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Discussion : Peri-implant biomechanical responses to standard, short-wide, and double mini implants replacing missing molar supporting hybrid ceramic or full-metal crowns under axial and off-axial loading: an in vitro study [4]

Discussion : Peri-implant biomechanical responses to standard, short-wide, and double mini implants replacing missing molar supporting hybrid ceramic or full-metal crowns under axial and off-axial loading: an in vitro study [4]

author: Lamiaa Said Elfadaly, Lamiaa Sayed Khairallah, Mona Atteya Al Agroudy | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Regarding the effect of superstructure material on induced microstrains, generally, different implant designs supporting Lava Ultimate crowns showed higher mean microstrain values(1927.3 ± 1536.6 μɛ), in comparison with those supporting metal crowns (1313.7 ± 973.1 μɛ).Theoretical considerations [44, 45] and in vitro experiments [46,47,48,49] suggest that an occlusal material with a low modulus of elasticity such as acrylic resin might dampen the occlusal impact forces, thereby decreasing its effect on the bone-implant interface. Various methods have been proposed to address the issue of reducing implant loads. Yet, all these studies were in contradiction with the results of our study. In accordance with our study, in vitro studies suggested a better load distribution from high elastic modulus material [44]. It has been suggested that stiffer prosthesis materials might distribute the stress more evenly to the abutments and implants [50]. Duyck et al. [51], in an in vivo study, demonstrated a better distribution of bending moments (in contrast to acrylic) when metal was used as prosthesis material in cantilevered or longer span prostheses. Stegaroiu et al. [52, 53] demonstrated that stresses on the bone-implant interface using resin prostheses were similar to or higher than models using gold or porcelain. Desai et al. [54] concluded by 3D FEA that PFM crown reduced stresses around the implant as compared to acrylic crown. Single crowns in the present study were loaded with vertical loads that increased with time. Most in vitro studies on the influence of superstructure materials on the strain transmitted through the implant have been conducted under impact forces. However, it was proven that the mandible is decelerated prior to tooth contact, in contrast to impact forces. Since it has been suggested that impact forces occur only accidently during mastication, the shock-absorbing effect of resilient materials that has been reported under this loading in vitro might not be relevant during most actual mastication. Consequently, the use of resilient material as a superstructure material, though previously recommended to ensure shock protection of the implant-bone interface, does not seem to ease the strain in the bone around implants under simulated masticatory cycles and static loading [52, 53, 55, 56].

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