• The Journal of Korean Academy of Prosthodontics
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• v.45 no.6
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• pp.717-723
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• 2007

Statement of problem. Unreasonable distal cantilevered implant-supported prosthesis can mask functional problems of reconstruction temporarily, but it can cause serious strain and stress around its supported implant and surrounding alveolar bone. Purpose. The purpose of this study was to evaluate strain of implants supporting distal cantilevered fixed prosthesis with two different cantilevered length under distal cantilevered static load. Material and methods. A partially edentulous mandibular test model was fabricated with auto-polymerizing resin (POLYUROCK; Metalor technologies, Stuttgart, Swiss) and artificial denture teeth (Endura; Shofu inc., Kyoto, Japan). Two implants-supported 5-unit screw-retained cantilevered fixed prosthesis was made using standard methods with Type III gold alloy (Harmony C&B55; Ivoclar-vivadent, Liechtenstein, Germany) for superstructure and reinforced hard resin (Tescera; Ivoclar-vivadent, Liechtenstein, Germany) for occlusal material. Two strain gauges (KFG-1-120-C1-11L1M2R; KYOWA electronic instruments, Tokyo, Japan) were then attached to the mesial and the distal surface of each standard abutment with adhesive (M-bond 200; Tokuyama, Tokyo, Japan). Total four strain gauges were attached to test model and connected to dynamic signal conditioning strain amplifier (CTA1000; Curiotech inc., Paju, Korea). The stepped $20{\sim}100$ N in 25 N increments, cantilevered static load 8mm apart (Group I) or 16mm apart (Group II), were applied using digital push-pull gauge (Push-Pull Scale & Digital Force Gauge, Axis inc., Seoul, Korea). Each step was performed ten times and every strain signal was monitored and recorded. Results. In case of Group I, the strain values were surveyed by $80.7{\sim}353.8{\mu}m$ in Ch1, $7.5{\sim}47.9{\mu}m/m$ in Ch2, $45.7{\sim}278.6{\mu}m/m$ in Ch3 and $-212.2{\sim}718.7{\mu}m/m$ in Ch4 depending on increasing cantilevered static load. On the other hand, the strain values of Group II were surveyed by $149.9{\sim}612.8{\mu}m/m$ in Ch1, $26.0{\sim}168.5{\mu}m/m$ in Ch2, $114.3{\sim}632.3{\mu}m/m$ in Ch3, and $-323.2{\sim}-894.7{\mu}m/m$ in Ch4. Conclusion. A comparative statistical analysis using paired sample t-test about Group I Vs Group II under distal cantilevered load shows that there are statistical significant differences for all 4 channels (P<0.05).

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.224-235
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• 2013

A passively fitting prosthesis is an essential prerequisite to attain long-lasting success and maintenance of osseointegration. However, true "passive fit" can not be achieved with the present implant-supported prosthesis fabrication protocol. Many clinical situations are suitably treated with cantilevered implant-supported fixed restorations. The purpose of this study was to compare the stress distribution pattern and magnitude in supporting tissues around ITI implants with cantilevered, implant-supported, screw-retained fixed prosthesis according to the fitness of superstructures. Photoelastic model was made with PL-2 resin (Measurements, Raleigh, USA) and three ITI implants (${\phi}4.1{\times}10mm$) were placed in the mandibular posterior edentulous area distal to the canine. Anterior and posterior extended 4-unit cantilevered FPDs were made with different misfit in the superstructures. 4 types of prosthesis were made by placing a $100{\mu}m$ gap between the abutment and the crown on the second premolar and/or the first molar. Photoelastic stress analysis were carried out to measure the fringe order around the implant supporting structure under simulated loading conditions (30 lb).

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.724-743
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• 2000

One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.4
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• pp.615-643
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• 1998

The purpose of this study was to evaluate the effect of cantilever length, load, and implant number on the stress distribution of implant supported fixed prosthesis. In the replica of an edentulous human mandible, four or five implants were placed and spaced evenly between the mental foramina and symmetrical gold alloy cast superstructures with cantilever were fabricated. Strain gauges were placed in buccal and lingual side of implants. 9, 15, 21kg of loads at varying cantilever lengths were applied to the occlusal surface of fixed prostheses. The strains were recorded from each gauge and principal stresses were calculated The results were as follows : 1. Increasing the length of the cantilever increased the stresses on the bone supporting implants. and the ratio of increase became high as increasing the load. 2. In the model with four implants, the highest compressive stress was measured on lingual side of the first implants nearest loading point and the highest tensile stress was measured on buccal side of the second implants. 3. In the model with five implants, the highest compressive stress was measured on lingual side of the first implants nearest loading point. And the highest tensile stress was measured on buccal side of the second implants, and lingual side of the third implants. 4. There was no significant change of the magnitude of stress on the most distal imp]ant of non cantilevered side as increasing the cantilever length or load. 5. In general, the superstructure supported by five implants reduced the stress and was less affected by cantilever length compared to the support provided by four implants.

• The Journal of Advanced Prosthodontics
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• v.14 no.1
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• pp.22-31
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• 2022

PURPOSE. The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS. Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS. Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) ㎛ while CAD-cast demonstrated the highest measurements of 29.2 (3.1) ㎛. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION. Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw's preload stability under an aggressive loading situation.