" rowspan="1" colspan="1">C</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">LD (left distal)</td>
<td valign="top" align="right" rowspan="1" colspan="1">182.760</td>
<td valign="top" align="center" rowspan="1" colspan="1">5.979</td>
<td valign="top" align="center" rowspan="1" colspan="1">D</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn>
<p>
<sup>*</sup>
<italic>P</italic>
is significant at 0.05 level of significance. The different upper case letters indicate significant differences between sites.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T3" orientation="portrait" position="float">
<label>Table 3</label>
<caption>
<title>Comparison of recorded microstrain values between unilateral and bilateral load application</title>
</caption>
<alternatives>
<graphic xlink:href="jap-8-116-i003"></graphic>
<table frame="hsides" rules="rows">
<col width="30.72%" span="1"></col>
<col width="21.39%" span="1"></col>
<col width="21.39%" span="1"></col>
<col width="26.51%" span="1"></col>
<thead>
<tr>
<th valign="top" align="left" rowspan="1" colspan="1"></th>
<th valign="top" align="center" rowspan="1" colspan="1">Mean</th>
<th valign="top" align="center" rowspan="1" colspan="1">St. error</th>
<th valign="top" align="center" rowspan="1" colspan="1">Paired samples t test</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Unilateral load application</td>
<td valign="top" align="right" rowspan="1" colspan="1">-144.870</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.228</td>
<td valign="middle" align="center" rowspan="2" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Bilateral load application</td>
<td valign="top" align="right" rowspan="1" colspan="1">-69.600</td>
<td valign="top" align="right" rowspan="1" colspan="1">4.228</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn>
<p>
<sup>*</sup>
<italic>P</italic>
is significant at 5% level.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T4" orientation="portrait" position="float">
<label>Table 4</label>
<caption>
<title>Comparison of peri-implant stain between groups and between sites of strain gauges during bilateral load application</title>
</caption>
<alternatives>
<graphic xlink:href="jap-8-116-i004"></graphic>
<table frame="hsides" rules="rows">
<col width="16.6%" span="1"></col>
<col width="17%" span="1"></col>
<col width="17%" span="1"></col>
<col width="17%" span="1"></col>
<col width="17%" span="1"></col>
<col width="15.4%" span="1"></col>
<thead>
<tr>
<th valign="middle" align="center" rowspan="2" colspan="1">Group</th>
<th valign="middle" align="center" rowspan="1" colspan="1">RD
<break></break>
(right distal)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">RM
<break></break>
(right mesial)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">LM
<break></break>
(left mesial)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">LD
<break></break>
(left distal)</th>
<th valign="middle" align="center" rowspan="2" colspan="1">2-way ANOVA</th>
</tr>
<tr>
<th valign="middle" align="center" rowspan="1" colspan="4">(X ± SD)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" align="center" rowspan="1" colspan="1">I</td>
<td valign="middle" align="center" rowspan="1" colspan="1">99.00 ± 2.23
<sup>A,a</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">-156.00 ± 2.23
<sup>A,b</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">-89.00 ± 4.18
<sup>A,c</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">134.00 ± 2.23
<sup>A,a</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">II</td>
<td valign="top" align="center" rowspan="1" colspan="1">169.00 ± 220.32
<sup>B,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-246.00 ± 14.74
<sup>B,b</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-304.00 ± 29.66
<sup>B,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">50.00 ± 10.60
<sup>B,d</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">III</td>
<td valign="top" align="center" rowspan="1" colspan="1">961.00 ± 66.93
<sup>C,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-1220.00 ± 57.00
<sup>C,b</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-408.00 ± 13.03
<sup>C,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">120.00 ± 15.81
<sup>C,d</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">IV</td>
<td valign="top" align="center" rowspan="1" colspan="1">1048.00 ± 5.70
<sup>D,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-1428.00 ± 28.19
<sup>D,b</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-309.00 ± 4.18
<sup>D,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">193.00 ± 2.73
<sup>D,d</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">IV
<sub>red</sub>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">94.00 ± 4.18
<sup>A,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-147.00 ± 7.58
<sup>A,b</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-84.00 ± 4.18
<sup>A,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">131.00 ± 2.23
<sup>A,d</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">2-way ANOVA (P)</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn>
<p>X; mean, SD; standard deviation, LSD; least significant differences. The different upper case letters indicate significant. The different upper case letters indicate significant differences between groups (Bonferroni,
<italic>P</italic>
< .05). The different lower case letters indicate significant differences between sites of strain gauges (Bonferroni,
<italic>P</italic>
< .05).
<sup>*</sup>
<italic>P</italic>
is significant at 5% level of significance.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T5" orientation="portrait" position="float">
<label>Table 5</label>
<caption>
<title>Comparison of peri-implant stain between groups and between sites of strain gauges during unilateral load application</title>
</caption>
<alternatives>
<graphic xlink:href="jap-8-116-i005"></graphic>
<table frame="hsides" rules="rows">
<col width="12.3%" span="1"></col>
<col width="17.54%" span="1"></col>
<col width="17.54%" span="1"></col>
<col width="17.54%" span="1"></col>
<col width="17.54%" span="1"></col>
<col width="17.54%" span="1"></col>
<thead>
<tr>
<th valign="middle" align="center" rowspan="2" colspan="1">Group</th>
<th valign="middle" align="center" rowspan="1" colspan="1">RD
<break></break>
(right distal)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">RM
<break></break>
(right mesial)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">LM
<break></break>
(left mesial)</th>
<th valign="middle" align="center" rowspan="1" colspan="1">LD
<break></break>
(left distal)</th>
<th valign="middle" align="center" rowspan="2" colspan="1">2-way ANOVA</th>
</tr>
<tr>
<th valign="middle" align="center" rowspan="1" colspan="4">(X ± SD)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" align="center" rowspan="1" colspan="1">I</td>
<td valign="middle" align="center" rowspan="1" colspan="1">98.00 ± 5.70
<sup>A,a</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">-313.00 ± 8.36
<sup>A,b</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">-119.00 ± 6.51
<sup>A,c</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">91.00 ± 4.18
<sup>A,a</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">II</td>
<td valign="top" align="center" rowspan="1" colspan="1">653.00 ± 42.66
<sup>B,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-936.00 ± 39.11
<sup>B,b</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-487.00 ± 5.70
<sup>B,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">259.00 ± 6.51
<sup>B,d</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">III</td>
<td valign="top" align="center" rowspan="1" colspan="1">714.00 ± 23.02
<sup>C,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-1220.00 ± 75.82
<sup>C,b</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-485.00 ± 3.53
<sup>C,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">354.60 ± 13.53
<sup>C,d</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">IV</td>
<td valign="top" align="center" rowspan="1" colspan="1">792.00 ± 4.47
<sup>D,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-1872.00 ± 25.64
<sup>D,b</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-596.00 ± 41.59
<sup>D,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">406.00 ± 5.47
<sup>D,d</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">IV
<sub>red</sub>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">93.00 ± 4.47
<sup>A,a</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">-306.00 ± 8.94A,b</td>
<td valign="top" align="center" rowspan="1" colspan="1">-103.00 ± 2.74
<sup>A,c</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">89.00 ± 2.23
<sup>A,d</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
</tr>
<tr>
<td valign="top" align="center" rowspan="1" colspan="1">2-way ANOVA (P)</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">.00
<sup>*</sup>
</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn>
<p>X; mean, SD; standard deviation, LSD; least significant differences. The different upper case letters indicate significant differences between groups (Bonferroni,
<italic>P</italic>
< .05). The different lower case letters indicate significant differences between sites of strain gauges (Bonferroni,
<italic>P</italic>
< .05).
<sup>*</sup>
<italic>P</italic>
is significant at 5% level of significance.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Libye</li>
<li>Égypte</li>
</country>
</list>
<tree>
<country name="Égypte">
<noRegion>
<name sortKey="Elsyad, Moustafa Abdou" sort="Elsyad, Moustafa Abdou" uniqKey="Elsyad M" first="Moustafa Abdou" last="Elsyad">Moustafa Abdou Elsyad</name>
</noRegion>
<name sortKey="Khirallah, Ahmed Samir" sort="Khirallah, Ahmed Samir" uniqKey="Khirallah A" first="Ahmed Samir" last="Khirallah">Ahmed Samir Khirallah</name>
</country>
<country name="Libye">
<noRegion>
<name sortKey="Setta, Fathi Abo" sort="Setta, Fathi Abo" uniqKey="Setta F" first="Fathi Abo" last="Setta">Fathi Abo Setta</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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