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This study aimed to compare biomechanical characteristics of immediately loaded (IL) and osseointegrated (OS) dental implants inserted into Sika deer antler and lay a foundation for developing an alternative animal model for dental implants studies. Two implants per antler were inserted. One implant was loaded immediately via a self-developed loading device; the other was submerged and unloaded as control. IL implants were harvested after different loading periods. The unloaded implants were collected after OS and the shedding of antler. Specimens were scanned by µCT scanner and finite element models were generated. A vertical force of 10 N was applied on the implant. The mean values of maximum displacements, stresses and strains were compared. The results showed that the density of antler tissue around the implants dramatically increased as the loading time increased. After shedding the antler, 3 pairs of antlers were collected and the density of antler tissue remained in a similar value in all specimens. The maximum values of displacement and stresses in implant and stresses and strains in antler tissue were significantly different among OS models. In one antler, all the biomechanical parameters of IL model were significantly higher than those of OS model of the same animal (P 0.05) and wider distributions were obtained from IL model. It can be concluded that implants inserted into Sika deer antler might not disturb the growth and calcification process of antler and the use of Sika deer antler model is a promising alternative for implant studies that does not require animal sacrifice.

The aim of the present study was to find out whether the high-performance polymer PEKK is an equivalent alternative compared to cobalt chrome (CoCr)-made restorations, regarding to biocompatibility, stability, and comfort. Twenty-two patients (m, 10; f, 12) who were indicated for a long-term temporary-fixed restoration were included. They were randomized through a lottery procedure into two groups: the first group was restored with veneered PEKK-made crowns and bridges (Pekkton ivory), while the second group was restored with veneered CoCr crowns. Clinical parameters (plaque index (PI), probing depth (PD), fracture, and chipping) were documented in a period of 3–5 months from the insertion of restoration. Furthermore, every patient completed the OHIP-14 questionnaire. An exchange of the restorations from the first to the alternative material was performed after a period of 3–5 months. All patients showed an improvement of the oral hygiene and probing depth after insertion of the temporary restorations. However, there were no significant differences between PEKK and CoCr-made restorations (P > 0.05). There was no chipping after 5 months for both kinds of materials. There was a noticeable reduction of pain and discomfort of patients after insertion of temporary restorations. However, there were no significant differences between the two materials (P > 0.05). PEKK-made temporary restorations offer a good and stable alternative to CoCr-made restorations. They have a high aesthetical advantage over CoCr restoration. Esthetic and price-efficient temporary crowns can be offered for the patient during periodontal therapy to improve its success, in particular by improving the oral hygiene.

Mini dental implants (MDI) were once thought of as transitional implants for treatment in selected clinical situations. Their reduced diameter makes them a very attractive option for patients with poor tolerance to maxillary and mandibular prostheses. Using the method of finite element analysis, a series of different designed MDI prototypes have been investigated. The prototypes differed in the geometry of implant body and/or design of implant head. The load transfer of the implant prototypes to the idealised alveolar bone has been regarded and the prototypes have been compared to each other and to a number of standard commercial implants. The prototype models have been virtually placed in the idealised bone with a cortical thickness of 1.5 mm and loaded laterally 30° from the implant's long axis. The condition of immediate loading was assumed for the numerical analyses through defining a contact interface between the implant and bone bed. The numerical analysis in this study showed that the design of the investigated prototype MDI of group 3 (mini-ball head) is the most advantageous design.

The effect of implants' number on overdenture stability and stress distribution in edentulous mandible, implants and overdenture was numerically investigated for implant-supported overdentures. Three models were constructed. Overdentures were connected to implants by means of ball head abutments and rubber ring. In model 1, the overdenture was retained by two conventional implants; in model 2, by four conventional implants; and in model 3, by five mini implants. The overdenture was subjected to a symmetrical load at an angle of 20 degrees to the overdenture at the canine regions and vertically at the first molars. Four different loading conditions with two total forces (120, 300 N) were considered for the numerical analysis. The overdenture displacement was about 2.2 times higher when five mini implants were used rather than four conventional implants. The lowest stress in bone bed was observed with four conventional implants. Stresses in bone were reduced by 61% in model 2 and by 6% in model 3 in comparison to model 1. The highest stress was observed with five mini implants. Stresses in implants were reduced by 76% in model 2 and 89% increased in model 3 compared to model 1. The highest implant displacement was observed with five mini implants. Implant displacements were reduced by 29% in model 2, and increased by 273% in model 3 compared to model 1. Conventional implants proved better stability for overdenture than mini implants. Regardless the type and number of implants, the stress within the bone and implants are below the critical limits.

The aim of the present study has been to analyze the influence of residual root number and bone density on the loading distribution of restorations combining implant and residual tooth after tooth hemisection using finite element analysis. Based on the image data of two patients, one has one distal root and the other has two distal roots in the mandibular right first molar, eight models were created (four models for each patient): a single crown was placed on the implant and residual tooth in two different bone densities; two separate crowns for the implant and residual tooth in two different bone densities. Vertical force of 100-N was applied on the crowns. The results show that the increase in number of residual roots decreased the magnitude of all biomechanical parameters. Higher values were observed in models with low bone density, especially in one distal root models. The maximum values of strains in spongious bone with the model (one distal root, low spongious bone density, a single crown was placed on the implant and residual tooth) even reached 9000μstrain. From a biomechanical point of view, when two residual roots exist, a single crown placed on the implant and distal half of the molar or two separate crowns for them seem to be an acceptable treatment option, regardless of the bone density. If there is one residual root and the bone density is low, the prosthesis which combines implant with the root might not be used.

The biting ability of patients improves noticeably after receiving implant-supported overdentures in comparison to conventional complete dentures. However, the change of biting with such treatment concepts has been quantitatively investigated in only a limited number of studies. The aim of the present study has been to measure the biting forces of edentulous patients with complete dentures and after receiving implant-supported overdentures. A total of 26 edentulous patients were included. Ten patients received two to four conventional implants (control group, Ø3.3-3.7mm, L11-13mm) and 16 patients received four to five mini implants (study group, Ø1.8-2.4mm, L13-15mm) inserted in the mandibular interforaminal region. All patients received a lower overdenture with ball/rubber ring attachments and a complete denture for the maxilla. The biting forces were measured using Prescale pressure sheets type low before the insertion of implants and after receiving implant-supported overdenture. The measured sheets were later scanned and analysed using FPD-8010E software. The range of biting forces before the insertion of implants was 80N-122N for the control group and 66-88N for the study group. After the insertion of implants, the range of biting forces increased to 167N-235N for the control group and to 81N-138N for the study group. However, the increase in biting forces after the insertion of implants was not significant for either group. No significant difference was obtained between the two implant systems. The biting forces improved after insertion of implants regardless of which implant system was used. However, the degree of improvement is noticeably related to the original bone quality of the mandible at the insertion regions of implants.

The periodontal ligament is a complex tissue with respect to its biomechanical behaviour. It is important to understand the mechanical behaviour of the periodontal ligament during physiological loading in healthy patients as well as during the movement of the tooth in orthodontic treatment or in patients with periodontal disease, as these might affect the mechanical properties of the periodontal ligament (PDL). Up to now, only a limited amount of in vivo data is available concerning this issue. The aim of this study has been to determine the time dependent material properties of the PDL in an experimental in vivo study, using a novel device that is able to measure tooth displacement intraorally. Using the intraoral loading device, tooth deflections at various velocities were realised in vivo on human teeth. The in vivo investigations were performed on the upper left central incisors of five volunteers aged 21-33 years with healthy periodontal tissue. A deflection, applied at the centre of the crown, was linearly increased from 0 to 0.15mm in a loading period of between 0.1 and 5.0s. Individual numerical models were developed based on the experimental results to simulate the relationship between the applied force and tooth displacement. The numerical force/displacement curves were fitted to the experimental ones to obtain the material properties of the human PDL. For the shortest loading time of 0.1s, the experimentally determined forces were between 7.0 and 16.2N. The numerically calculated Young's modulus varied between 0.9MPa (5.0s) and 1.2MPa (0.1s). By considering the experimentally and numerically obtained force curves, forces decreased with increasing loading time. The experimental data gained in this study can be used for the further development and verification of a multiphasic constitutive law of the PDL.

Tooth hemisection preserves partial tooth structure and reduces the resorption of alveolar bone. The aim of this study was to analyze the feasibility of preserving a molar after hemisection and inserting a dental implant with different prosthetic superstructures by means of finite element analysis. First, the distance between the root of the mandibular second premolar and the distal root of the first molar were measured in 80 cone beam computed tomography (CBCT) data sets. Based on these data, the lower right posterior jaw segment was reconstructed and the geometries of the appropriate implant were imported. Four models were created: (1) Hemi-1: An implant (3.7×9mm) replaced the mesial root of the molar, and a single crown was placed on the implant and residual tooth. (2) Hemi-2: Two separate crowns were generated for the implant and the residual tooth. (3) Single: An implant (5.5×9mm) with crown replaced the whole molar. (4) FPD: A 3-unit fixed partial denture combined the distal residual part of the molar and premolar. The results indicated that stresses in the cortical bone and strains in the majority region of the spongious bone were below the physiological upper limits. There were higher stresses in implant with the Hemi-1 and Single models, which had the same maximum values of 45.0MPa. The FPD models represented the higher values of stresses in the teeth and strains in PDL compared to other models. From a biomechanical point of view, it can be concluded that a combination of an implant and residual molar after tooth hemisection is an acceptable treatment option.

The aim of this study was to investigate the retention forces of secondary telescopic crowns made of polyetherketoneketone (PEKK) in combination with primary crowns made of four different dental alloys and to determine whether the retention forces change in the course of up to 5000 simulated wear cycles. A total of four groups of telescopic crowns were investigated: group 1: 10 primary crowns made of a gold alloy (NEOCAST®3), group 2: 10 primary crowns made of a non-precious metal alloy (Girobond NB), group 3: 10 primary crowns made of zirconium (Cercon®base) and group 4: 10 primary crowns made from PEKK (Pekkton®ivory). The corresponding secondary crowns were made from PEKK in all the four groups. Each pair was fixed axially in a wear simulator specifically designed for the study. Overall, 10,000 joining and separating cycles were performed for each group. To simulate intraoral conditions, a saliva substitute served as a lubricant. Force transducers were used to record the retention forces and after completing 10,000 cycles, the surface of each primary crown was examined using a scanning electron microscope (SEM). All groups showed an increase in the retention force for the first 2000 cycles which stayed constant for the remaining 8000 cycles. The Pekkton®ivory/Pekkton®ivory and NEOCAST®3/Pekkton®ivory combinations displayed mean retention force values of 16 N after a slight increase in the retention force. The Cercon®base/Pekkton®ivory and Girobond NB/Pekkton®ivory combinations displayed an initially high increase in the retention force and then showed a mean retention force of up to 29 N. All primary crowns displayed surface wear. Zirconium primary crowns showed the least wear compared to PEKK and the gold and non-precious metal alloys.

The formation of the alveolar bone, which houses the dental primordia, and later the roots of tooth, may serve as a model to approach general questions of alveolar bone formation. In this respect, this study aimed to investigate the potential interactions between the alveolar bone formation and tooth eruption by using finite element (FE) methods, and to figure out whether the expanding tooth systems induce shear stresses that lead to alveolar bone formation. 3D geometric surface models were generated from the 3D histological data of the heads of mice (C57 Bl/6J) ranging from stages embryonic (E) to postnatal (P) stages E15 to P20 using the reconstruction software 3-Matic. Bone, dentin, enamel and dental follicle around the primordia were generated and converted into 3D FE models. Models were imported into the FE software package MSC.Marc/Mentat. As material parameters of embryonic dentine, pulp, enamel, dental follicle, and bony structures basically are unknown, these were varied from 1% to 100% of the corresponding known material parameters for humans and a sensitivity analysis was performed. Surface loads were applied to the outside surface of dental follicle ranging from 0.1 to 5.0N/mm2. The validity of the model was analysed by comparing the activity pattern of the alveolar bone as determined in the histological study with the loading pattern from the numerical analysis. The results show that when varying the surface loads, the distribution of shear stresses remained same, and while varying the material properties of the hard tissues, the location of highest shear stresses remained stable. Comparison of the histologically determined growth regions with the distribution of shear stresses computed in the numerical model showed a very close agreement. The results provide a strong proof to support Blechschmidt's hypothesis that the bone in general is created under the influence of shear forces.

The rigidity of framework materials and overload of the implant system directly affect the final transferred load of the bone around implants. The aim of the present study has been to analyse the influence of framework materials on the transferred load to the implant system and the surrounding bone. A finite element model of a long-span cementable implant-supported fixed prosthesis was created with two coping layers (gold and hybrid composite) to optimise the fitting of the prosthesis to the abutments. Three framework materials were analysed: titanium, gold alloy, and zirconia. The connection screws were first preloaded with 200 N. The framework was then loaded with 500 N vertically and at 30° to the framework long axis. Two loading conditions were considered: at the mesial and distal boundaries of the framework and at the centre of the framework. The stresses and strains within the framework materials and bone bed around the supporting implants were analysed. The region and angle of load applications showed an obvious effect on the values of the stresses and strains within the framework itself and, consequently, their distribution in the implant system and surrounding bone. A correlation of the framework material and stresses of the coping materials was observed as well. The gold framework showed acceptable values of stress within the cortical bone (92 MPa and 89 MPa with 30° loading at two points and at the centre, respectively) in comparison to titanium (92 MPa and 113 MPa) and zirconia (88 MPa and 115 MPa).

Understanding the changes in bone density after insertion of dental implants and their relation to immediate loading is essential to achieving improvements in their survival rate. Histological investigations of the bone bed in humans are limited, which in turn hampers opportunities to deepen knowledge about the remodelling process around dental implants. The aim of the present study was to follow the change in bone density by measuring the grey values of cone beam computed tomography (CBCT) at different periods subsequent to implant insertion. The CBCTs of 20 individual immediately loaded implants were evaluated at three time points: prior to surgery, one month following, and six months after the operation. The grey values were measured at different regions around the implants. Reduction in the grey values was observed with respect to the reference values after one month and six months from implant insertion in the apical, middle, and cervical regions. No correlation was detected either between the change in grey values and drilling method or with the measured primary and secondary stabilities by Osstell ISQ instrument. Cone beam computed tomography can be used as a qualitative method to support clinical follow up and monitor the changes in bone density around implants in critical cases.

Analysing the influence of implant splinting and its relation to different framework materials is a complex issue. The stiffness of framework materials and the overload of the implant system directly affect the final transferred load of the bone around implants. A finite element model of a long-span cementable implant-supported fixed prosthesis was created. Three materials were analysed for the framework: Titanium, gold alloy, and zirconia. The connection screws were first preloaded with 200 N. Two loading conditions were studied: The implant at the molar region was first loaded without splinting to the framework, and in the second condition, the implant was splinted to the framework. A total force of 500 N and 1000 N in 30° from the long axis of the framework were applied in buccal or distal direction on the implant system. The stresses and strains within the framework materials, implant system, and bone bed around the supporting implants were analysed. Loading the implant distally was associated with high stresses within the implant system in comparison to buccal loading. By splinting the implant, the stress in the implant system was reduced from 5393 MPa to 2942 MPa. Buccal loading of the implant was more critical than the distal loading. In the splinted condition of the implant, the stresses in the cortical bone were reduced from 570 MPa to 275 MPa.

Dental implants are important tools for restoring the loss of teeth. The rapid growth and periodic regeneration of antlers make Sika deer a good and less invasive alternative model for studying bone remodelling in mammals. We developed a special loading device for antlers and analysed the bone reaction around unloaded implants and under immediate loading conditions until osseointegration occurred. In micro-computed tomography images, the density of antler tissue around the implants increased as the loading time increased. This finding was histologically confirmed by the good osseointegration observed in unloaded and loaded specimens. Antler tissue displays a similar healing process to human bone. The use of an antler model is a promising alternative for implant studies that does not require animal sacrifice.

Poor stability of a complete denture is a common problem due to bone atrophy of the edentulous ridge. The aim of the present study was to analyze denture stability after receiving implants and to study the biomechanical properties of denture implants and the bone bed using conventional or mini implants. Five models based on computed tomography (CT) data of edentulous patients were created. The overdentures’ connection to the implants was assured by means of ball head abutments and rubber rings. In three models, the denture was supported by two to four conventional implants and in two models, the overdenture was supported by three to five mini implants. The dentures were loaded according to the individual biting forces which was clinically measured by means of pressure sheets. After implantation, the biting forces and displacements of overdentures increased in comparison to complete dentures. Displacements and stresses were higher with mini implants than with conventional ones. Stress in the implants was markedly below the yield stress of titanium grade 5 (880 MPa). An increase in the stress in the bone around the implants was noticed as compared to the situation with complete dentures which was below the physiological range of bone loading (

The survival of dental implants, in particular immediately loaded implants, critically depends on the biomechanical properties of the bone bed surrounding them. In experimental animal investigations of immediately loaded implants the initial stability, implant design as well as stress and strain distributions in the surrounding bone have been extensively studied. It was the aim of this study to investigate the biomechanical properties of the reindeer antler used as a bony tissue surrounding dental implants, in particular the Young's modulus, Poisson's ratio, and further numerical parameters such as mesh density, friction models and the corresponding frictional coefficients and relative velocities for establishing a novel animal model that can be used in the numerical analyses of experimentally investigated antler specimens. The sensitivity of the investigated parameters was analysed based on the close correlation of numerical and experimental results. No obvious influence of the frictional coefficient and/or relative velocity was observed on the implant displacement using a finite element model. Moreover, nearly identical numerical and experimental results were observed for two kinds of implants concerning implant deflection in the x-axis and implant rotation around the y-axis.

This study aimed to predict the distribution of bone trabeculae, as a density change per unit time, around a dental implant based on applying a selected mathematical remodelling model. The apparent bone density change as a function of the mechanical stimulus was the base of the applied remodelling model that describes disuse and overload bone resorption. The simulation was tested in a finite element model of a screw-shaped dental implant in an idealised bone segment. The sensitivity of the simulation to different mechanical parameters was investigated; these included element edge length, boundary conditions, as well as direction and magnitude of the implant loads. The alteration in the mechanical parameters had a significant influence on density distribution and model stability, in particular at the cortical bone region. The remodelling model could succeed to achieve trabeculae-like structure around osseointegrated dental implants. The validation of this model to a real clinical case is required.

In recent years, mini and short dental implants have become increasingly popular as treatment alternatives for patients in whom the bone is unsuitable for a standard implant. As yet, no detailed scientific analysis of the mechanical and biomechanical impact of the reduced diameter and length of these implants has been published. We analysed 21 commercially available implants (13 mini, eight short) with respect to material behaviour and load transfer to the alveolar bone, using finite element (FE) analysis. Following μCT scanning and geometry reconstruction, FE models of mini implants and short implants were inserted into idealised bone segments. Mini implants were analysed in the anterior mandibular jaw region at a force of 150 N under immediate loading, using a contact analysis in the FE software package Marc Mentat 2007. Short implants were inserted in posterior bone segments and analysed in the osseointegrated state at an occlusal force of 300 N. Von Mises stresses (up to 1150 MPa) in mini implants partly exceeded the ultimate strength. Implant diameter and geometry had a pronounced effect on stresses in the cortical plate (up to 266 MPa). Strains in spongy bone and stresses in cortical bone around short implants were markedly increased compared to those in standard implants. An increased risk of bone damage or implant failure may be assumed in critical clinical situations.

Periodontal diseases like gingivitis and periodontitis have damaging effects on the periodontium and commonly affect the mechanical properties of the periodontal ligament (PDL), which in the end might lead to loss of teeth. Monitoring tooth mobility and changes of the material properties of the PDL might help in early diagnosis of periodontal diseases and improve their prognosis. It was the aim of this study to develop a novel intraoral device to determine the biomechanical characteristics of the periodontal ligament. This includes the measurement of applied forces and resulting tooth displacement in order to investigate the biomechanical behaviour of the periodontium with varying loading protocols with respect to velocity and tooth displacement. The developed device uses a piezoelectric actuator to apply a displacement to a tooth's crown, and the resulting force is measured by an integrated force sensor. To measure the tooth displacement independently and non-invasively, two magnets are fixed on the teeth. The change in the magnetic field caused by the movement of the magnets is measured by a total of 16 Hall sensors. The displacement of the tooth is calculated from the movement of the magnets. The device was tested in vitro on premolars of four porcine mandibular segments and in vivo on two volunteers. The teeth were loaded with varying activation curves. Comparing the force progression of different activation velocities, the forces decreased with decreasing velocity. Intensive testing demonstrated that the device fulfils all requirements. After acceptance of the ethical committee, further testing in clinical measurements is planned.

In recent years, the use of immediately loaded implants became more acceptable as a standard protocol for completely edentulous lower jaw and/or partially edentulous upper jaw cases, predominantly in the anterior region, after it was one of the cornerstones of the early protocols to avoid any occlusal loading of the implants for at least 3 months. This technique could potentially provide immediate function and aesthetics to the patient. This review aims to present the clinical indications of the immediately loaded protocol according to the individual cases and the corresponding risk factors and contraindications. The clinical, biomechanical and biological requirements concerning bone quality, occlusal loading and implant primary stability are discussed. Primary stability in immediate loading is determined rather by surgical than biological parameters. Peri-implant osteogenesis leading to secondary stability depends on the same biological factors than in unloaded implant healing. However, specific mechanical effects on the biology of immediate loading osseointegration are yet to be investigated.

Conventional dental implants are not applicable in the mandibular interforaminal region if bone volume is limited. Mini-dental implants offer an alternative means of supporting mandibular overdentures in a narrow residual ridge, without additional surgery.The purpose of this nonrandomized clinical trial was to compare the ability of mini-dental implants with that of conventional dental implants in supporting mandibular overdentures during a 2-year clinical follow-up. Bone quality, bone resorption, implant stability, and oral health were assessed radiographically.A total of 32 participants with edentulism were included. Twenty-two participants (99 implants) received 4 to 5 mini-dental implants (diameter: 1.8-2.4 mm; length: 13-15 mm, study group), and 10 participants (35 implants) received 2 to 4 conventional dental implants (diameter: 3.3-3.7 mm; length: 11-13 mm, control group). The selection of the participants in the study or control group was based on the available bone volume in the mandible. The selection was not randomized. The density of cortical bone thickness was measured in Hounsfield units (HU) from computed tomography data, and patients were followed for 2 years. The participants were examined 3, 6, 12, and 24 months after surgery. Primary stability immediately after the insertion of dental implants (Periotest), secondary stability 6 months after implantation, modified plaque, bleeding on probing indices, and probing depth were measured and analyzed statistically (α=.05).The mean HU value 6 months after implantation in the participants who received mini-dental implants was significantly (P=.035) higher (1250 HU) than that in the participants who received conventional dental implants (1100 HU). The probing depths around the conventional dental implants (1.6 and 1.8 mm, respectively) were significantly higher than those around the mini-dental implants (1.3 and 1.2 mm, respectively) 12 and 24 months after surgery, respectively (P.001). The mean primary and secondary stability values for conventional dental implants were -4.0 and -4.9, respectively. The primary and secondary stability values for the mini-dental implants were -0.3 and -1.4, respectively. The Periotest values of the primary (measured immediately after implant insertion) and secondary implant stabilities (measured 6 months after implant insertion) were significantly higher for the conventional dental implants than for the mini-dental implants (P.001).Based on this 2-year clinical trial, patients receiving mini-dental implants had clinical outcomes similar to those of patients receiving conventional dental implants to support overdenture prostheses.

Small diameter (mini) dental implants have become more popular in recent years as alternatives to classical implant treatment in clinical cases with critical bony situations. However, an in-depth scientific analysis of the mechanical and biomechanical effects of small diameter implants has not yet been published. The aim of the present study was to investigate experimentally different commercial mini implants by measuring their displacements under immediate loading. Twelve commercially available mini implants were measured. Implants were inserted into porcine mandibular segments and loaded by means of a predefined displacement of 0.5 mm of the loading system. The implants were loaded at an angle of 30° to the implant long axis using the self-developed biomechanical hexapod measurement system. Implant displacements were registered. The experimental results were compared to the numerical ones from a previous study. Measured implant displacements were within the range of 39–194 μm. A large variation in the displacements was obtained among the different implant systems due to the different designs and thread profiles. Comparing experimental and numerical results, the displacements that were obtained numerically were within the range of 79–347 μm. The different commercial mini implants showed acceptable primary stability and could be loaded immediately after their insertion.

INTRODUCTION Biomechanical analysis of orthodontic tooth movement is complex, as many different tissues and appliance components are involved. The aim of this finite element study was to assess the relative effect of material alteration of the various components of the orthodontic appliance on the biomechanical behaviour of tooth movement. METHODS A three-dimensional finite element solid model was constructed. The model consisted of a canine, a first, and a second premolar, including the surrounding tooth-supporting structures and fixed appliances. The materials of the orthodontic appliances were alternated between: (1) composite resin or resin-modified glass ionomer cement for the adhesive, (2) steel, titanium, ceramic, or plastic for the bracket, and (3) β-titanium or steel for the wire. After vertical activation of the first premolar by 0.5mm in occlusal direction, stress and strain calculations were performed at the periodontal ligament and the orthodontic appliance. RESULTS The finite element analysis indicated that strains developed at the periodontal ligament were mainly influenced by the orthodontic wire (up to +63 per cent), followed by the bracket (up to +44 per cent) and the adhesive (up to +4 per cent). As far as developed stresses at the orthodontic appliance are concerned, wire material had the greatest influence (up to +155 per cent), followed by bracket material (up to +148 per cent) and adhesive material (up to +8 per cent). LIMITATIONS The results of this in silico study need to be validated by in vivo studies before they can be extrapolated to clinical practice. CONCLUSION According to the results of this finite element study, all components of the orthodontic fixed appliance, including wire, bracket, and adhesive, seem to influence, to some extent, the biomechanics of tooth movement.

The similar bone structure of reindeer antler to human bone permits studying the osseointegration of dental implants in the jawbone. As the friction is one of the major factors that have a significant influence on the initial stability of immediately loaded dental implants, it is essential to define the frictional coefficient of the implant-antler interface. In this study, the kinetic frictional forces at the implant-antler interface were measured experimentally using an optomechanical setup and a stepping motor controller under different axial loads and sliding velocities. The corresponding mean values of the static and kinetic frictional coefficients were within the range of 0.5–0.7 and 0.3–0.5, respectively. An increase in the frictional forces with increasing applied axial loads was registered. The measurements showed an evidence of a decrease in the magnitude of the frictional coefficient with increasing sliding velocity. The results of this study provide a considerable assessment to clarify the suitable frictional coefficient to be used in the finite element contact analysis of antler specimens.

The bone bed around dental implants is influenced by implant and augmentation materials, as well as the insertion technique used. The primary influencing factors include the dental implant design, augmentation technique, treatment protocol, and surgical procedure. In addition to these treatment-related factors, in the literature, local and systemic factors have been found to be related to the bone stability around implants. Bone is a dynamic organ that optimises itself depending on the loading condition above it. Bone achieves this optimisation through the remodelling process. Several studies have confirmed the importance of the implant design and direction of the applied force on the implant system. Equally dispersed strains and stresses in the physiological range should be achieved to ensure the success of an implant treatment. If a patient wishes to accelerate the treatment time, different protocols can be chosen. However, each one must consider the amount and quality of the available local bone. Immediate implantation is only successful if the primary stability of the implant can be provided from residual bone in the socket after tooth extraction. Immediate loading demands high primary stability and, sometimes, the distribution of mastication forces by splinting or even by inserting additional implants to ensure their success. Augmentation materials with various properties have been developed in recent years. In particular, resorption time and stableness affect the usefulness in different situations. Hence, treatment protocols can optimise the time for simultaneous implant placements or optimise the follow-up time for implant placement.

The use of short implants has increased widely within the last years. However, the stability of these implants has not yet been comprehensively investigated, in particular the difference in geometry and dimension of short implants. The aim of the present study was to investigate experimentally the difference of the secondary stability of different commercial short implants by measuring their displacements. Eleven implant geometries were investigated in this study. A total of 22 implants were inserted in porcine rib segments, two implants for each system. Implant displacements were measured using a self-developed biomechanical hexapod measurement system (HexMeS). The highest displacement was observed with Straumann BL NC 3.3×8.0 mm (266 μm), followed by Straumann Standard 4.1×6.0 mm (156 μm), while the lowest displacement of 61 μm was shown by Dentaurum type 1 implant (4.2×5.0 mm). No obvious difference of displacements was observed between hammered and screw-shaped implants with relevant dimensions. The experimental results were in good agreement with the numerical ones (19–42%) for Dentaurum implants. However, a difference of 70–80% was obtained for the Astra implant (4.0×6.0 mm) and Bicon implant (6.0×5.7 mm). The geometry of short implants directly affects their stability within the bone.

This paper was aimed to review the studies published about short dental implants. In the focus were the works that investigated the effect of biting forces of the rate of marginal bone resorption around short implants and their survival rates. Bone deformation defined by strain was obviously higher around short implants than the conventional ones. The clinical outcomes of 6 mm short implants after 2 years showed a survival rate of 94% to 95% and lower survival rate (

SUMMARY The analysis of the non-linear and time-dependent viscoelasticity of the periodontal ligament (PDL) enables a better understanding of the biomechanical features of the key regulator tissue for tooth movement. This is of great significance in the field of orthodontics as targeted tooth movement remains still one of the main goals to accomplish. The investigation of biomechanical aspects of the PDL function, a difficult area of research, helps towards this direction. After analysing the time-dependent biomechanical properties of pig PDL specimens in an in vitro experimental study, it was possible to confirm that PDL has a viscoelastic anisotropic behaviour. Three-dimensional finite element models of mini-pig mandibular premolars with surrounding tissues were developed, based on micro-computed tomography (μCT) data of the experimental specimens. Tooth mobility was numerically analysed under the same force systems as used in the experiment. A bilinear material parameter set was assumed to simulate tooth displacements. The numerical force/displacement curves were fitted to the experimental curves by repeatedly calculating tooth displacements of 0.2mm varying the loading velocities and the parameters, which describe the nonlinearity. The experimental results showed a good agreement with the numerical calculations. Mean values of Young's moduli E1, E2 and ultimate strain ε12 were derived for the elastic behaviour of the PDL for all loading velocities. E1 and E2 values increased with increasing the velocity, while ε12 remained relatively stable. A bilinear approximation of material properties of the PDL is a suitable description of measured force/displacement diagrams. The numerical results can be used to describe mechanical processes, especially stress-strain distributions in the PDL, accurately. Further development of suitable modelling assumptions for the response of PDL under load would be instrumental to orthodontists and engineers for designing more predictable orthodontic force systems and appliances

This study aimed to evaluate the biomechanical behaviour of adhesive endo-crowns and the influence of their design on the restoration prognosis when four loading positions are applied from the restoration–tooth junction. Two three-dimensional finite element models for the lower first molar were developed: endo-crown as a monobloc and endo-crown of a primary abutment and a full crown. Four crown loading positions were considered: 5, 6, 7 and 8 mm. A force of 1400 N was applied buccally on the middle of the mesiodistal width. No differences were observed for the two endo-crowns concerning restoration displacement and the distribution of equivalent von Mises stress and total equivalent strain. Shifting the position of the applied load to 8 mm resulted in an increase in the displacement from 25 to 42 µm and an increase of equivalent von Mises stress concentration at the tooth. The height of load application on the restoration has a significant role in the prognosis of endo-crowns.

The aim of this study has been to systematically evaluate the loading behaviour of a novel pre-fabricated chair-side SFI-Bar ® bar system supported by two implants using finite element (FE) analysis. Two series of FE models were created of the bar placed on two idealised implants and embedded in idealised bone segments using CAD data. In the first series, the inter-implant distance varied from 10 to 26 mm; the second series consisted of a bar with a fixed implant distance of 26 mm and varying horizontal fitting inaccuracy from 0.0 to 0.3 mm. The bar was loaded vertically at 500 N. In all simulations, the regions with the greatest amount of stress were concentrated on the connecting elements of the bar and the bar itself. A slight increase in stress was observed with decreasing inter-implant distance. With a non-zero fitting inaccuracy, no clear correlation was observed between the amount of play and the stress distribution in the system. For a perfect fit, an obvious increase in stress was found in the implant and strain in the implant bed. With respect to the excessive static loading performed in our simulations and the resulting loading behaviour, we conclude that the SFI-Bar is a system suitable for clinical application.

Summary Aims To compare the reaction of the alveolar bone to the preservation of the extraction socket by Bio-Oss Collagen with and without combination of implant treatment. To evaluate whether early implant insertion 8–10 weeks thereafter could be a suitable time point for long term bone stability around the implant. Methods A total of 25 patients were divided into three groups: The first group (seven patients) received Bio-Oss Collagen after extraction and 8–10 weeks later an implant, the second group (eight patients) received only Bio-Oss Collagen without implantation thereafter, while the third group was considered as a control (eleven patients), where the sockets healed without any treatment. The change in the vertical bone level of the alveolar crests were measured from panoramic radiographs and statistically analysed. Results Bone level change was significantly less for Group 1 than Group 3 ( P P = 0.23). However, the rate of bone level change per year was statistically smaller for Group 1 compared to Group 3 ( P = 0.019) and as well as for Group 1 than for Group 2 ( P = 0.003), whereas the change per year was not significantly different for Group 2 vs. Group 3 ( P = 0.122). Conclusion Bone level preservation of extraction sockets using Bio-Oss Collagen with implantation is significantly better compared to using Bio-Oss Collagen only and untreated sockets. Implant insertion 8–10 weeks after extraction is a suitable time point after socket augmentation.

The influence of abutment design on bone resorption around immediately loaded and osseointegrated implants used to support fixed partial prostheses was investigated in a 1-year study. One hundred ten implants were placed in 24 anterior partially edentulous maxillae. The probing depths of each implant were measured 6 and 12 months after abutment placement and analyzed statistically. Total probing depth was 1.75 ± 0.75 mm. There were significant differences between non- and submerged implants with angled abutments and between submerged implants with straight and angled abutments. No significant differences were observed between non- and submerged implants with straight abutments and between nonsubmerged implants with straight and angled abutments. Bone resorption around dental implants is influenced by the abutment design and the associated implantation protocol.

The effect of bone remodeling on the long-time success of dental implants is becoming critical for implant design and presurgical assessments. This study applies a previously presented remodeling simulation scheme on a computer tomography (CT)-based finite element model. The CT data of a dental implant at the upper right central incisor region 6 years after implant insertion was used. The time-dependent density change of the trabecular bone after osseointegration was studied. The trabecular structure, by means of density distribution, around the implant showed similarities to the CT images at many regions.

Over the past decade, coinciding with the appearance of a number of new ultrasonic surgical devices, there has been a marked increase in interest in the use of ultrasound in oral surgery and implantology as alternative osteotomy method. The aim of this study was the comparison of the effect of osteotomies performed using ultrasonic surgery (Piezosurgery(®)), sonic surgery SONICflex(®) and the conventional bur method on the heat generation within the bone underneath the osteotomy and light-microscopy observations of the bone at different cutting positions in porcine mandibular segments. It was found that the average heat generated by SONICflex(®) sonic device was close to that by conventional rotary bur (1.54-2.29°C), whereas Piezosurgery(®) showed a high generated heat up to 18.17°C. Histological investigations of the bone matrix adjacent to the defect radius showed intact osteocytes with all three instruments and similar wide damage diameter at the bottom region. SONICflex(®) showed smooth cutting surfaces with minimal damage in the upper defect zone. Finally, presented results showed that sonic surgery performed with SONICflex(®) is an alternative osteotomy method and can be used as an alternative to the conventional bur method.

Short and mini dental implants have been widely used as treatment alternatives in certain selected clinical situations. However, a profound scientific analysis of the mechanical and biomechanical impact of the reduced length and diameter of these implant geometries has not been published until now. Using finite element analysis, a series of different experimentally designed short and mini implants have been analysed with regard to their load transfer to the alveolar bone and have been compared to respective standard commercial implants. Mini implants have been inserted in an idealised bone bed representing the anterior mandibular jaw region and loaded with a force of 150 N. An immediate loading condition was assumed and analysed using the contact analysis option of the FE package MSC.Marc/Mentat. Short implants were inserted in an idealised posterior bone segment and loaded in osseointegrated state with forces of 300 N. Clearly increased bone loading was observed for the short and mini dental implants compared with standard implants, clearly exceeding the physiological limit of 100 MPa. The determined biomechanical characteristics could explain the slightly increased failure rate of short and mini dental implants.

Bone resorption and peri-implantitis are some of the most important problems of dental implantology. The implant macrodesign might decrease initial bone loss. The aim of this longitudinal study was to investigate crestal bone loss around screw type, tapered implants showing a fine threaded neck and platform switching design. In 32 patients of a dental practice, 147 maxillary implants with a diameter of 3.7 mm and 4.2 mm were placed and loaded according to clinical criteria. Immediate loading was exclusively performed in 3.7 mm diameter implants when adequate splinting and implant stability could be guaranteed (n=50). The remaining implants were loaded delayed. The bone level change was measured mesially and distally of the implant shoulder using follow-up X-rays and calculated per year in a linear mixed model. Bone resorption was low in all groups (3.7 immediate: -0.06 mm/year; 3.7 delayed: -0.16 mm/year; 4.2 delayed: -0.09 mm/year) after a mean follow-up period of 1.6 years (0.5-3.2 years). Based on the results of this study, it can be concluded that this implant macrodesign showed negligible bone resorption for all loading times. Immediate loading seems to be a reliable treatment option in the maxilla when clinical criteria are considered.

It is always recommended to use more implants for supporting a prosthesis in the immediate loading condition than in the classical two-stage treatment procedure. By means of the finite element (FE) method, the influence of the number of implants used in immediately loaded fixed partial prosthesis (FPP) on the load distribution was investigated, considering the abutment geometry. Two 3D FE models were studied employing four implants to support a FPP in the premaxilla. One model was designed with straight abutments and the other with 20°-angled abutments. The results concerning implant displacements, stresses and strains were compared with those of two implant-supported FPPs, obtained in a previous study. A noticeable reduction in the determined biomechanical bone loading was observed with the use of more implants in supporting an immediately loaded prosthesis. This study confirms that the use of additional numbers of implants in an immediately loaded prosthesis is highly recommended.

The aim of this study was to gain insight into the behaviour of the stresses and strains at the bone-implant interface of an implant-supported fixed partial prosthesis (FPP) in the premaxilla under immediate loading and osseointegrated conditions. Finite element models of a four-unit FPP were generated. An extreme condition was simulated, using only two immediately loaded implants in order to derive recommendations for possible clinical application. Straight and 20°-angled abutments and bonded or sliding contact between the bridge and abutment were simulated. In addition, two models were generated with two completely osseointegrated implants. A 150 N load to the prosthesis at a 45° angle to the long axis of each implant was applied. Minor differences were observed in implant displacements, stress and strain distributions of the two abutment designs. However, bone loading exceeded the physiological limits, including a risk of bone atrophy. A considerable decrease in implant displacements and bone loading was observed in the osseointegrated cases. An FPP supported by only two implants cannot be recommended for immediate loading.

Abutment angulation is one of the numerous biomechanical variables involved in implant dentistry that need scientific evaluation [Saab, 2007]. The aim of the present study was to investigate experimentally and numerically the influence of a fine threadedagainst a roughenedcervical region of immediately loaded dental implants in combination with straight and 20°angled abutments on the implant primary stability followed by a clinical validation of the results in a one year follow up study for immediately loaded and osseointegrated cases.

In recent years, Mini and Short dental implants became more and more popular as treatment alternatives in clinical cases with critical bony situations. So-called ‘Minis’ have a reduced diameter of about 2.5 mm and are designed to be inserted in the anterior region of the maxilla or mandible. Extremely short implants, called ‘Shorties’, have a length of 5 to 7 mm and are commonly used in the posterior region after severe bone atrophy. A profound scientific analysis of the mechanical and biomechanical impact of the reduced diameter and length of these implants has not been published yet. A combined experimental and numerical study was performed in order to determine whether ultimate dimensions with respect to length and diameter can be defined for dental implants.