RESUMEN
Short dental implants with platform matching connection have been used for the rehabilitation of atrophic jaws whenever standard-length dental implants cannot be placed without prior bone augmentation. Yet, there remains a lack of data regarding the risk of technical failures when the all-on-4 configuration is performed in atrophic jaws with platform-switching distal short dental implants. Thus, the current study used the finite element method to evaluate the mechanical behavior at the level of the prosthetic components of the all-on-4 concept performed in atrophic mandible using short-length distal implants with platform switching (PSW) connection. Three models of the all-on-4 configuration were generated in human atrophic mandibles. The geometric models consisted of PSW connection tilted standard (AO4T; θ = 30 deg; 11 mm-length), straight standard (AO4S; θ = 0 deg; 11 mm-length) and straight short (AO4Sh; θ = 0 deg; 8 mm-length) distal implants. A resultant force of 300 N was performed obliquely in the left side and posterior region of the prosthetic bar. The von Mises equivalent stress (σvm) and maximum and minimum principal stresses (σmax and σmin) were performed at level of the prosthetic components/implants and peri-implant bone crest, respectively. The general displacement of the models was also evaluated. The stress analysis was performed on the side of load application. The AO4S configuration showed the lowest values of σvm in the mesial left (ML) and distal left (DL) abutments (37.53 MPa and 232.77 MPa, respectively) and dental implants (91.53 MPa and 231.21 MPa, respectively). The AO4Sh configuration showed the highest values of σvm in the bar screw (102.36 MPa), abutment (117.56 MPa), and dental implant (293.73 MPa) of the ML area. Among the models, the highest values of σmax and σmin were noticed in the peri-implant bone crest of the AO4T design (131.48 MPa and 195.31 MPa, respectively). All models showed similar values of general displacements, which were concentrated in the mandible symphysis. The all-on-4 configurations designed with PSW connection and tilted standard (AO4T; θ = 30 deg; 11 mm-length), straight standard (AO4S; θ = 0 deg; 11 mm-length) or straight short (AO4Sh; θ = 0 deg; 8 mm-length) distal implants were not associated with higher odds of technical failures. The AO4Sh design may be a promising option for the prosthetic rehabilitation of atrophic jaws.
Asunto(s)
Implantes Dentales , Humanos , Estrés Mecánico , Análisis de Elementos Finitos , Mandíbula/cirugía , Análisis del Estrés DentalRESUMEN
High implant survival rates have been achieved in recent decades due to continual modifications in implant design and surface topography, however there is still an ongoing quest to control peri-implant bone loss. The objective of this work was to develop Ti-35Nb-7Zr-5Ta (TNZT) alloys, perform physicochemical and morphological characterization of their surface modified by electrolytic oxidative plasma technique with ions related to osseointegration and lastly evaluate bacterial colonization in vitro. Three groups were evaluated: C group (polished TNZT), CaP group (sodium ß glycerophosphate + calcium acetate) and Mg group (magnesium acetate). Before and after anodizing the surfaces, physicochemical and morphological analyses were performed: scanning electron microscopy with field emission gun (FEG-SEM), energy dispersion spectroscopy (EDS), X-ray diffraction (DRX), wettability (goniometer) and roughness (rugometer). Controlled and treated specimens were contaminated with unstimulated saliva collected from 10 healthy volunteers. Then, biofilm samples were collected and up to 35 microbial species, including commensal and pathogenic microorganisms, were identified and quantified by the Checkerboard DNA-DNA Hybridization method. The CaP group modified the surface morphology in the form of pores, while the Mg group modified it in the form of flakes. The contact angle was significantly smaller in the CaP group. The average roughness was higher in the CaP and Mg groups. A smaller total amount of bacteria was identified in the Mg group and relevant differences were found in the microbial profile associated with different surface treatments. Therefore, considering the microbiological profile and for the prevention of peri-implantitis, the Mg group presented more satisfactory and encouraging results for the manufacture of dental implants.