Fatigue of Narrow Dental Implants: Influence of the Hardening Method

The use of narrow titanium dental implants (NDI) for small ridges, reduced interdental space, or missing lateral incisors can be a viable option when compared to the conventional wider dental implants. Furthermore, in many cases, standard diameter implant placement may not be possible without grafting procedures, which increases the healing time, cost, and morbidity. The aim of this study was to analyze the mechanical viability of the current narrow implants and how narrow implants can be improved. Different commercially available implants (n = 150) were tested to determine maximum strength, strain to fracture, microhardness, residual stress, and fatigue obtaining the stress–number of cycles to fracture (SN) curve. Fractography was studied by scanning electron microscopy. The results showed that when the titanium was hardened by the addition of 15% of Zr or 12% cold worked, the fatigue limit was higher than the commercially pure grade 4 Ti without hardening treatment. Grade 4 titanium without hardening treatment in narrow dental implants can present fractures by fatigue. These narrow implants are subjected to high mechanical stresses and the mechanical properties of titanium do not meet the minimal requirements, which lead to frequent fractures. New hardening treatments allow for the mechanical limitations of conventional narrow implants to be overcome in dynamic conditions. These hardening treatments allow for the design of narrow dental implants with enhanced fatigue life and long-term behavior.

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Influence of Connection Type and Platform Diameter on Titanium Dental Implants Fatigue: Non-Axial Loading Cyclic Test Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17238988 ◽

2020 ◽

Vol 17 (23) ◽

pp. 8988

Author(s):

Ana I. Nicolas-Silvente ◽

Eugenio Velasco-Ortega ◽

Ivan Ortiz-Garcia ◽

Alvaro Jimenez-Guerra ◽

Loreto Monsalve-Guil ◽

...

Keyword(s):

Dental Implants ◽

Axial Loading ◽

Test Analysis ◽

Load Limit ◽

Implant Abutment ◽

Connection Type ◽

Number Of Cycles ◽

Oblique Load ◽

Titanium Dental Implants

Two-pieces dental implants must provide stability of the implant-abutment-interface. The connection type and platform diameter could influence the biomechanical resistance and stress distribution. This study aims to evaluate the fatigue for different types of connections, external and internal, and different platform diameters. Three implant designs with the same length were used: (a) external hexagon/narrow platform; (b) internal double hexagon/narrow platform; (c) internal octagon/regular platform. A fatigue test was developed to establish the number of cycles needed before fracture. A 30º oblique load with a sinusoidal function of fatigue at a frequency of 15 Hz and 10% stress variation was applied to each system. The fatigue load limit (FLL) for design (a) was 190 N, being the nominal-curvature-moment (NCM) = 1.045; FLL = 150 N, with a NCM = 0.825 for (b), and FLL = 325 N, with a NCM = 1.788 for (c). The platform diameter affects the FLL, obtaining lower FLL on a narrow platform. The connection type interferes with the implant walls’ width, especially in narrow implants, making internal connections more unstable at this level. Long-term clinical studies to assess the restoration’s success rate and survival are mandatory.

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Clinical long-term and patient-reported outcomes of dental implants in oral cancer patients

International Journal of Implant Dentistry ◽

10.1186/s40729-021-00373-4 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Eik Schiegnitz ◽

Lena Katharina Müller ◽

Keyvan Sagheb ◽

Lisa Theis ◽

Vahide Cagiran ◽

...

Keyword(s):

Radiation Therapy ◽

Oral Cancer ◽

Cancer Patients ◽

Dental Implants ◽

Survival Rates ◽

Implant Survival ◽

Implant Placement ◽

Patient Reported ◽

Oral Cancer Patients

Abstract Background and purpose The aim of this clinical study was to investigate the clinical long-term and patient-reported outcome of dental implants in patients with oral cancer. In addition, analysis of the influence of radiation therapy, timing of implant insertion, and augmentation procedures on implant survival was performed. Material and methods This retrospective study investigated the clinical outcome of 711 dental implants in 164 oral cancer patients, inserted by experienced surgeons of the Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Germany. Oral health-related quality of life (OHRQoL) was evaluated. Results Cumulative 5-year and 10-year implant survival rates for all included implants were 87.3% and 80.0%. Implants placed straight after ablative surgery (primary implant placement) and implants placed after completing the oncologic treatment (secondary implant placement) showed a comparable implant survival (92.5% vs. 89.5%; p = 0.635). Irradiation therapy had no significant influence on implant survival of secondary placed implants (p = 0.929). However, regarding implant site (native bone vs. augmented bone) and radiation therapy (non-irradiated bone vs. irradiated bone), implants inserted in irradiated bone that received augmentation procedures showed a statistically significant lower implant survival (p < 0.001). Patients reported a distinct improvement in OHRQoL. Conclusions Promising long-term survival rates of dental implants in patients after treatment of oral cancer were seen. In addition, patients benefit in form of an improved OHRQoL. However, bone augmentation procedures in irradiated bone may result in an impaired implants’ prognosis.

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Use of 3-D Printed Models for Implant Placement - A Case Series

Journal of Dentistry and Oral Sciences ◽

10.37191/mapsci-2582-3736-3(4)-108 ◽

2021 ◽

Author(s):

Soundariya Bala Muralei

Keyword(s):

Dental Implants ◽

Alveolar Bone ◽

Three Dimensional ◽

Case Series ◽

Proper Position ◽

Anatomical Structures ◽

Long Term Stability ◽

Implant Placement ◽

Plaster Models

Long-term stability of a dental implant depends on various factors, one among them is proper position within the alveolar bone. Pre-operative thorough examination of the surgical site is preliminary step while planning dental implants. Conventional techniques such as Intra-Oral Periapical Radiograph and Ortho Pantamogram sometimes not sufficient and clinical scenario always surprises the surgeon. Later advent of Cone-Beam Computed Tomography alleviated this problem to some extent but there are some clinical situations such as resorbed ridge where better visualisation is needed. This led to the innovation of rapid prototyping techniques for the fabrication of three-dimensional complex structures. This technology has numerous applications from the development of an instrument, 3-D printed anatomical models to the fabrication of 3-D printed tissues for regeneration procedures. A 3-D printed model is much more useful than plaster models in many aspects such as demonstrating anatomical structures, better treatment planning, and better understanding for the patient. Hence, this case series focuses on the use of 3-D printed models in the placement of dental implants.

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Full Mouth Rehabilitation with Implant-Supported Prostheses for Severe Periodontitis: A Case Report

The Open Dentistry Journal ◽

10.2174/1874210601004010165 ◽

2010 ◽

Vol 4 (1) ◽

pp. 165-171 ◽

Cited By ~ 6

Author(s):

Sompop Bencharit ◽

Debra Schardt-Sacco ◽

Michael B Border ◽

Colin P Barbaro

Keyword(s):

Dental Implants ◽

Bone Grafting ◽

Alveolar Bone ◽

Primary Stability ◽

Healing Time ◽

Oral Rehabilitation ◽

Implant Placement ◽

Periodontal Inflammation ◽

Severe Periodontitis ◽

Full Mouth Rehabilitation

Oral rehabilitation for a patient with severe loss of alveolar bone and soft tissue resulting from severe periodontitis presents a challenge to clinicians. Replacing loosening natural teeth with fixed prostheses supported by dental implants often requires either gingival surgery or bone grafting. The outcome of the bone grafting is sometimes unpredictable and requires longer healing time and/ or multiple surgeries. The presence of periodontal inflammation and periapical lesions often delay the placement of bone grafts as well as dental implants. Here we present a clinical case of a patient undergone full mouth reconstruction with implant-supported fixed prostheses. We demonstrated that early placement of implants (three weeks after extractions) with minimal bone grafting may be an alternative to conventional bone grafting followed by implant placement. We believe that primary stability during implant placement may contribute to our success. In addition, composite resin gingival material may be indicated in cases of large fixed implant prostheses as an alternative to pink porcelain.

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Immediate Placement and Temporization of Implants: Three- to Five-year Retrospective Results

Journal of Oral Implantology ◽

10.1563/1548-1336-35.3.136 ◽

2009 ◽

Vol 35 (3) ◽

pp. 136-142 ◽

Cited By ~ 7

Author(s):

Pierluigi Avvanzo ◽

Domenico Ciavarella ◽

Andrea Avvanzo ◽

Nicola Giannone ◽

Mauro Carella ◽

...

Keyword(s):

Retrospective Analysis ◽

Dental Implants ◽

Treatment Goal ◽

Extraction Socket ◽

Implant Placement ◽

Immediate Placement ◽

Immediate Function ◽

Term Data

Abstract The immediate placement of dental implants in esthetic areas is a primary challenge for modern implantology. The underlying treatment goal is to preserve the natural periodontal architecture; in recent years, however, a concurrent goal has been to reduce the period between implant placement in the fresh extraction socket and delivery of the definitive restoration, but adequate long-term data are still lacking on the efficacy of this technique. A 3- to 5-year retrospective analysis of 282 dental implants immediately placed into extraction sockets, and temporized with nonoccluding provisional prostheses has been undertaken. All recorded outcomes and complications, as well as a proposed protocol for management of immediate function, are discussed.

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Elevated Systemic L-Kynurenine/L-Tryptophan Ratio and Increased IL-1 Beta and Chemokine (CX3CL1, MCP-1) Proinflammatory Mediators in Patients with Long-Term Titanium Dental Implants

Journal of Clinical Medicine ◽

10.3390/jcm8091368 ◽

2019 ◽

Vol 8 (9) ◽

pp. 1368 ◽

Cited By ~ 2

Author(s):

José Joaquín Merino ◽

María Eugenia Cabaña-Muñoz ◽

Adolfo Toledano Gasca ◽

Alba Garcimartín ◽

Juana Benedí ◽

...

Keyword(s):

Dental Implants ◽

Dental Materials ◽

Study Groups ◽

Dental Amalgam ◽

Titanium Implants ◽

Monocyte Chemoattractant Protein 1 ◽

Proinflammatory Mediators ◽

Dental Amalgam Fillings ◽

Titanium Dental Implants

Titanium is the mean biocompatible metal found in dental titanium alloys (Ti-6Al-4V). The safety of certain dental biomaterial amalgams has been questioned in patients. The levels of several systemic cytokines (interleukin (IL)-1 beta, IL-4: pg/mL) and chemokines (monocyte chemoattractant protein-1 (MCP-1), soluble fractalkine (CX3CL1: pg/mL) were determined using ELISA and compared between these study groups. The study included 30 controls without dental materials (cont), 57 patients with long-term titanium dental implants plus amalgams (A + I group) as well as 55 patients with long-term dental amalgam alone (A group). All patients (except controls) have had dental titanium implants (Ti-6Al-4V) and/or amalgams for at least 10 years (average: 15 years). We evaluated whether systemic levels of cytokines/chemokines, kyn/L-trp ratio and aromatic amino acid levels (HPLC: mM/L, Phe, L-Trp, His, Treo) could be altered in patients with long-term dental titanium and/or amalgams. These systemic markers were evaluated in 142 patients. The A + I group had higher L-Kynurenine/L-Tryptophan ratios than patients with long-term dental amalgam fillings alone (A). In addition, levels of IL-1 Beta cytokine, CX3CL1 and MCP-1 chemokines were higher in the A + I group than in the A group (A). The increased L-kyn/L-trp ratio and MCP-1 and fractalkine receptor (CX3CR1) elevations could suggest enhanced chemotactic responses by these chemokines in the A + I group.

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Increased Systemic Malondialdehyde Levels and Decreased Mo/Co, Mo/Hg2+, Co/Fe2+ Ratios in Patients with Long-Term Dental Titanium Implants and Amalgams

Journal of Clinical Medicine ◽

10.3390/jcm8010086 ◽

2019 ◽

Vol 8 (1) ◽

pp. 86 ◽

Cited By ~ 4

Author(s):

María Cabaña-Muñoz ◽

José Parmigiani-Izquierdo ◽

Fabio Camacho Alonso ◽

José Merino

Keyword(s):

Oxidative Stress ◽

Dental Implants ◽

Dental Materials ◽

Dental Amalgam ◽

Titanium Implants ◽

Systemic Oxidative Stress ◽

Hair Samples ◽

Dental Amalgams ◽

Titanium Dental Implants

Introduction: the biological safety of dental biomaterials has been questioned in human studies. Material and Methods: Several heavy metals/oligoelements were compared by Inductive Coupled Mass Spectrometry (ICP-MS) in hair samples from 130 patients (n = 54 patients with long-term titanium dental implants and amalgams (A + I group), 51 patients with long-term dental amalgam alone (A group), as well as controls (n = 25: without dental materials) of similar age. All patients (except controls) had had titanium dental implants and/or dental amalgams for at least 10 years (average: 17). We evaluated whether A + I patients could present higher systemic malondialdehyde levels (MDA) as compared to the A group. Results: The A + I group have lower molybdenum levels (A + I) and reduced Mo/Co and Mo/Fe2+ ratios, which could predispose them to oxidative stress by raising MDA levels as compared to the A group alone; our findings suggest that higher Co levels could enhance oxidative stress in the A + I group. However, there were no differences on metals from titanium alloy (Ti-6Al), Cr from crowns or Hg2+, Sn, Zn2+, Cu2+ levels between the A + I and A groups. Conclusion: patients with long-term dental titanium and amalgams have systemic oxidative stress due to rising MDA levels and lower Mo/Co and Mo/Fe2+ ratios than those with amalgams alone.

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Superhydrophilic Multifunctional Nanotextured Titanium Dental Implants: In Vivo Short and Long-term Response in a Porcine Model

Biomaterials Science ◽

10.1039/d1bm01223a ◽

2021 ◽

Author(s):

Anil Mathew ◽

Silpa Abraham ◽

Shamilin Stephen ◽

Anna Serene Babu ◽

Siddaramana Gowd ◽

...

Keyword(s):

Mechanical Properties ◽

Dental Implants ◽

Porcine Model ◽

Multifunctional Device ◽

Short And Long Term ◽

Pathogenic Agents ◽

Titanium Dental Implants ◽

Term Response

Current clinical demand in dental implantology is for a multifunctional device with optimum mechanical properties, improved biocompatibility, and bioactivity, and having differential interactions with cells and pathogenic agents. This would...

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Clinical and radiological assessment of the condition of implants with fixed structures in the dynamics of 20-year follow-up

10.47183/mes.2021.040 ◽

2021 ◽

Author(s):

EE Olesov ◽

AS Ivanov ◽

RS Zaslavskiy ◽

AV Ragulin ◽

AS Romanov

Keyword(s):

Dental Implants ◽

Long Term Results ◽

Missing Teeth ◽

Average Life ◽

Clinical Center ◽

The Moment ◽

Titanium Dental Implants ◽

Single Implant

The statistically significant long-term results of the implant survival and the effectiveness of prostheses are inadequately represented in scientific literature. The study was aimed to assess the effectiveness of prosthetics with fixed structures on the intraosseous dental implants for the replacement of partially absent dentition in the dynamics of the 20-year follow-up. A total of 671 patients with partially missing teeth were examined at the Clinical Center of Dentistry of the FMBA of Russia, who were fitted with 1,700 intraosseous titanium dental implants with the terms from the moment of completion of prosthetics on implants of 5, 10, 15 or 20 years. The criteria for clinical and radiological evaluation of the implant condition were as follows: no complications affecting the condition of periimplant tissues (normal), mucositis, periimplantitis with bone resorption at 1/3 or 1/2 of the implant height, implant removal. Based on 20 years of experience, prosthetics with fixed structures on implants is highly effective in replacing the partial defects of dentition. In total, 62.2% of implants remain functional for 20 years. The average life of implant-supported fixed prostheses is 15 years for bridges, and 20 years for single and combined implant-supported crowns. The most effective are single implant-supported crowns, and the least effective are prostheses supported by implants and teeth. The significantly preserved implant-supported prostheses make it possible to support the concept of the long-term implant installation with respect to the implant-supported non-removable prostheses. The view is thus confirmed that the effectiveness of the implant-supported prosthetics is reduced with the inclusion of teeth in the bridge support, along with implants.

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Impact of a hydrophilic dental implant surface on osseointegration: biomechanical results in rabbit.

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00217 ◽

2020 ◽

Author(s):

Yohei Jinno ◽

Michele Stocchero ◽

Silvia Galli ◽

Marco Toia ◽

Jonas Peter Becktor

Keyword(s):

Dental Implants ◽

Test Group ◽

Mature Female ◽

Control Group ◽

Insertion Torque ◽

Implant Surface ◽

Implant Placement ◽

Dental Implant Surface ◽

Pure Grade ◽

Surface Test

This study aimed to evaluate the effect of surface hydrophilicity on the biomechanical aspects of osseointegration of dental implants in the tibia and femur of rabbits. Forty-eight mature female New Zealand White rabbits were included, and 96 commercially pure, Grade 4, titanium dental implants (control group), and 96 implants of same macro geometry with the hydrophilic surface (test group) were used in this study. One osteotomy was performed in each tibia and femur on both sides of the rabbit, and four implants were placed in each rabbit. Control and test groups were randomly allocated on the left and right sides. During surgery, insertion torque (ITQ) value of the complete implant placement was recorded. After healing periods of 0, 2, 4, and 8 weeks after surgery, Implant Stability Quotient (ISQ) value, and removal torque (RTQ) values were measured. No statistical difference was observed for ITQ, for ISQ and for RTQ between the control group and test group in tibia/femur for all time periods. The effect of hydrophilic properties on moderately roughened surfaces has no impact in terms of biomechanical outcomes (ISQ values and RTQ values) after a healing period of 2 to 8 weeks in rabbit tibias /femurs.

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