Prosthetic rehabilitation of a completely edentulous patient no longer confines to only replacement of missing teeth. Patients are increasingly demanding improvement in esthetics at the end of treatment. Aging leads to a high impact on external facial esthetics resulting in slumped cheek leading to undesirable facial esthetics. Cheek plumper is a commonly used prosthesis to enhance the support of sunken cheeks providing better esthetics. This clinical report describes a novel technique to fabricate detachable cheek plumber to improve support for sunken cheeks retained with a ball bearing and a new commercially available material.
Background: Occlusal loading of osseointegrated implants is believed to be an essential determining factor in the long-term success of an implant treatment. Numerous studies have been conducted on the evaluation of stress distribution by definitive restoration materials for Implant-supported fixed prosthesis, but very few have evaluated provisional restoration materials for the same. This study aims to evaluate the influence of provisional restoration material – Milled Polymethylmethacrylate (PMMA) and Milled Polyetheretherketone (PEEK), over stress distribution on the peri-implant bone around an implant-supported three-unit, fixed dental prosthesis using finite element analysis method. Materials and Methods: Three-dimensional models of a pair of bone-level implant system and titanium base abutments were created using the standard tessellation language data of original implant components. A bone block representing the mandibular posterior area was created, and the implants were placed in the bone block with 100% osseointegration in the 2nd premolar to 2nd molar region. A superstructure of an implant-supported 3-unit bridge was modeled on top of the abutments, each crown to be 8 mm in height and with an outer diameter of 6 mm in 2nd premolar region and 10 mm in 1st molar and 2nd molar region. Two different models were created according to combinations of provisional restoration materials, namely, Milled PMMA and Milled PEEK based on. In each model, the implants were loaded vertically (300 N) and obliquely (150 N at 30°). The stress distribution in the cortical bone, cancellous bone, and implant was evaluated through the von Mises stress analysis. Results: The results showed no difference in stress distribution due to the different provisional restorations – Milled PMMA and Milled PEEK. In addition, the vertical load resulted in higher stress values in the implant components, cortical bone, and cancellous bone in both PEEK and PMMA models as compared to oblique loading. Conclusion: The new polymer, PEEK was seen to provide comparable stress generation in the current study without exceeding the physiological limits of peri-implant bone. Thus, it can be considered as a good alternative to PMMA resin as a provisional crown material since it provides certain additional benefits.
Background: Stresses on prosthetic crown directly influences the survival rate of implants hence it should be considered while selecting prosthetic material. The aim of the study is to evaluate stress analysis on implant, abutment and peripheral bone with change in different abutment and different crown materials by 3D finite element study. Materials and Methods: A numerical procedure based on finite element method was adopted to investigate the influence of different prosthetic materials and abutment materials on stress situation. Eight different three-dimensional (3D) models of a bone-level implant system and an abutment were created by using the standard tessellation language (STL) data of original implant components. Combinations included of abutment materials i.e., Titanium (Ti), Polyetheretherketone (PEEK), Polyetherketoneketone (PEKK), Polymer infilterated hybrid ceramic (TZI) along with different restoration materials Monolithic Zirconia (MZ) and lithium disilicate glass ceramic (IPS e-max). In each model, the implants were loaded obliquely (150 N). The stress distribution in the implant, Abutment and peripheral bone was evaluated through the von Mises stress analysis. Results: Higher stresses were found on neck of implants irrespective of abutment material and restorative material. Highest stress was found with PEEK material. The pattern of stress distribution in implant and peripheral bone was similar in all models. Conclusion: There is no difference in stresses with the change in restorative material but the change in abutment material has effect on stresses on implants.
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