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Influence of the length and location of implants on distal extension removable partial dentures: finite element analysis

후방연장 가철성 국소의치에서 임플란트의 길이와 위치가 응력분산에 미치는 영향

  • Kim, Jin-Hee (Department of Prosthodontics, School of Dentistry, Kyungpook National University) ;
  • Cho, Jin-Hyun (Department of Prosthodontics, School of Dentistry, Kyungpook National University) ;
  • Lee, Cheong-Hee (Department of Prosthodontics, School of Dentistry, Kyungpook National University)
  • 김진희 (경북대학교 치의학전문대학원 치과보철학교실) ;
  • 조진현 (경북대학교 치의학전문대학원 치과보철학교실) ;
  • 이청희 (경북대학교 치의학전문대학원 치과보철학교실)
  • Received : 2015.06.22
  • Accepted : 2015.07.30
  • Published : 2015.09.30

Abstract

Purpose: To evaluate the effects of implant location and length on stress distribution and displacement in osseointegrated-implants that were associated with mandibular distal extension removable partial dentures (DERPD). Materials and Methods: A sagittally cut model with the #33, #34 teeth and a removable partial denture of the left mandible was used. Seven models were designed with NX 9.0. Models A, B, C had implants with lengths of 11, 6, 4 mm, respectively, under the denture base of the #37 artificial tooth. Models D, E, F had implants with lengths of 11, 6, 4 mm, respectively, under the denture base of the #36 artificial tooth. Model G did not have any implants. Axial force (250 N) was loaded on #36 central fossa. The finite element analysis was performed with MSC Nastran. Von Mises stress maps were plotted to visualize the results. Results: The models of #37 implant placement showed much lower stress concentration on the surrounding bone of the implant compared with #36. The #36 implant position tended to reduce displacement more than #37. Conclusion: When an IARPD is designed, the distal positioning of implant placement has more advantages in the edentulous bone of DERPD on the prognosis of short implants and the stress distribution of edentulous alveolar bone. Using implants with longer lengths are important for stress distribution. However, Additional studies are necessary of the effects of length on implant survival.

목적: 임플란트 위치와 길이가 하악 후방연장 가철성 국소의치(DERPD)와 연관된 임플란트의 응력 분포와 변위에 미치는 영향을 알아보는 것이다. 연구 재료 및 방법: #35, 36, 37이 소실된 시상절단면의 후방연장모형과 가철성 국소의치를 기본모형으로 사용했다. NX 9.0으로 7개의 모델을 디자인했다. 모델 A, B, C에서 각각 11, 6, 4 mm 길이의 임플란트가 #37 인공치 하방에 위치되었다. 모델 D, E, F에서 각각 11, 6, 4 mm의 임플란트가 #36 인공치 하방에 위치되었다. 모델 G는 임플란트가 없었다. 수직하중(250 N)을 #36의 중심와에 가했고, 유한요소 분석프로그램을 이용해 von Mises stress와 변위를 관찰했다. 결과: #37에 위치한 임플란트는 #36에 위치한 것과 비교시 주변골에 더 낮은 응력집중도를, #36에 위치한 임플란트는 #37에 위치한 것보다 더 적은 변위를 보였다. 결론: 임플란트 지지형 가철성 국소의치에서 후방부에 위치한 임플란트는 전방부에서보다 더 이점을 가지며, 길이가 더 긴 임플란트의 사용은 응력분산을 위해서 중요하다.

Keywords

References

  1. Kim SK, Yoo SY, Park IP, Lee JH. Implants in conjunction with removable partial denture. J Korean Dent Assoc 2011;49:77-84.
  2. Kordatzis K, Wright PS, Meijer HJ. Posterior mandibular residual ridge resorption in patients with conventional dentures and implant overdentures. Int J Oral Maxillofac Implants 2003;18:447-52.
  3. Giffin KM. Solving the distal extension removable partial denture base movement dilemma: a clinical report. J Prosthet Dent 1996;76:347-9. https://doi.org/10.1016/S0022-3913(96)90536-3
  4. Keltjens HM, Kayser AF, Hertel R, Battistuzzi PG. Distal extension removable partial dentures supported by implants and residual teeth: considerations and case reports. Int J Oral Maxillofac Implants 1993;8:208-13.
  5. Verri FR, Pellizzer EP, Rocha EP, Pereira JA. Influence of length and diameter of implants associated with distal extension removable partial dentures. Implant Dent 2007;16:270-80. https://doi.org/10.1097/ID.0b013e31805007aa
  6. Witter DJ, de Haan AF, Käyser AF, van Rossum GM. A 6-year follow-up study of oral function in shortened dental arches. Part I: Occlusal stability. J Oral Rehabil 1994;21:113-25. https://doi.org/10.1111/j.1365-2842.1994.tb01131.x
  7. Jorge JH, Quishida CC, Vergani CE, Machado AL, Pavarina AC, Ciampaolo ET. Clinical evaluation of failures in removable partial dentures. J Oral Sci 2012;54:337-42. https://doi.org/10.2334/josnusd.54.337
  8. Shahmiri R, Aarts JM, Bennani V, Das R, Swair MV. Strain distribution in a Kennedy class I implant assisted removable partial denture under various loading conditions. Int J Dent 2013;2013:351279.
  9. Wills DJ, Manderson RD. Biomechanical aspects of the support of partial denture. J Dent 1977;5:310-8 https://doi.org/10.1016/0300-5712(77)90123-3
  10. Itoh H, Caputo AA, Wylie R, Berg T. Effects of periodontal support and fixed splinting on load transfer by removable partial dentures. J Prosthet Dent 1998;79:465-71. https://doi.org/10.1016/S0022-3913(98)70163-5
  11. Tebrock OC, Rohen RM, Fenster RK, Pelleu GB Jr. The effect of various clasping systems on the mobility of abutment teeth for distal-extension removable partial dentures. J Prosthet Dent 1979;41:511-6. https://doi.org/10.1016/0022-3913(79)90082-9
  12. Starr NL. The distal extension case: an alternative restorative design for implant prosthetics. Int J Periodontics Restorative Dent 2001;21:61-7.
  13. Monteith BD. Management of loading forces on mandibular distal-extension prostheses. Part I: Evaluation of concepts for design. J Prosthet Dent 1984;52:673-81. https://doi.org/10.1016/0022-3913(84)90140-9
  14. Shahmiri RA, Atieh MA. Mandibular Kennedy class I implant-tooth-borne removable partial denture: a systematic review. J Oral Rehabil 2010;37:225-34. https://doi.org/10.1111/j.1365-2842.2009.02044.x
  15. Mijiritsky E, Ormianer Z, Klinger A, Mardinger O. Use of dental implants to improve unfavorable removable partial denture design. Compend Contin Educ Dent 2005;26:744-746,748,750 passim.
  16. Pellizzer EP, Verri FR, Falcon-Antenucci RM, Goiato MC, Gennari Filho H. Evaluation of different retention systems on a distal extension removable partial denture associated with an osseointegrated implant. J Craniofac Surg 2010;21:727-34. https://doi.org/10.1097/SCS.0b013e3181d8098a
  17. Ohkubo C, Kobayashi M, Suzuki Y, Hosoi T. Effect of implant support on distal-extension removable partial dentures: in vivo assessment. Int J Oral Maxillofac Implants 2008;23:1095-101.
  18. Bortolini S, Natali A, Franchi M, Coggiola A, Consolo U. Implant-retained removable partial dentures: an 8-year retrospective study. J Prosthodont 2011;20:168-72. https://doi.org/10.1111/j.1532-849X.2011.00700.x
  19. Grossmann Y, Nissan J, Levin L. Clinical effectiveness of implant-supported removable partial dentures: a review of the literature and retrospective case evaluation. J Oral Maxillofac Surg 2009;67:1941-6. https://doi.org/10.1016/j.joms.2009.04.081
  20. Lee JH, Kim DG, Park CJ, Cho LR. A literature review on implant assisted removable partial denture. J Dent Rehabil Appl Sci 2012;28:179-90.
  21. Cunha LD, Pellizzer EP, Verri FR, Pereira JA. Evaluation of the influence of location of osseointegrated implants associated with mandibular removable partial dentures. Implant Dent 2008;17:278-87. https://doi.org/10.1097/ID.0b013e31818363b2
  22. Wheeler RC. Dental anatomy, physiology and occlusion. 5th ed. Philadelphia; WB Saundders Co.;1974. p. 185-194&216-28.
  23. Pellecchia M, Pellecchia R, Emtiaz S. Distal extension mandibular removable partial denture connected to an anterior fixed implant-supported prosthesis: a clinical report. J Prosthet Dent 2000;83:607-12. https://doi.org/10.1067/mpr.2000.107114
  24. Chronopoulos V, Sarafianou A, Kourtis S. The use of dental implants in combination with removable partial dentures: a case report. J Esthet Restor Dent 2008;20:355-64; discussion 365. https://doi.org/10.1111/j.1708-8240.2008.00209.x

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