Shirin Shahrbaf

Effect of surface treatment on stress distribution in immediately loaded dental implants—A 3D finite element analysis

OBJECTIVE To investigate, by means of FE analysis, the effect of surface roughness treatments on the distribution of stresses at the bone-implant interface in immediately loaded mandibular implants. MATERIALS AND METHODS An accurate, high resolution, digital replica model of bone structure (cortical and trabecular components) supporting an implant was created using CT scan data and image processing software (Mimics 13.1; Materialize, Leuven, Belgium). An anatomically accurate 3D model of a mandibular-implant complex was created using a professional 3D-CAD modeller (SolidWorks, DassaultSystèmes Solid Works Corp; 2011). Finite element models were created with one of the four roughness treatments on the implant fixture surface. Of these, three were surface treated to create a uniform coating determined by the coefficient of friction (μ); these were either (1) plasma sprayed or porous-beaded (μ=1.0), (2) sandblasted (μ=0.68) or (3) polished (μ=0.4). The fourth implant had a novel two-part surface roughness consisting of a coronal polished component (μ=0.4) interfacing with the cortical bone, and a body plasma treated surface component (μ=1) interfacing with the trabecular bone. Finite element stress analysis was carried out under vertical and lateral forces. RESULTS This investigation showed that the type of surface treatment on the implant fixture affects the stress at the bone-implant interface of an immediately loaded implant complex. Von Mises stress data showed that the two-part surface treatment created the better stress distribution at the implant-bone interface. SIGNIFICANCE The results from this FE computational analysis suggest that the proposed two-part surface treatment for IL implants creates lower stresses than single uniform treatments at the bone-implant interface, which might decrease peri-implant bone loss. Future investigations should focus on mechanical and clinical validation of these FE results.

The Effect of Marginal Ridge Thickness on the Fracture Resistance of Endodontically-treated, Composite Restored Maxillary Premolars

This study evaluated the effect of varying thicknesses of marginal ridge on the fracture resistance of endodontically-treated maxillary premolars restored with composite. Ninety non-carious maxillary premolars, extracted for orthodontic reasons, were selected for this experimental in vitro study. The teeth were randomly assigned to six groups (n=15). Group 1 received no preparation. In groups 2 through 6, the premolars were root filled and DO preparations were created, while MOD preparations were also created for group 2. The condition of the boxes was: the gingival seat was 1.5 mm above the CEJ and the buccolingual dimensions were 3.5 mm in gingival and 3 mm in occlusal. In groups 3 through 6, the dimensions of the mesial marginal ridge were measured using a digital caliper as follows: 2 mm, 1.5 mm, 1 mm and 0.5 mm, respectively. All samples in groups 2 through 6 were restored with a dentin bonding system (DBS: Single Bond, 3M) and resin composite (Z 250, 3M). Subsequently, premolars from all six groups were subjected to a thermocycling regimen of 500 cycles between 5 degrees C and 55oC water baths. Dwell time was 30 seconds, with a 10-second transfer time between baths. The premolars were submitted to axial compression up to failure at a 45 degrees angle to the palatal cusp in Universal Test Equipment (Tinius Olsen, Ltd, H5K-S model). The mean load necessary to fracture the samples was recorded in newtons (N), and data were subjected to analysis of variance (ANOVA) and LSD post-hoc test. According to these results, the mean loads necessary to fracture the samples in each group were (in N): group 1: 732 +/- 239, group 2:489 +/- 149, group 3: 723 +/- 147, group 4: 696 +/- 118, group 5: 654 +/- 183 and group 6: 506 +/- 192). Differences between group 1 and groups 2 and 6, and also differences between groups 3, 4 and 5 compared with group 2 and 6 were statistically significant (p < 0.05).

Fracture strength of machined ceramic crowns as a function of tooth preparation design and the elastic modulus of the cement

OBJECTIVES To determine, by means of static fracture testing the effect of the tooth preparation design and the elastic modulus of the cement on the structural integrity of the cemented machined ceramic crown-tooth complex. METHODS Human maxillary extracted premolar teeth were prepared for all-ceramic crowns using two preparation designs; a standard preparation in accordance with established protocols and a novel design with a flat occlusal design. All-ceramic feldspathic (Vita MK II) crowns were milled for all the preparations using a CAD/CAM system (CEREC-3). The machined all-ceramic crowns were resin bonded to the tooth structure using one of three cements with different elastic moduli: Super-Bond C&B, Rely X Unicem and Panavia F 2.0. The specimens were subjected to compressive force through a 4mm diameter steel ball at a crosshead speed of 1mm/min using a universal test machine (Loyds Instrument Model LRX.). The load at the fracture point was recorded for each specimen in Newtons (N). These values were compared to a control group of unprepared/unrestored teeth. RESULTS There was a significant difference between the control group, with higher fracture strength, and the cemented samples regardless of the occlusal design and the type of resin cement. There was no significant difference in mean fracture load between the two designs of occlusal preparation using Super-Bond C&B. For the Rely X Unicem and Panavia F 2.0 cements, the proposed preparation design with a flat occlusal morphology provides a system with increased fracture strength. SIGNIFICANCE The proposed novel flat design showed less dependency on the resin cement selection in relation to the fracture strength of the restored tooth. The choice of the cement resin, with respect to its modulus of elasticity, is more important in the anatomic design than in the flat design.

Effect of self-etching primer/adhesive and conventional bonding on the shear bond strength in metallic and ceramic brackets

Introduction: Bracket debonding from the tooth surface is a common problem in fixed orthodontics. The aims of the present study were to assess the bond strength and failure sites in two ways of bonding technique, with metallic and ceramic brackets. Material and Methods: One hundred premolars were assigned to 4 groups of 25 each: Group A, metallic brackets/ conventional procedure; Group B, metallic brackets/Transbond XT; Group C, ceramic brackets/conventional procedure; and Group D, ceramic brackets/Transbond XT. Transbond XT composite paste was used for bracket bonding and cured by conventional light-cure device. Specimens were subjected to thermocycling. One week after bonding shearing force was applied to the bracket-tooth interface. Bonding failure site optically examined using a stereomicroscope under 10 × magnifications and scoring was done using the adhesive remnant index (ARI). Data were subjected to analysis of One-way variance, Tukey post hoc, Chi-square and Spearman’s tests. Results: Mean bond strength (in MPa) were: group A=9.2, group B=8.5, group C=6.2 and group D=5.7. Bond strength differences between groups A and B, and between C and D were not significant, (p<0.0005). Insignificant difference found in ARI in all groups. Conclusion: The bond strengths of metallic brackets were significantly higher than ceramic ones and the selfetching primer produce fewer bonds than the conventional method (clinically acceptable). A positive correlation found between changes in shearing bond strength and ARI. Key words: Acid etching, adhesive remnant index, orthodontic brackets, self-etching primer, shearing bond strength.

Effect of the crown design and interface lute parameters on the stress-state of a machined crown-tooth system: a finite element analysis.

The effect of preparation design and the physical properties of the interface lute on the restored machined ceramic crown-tooth complex are poorly understood. The aim of this work was to determine, by means of three-dimensional finite element analysis (3D FEA) the effect of the tooth preparation design and the elastic modulus of the cement on the stress state of the cemented machined ceramic crown-tooth complex. The three-dimensional structure of human premolar teeth, restored with adhesively cemented machined ceramic crowns, was digitized with a micro-CT scanner. An accurate, high resolution, digital replica model of a restored tooth was created. Two preparation designs, with different occlusal morphologies, were modeled with cements of 3 different elastic moduli. Interactive medical image processing software (mimics and professional CAD modeling software) was used to create sophisticated digital models that included the supporting structures; periodontal ligament and alveolar bone. The generated models were imported into an FEA software program (hypermesh version 10.0, Altair Engineering Inc.) with all degrees of freedom constrained at the outer surface of the supporting cortical bone of the crown-tooth complex. Five different elastic moduli values were given to the adhesive cement interface 1.8GPa, 4GPa, 8GPa, 18.3GPa and 40GPa; the four lower values are representative of currently used cementing lutes and 40GPa is set as an extreme high value. The stress distribution under simulated applied loads was determined. The preparation design demonstrated an effect on the stress state of the restored tooth system. The cement elastic modulus affected the stress state in the cement and dentin structures but not in the crown, the pulp, the periodontal ligament or the cancellous and cortical bone. The results of this study suggest that both the choice of the preparation design and the cement elastic modulus can affect the stress state within the restored crown-tooth complex.

Shear bond strength and debonding characteristics of metal and ceramic brackets bonded with conventional acid-etch and self-etch primer systems: An in-vivo study

Background Different in-vitro studies have reported various results regarding shear bond strength (SBS) of orthodontic brackets when SEP technique is compared to conventional system. This in-vivo study was designed to compare the effect of conventional acid-etching and self-etching primer adhesive (SEP) systems on SBS and debonding characteristics of metal and ceramic orthodontic brackets. Material and Methods 120 intact first maxillary and mandibular premolars of 30 orthodontic patients were selected and bonded with metal and ceramic brackets using conventional acid-etch or self-etch primer system. The bonded brackets were incorporated into the wire during the study period to simulate the real orthodontic treatment condition. The teeth were extracted and debonded after 30 days. The SBS, debonding characteristics and adhesive remnant indices (ARI) were determined in all groups. Results The mean SBS of metal brackets was 10.63±1.42 MPa in conventional and 9.38±1.53 MPa in SEP system, (P=0.004). No statistically significant difference was noted between conventional and SEP systems in ceramic brackets. The frequency of 1, 2 and 3 ARI scores and debonding within the adhesive were the most common among all groups. No statistically significant difference was observed regarding ARI or failure mode of debonded specimens in different brackets or bonding systems. Conclusions The SBS of metal brackets bonded using conventional system was significantly higher than SEP system, although the SBS of SEP system was clinically acceptable. No significant difference was found between conventional and SEP systems used with ceramic brackets. Total SBS of metal brackets was significantly higher than ceramic brackets. Due to adequate SBS of SEP system in bonding the metal brackets, it can be used as an alternative for conventional system. Key words:Shear bond strength, Orthodontic brackets, Adhesive remnant index, self-etch.

Pattern of stress distribution in different bracket–adhesive–tooth systems due to debonding load application

Abstract Purpose Orthodontic bracket debonding during treatment period is an unbecoming occurrence for both orthodontists and patients. Various clinical and numerical studies have been done to specify different parameters which affect the bond strength of bracket–adhesive–tooth system. Pattern of stress distribution seems to be an appropriate factor to estimate bond strength of different systems. Since it is not possible to experimentally define stress distribution in bracket–adhesive–tooth systems, three dimensional finite element method is used. The purpose of this study is to obtain and compare stress distribution of five bracket–adhesive–tooth systems with various enamel surface morphologies as an indicator parameter of these systems’ bond strength. Materials and methods In order to specify and compare stress in five different teeth, including maxillary central incisor, mandibular central incisor, maxillary canine, and maxillary and mandibular premolar, 3D STL files of teeth and brackets were reconstructed in MIMICS10 and were imported to HYPERMESH for each tooth, separately. Space between enamel and bracket was filled with orthodontic adhesive, mechanical property of each layer was assigned and appropriate boundary conditions were applied. Results It was observed that stress distribution in bracket, adhesive and tooth due to shear load application had irregular pattern. For all of systems stress concentration was observed either on the borders or incisal and gingival regions of enamel–adhesive bonding region and adhesive layer. Conclusion Despite the overall similarity in stress distribution pattern of different bracket–adhesive–tooth systems, some differences on pattern of stress distribution and magnitude of stress were also observed. This may bring about more susceptibility of curved enamel surface teeth to lower bond strength, damage and fracture than flat enamel surface teeth.