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College of Applied Medical Sciences, Department of Dental Health, King Saud University, Riyadh, Saudi Arabia
College of Applied Medical Sciences, Dental Biomaterials Research Chair, Department of Dental Health,
King Saud University, Riyadh, Saudi Arabia
c Advanced Manufacturing Institute, College of Engineering, King Saud University, Riyadh, Saudi Arabia
d Department of Material Science and Engineering, The Kroto Research Institute, The University of Shefeld,
Shefeld S3 7HQ, UK
b
a r t i c l e
i n f o
a b s t r a c t
Article history:
Objective. The purpose of this study was to investigate and compare the load distribu-
tion and displacement of cantilever prostheses with and without glass abutment by three
dimensional nite element analysis. Micro-computed tomography was used to study the
28 December 2014
Methods. The external surface of the maxilla was scanned, and a simplied nite element
model was constructed. The ZX-27 glass abutment and the maxillary rst and second premolars were created and modied. The solid model of the three-unit cantilever xed partial
Keywords:
denture was scanned, and the tting surface was modied with reference to the created
abutments using the 3D CAD system. The nite element analysis was completed in ANSYS.
Micro-computed tomography
The t and total gap volume between the glass abutment and dental model were determined
Results. The results of the nite element analysis in this study showed that the cantilever
3D analysis
prosthesis supported by the glass abutment demonstrated signicantly less stress on the
terminal abutment and overall deformation of the prosthesis under vertical and oblique
Prosthesis deformation
Gap volume
Signicance. By contacting the mucosa, glass abutments transfer some amount of masticatory load to the residual alveolar ridge, thereby preventing damage to the periodontal
microstructures of the terminal abutment. The passive contact of the glass abutment with
the mucosa not only preserves the health of the mucosa covering the ridge but also permits
easy cleaning. It is possible to increase the success rate of cantilever FPDs by supporting the
cantilevered pontic with glass abutments.
2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Corresponding author at: Department of Materials Science and Engineering, The Kroto Research Institute, The University of Shefeld,
North Campus, Broad Lane, Shefeld S3 7HQ, UK. Tel.: +44 01142225946; fax: +44 01142225945.
E-mail address: i.u.rehman@shefeld.ac.uk (I.U. Rehman).
http://dx.doi.org/10.1016/j.dental.2015.02.003
0109-5641/ 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
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d e n t a l m a t e r i a l s 3 1 ( 2 0 1 5 ) 514521
1.
Introduction
Cortical bone
Cancellous bone
Enamel
Dentin
ZX-27 Glass
Nickel chromium alloy
Periodontal ligament
Pulp
Oral mucous membrane
Youngs
modulus (MPa)
Poissons ratio
1340
150
80, 000
15, 000
69, 000
200, 000
6.9
5.4
7.5
0.30
0.30
0.30
0.31
0.19
0.29
0.45 [35]
0.44 [35]
0.45 [36]
and compare the functional load distribution and displacement of the cantilever FPD with and without glass abutments
using 3D nite element analysis. This analysis was preferred
over 2D analysis because 3D analysis provides an actual representation of the stress behavior of the supporting alveolar
bone. Furthermore, for the rst time, micro-computed tomography (micro-CT) was used to study the relationship between
the glass abutment and the ridge.
2.
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d e n t a l m a t e r i a l s 3 1 ( 2 0 1 5 ) 514521
d e n t a l m a t e r i a l s 3 1 ( 2 0 1 5 ) 514521
517
Fig. 3 Stresses created at the pontic-retainer interface with and without a glass abutment.
3.
Results
4.
Deformation
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d e n t a l m a t e r i a l s 3 1 ( 2 0 1 5 ) 514521
Fig. 4 Total deformation of the cantilevered pontic with and without a glass abutment.
supported by the glass abutment was less than that of pontic without the glass abutment support. After the application
of a vertical load, the pontic supported by the glass abutment
showed deformation of 1.1233 mm, whereas the pontic without the glass abutment showed a deformation of 1.2266 mm.
After the application of an oblique load, the deformation
was 8.5774 mm for the pontic with the glass abutment and
9.2381 mm for the pontic without the glass abutment.
5.
Stresses
6.
Discussion
d e n t a l m a t e r i a l s 3 1 ( 2 0 1 5 ) 514521
519
in lower stresses on the terminal abutments than in unsupported FPD. After the application of both vertical and oblique
loads, the displacement of the prostheses was mainly in
the vertical direction because the cantilevered end remained
unsupported distally. Deformation of the prostheses is the
major factor that determines the success of FPD treatment
[30]. Excessive deformation during mastication transfers damaging forces to the terminal abutment, aggravates the clinical
symptoms of periodontally compromised abutment teeth and
damages the mucosa covering the edentulous alveolar ridge
at the cantilevered end. The amount of vertical displacement
depends on the number and mesio-distal length of the cantilevered pontic; increasing the number of cantilevered pontics
increases the amount of vertical displacement, and the extent
of displacement may be more when observed clinically than
when measured by nite element analyses. Hence, every effort
must be made to limit the displacement of prostheses, especially in posterior cantilever FPDs.
Simple cantilever FPD can be used to replace anterior teeth
by increasing the number of abutments to provide maximum support because masticatory forces are minimal in the
anterior segment. In contrast, simply increasing the number
of abutments in the posterior segment does not drastically
improve the success rate because the generated masticatory
load is greater. Yokoyama et al. [31] and Correa et al. [32] recommended the placement of implants to support cantilevered
pontics through a nite element study because it reduces
the amount of stress created on the supporting abutment.
However, there are several clinical situations where implant
treatment is contraindicated. In such situations, glass abutments serve as an alternative and non-invasive method of
providing support for the cantilevered pontic to limit deformation under a vertical load, thereby minimizing stresses created
on the terminal abutment. Glass abutments are chemically
treated, biocompatible and fabricated to rest on soft tissues
and can be cemented to cantilevered pontics. This chemically
modied glass abutment can be shaped to any pontic design,
and its smooth, transparent surface not only prevents plaque
accumulation but also enhances esthetics.
However, active contact of the glass abutment and transfer
of masticatory load can have adverse effects on the resorption
pattern of the residual alveolar ridges. Hence, micro-CT analysis was performed to study the relationship between glass
abutments and residual alveolar ridges. The results of the
micro-CT showed point contact (0.1 mm) of the glass abutment at the crest of the residual alveolar ridge (Fig. 5). The
glass abutment is cemented to the cantilevered pontic, and if
deformation occurs during mastication, then the glass abutment prevents further displacement of the cantilevered pontic
by contacting the ridge and transferring some of the masticatory forces to the residual alveolar ridge without damaging
the periodontal health of the terminal abutment. Kerenyi performed cytological, histological and elemental analyses of the
oral mucosa of patients with glass abutments and reported
no adverse effects on the oral mucosa. The surface and chemical composition of the glass abutments did not change after
being in the oral cavity for 8 months [33]. Keszthelyi [34] studied the hemolytic activity of glass abutments on rabbits, and
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d e n t a l m a t e r i a l s 3 1 ( 2 0 1 5 ) 514521
Fig. 6 Gap distance and gap volume between the glass abutment and the dental model.
7.
Conclusion
Acknowledgement
We would like to extend our appreciation to the Research
Centre, College of Applied Medical Sciences and Deanship of
Scientic Research at King Saud University for funding this
research.
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