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Over the past decades, the technological development in the medical field, coupled with the ongoing scientific research, has led to the development and improvement of dental prostheses supported by screw-retained metal frameworks. A key point in the manufacture of the framework is the achievement of a passive fit, intended as the capability of an implant-supported reconstruction to transmit minimum strain to implant components as well as to the surrounding bone, when subject to any load. The fitting of four different kinds of screw-retained metal frameworks was tested in this article. They differ both in materials and manufacturing process: two frameworks are made by casting, one framework is made by computer-aided design and computer-aided manufacturing and one framework is made by electric resistance spot welding (WeldONE, DENTSPLY Implants Manufacturing GmbH, Mannheim, Germany). The passivity of the frameworks was evaluated on the entire system, composed of a resin master cast, the implant analogues embedded in the cast and the frameworks. Strains were recorded by means of an electrical strain gauge connected to a control unit for strain gauge measurements. The experimental tests were carried out in the laboratories of the Department of INdustrial engineering at the University of Bologna. The results of the test campaigns, which compared three samples for each technological process, showed that no significant differences exist between the four framework types. In particular, the frameworks made by the resistance welding approach led to a mechanical response that is well comparable to that of the other tested frameworks.

This study aims to compare in-vitro the fitting accuracy of implant-supported metal frameworks used for full-arch orthodontic restoration. The hypotheses tested were as follows: (1) for a fixed implant morphology, strains developed within the framework depend on how the framework had been fabricated and (2) stresses transferred to the implant–bone interface are related to the amount of framework misfit. Metal frameworks were fabricated using four different manufacturing techniques: conventional lost-wax casting, resin cement luting, electrospark erosion, and computer-aided design/computer-aided manufacturing milling. Each framework was instrumented with three strain gauges to measure strains developed because of prosthetic misfit, while quantitative photoelastic analysis was used to assess the effect of misfit at the implant–resin interface. All the tested frameworks presented stress polarization around the fixtures. After screw tightening, significantly greater strains were observed in the lost-wax superstructure, while the lowest strains were observed in the luted framework, demonstrating consistent adaptation and passive fitting. No significant difference in stress distribution and marginal fit was found for bars fabricated by either computer-aided design/computer-aided manufacturing or spark erosion. This study suggested that, in spite of known limitations of in-vitro testing, direct luting of mesostructures and abutments should be the first clinical option for the treatment of complete edentulism, ensuring consistent passive fitting and effective cost–benefit ratio.

Purpose: The purpose of this study was to evaluate the effects of two different prosthetic designs (screw-retained versus cement-retained) and two impression techniques (open versus closed tray) on bone-level strains around implants. Materials and methods: Two Ø 4.1 mm × 10 mm Straumann implants were placed in the bilateral fibulas of six fresh cadavers; bone segments were removed en bloc. Twelve implant-level and six abutment-level (18 total) working casts were made to fabricate fixed partial dentures, resulting in three test groups: Group 1: closed-tray technique/implant-level model/screw-retained prostheses; Group 2: closed-tray technique/abutment-level model/cement-retained prostheses; Group 3: open-tray technique/implant-level model/screw-retained prostheses. Linear strain-gauges were bonded to the cortical bone between implants and the lateral wall of the fibula in close proximity to the implant necks in each bone fragment. Strain-gauge signals were digitized by a data acquisition system and corresponding software at a sample rate of 10 KHz, simultaneously monitored from the computer during application of an external static load of 150 N on the middle of the pontic, using a loading frame. Results: The approximal and lateral strains were extremely similar in both prosthetic groups (p > 0.05). Within-group comparisons for the indirect impression technique showed that approximal and lateral strains in screw- and cement-retained prostheses were similar (p > 0.05). Neither the prostheses design nor the impression technique had any discernable effect on bone-level strain. Conclusion: Strains on the cortical bone around two implant supported, 3-unit screw- or cement-retained fixed prostheses, fabricated either by direct or indirect impression techniques on Straumann dental implants, are similar under a 150 N static load. © 2009 IPEM. 01 K 120 650 & 02 K 120 290-10 Devlet Planlama Ürgütü This study was partly supported by the State Planning Organization, Prime Ministry, Republic of Turkey (Project no: 01 K 120 650 & 02 K 120 290-10).

Purpose: The aim of this study was to evaluate the vertical marginal misfit of the metal framework of an implant-supported prosthesis. Methods: Ten frameworks were made of cobalt-chromium alloy (Co-Cr), simulating a three-element fixed prosthesis on two implants. Five frameworks were constructed using prefabricated cylinders, and the other five were constructed using calcinable cylinders. All frameworks were cast by the induction technique and laser-welded. Marginal misfit was measured by means of scanning electron microscopy with the frameworks subjected to the single-screw test. Twenty-five measurements of marginal fit were recorded per abutment and averaged for statistical analysis (ANOVA, α=0.05). Results: There was no statistically significant difference in marginal fit between the groups tested. The only difference found was when comparing the abutments with and without screw. Conclusion: It was concluded that there is no difference in marginal fit between frameworks cast in Co-Cr with calcinable and prefabricated cylinders using induction casting, laser-welding, and single-screw test. Key words: Dental implants; passive fit; manual rectification Objetivo: O objetivo deste trabalho foi avaliar o desajuste marginal vertical de infra-estruturas metálicas de prótese fixa sobre implantes. Metodologia: Foram confeccionadas 10 infra-estruturas em liga de cobalto-cromo (Co-Cr), simulando uma prótese fixa de três elementos sobre dois implantes, com o auxílio de uma matriz metálica. Cinco infra-estruturas foram confeccionadas com cilindros pré-usinados. Outras cinco foram confeccionadas com cilindros calcináveis. Todas as infra-estruturas foram fundidas pela técnica de indução e soldadas a laser. As leituras do desajuste marginal foram realizadas através de microscopia eletrônica de varredura, utilizando a técnica do parafuso único, totalizando 25 medições em cada cilindro. As médias de desajuste marginal de cada cilindro foram utilizadas para a análise estatística (ANOVA, α=0,05). Resultados: Não houve diferença estatística no grau de desajuste marginal entre os grupos testados. Apenas houve diferença quando comparados os cilindros com e sem parafuso. Conclusão: Foi concluído que não há diferença de adaptação marginal entre as infra-estruturas fundidas em Co-Cr com cilindros calcináveis e pré-usinados, utilizando fundição por indução, soldagem a laser e teste do parafuso único. Palavras-chave: Adaptação passiva; implantes dentários; desajuste marginal

A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid denture is fixed on implants while the posterior part of the denture is extended and cantilevered from implants. This article presents the fabrication of a maxillary over-denture opposing mandibular implant retained hybrid prosthesis. A total of four implants were placed in the mandibular arch. Castable abutments were used to produce the optimal angulations. Framework was waxed, cast recovered, and the fit was refined until the framework seated passively on the master cast. The mandibular denture teeth were waxed to the hybrid framework, and a final wax try-in was performed to verify and correct maxillomandibular relations before processing. The prosthesis was inserted after verification of occlusion, retention, and stability. The rehabilitation of edentulous patients with hybrid dentures has been observed to achieve greater masticatory function and psychological satisfaction than with conventional over-dentures. Producing a passive-fitting substructure for a fixed removable screw retained hybrid prosthesis is arguably one of the most technically complex tasks in implant dentistry. The technique presented may not initially produce a perfectly passive framework, but use of disclosing media and adjusting the internal aspect of the casting can result in non-binding, fully seated prostheses.

PURPOSE. The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. MATERIALS AND METHODS. A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of α=.05. RESULTS. The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 μm/m at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. CONCLUSION. Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit. [J Adv Prosthodont 2013;5:312-8]

Purpose The purpose of this study was to investigate the marginal precision of computer numeric control-milled frameworks fabricated of grade 4 commercially pure titanium or cobalt-chrome alloy through digital technology and to compare them with conventional cast frameworks. Material and methods A titanium cast of a mandibular arch with six implant analogs was used as a master. The master cast was measured with a coordinate measuring machine. Fifteen rigid anatomic frameworks were created on the master cast in cast gold alloy and milled in titanium or cobalt-chrome material. The fifteen anatomic frameworks were measured in the same manner as the master cast. While the milled frameworks were measured once, at the end of the milling process, the cast anatomic frameworks were measured twice: immediately after the casting and divesting procedures and again after a technical adaptation procedure. Each anatomic framework was weighed. To compare the measurements obtained from each group of frameworks, descriptive statistics were calculated and one-way analysis of variance was performed, with values considered statistically significant at P Results The mean weight of the cast frameworks was 33.41 g, the cobalt-chrome frameworks weighed 18.12 g on average, and the titanium frameworks averaged 8.7 g. The mean values for three-dimensional deviation of the center point position for each group of frameworks were 261 μm (cast frameworks before adaptation), 49 μm (cast frameworks after adaptation), 26 μm (milled frameworks in cobalt-chrome), and 26 μm (milled frameworks in titanium). Conclusions Within the limitations of this in vitro study, absolute passive fit cannot be achieved, regardless of material and fabrication technique. Anatomic milled frameworks fabricated in titanium or cobalt-chrome presented reduced center point deviation compared to cast frameworks. Titanium frameworks weighed less than cobalt-chrome and cast gold alloy frameworks.