Evaluation of Bicon Short Implant Longevity in Terms of Annual Bone Loss- 3D FE Study PDF Download
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Author: Larisa Linetska
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Languages : en
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Bone loss is the most essential cause of dental implant failure. Comparing to the conventional implants, short implants may fail more rapidly because of their reduced length, especially in case of crestal placement. 0.2 mm mean annual bone loss was recommended as a criterion for implant success. Due to bone loss, even under physiological functional loading, bone overload may occur, which, in turn, provokes complementary bone loss. These processes significantly worsen implant long-term prognosis.The aim of this study was to evaluate and compare load-carrying capacities of the spectrum of fully and partially osseointegrated Bicon short implants to establish their prognosis in posterior maxilla under oblique functional loading.The concept of ultimate functional load (UFL) was proposed (Demenko et al., 2011) to compare load-carrying capacities of fully and partially osseointegrated (0.2 mm annual bone loss) 5.0 (S), 6.0 (M) and 8.0 mm (L) length and 5.0 mm diameter Bicon SHORTu00ae implants. Their 3D models were placed crestally and bicortically in corresponding posterior maxilla segment models with type III bone. They were designed in Solidworks 2016 software and had 1.0 mm cortical crestal and sinus bone layers. Implant and bone were assumed as linearly elastic and isotropic. Elasticity moduli of cortical/cancellous bone were 13.7/1.37 GPa. Bone-implant assemblies were analyzed in FE software Solidworks Simulation. 4-node 3D FEs were generated with a total number of up to 2,532,000. 120.92 N oblique load was applied to the center of 7.0 mm abutment. Von Mises stresses (MESs) were evaluated for bone-implant assemblies to determine UFL magnitudes for fully and partially osseointegrated implants and compare them.Maximal MESs for fully osseointegrated implants (26u202631 MPa) were found on the surface of crestal cortical bone. For partially osseointegrated implants they were discovered in migrating critical points inside crestal cortical bone (27u202632 and 41u202646 MPa for 0.2 and 1.0 mm bone loss). For fully osseointegrated implants, UFL magnitudes were 396u2026465 N. For partially osseointegrated implants and 0.2 bone loss, UFL magnitudes were 377u2026447 N, while for 0.4 mm u2013 356u2026417 N, for 0.6 mm u2013 327u2026366 N, for 0.8 mm u2013 314u2026356 N, and for 1.0 mm u2013294u2026336 N. So, after 5 years in function (1.0 mm bone loss), the following reduction of implant load-carrying capacity was determined: 26, 27 and 28% for S, M and L implants. Thus, all UFL magnitudes were much higher than mean maximal functional loading (120.92 N). Furthermore, for all scenarios, UFL magnitudes were above 275 N maximal functional loading for molar area. Finally, the difference between UFL magnitudes for S and M implants was approximately 5%. Short implant prognosis in terms of gradual bone loss is of crucial importance in implant dentistry. Studied Bicon SHORTu00ae implants were found moderately sensitive to bone loss, at least for 5 years in function and 1.0 mm cortical bone thickness. They were also capable to withstand 275 N maximum functional loading for molar area. Their load-carrying capacity was not substantially dependent on implant length, at least within 5u20268 mm, so this extends their application, especially in bone loss.
Author: Larisa Linetska
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
Bone loss is the most essential cause of dental implant failure. Comparing to the conventional implants, short implants may fail more rapidly because of their reduced length, especially in case of crestal placement. 0.2 mm mean annual bone loss was recommended as a criterion for implant success. Due to bone loss, even under physiological functional loading, bone overload may occur, which, in turn, provokes complementary bone loss. These processes significantly worsen implant long-term prognosis.The aim of this study was to evaluate and compare load-carrying capacities of the spectrum of fully and partially osseointegrated Bicon short implants to establish their prognosis in posterior maxilla under oblique functional loading.The concept of ultimate functional load (UFL) was proposed (Demenko et al., 2011) to compare load-carrying capacities of fully and partially osseointegrated (0.2 mm annual bone loss) 5.0 (S), 6.0 (M) and 8.0 mm (L) length and 5.0 mm diameter Bicon SHORTu00ae implants. Their 3D models were placed crestally and bicortically in corresponding posterior maxilla segment models with type III bone. They were designed in Solidworks 2016 software and had 1.0 mm cortical crestal and sinus bone layers. Implant and bone were assumed as linearly elastic and isotropic. Elasticity moduli of cortical/cancellous bone were 13.7/1.37 GPa. Bone-implant assemblies were analyzed in FE software Solidworks Simulation. 4-node 3D FEs were generated with a total number of up to 2,532,000. 120.92 N oblique load was applied to the center of 7.0 mm abutment. Von Mises stresses (MESs) were evaluated for bone-implant assemblies to determine UFL magnitudes for fully and partially osseointegrated implants and compare them.Maximal MESs for fully osseointegrated implants (26u202631 MPa) were found on the surface of crestal cortical bone. For partially osseointegrated implants they were discovered in migrating critical points inside crestal cortical bone (27u202632 and 41u202646 MPa for 0.2 and 1.0 mm bone loss). For fully osseointegrated implants, UFL magnitudes were 396u2026465 N. For partially osseointegrated implants and 0.2 bone loss, UFL magnitudes were 377u2026447 N, while for 0.4 mm u2013 356u2026417 N, for 0.6 mm u2013 327u2026366 N, for 0.8 mm u2013 314u2026356 N, and for 1.0 mm u2013294u2026336 N. So, after 5 years in function (1.0 mm bone loss), the following reduction of implant load-carrying capacity was determined: 26, 27 and 28% for S, M and L implants. Thus, all UFL magnitudes were much higher than mean maximal functional loading (120.92 N). Furthermore, for all scenarios, UFL magnitudes were above 275 N maximal functional loading for molar area. Finally, the difference between UFL magnitudes for S and M implants was approximately 5%. Short implant prognosis in terms of gradual bone loss is of crucial importance in implant dentistry. Studied Bicon SHORTu00ae implants were found moderately sensitive to bone loss, at least for 5 years in function and 1.0 mm cortical bone thickness. They were also capable to withstand 275 N maximum functional loading for molar area. Their load-carrying capacity was not substantially dependent on implant length, at least within 5u20268 mm, so this extends their application, especially in bone loss.
Author: Larisa Linetska
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
Among other reasons, dental implants often fail due to bone loss. Because of reduced length, short implants should be more susceptible to bone loss, especially if placed crestally. As a result of osseointegration loss, bone overload may take place under physiological functional loading, which, in turn, leads to bone loss progression. So, implant long-term prognosis would be heavily compromised.The aim of this study was to evaluate the role of implant diameter on long-term prognosis of short plateau implants in posterior maxilla considering bone loss.In order to compare load-carrying capacities of fully and partially osseointegrated (0.2 mm annual bone loss) 4.5 (N), 5.0 (M) and 6.0 mm (W) diameter and 5.0 mm length Bicon Shortu00ae implants, the concept of ultimate functional load (UFL) was proposed (Demenko, 2011). The implants 3D models were placed crestally and bicortically in posterior maxilla models with type III bone and 1.0 mm cortical crestal and sinus bone, which were generated in Solidworks 2016 software with a total number of up to 2,840,000 4-node 3D finite elements (FEs). Materials were assumed as linearly elastic and isotropic. Young moduli of cortical/cancellous bone were 13.7/1.37 GPa and cortical bone compression strength was 100 MPa. The models were analyzed in FE software Solidworks Simulation. 120.92 N oblique load was applied to the center of 7.0 mm abutment. Maximal von Mises stresses (MESs) were evaluated in bone-implant interface to determine UFL magnitudes for fully and partially osseointegrated implants.Maximal MESs for osseointegrated implants (14u202628 MPa) were found on the surface of crestal cortical bone. For implants with 0.2, 0.4, 0.6, 0.8, 1.0 mm bone loss, they were observed in migrating critical points inside crestal cortical bone: 23u202635, 32u202641, 38u202645, 41u202648, 43u202650 MPa. For osseointegrated implants, UFL magnitudes were 432u2026864 N. For the ones with 0.2, 0.4, 0.6, 0.8, 1.0 mm bone loss, UFL magnitudes were 345u2026526, 295u2026378, 269u2026318, 252u2026295, 242u2026278 N. So, after 5 years in function (1.0 mm bone loss), the following reduction of implant load-bearing capacity was determined: 44, 58 and 69% for N, M and W implants. Comparing to osseointegrated state, UFL drop with 0.2, 0.4, 0.6, 0.8 and 1.0 mm bone loss was found: 20, 32, 38, 42, 44% for N; 33, 46, 52, 56, 58% for M; 39, 56, 63, 66, 68% for W implants. It was determined that W implant had 53, 28, 18, 17, 15% UFL magnitude increase for 0.2, 0.4, 0.6, 0.8, 1.0 mm bone loss relative to N implant.All UFL magnitudes were found much higher than mean maximal functional loading (120.92 N). Furthermore, for all scenarios, UFL magnitudes were above 275 N maximal functional loading for molar area. By evaluating implant load-bearing capacity reduction, dental professionals may consider the factor of implant longevity in selection of a proper implant diameter.
Author: Igor Linetskiy
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ISBN:
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Languages : en
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Short implants are indispensable in posterior maxilla with insufficient bone height. Implant design, bone quality and degree of bone loss predetermine safe functional load transfer to adjacent bone. Adequate bone strains are key stimuli of bone turnover, but their extreme magnitudes lead to implant failure. Computer simulation allows to correlate bone and implant parameters with bone strain spectrum and to evaluate implant perspective.The aim of the study was to evaluate the impact of plateau implants and bone quality on strain levels in adjacent bone at several levels of bone loss to assess implant prognosis.Cortical and cancellous bone first principal strains (FPSs) were selected to evaluate bone turnover around fully and partially osseointegrated 4.5 (N), 5.0 (M) and 6.0 mm (W) diameter and 5.0 mm length Bicon SHORTu00ae implants at five levels of bone loss from 0.2 to 1.0 mm. Implant 3D models were placed crestally in corresponding posterior maxilla segment models with type III bone and 1.0 mm cortical crestal and sinus bone layers. The models were designed in Solidworks 2016 software. All materials were assumed as linearly elastic and isotropic. Elasticity modulus of cortical bone was 13.7 GPa, cancellous bone u2013 1.37 GPa. Bone-implant assemblies were analyzed in FE software Solidworks Simulation. A total number of 4-node 3D FEs was up to 3,450,000. 120.92 N mean maximal oblique load (molar area) was applied to the center of 7 Series Low 0u00b0 abutment. Maximal FPSs were correlated with 3000 microstrain minimum effective strain pathological (MESp) to evaluate bone turnover around the implants.Maximal FPSs for osseointegrated implants (1800u20263270 microstrain) were found in the cancellous bone at the first fin edge. For implants with bone loss, they were observed at the same location and were significantly dependent on bone loss level (2140u20263600, 2300u20264100, 2800u20264900, 3500u20265900 and 4200u20267000 microstrain for 0.2, 0.4, 0.6, 0.8 and 1.0 mm bone loss). Maximal FPSs were also substantially dependent on implant diameter: diameter increase from 4.5 to 6.0 mm have led to 41, 44, 43, 41, 40% FPS decrease for 0.2, 0.4, 0.6, 0.8 and 1.0 mm bone loss. Comparing to the osseointegrated implants, the following FPS increase on five bone loss levels was determined: for N implants it was 10, 25, 50, 80 and 114%, for M implants u2013 12, 32, 62, 92, 131%, for W implants u2013 19, 28, 56, 94 and 133%.Bone turnover was found to be significantly influenced by implant diameter and bone loss level. 4.5 mm diameter implant is not recommended for type III bone because bone strains exceed 3000 microstrain threshold even for the osseointegrated implant. 6.0 mm diameter implant caused positive bone turnover balance for up to 0.6 mm bone loss, while 5.0 mm u2013 only for up to 0.3 mm bone loss. Clinicians should consider these findings in treatment with short plateau implants.
Author: Igor Linetskiy
Publisher:
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Languages : en
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Bicon short implants have successfully proven themselves in the maxillary molar region with insufficient bone height and poor bone quality. To improve crestal bone healing, autogenous bone is placed in the gap between implant neck and implant bed. But even for such approach, the quality of the augmented bone is not fully predictable, though cortical bone strength is the key criterion of implant success. Finite element (FE) method allows precise analysis of this complex biomechanical system. The aim of this study was to evaluate the prospect of different-sized short plateau implants placed in atrophic posterior maxilla depending on the degree of augmented bone quality under oblique functional loading. 5.0 mm length and 4.0 (N), 5.0 (M), 6.0 (W) mm diameter Bicon SHORT u00ae implants were selected for this comparative study. Their 3D models were placed crestally in twelve posterior maxilla segment models with type III bone. They were designed using CT images in Solidworks 2016 software with 1.0 mm crestal/sinus cortical and 4.0 mm cancellous bone layers. Each model geometry was 10u00d730u00d719 mm. Implant and bone were assumed as linearly elastic and isotropic. Elasticity moduli of cortical/cancellous bone were 13.7/1.37 GPa. Four degrees of augmented bone quality were simulated: 100% (E1=13.7 GPa), 75% (E2=10.3 GPa), 50% (E3=6.85 GPa) and 25% (E4=3.43 GPa). Bone-implant assemblies were analyzed in FE software Solidworks Simulation. 4-node 3D FEs were generated with a total number of up to 4,040,000. 120.92 N mean maximal oblique load (molar area) was applied to the center of 7.0 mm abutment. Von Mises equivalent stress (MES) distributions were studied to determine the areas of bone overload. Analysis of MESs distributions in cortical bone has showed that their maximal magnitudes were found in crestal area. The spectrum of maximal MESs in augmented bone was between 9.5 MPa (W,E4) and 37 MPa (N,E1). They were influenced by implant diameter and augmented bone quality. MES reduction due to diameter increase from 4.0 to 6.0 mm was 52.7, 54.5, 55.4 and 54.8% for E1, E2, E3 and E4 bone quality. MES reduction due to two-fold augmented bone quality decrease (E1 versus E3) was 24.3, 30.2 and 28.6% for N, M and W implants. However, reduction of augmented bone quality caused significant overload of cancellous bone (5-17 MPa). Only for E1 bone, maximal MES in cancellous bone was approximately 5-7 MPa. In all other scenarios, maximal MES substantially exceeded 5 MPa strength of cancellous bone. N implants were found to be the most susceptible to the quality of augmented bone: E1 to E4 bone quality reduction has led to 126 and 82% MES rise for N and W implants. Under mean maximal functional loading, sufficient influence of augmented bone quality on crestal bone-implant interface was established. However, crestal bone overload is highly unlikely because MESs were found to be lesser than 100 MPa ultimate bone strength. Contrarily, E2-E4 bone quality scenarios are critical from the viewpoint of cancellous bone overload and implant failure. Placement of wider implant allows to decrease this risk.
Author: Young-Jun Lim
Publisher:
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Languages : en
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Background : Short implants are considered to be the simpler and more effective alternative to complicated bone graft surgery in clinical situations with reduced alveolar bone height. But, a considerable number of clinicians still hesitate to use short implants questioning about their prognoses mainly due to the reduced contact area between the bone and implant and unfavorable crown to implant ratio compared to longer implants. Aim : The aim of the study is to evaluate the clinical and radiographic outcomes of short implants supporting fixed prostheses in posterior regions. Methods : A retrospective study design was adopted. 69 short implants(intra-bony length u2264 8 mm) supporting fixed prostheses in posterior regions of 56 patients were included. The implant success rate and periimplant marginal bone loss were evaluated. The effects of associated factors on the implant performance were analyzed. Results : A total of 3 implants failed. 2 implants were lost before loading and 1 implant was lost at 7 months after loading. The mean follow up was 30.1 months(SD=11.8 months). Success rate was 95.7% and 94.6% for the implant and patient-based analysis respectively. The average marginal bone loss after 1 year of follow-up was 0.02 u00b1 0.16 mm at mesial and 0.03 u00b1 0.14 mm at distal aspect. No relationship was observed between the studied variables and the marginal bone loss. Conclusions: High survival rates for short implants in posterior regions could be achieved with minimal marginal bone loss in this study. Within the limits of the short term follow up, a short implant (u2264 8 mm ) may be considered as a predictable treatment modality for posterior region with reduced bone height.
Author: Larisa Linetska
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Languages : en
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Book Description
Crestal cortical bone at the implant neck is the key structural element of the jaw, which withstands the functional loading. Bone loss progression results in overloading of u201csoftu201d cancellous bone with the risk of implant failure. Comparing to conventional ones, short implants should be more sensitive to this issue. Plateau implants reduce the impact of bone loss, but there is no quantitative confirmation to this.The aim of this study was to assess the load-bearing ability of cancellous bone on several levels of bone loss after it propagates through the crestal cortical bone.Cancellous bone von Mises stresses (MESs) were proposed to evaluate load-bearing ability of fully and partially osseointegrated 4.5 (N), 5.0 (M), 6.0 mm (W) diameter and 5.0 mm length Bicon SHORTu00ae implant on 5 levels of bone loss from 1.2 to 2.0 mm. Implant 3D models were placed crestally and bicortically in posterior maxilla segment models with type III bone and 1.0 mm cortical crestal and sinus bone. Bone models were drawn in Solidworks 2016 software. Materials were assumed to be linearly elastic and isotropic. Elasticity moduli of cortical/cancellous bone were 13.7/1.37 GPa. Bone-implant assemblies were analyzed in finite element (FE) software Solidworks Simulation. 4-node 3D FEs were generated with a total number of up to 2,516,000. 120.92 N oblique load was applied to the center of 7 Series Low 0u00b0 abutment. MESs were evaluated in cancellous bone-implant interface for fully and partially osseointegrated implant and were compared.6.0, 5.0, 3.5 MPa maximal MESs for the osseointegrated N, M, W implants were found in cancellous bone at the first fin. For 1.2, 1.4, 1.6, 1.8, 2.0 mm bone loss, maximal MESs were calculated in migrating critical points of cancellous bone-implant interface, which were located on the border of disosseointegrated-osseointegrated cancellous bone: 8.0, 10.0, 12.5, 15.0, 17.5 MPa for N, 7.3, 9.3, 11.5, 13.5, 16.0 MPa for M, 4.5, 7.5, 8.5, 10.3, 12.0 MPa for W implant. For N, M, W implants after 6 years in function (1.2 mm bone loss), 33, 46, 58% MESs increase was determined, for 7 years (1.4 mm bone loss) u2013 67, 86, 114%, for 8 years (1.6 mm bone loss) u2013 108, 130, 143%, for 9 years (1.8 mm bone loss) u2013 150, 170, 194%, for 10 years (2.0 mm bone loss) - 192, 220, 243%.The studied Bicon SHORTu00ae implants were found extremely sensitive to bone loss after 5 years in function, when it has spread outside the cortical bone (1.2u20262.0 mm) and cancellous bone has become the only load-bearing element, since maximal MESs have exceeded the ultimate strength of dense cancellous bone (5.0 MPa). Therefore, implantologists should consider the obtained data in treatment planning.
Author: E. Meani
Publisher: Springer Science & Business Media
ISBN: 3540479996
Category : Medical
Languages : en
Pages : 400
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Book Description
The management of orthopedic infection is an area of growing importance in orthopedic surgery. This text provides a complete overview from basic research to clinical application and future perspectives in the treatment of orthopedic infection emphasizing the role of local therapy. Coverage details the various approaches to the treatment of orthopedic infections, making the book an important tool for the daily practice of its readers.
Author: Francesco M. Veronese
Publisher: Springer Science & Business Media
ISBN: 3764386797
Category : Medical
Languages : en
Pages : 289
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Book Description
PEGylation technology and key applications are introduced by this topical volume. Basic physical and chemical properties of PEG as basis for altering/improving in vivo behaviour of PEG-conjugates such as increased stability, improved PK/PD, and decreased immunogenicity, are discussed. Furthermore, chemical and enzymatic strategies for the coupling and the conjugate characterization are reported. Following chapters describe approved and marketed PEG-proteins and PEG-oligonucleotides as well as conjugates in various stages of clinical development.
Author: Ian A. Trail
Publisher: Springer
ISBN: 3319700995
Category : Medical
Languages : en
Pages : 605
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Book Description
This textbook provides the most up-to-date information on shoulder surgery along with practical approaches for patient evaluation and treatments options. The book is divided into key sections, providing coverage on Soft Tissue Disorders of the Shoulder, Arthritis of the Shoulder, The Paediatric Shoulder and other miscellaneous topics relevant to treating this area. Its strong clinical focus will help residents and medical students to manage patients in a practical way, based on the most recent scientific evidence and the most effective surgical and non-surgical techniques. Thus, it will become a valuable reference and resource for young doctors and students looking to increase their professional skills and knowledge when treating shoulder injuries and disorders in clinical practice.
Author: John D. Kelly IV
Publisher: Springer
ISBN: 3319251031
Category : Medical
Languages : en
Pages : 334
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Book Description
Ideal for shoulder surgeons who want to upgrade their skills to the next level, this practical, step-by-step text presents the latest cutting-edge management strategies and science aimed at shoulder preservation surgery. Highlighting four main areas - the overhead athlete, shoulder instability, glenohumeral arthritis, and the rotator cuff - these innovative techniques focus on the maintenance of the native shoulder joint. Chapters open with an introduction to the clinical problem, followed by misgivings related to open surgery or arthroplasty as treatment strategies. A rationale for the arthroscopic treatment is then presented, along with an in-depth description of the technique itself as well as preliminary results. Techniques presented include posterior capsule release for the overhead athlete, arthroscopic Latarjet for instability, the CAM procedure for glenohumeral arthritis, biological augmentation for rotator cuff repair. A fifth section covers post-operative care and return-to-play considerations. With contributions from many of the top thinkers and surgeons of the shoulder, Elite Techniques in Shoulder Arthroscopy brings these exciting new management strategies to the fore with the aim of elevating them to more common practice for orthopedic surgeons and sports medicine specialists.
