Biomedical subjects

Matthias Karl

Publications and source records attributed to Matthias Karl.

7 recordsLinked to original sources

PubMed2006

Loading of bone surrounding implants through three-unit fixed partial denture fixation: a finite-element analysis based on in vitro and in vivo strain measurements.

Implant-borne fixed partial dentures (FPDs), whether cementable or screwable superstructures, ought to display a true passive fit. The objective of this in vivo-based finite-element analysis is, therefore, to quantify the degree of stress which occurs in the bone around the implants as a result of the fixation of cemented and screw-retained FPDs. On the basis of a simulated patient situation with two implants, six groups of implant-supported superstructures containing 10 samples each were fabricated. Strain gauges which were mounted on the pontics of the restorations were subsequently used to take in vivo measurements (Ethics Commission Approval No. 2315). Taking the values obtained as a basis, the von Mises equivalent stress was chosen to illustrate bone loading in three-dimensional finite-element models. Superstructure fixation caused residual interface stress as high as 30 MPa. Similar stress magnitudes can be observed for axial implant loading of 200 N. Assuming that the axial loading of a single implant with 200 N is within the bone's physiological range, it can be concluded that the degree of stress resulting from the fixation of superstructures alone does not constitute a risk.

Cementation↗

PubMed2005

Static implant loading caused by as-cast metal and ceramic-veneered superstructures.

STATEMENT OF PROBLEM: The passive fit of superstructures for implant-supported restorations is affected by each step of the fabrication process. In this context the question arises whether ceramic veneering would increase static implant loading. PURPOSE: The purpose of this study was to quantify the strain development of various fixed partial dentures (FPDs) both in the as-cast condition and after ceramic veneering. MATERIAL AND METHODS: Four different types (n = 10) of 5-unit FPDs (cementable, screw retained/plastic cylinder, screw retained/gold cylinder, screw retained/cemented) representing commonly used types of FPDs were investigated before and after ceramic veneering. Three implants were placed in a model simulating a patient situation, and strain gauges were mounted mesially and distally adjacent to the implants. The strain development was recorded during cement setting (provisional cement) and screw fixation. The data were analyzed statistically using multivariate 2-sample tests (alpha=.1). RESULTS: All FPDs revealed measurable amounts of strain. Neither the type of retention nor the mode of fabrication for conventional screw-retained FPDs had a significant influence on strain development. Ceramic veneering caused an increase in strain development for the conventional fixed partial dentures tested. The lowest strains were found in FPDs cemented to gold cylinders on the model for the metal frames and the ceramic-veneered FPDs. CONCLUSION: Conventional procedures were unable to produce superstructures with absolute passive fit. Ceramic veneering appeared to increase strain development and, thus, inaccuracy of the fit. The technique of cementing superstructures to prefabricated components directly on the implants may compensate for dimensional errors caused by impression making and superstructure fabrication.

Cementation↗

PubMed2005

Strain situation after fixation of three-unit ceramic veneered implant superstructures.

The passive fit of superstructures used in implant prosthodontics is affected by several variables. The objective of this study was to quantify the strain development in various fixed partial dentures (FPDs), both in the condition as cast and after ceramic veneering. Five different types of three-unit FPDs (cementable/repositioning technique impression; cementable/pick-up technique impression; screw-retained/plastic cylinder; screw-retained/gold cylinder; screw-retained/bonded) with 10 samples each, representing commonly used FPD-types, were investigated before and after ceramic veneering. Two ITI implants were anchored in a measurement model simulating a real-life patient situation and strain gauges were mounted close to the implants. The strain development was recorded during cement setting and screw fixation. For statistical analysis, multivariate two-sample tests were performed with the level of significance set at P = 0.1. All FPDs revealed measurable amounts of strain. Neither the impression technique nor the fabrication modes for conventional screw-retained FPDs had a significant influence on strain development. Ceramic veneering caused an increase in strain development for the conventional bridge types. Furthermore, cementing appears to be able to compensate fabrication inaccuracies better than screw retention. The lowest strains were found in FPDs bonded to gold cylinders on the measurement model for metal frames and ceramic-veneered FPDs. Conventional procedures are unable to produce superstructures with an absolute passive fit. The technique of bonding superstructures to prefabricated components in the oral cavity seems to compensate for various shortcomings in superstructure fabrication.

Cementation↗

PubMed2004

Cement fixation and screw retention: parameters of passive fit. An in vitro study of three-unit implant-supported fixed partial dentures.

It is generally assumed that passively fitting superstructures are a prerequisite for long-lasting implant success. In the study presented, the strain development of three-unit implant fixed partial dentures (FPDs) was evaluated at the bone surrounding the implant and on the superstructure using a strain gauge technique. Six groups of three-unit FPDs representing the commonly used techniques of bridge fabrication were investigated with 10 samples each, in order to quantify the influence of impression technique, mode of fabrication and retention mechanism on superstructure fit. Two ITI implants (Straumann, Waldenburg, Switzerland) were anchored in a measurement model according to a real-life patient situation and strain gauges were fixed mesially and distally adjacent to the implants and on the bridge pontics. The developing strains were recorded during cement setting and screw fixation. For statistical analysis, multivariate two sample tests were performed setting the level of significance at P=0.1. None of the investigated bridges revealed a truly passive fit without strains occurring. About 50% of the measured strains were found to be due to impression taking and model fabrication, whereas the remaining 50% were related to laboratory inaccuracies. The two impression techniques used did not reveal any significant differences in terms of precision. Both modes of fixation--i.e. cement and screw retention--provoked equally high stress levels. In the fabrication of screw-retained FPDs, similar results were obtained from the use of burn-out plastic copings and the technique of casting wax moulds to premachined components. Bonding bridge frames onto gold cylinders directly on the implants significantly reduces strain development.

Aged↗

PubMedDate not supplied

In vivo stress behavior in cemented and screw-retained five-unit implant FPDs.

PURPOSE: When fixing implant-supported fixed partial dentures (FPDs), it is important to achieve passive fit. The objective of the in vivo study presented was to quantify the strain development during the fixation of screw- and cement-retained FPDs. MATERIALS AND METHODS: After informed patient consent had been obtained (Ethics commission Approval No. 2315; FAU Erlangen-Nuremberg, Germany), four groups of five-unit FPDs (five samples per group) were fabricated and investigated in vivo. Group 1: Cementable, repositioning technique impression, burn out plastic coping; Group 2: Screwable, pickup technique impression, burn out plastic coping; Group 3: Screwable, pickup technique impression, cast to gold cylinder; Group 4: Screwable, pickup technique impression, bonded to gold cylinder. Two strain gauges (SG) were attached to the pontics of each bridge (SG-M and SG-D) to measure the strains that occurred during either the cementing or screw-in process. The final values were recorded for analysis. RESULTS: The mean strain values (microm/m) for each SG were: Group 1: SG-M 32 microm/m, SG-D: 89 microm/m; Group 2: SG-M 302 microm/m, SG-D: 197 microm/m; Group 3: SG-M 458 microm/m, SG-D: 268 microm/m; Group 4: SG-M 269 microm/m, SG-D: 52 microm/m. CONCLUSIONS: Although the bridges were clinically acceptable, none of them revealed a truly passive fit with zero microstrain. In contrast to conventional screw-retained bridges, cement retention seems to result in lower strain levels. Bonding bridge pontics to prefabricated implant components seems to allow both the retrievability of a screw-retained bridge and produce moderate strain values.

Aged↗

PubMedDate not supplied

In vitro study on passive fit in implant-supported 5-unit fixed partial dentures.

PURPOSE: Fabrication and retention methods have an influence on the passivity of superstructure fit. The objective of the study was to quantify the strain development of various cemented and screw-retained fixed partial dentures (FPDs). MATERIALS AND METHODS: Forty samples of 4 different types of FPDs (10 of each type) were investigated. Each sample had 3 ITI implant abutments and 2 pontics. The 3 implants were anchored in a straight-line configuration in a measurement model simulating a real-life patient situation. Strain gauges were mounted close to the implants and on the pontics. The developing strains were recorded during cement setting and screw fixation. For statistical analysis, multivariate 2-sample tests were performed, with the level of significance set at P = .1. RESULTS: All FPDs investigated revealed a considerable amount of strain, with no significant difference between cement and screw retention. Furthermore, no significant difference was found between the conventional fabrication modes for screw-retained FPDs. The lowest strains were found in prostheses that were intraorally bonded onto gold cylinders. DISCUSSION: Because bonding of the superstructure in the oral cavity may compensate for impression and laboratory variables, restorations with the best possible passive fit can result from this retention technique. Before this technique can be recommended, the long-term stability of the adhesive layer should be investigated. CONCLUSIONS: As an absolute passive fit of superstructures is not possible using conventional clinical and laboratory procedures, and as clinical fit-evaluation methods often do not detect "hidden" inaccuracies, the more sensitive strain-gauge technique should be utilized for an objective accuracy test. Reference strain values from implant-supported prostheses that have served without complications could help define a "biologically acceptable fit.

Aged↗

PubMedDate not supplied

Fixation of 5-unit implant-supported fixed partial dentures and resulting bone loading: a finite element assessment based on in vivo strain measurements.

PURPOSE: It is believed that implant-supported fixed partial dentures (FPDs) should display passive fit. The objective of this in vivo-based finite element analysis (FEA) was to quantify the magnitude of bone loading occurring on account of the fixation of cemented or screw-retained 5-unit superstructures. MATERIALS AND METHODS: Based on a patient situation with 3 implants, 4 different groups of restorations with 10 samples each were fabricated. Strain gauges on the pontics of the restorations were used for in vivo measurements. Using the values obtained, bone loading in 3-dimensional FE models was simulated as von Mises equivalent stress. RESULTS: The in vivo measured mean strain values ranged from 32 microm/m to 458 microm/m at the different sites. FEA revealed stresses between 5 and 30 MPa in the cortical area, while in trabecular bone values ranging from 2 MPa to 5 MPa were observed. Stress of a similar magnitude was found for axial implant loading with 200 N. DISCUSSION: Assuming that the axial loading of a single implant with 200 N is within the realm of the bone's adaptation ability, it would appear that the amount of stress resulting from the fixation of superstructures alone does not constitute a risk. CONCLUSIONS: The level of precision of fit which can be obtained in superstructure fabrication would appear to suffice to produce restorations that do not cause bone damage.

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