journal club

JSS ACADEMY OF HIGHER EDUCATION & RESEARCH

JSS Dental College & Hospital

Presenter
PRIYA PRABHAKARAN
III Year PG Student
DEPT.of Prosthodontics and
Crown & Bridge
Department of prosthodontics and crown &
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bridge
JSS ACADEMY OF HIGHER EDUCATION & RESEARCH
JSS Dental College & Hospital

Introduction

Treatment
Reference
plan

CONTENTS
Review Of
conclusion Literature

Critical
evaluation
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A 3D model of aCollege & bone
human jaw Hospital
was designed
using a CAD software
MATERIAL AND METHODS

An implant (4.5×11 mm) was modeled and screwed

into the bone block.

PM, 4.5-mm implant with 4.5-mm abutment and PS,

4.5-mm implant with 3.5-mm abutment.

An intermediate-sized mesh with tetra elements was

selected for discretization of the models into finite
elements.
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JSS ACADEMY OF HIGHER EDUCATIONLinear & RESEARCH 03
01
JSS Dental College & Hospital elastic analysis was
An insertion
performed using a
torque of 35 Ncm -
software program
implant
(ANSYS Workbench
abutment -preloaded
16.0; ANSYS Inc).
to 25 Ncm

02 04

01 03
02 von Mises 04
Vertical force
(200 to 800 N) and equivalent stresses in the
oblique force (50 to 150 implant assemblies and
N) at an angle of 45 periimplant
degrees to the long axis bone were calculated and
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compared
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RESULTS& RESEARCH
JSS Dental College & Hospital

Higher stress values were seen for

the PS model.
mean stress values in dental
implant assemblies did not differ
significantly
When stress within peri-implant
bone was evaluated, significantly
higher stress was seen in peri-
implant bone surrounding the PM
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dental implant
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Under nonaxial loads, maximum stress in the PS model is directed along the center
of the implant assembly, whereas the point of maximum stress in the PM model
shifts toward the edge of the assembly, closer to the bone-implant interface.
For the same applied loads, the strain and corresponding deformation is of a
greater magnitude for the PM model, indicating probable bone resorption
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DISCUSSION

When stress in the implant assemblies was compared, higher von Mises equivalent
stress values were seen for the PS model.
However, mean stress values in implant assemblies did not differ significantly under
axial (P=.918) and nonaxial loads (P=.211).
Mean stress in the periimplant bone was significantly higher in the PM model under
both axial (P=.002) and nonaxial loads (P<.001).
For the PM model, stress values approached and even exceeded the compressive
and tensile yield strength of cortical bone (130 to 150 MPa).

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The results of the present study are also consistent with those of Liu et al,Sahabi et
al,and Chang et al.
An FEA study by Pellizzer et al also reported results favoring platform switching.
They also reported that stresses were not only high in the PM model but were even
higher if an implant was restored with a wider abutment.

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The results of the present study suggest that PM assemblies

are more likely to result in peri-implant MBL as
a result of occlusal contact during mastication

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CRITICAL EVALUATION

Analysis was
used a 3D rather All data pertaining performed over a
than a 2D model to material range of applied
for analysis, which properties and loads because
helps simulate the model dimensions occlusal forces vary
oral conditions and were derived from among individuals
responses more published
realistically. literature;

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 anatomic or physiological variation.

 Occlusal loads were simulated as static not dynamic loads.
 Mechanical properties of bone vary from person to person depending
on their build, health, diet, and genetic makeup.
 FEA gives a mathematical approximation of the problem but does not
take into account ongoing biological processes.

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Effect of platform switching on implant crest bone stress: a finite element analysis.
Schrotenboer J, Tsao Y-P, Kinariwala V, Wang H-L.
ImplantDent 2009;18:260-9.

 They carried out a 2D FEA to analyze stress in peri-implant crestal bone under
vertical and oblique forces.
 PM implants showed a von Mises stress of 28 MPa and 6.977 MPa under oblique
and vertical loading, respectively, whereas PS implants showed 27.43 MPa and
6.502 MPa under the same loads.
 They concluded that platform switching has no significant effect in reducing peri-
implant bone stress.

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Stress Analysis in Platform-Switching Implants:

A 3-Dimensional Finite Element Study
Eduardo Piza Pellizzer, Fellippo Ramos Verri, Rosse Mary Falco´ n-AntenucciJoel Ferreira Santiago Ju´
nior, Paulo Se´rgio Perri de Carvalho, Sandra Lu´ cia Dantas de Moraes, Pedro Yoshito Noritomi,

 model was composed of a bone block with one implant 10 mm long and of
different diameters (3.75 and 5.00 mm).
 The UCLA abutments also ranged in diameter from 5.00 mm to 4.1 mm.
 After obtaining the geometries, the models were transferred to the software
FEMAP 10.0 for pre- and postprocessing of finite elements to generate the mesh,
loading, and boundary conditions.

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 A total load of 200 N was applied in axial (08),

oblique (458), and lateral (908) directions.
 The models were solved by the software
NeiNastran 9.0 and transferred to the software
FEMAP 10.0 to obtain the results that were
visualized through von Mises and maximum
principal stress maps

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CONCLUSON
• “Platform switching” is a simple and effective way to control circumferential bone
loss around dental implants.

• By altering the horizontal position of the micro-gap, the horizontal component of

bone loss after abutment connection can be reduced.

• This technique, however, has its faults. Switching can be used with components that
have similar designs, that is, the screw access hole must be uniform.

• In addition, sufficient space is needed to develop a proper emergence profile

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• Although the biological basis for platform switching has been proposed, the
biomechanical aspect still needs to be investigated.

• In a study done to analyze the biomechanical rationale for platform switching,

Maeda et al. suggested that platform switching has the biomechanical advantage of
shifting the stress concentration away from the cervical bone-implant interface.

• It also may have the disadvantage of increasing stress in abutment or abutment

screw.

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 Thank you

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