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Comparative finite element analysis of mandibular posterior single zirconia and titanium implants: a 3-dimensional finite element analysis

  • Choi, Sung-Min (Department of Dental Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Choi, Hyunsuk (Department of Dentistry and Prosthodontics, Daegu Catholic University School of Medicine) ;
  • Lee, Du-Hyeong (Department of Prosthodontics, School of Dentistry, Kyungpook National University) ;
  • Hong, Min-Ho (Department of Dental Laboratory Science, College of Health Sciences, Catholic University of Pusan)
  • Received : 2021.08.27
  • Accepted : 2021.12.06
  • Published : 2021.12.31

Abstract

PURPOSE. Zirconia has exceptional biocompatibility and good mechanical properties in clinical situations. However, finite element analysis (FEA) studies on the biomechanical stability of two-piece zirconia implant systems are limited. Therefore, the aim of this study was to compare the biomechanical properties of the two-piece zirconia and titanium implants using FEA. MATERIALS AND METHODS. Two groups of finite element (FE) models, the zirconia (Zircon) and titanium (Titan) models, were generated for the exam. Oblique (175 N) and vertical (175 N) loads were applied to the FE model generated for FEA simulation, and the stress levels and distributions were investigated. RESULTS. In oblique loading, von Mises stress values were the highest in the abutment of the Zircon model. The von Mises stress values of the Titan model for the abutment screw and implant fixture were slightly higher than those of the Zircon model. Minimum principal stress in the cortical bone was higher in the Titan model than Zircon model under oblique and vertical loading. Under both vertical and oblique loads, stress concentrations in the implant components and bone occurred in the same area. Because the material itself has high stiffness and elastic modulus, the Zircon model exhibited a higher von Mises stress value in the abutments than the Titan model, but at a level lower than the fracture strength of the material. CONCLUSION. Owing to the good esthetics and stress controllability of the Zircon model, it can be considered for clinical use.

Keywords

Acknowledgement

This research was supported by the Ministry of Trade, Industry & Energy (MOTIE), Korea Institute for Advancement of Technology (KIAT) [P0018960] and RESEARCH FUND (2021) offered from Catholic University of Pusan.

References

  1. Caglar A, Bal BT, Karakoca S, Aydin C, Yilmaz H, Sarisoy S. Three-dimensional finite element analysis of titanium and yttrium-stabilized zirconium dioxide abutments and implants. Int J Oral Maxillofac Implants 2011;26:961-9.
  2. Cionca N, Hashim D, Mombelli A. Zirconia dental implants: where are we now, and where are we heading? Periodontol 2000 2017;73:241-58. https://doi.org/10.1111/prd.12180
  3. Buser D, Janner SF, Wittneben JG, Bragger U, Ramseier CA, Salvi GE. 10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study in 303 partially edentulous patients. Clin Implant Dent Relat Res 2012;14:839-51. https://doi.org/10.1111/j.1708-8208.2012.00456.x
  4. Bidra AS, Rungruanganunt P. Clinical outcomes of implant abutments in the anterior region: a systematic review. J Esthet Restor Dent 2013;25:159-76. https://doi.org/10.1111/jerd.12031
  5. Thoma DS, Naenni N, Figuero E, Hammerle CHF, Schwarz F, Jung RE, Sanz-Sanchez I. Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis. Clin Oral Implants Res 2018;29:32-49.
  6. Siddiqi A, Payne AGT, De Silva RK, Duncan WJ. Titanium allergy: could it affect dental implant integration? Clin Oral Implants Res. 2011;22:673-80. https://doi.org/10.1111/j.1600-0501.2010.02081.x
  7. Sivaraman K, Chopra A, Narayan AI, Balakrishnan D. Is zirconia a viable alternative to titanium for oral implant? A critical review. J Prosthodont Res 2018;62:121-33. https://doi.org/10.1016/j.jpor.2017.07.003
  8. Becker J, John G, Becker K, Mainusch S, Diedrichs G, Schwarz F. Clinical performance of two-piece zirconia implants in the posterior mandible and maxilla: a prospective cohort study over 2 years. Clin Oral Implants Res 2017;28:29-35.
  9. Depprich R, Naujoks C, Ommerborn M, Schwarz F, Kubler NR, Handschel J. Current findings regarding zirconia implants. Clin Implant Dent Relat Res 2014;16:124-37. https://doi.org/10.1111/j.1708-8208.2012.00454.x
  10. Denry I, Kelly JR. State of the art of zirconia for dental applications. Dent Mater 2008;24:299-307. https://doi.org/10.1016/j.dental.2007.05.007
  11. Al-Amleh B, Lyons K, Swain M. Clinical trials in zirconia: a systematic review. J Oral Rehabil 2010;37:641-52. https://doi.org/10.1111/j.1365-2842.2010.02094.x
  12. Gautam C, Joyner J, Gautam A, Rao J, Vajtai R. Zirconia based dental ceramics: structure, mechanical properties, biocompatibility and applications. Dalton Trans 2016;45:19194-215. https://doi.org/10.1039/c6dt03484e
  13. Joos M, Sailer I, Filippi A, Mukaddam K, Rosentritt M, Kuhl S. Stability of screw-retention in two-piece zirconia implants: An in vitro study. Clin Oral Implants Res 2020;31:607-14. https://doi.org/10.1111/clr.13597
  14. Talmazov G, Veilleux N, Abdulmajeed A, Bencharit S. Finite element analysis of a one-piece zirconia implant in anterior single tooth implant applications. PLoS One 2020;15:e0229360. https://doi.org/10.1371/journal.pone.0229360
  15. Linares A, Grize L, Munoz F, Pippenger BE, Dard M, Domken O, Blanco-Carrion J. Histological assessment of hard and soft tissues surrounding a novel ceramic implant: a pilot study in the minipig. J Clin Periodontol 2016;43:538-46. https://doi.org/10.1111/jcpe.12543
  16. Roehling S, Astasov-Frauenhoffer M, Hauser-Gerspach I, Braissant O, Woelfler H, Waltimo T, Kniha H, Gahlert M. In vitro biofilm formation on titanium and zirconia implant surfaces. J Periodontol 2017;88:298-307. https://doi.org/10.1902/jop.2016.160245
  17. Janner SFM, Gahlert M, Bosshardt DD, Roehling S, Milz S, Higginbottom F, Buser D, Cochran DL. Bone response to functionally loaded, two-piece zirconia implants: A preclinical histometric study. Clin Oral Implants Res 2018;29:277-89.
  18. Balmer M, Spies BC, Vach K, Kohal RJ, Hammerle CHF, Jung RE. Three-year analysis of zirconia implants used for single-tooth replacement and three-unit fixed dental prostheses: A prospective multicenter study. Clin Oral Implants Res 2018;29:290-9.
  19. Bormann KH, Gellrich NC, Kniha H, Schild S, Weingart D, Gahlert M. A prospective clinical study to evaluate the performance of zirconium dioxide dental implants in single-tooth edentulous area: 3-year follow-up. BMC Oral Health 2018;18:181. https://doi.org/10.1186/s12903-018-0636-x
  20. Cionca N, Muller N, Mombelli A. Two-piece zirconia implants supporting all-ceramic crowns: a prospective clinical study. Clin Oral Implants Res 2015;26:413-8. https://doi.org/10.1111/clr.12370
  21. Lopez CAV, Vasco MAA, Ruales E, Bedoya KA, Benfatti CM, Bezzon OL, Deliberador TM. Three-dimensional finite element analysis of stress distribution in zirconia and titanium dental implants. J Oral Implantol 2018;44:409-15. https://doi.org/10.1563/aaid-joi-D-16-00109
  22. Lin YT, Shen YF, Wei PC, Hsu KW. Clinical evaluation of two-piece zirconia abutments with bonded titanium inserts for implant-supported restorations. J Prosthet Dent 2020;123:449-54. https://doi.org/10.1016/j.prosdent.2019.01.006
  23. Brandao de Holanda KA, Armini Caldas R, Amaral M, da Silva Concilio LR, Pino Vitti R. Biomechanical evaluation of anterior implants associated with titanium and zirconia abutments and monotype zirconia implants. J Prosthodont Res 2021;65:73-7. https://doi.org/10.2186/jpr.JPOR_2019_527
  24. de Matos JDM, Lopes GDRS, Nakano LJN, Ramos NC, Vasconcelos JEL, Bottino MA, Tribst JPM. Biomechanical evaluation of 3-unit fixed partial dentures on monotype and two-piece zirconia dental implants. Comput Methods Biomech Biomed Engin 2021:1-8.
  25. Bulaqi HA, Mousavi Mashhadi M, Safari H, Samandari MM, Geramipanah F. Effect of increased crown height on stress distribution in short dental implant components and their surrounding bone: A finite element analysis. J Prosthet Dent 2015;113:548-57. https://doi.org/10.1016/j.prosdent.2014.11.007
  26. Bankoglu Gungor M, Yilmaz H. Evaluation of stress distributions occurring on zirconia and titanium implant-supported prostheses: A three-dimensional finite element analysis. J Prosthet Dent 2016;116:346-55. https://doi.org/10.1016/j.prosdent.2016.01.022
  27. Kaleli N, Sarac D, Kulunk S, Ozturk O. Effect of different restorative crown and customized abutment materials on stress distribution in single implants and peripheral bone: A three-dimensional finite element analysis study. J Prosthet Dent 2018;119:437-45. https://doi.org/10.1016/j.prosdent.2017.03.008
  28. Sannino G, Gloria F, Ottria L, Barlattani A. Influence of finish line in the distribution of stress trough an all ceramic implant-supported crown: A 3D finite element analysis. Oral Implantol (Rome) 2009;2:14-27.
  29. Zhang G, Yuan H, Chen X, Wang W, Chen J, Liang J, Zhang P. A three-dimensional finite element study on the biomechanical simulation of various structured dental implants and their surrounding bone tissues. Int J Dent 2016;2016:4867402.
  30. Kim WH, Lee JC, Lim D, Heo YK, Song ES, Lim YJ, Kim B. Optimized dental implant fixture design for the desirable stress distribution in the surrounding bone region: a biomechanical analysis. Materials (Basel) 2019;12:2749. https://doi.org/10.3390/ma12172749
  31. Lee H, Park S, Kwon KR, Noh G. Effects of cementless fixation of implant prosthesis: A finite element study. J Adv Prosthodont 2019;11:341-9. https://doi.org/10.4047/jap.2019.11.6.341
  32. Lin D, Li Q, Li W, Swain M. Dental implant induced bone remodeling and associated algorithms. J Mech Behav Biomed Mater 2009;2:410-32. https://doi.org/10.1016/j.jmbbm.2008.11.007
  33. Geng JP, Tan KB, Liu GR. Application of finite element analysis in implant dentistry: a review of the literature. J Prosthet Dent 2001;85:585-98. https://doi.org/10.1067/mpr.2001.115251
  34. Bal BT, Caglar A, Aydin C, Yilmaz H, Bankoglu M, Eser A. Finite element analysis of stress distribution with splinted and nonsplinted maxillary anterior fixed prostheses supported by zirconia or titanium implants. Int J Oral Maxillofac Implants 2013;28:e27-38. https://doi.org/10.11607/jomi.2442
  35. Caglar A, Bal BT, Aydin C, Yilmaz H, Ozkan S. Evaluation of stresses occurring on three different zirconia dental implants: three-dimensional finite element analysis. Int J Oral Maxillofac Implants 2010;25:95-103.
  36. Akca K, Iplikcioglu H. Finite element stress analysis of the effect of short implant usage in place of cantilever extensions in mandibular posterior edentulism. J Oral Rehabil 2002;29:350-6. https://doi.org/10.1046/j.1365-2842.2002.00872.x
  37. Nakamura K, Kanno T, Milleding P, Ortengren U. Zirconia as a dental implant abutment material: a systematic review. Int J Prosthodont 2010;23:299-309.
  38. Kim JS, Raigrodski AJ, Flinn BD, Rubenstein JE, Chung KH, Mancl LA. In vitro assessment of three types of zirconia implant abutments under static load. J Prosthet Dent 2013;109:255-63. https://doi.org/10.1016/S0022-3913(13)60054-2
  39. Reilly DT, Burstein AH. The elastic and ultimate properties of compact bone tissue. J Biomech 1975;8:393-405. https://doi.org/10.1016/0021-9290(75)90075-5
  40. Perez-Pevida E, Brizuela-Velasco A, Chavarri-Prado D, Jimenez-Garrudo A, Sanchez-Lasheras F, Solaberrieta-Mendez E, Dieguez-Pereira M, Fernandez-Gonzalez FJ, Dehesa-Ibarra B, Monticelli F. Biomechanical consequences of the elastic properties of dental implant alloys on the supporting bone: finite element analysis. Biomed Res Int 2016;2016:1850401.
  41. Glauser R, Sailer I, Wohlwend A, Studer S, Schibli M, Scharer P. Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. Int J Prosthodont 2004;17:285-90.
  42. Yildirim M, Fischer H, Marx R, Edelhoff D. In vivo fracture resistance of implant-supported all-ceramic restorations. J Prosthet Dent 2003;90:325-31. https://doi.org/10.1016/S0022-3913(03)00514-6
  43. El-Anwar MI, El-Zawahry MM, Ibraheem EM, Nassani MZ, ElGabry H. New dental implant selection criterion based on implant design. Eur J Dent 2017;11:186-91. https://doi.org/10.4103/1305-7456.208432
  44. Bryington M, De Kok IJ, Thalji G, Cooper LF. Patient selection and treatment planning for implant restorations. Dent Clin North Am 2014;58:193-206. https://doi.org/10.1016/j.cden.2013.09.009
  45. Brodt MD, Swan CC, Brown TD. Mechanical behavior of human morselized cancellous bone in triaxial compression testing. J Orthop Res 1998;16:43-9. https://doi.org/10.1002/jor.1100160108
  46. Webber LP, Chan HL, Wang HL. Will zirconia implants replace titanium implants? Appl Sci 2021;11:6776. https://doi.org/10.3390/app11156776