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Prosthetic and Mechanical Parameters of the Facial Bone Under the Load of Different Dental Implant Shapes: a Parametric Study

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Prosthetic and Mechanical Parameters of the Facial Bone Under the Load of Different Dental Implant Shapes: a Parametric Study Article Prosthetic and Mechanical Parameters of the Facial Bone under the Load of Different Dental Implant Shapes: A Parametric Study Marco Cicciù 1 , Gabriele Cervino 1 , Antonella Terranova 1, Giacomo Risitano 2 , Marcello Raffaele 2 , Filippo Cucinotta 2 , Dario Santonocito 2 and Luca Fiorillo 1,3,* 1 Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina, Italy; [email protected] (M.C.); [email protected] (G.C.); [email protected] (A.T.) 2 Department of Engineering, Messina University, 98100 Messina, Italy; [email protected] (G.R.); marcello.raff[email protected] (M.R.); fi[email protected] (F.C.); [email protected] (D.S.) 3 Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80141 Naples, Italy * Correspondence: lucafi[email protected]; Tel.: +39-090-2216920 Received: 26 October 2019; Accepted: 12 November 2019; Published: 14 November 2019 Abstract: In recent years the science of dental materials and implantology have taken many steps forward. In particular, it has tended to optimize the implant design, the implant surface, or the connection between implant and abutment. All these features have been improved or modified to obtain a better response from the body, better biomechanics, increased bone implant contact surface, and better immunological response. The purpose of this article, carried out by a multidisciplinary team, is to evaluate and understand, through the use also of bioengineering tests, the biomechanical aspects, and those induced on the patient’s tissues, by dental implants. A comparative analysis on different dental implants of the same manufacturer was carried out to evaluate biomechanical and molecular features. Von Mises analysis has given results regarding the biomechanical behavior of these implants and above all the repercussions on the patient’s tissues. Knowing and understanding the biomechanical characteristics with studies of this type could help improve their characteristics in order to have more predictable oral rehabilitations. Keywords: dental implants; osseointegrated implants; dental prosthesis design; biomechanical phenomena; dental occlusion; osseointegration; wound healing; immunological; bone tissue; finite element analysis 1. Introduction The dental implant (also known as endosseous implant) is a surgical-type medical device used to functionally and aesthetically rehabilitate the loss or congenital deficiency of one or more teeth, allowing the support of a prosthetic substitute through direct bone support thanks to a biological process known as osseointegration. The long-term prognosis of dental implants can be considered reliable and predictable, as it can now be based on more than forty years of worldwide clinical experience. The data reported in the literature report variable failure rates, depending on the operating techniques and types used. The type of surface treatment also appears to involve significant differences in the implant survival data. The failures are divided according to the causes, biological, biomechanical, and aesthetic. Biological failures are divided into early and late, depending on the period in which they occur. Early failure is typically linked to a deficient initial osseointegration process following the surgical procedure, more rarely to operational errors in the procedure itself, while late failures are due Prosthesis 2019, 1, 41–53; doi:10.3390/prosthesis1010006 www.mdpi.com/journal/prosthesis Prosthesis 2019, 1 42 Prosthesis. 2019, 1, x FOR PEER REVIEW 2 of 13 to progressive infectious processes affecting the peri-implant tissues and therefore the supporting bone thatprocess surrounds following the implant the surgical (peri-implantitis) procedure, more [1–6 ].rarely Biomechanical to operational failures errors derive in the fromprocedure problems itself, due to overloadwhile late and failures functional are due trauma, to progressive which caninfectious occur processes with structural affecting failure the peri-implant at both the tissues implants and and the supportedtherefore the prosthetic supporting structures. bone that The surrounds direct implant-bone the implant connection(peri-implantitis) linked [1–6]. to the Biomechanical osseointegration processfailures leads derive to a from greater problems functional due loadto overload both on and the prostheticfunctional elementstrauma, which of the can implants occur with and on thestructural antagonist failure elements at both that the come implants into and contact the su withpported the implantprosthetic prosthetic structures. elements. The direct Theimplant- lack of bone connection linked to the osseointegration process leads to a greater functional load both on the the physiological periodontal ligament also implies the absence of the proprioceptive structures that prosthetic elements of the implants and on the antagonist elements that come into contact with the contribute to limiting trauma, through some opportune reflex mechanisms. This explains the tendency implant prosthetic elements. The lack of the physiological periodontal ligament also implies the to increase mechanical problems over time. Some systems have been proposed to limit these problems absence of the proprioceptive structures that contribute to limiting trauma, through some opportune by insertingreflex mechanisms. elastic elements This explains in the structurethe tendency of the to plants.increase Theremechanical is talk pr ofoblems aesthetic over failure time. Some when in areassystems of high have aesthetic been proposed relevance to therelimit these are exposures problems ofby metalinserting parts, elastic bone elements dehiscence in the and structure gums of with retractionthe plants. of the There interdental is talk papillaeof aesthetic and failure the creation when ofin darkareas trianglesof high aesthetic below the relevance contact pointsthere are of the teeth.exposures The success of metal or failure parts, ofbone the dehiscence implants depends and gums both with on retraction the health of status the interdental of the person papillae receiving and it, on anythe medicationscreation of dark taken triangles which havebelow a possiblethe contact impact points with of osseointegration,the teeth. The success and theor failure condition of the of the tissuesimplants of the depends mouth [both7,8]. on The the mechanical health status stress of the that person the implantreceiving would it, on an encountery medications during taken its which life must be carefullyhave a possible evaluated. impact The with correct osseointegration, planning of theand position the condition and number of the tissues of implants of the mouth is fundamental [7,8]. The for the long-termmechanical preservation stress that the of implant the prosthesis, would encounter as the biomechanical during its life forces must actingbe carefully during evaluated. chewing The can be significant.correct planning The position of the of theposition implant and is determinednumber of byimplants the position is fundamental and angle for of thethe adjacent long-term teeth, by laboratorypreservation simulations, of the prosthesis, or by as the the use biomechanical of computerized forces tomographyacting during withchewing CAD can/CAM be significant. simulations The position of the implant is determined by the position and angle of the adjacent teeth, by and surgical guides [9]. laboratory simulations, or by the use of computerized tomography with CAD / CAM simulations and The objective of this study is to evaluate how the geometric and therefore biomechanical surgical guides [9]. characteristics of a dental implant, in addition to having repercussions on the components of the The objective of this study is to evaluate how the geometric and therefore biomechanical implant,characteristics can influence of a dental the response implant, of in the addition patient’s to oralhaving tissues repercussions [10–13]. on the components of the implant, can influence the response of the patient's oral tissues [10–13]. 2. Results 2.The Results equivalent Von Mises stress distribution at the maximum load during the masticatory cycle has beenThe evaluated. equivalent A Von vertical Mises compressive stress distribution load wasat the applied maximum on load the threeduring di thefferent masticatory prostheses cycle and afterhas the been simulation evaluated. was A performedvertical compressive the obtained load data was wereapplied post-processed. on the three different The results prostheses are presented and adoptingafter the a unifiedsimulation color was scale performed for each the kind obtained of prosthesis data were component, post-processed. ranging The fromresults a minimumare presented value in megapascaladopting a unified (MPa), color represented scale for each by bluekind of color, prosthesis and a component, maximum ranging value, representedfrom a minimum by red value color. In orderin megapascal to show the (MPa), internal represented stress arising by blue in color, the di andfferent a maximum parts of value, the finite represented element by models, red color. the stressIn hasorder been evaluatedto show the in internal section stress views. arising in the different parts of the finite element models, the stress hasAs been a first evaluated result, it in is section possible views. to see how all of the prosthesis components reach a maximum stress value lowerAs a thanfirst result, the yielding it is possible stress
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