Occlusal scheme effect on the biomechanical response of full-arch dental prosthesis supported by titanium implants: A systematic review

Dental implant-supported prosthesis are widely used in oral reconstruction of totally edentulous patients. Nonetheless, one of the most common failures in these cases is caused by overloading from improper occlusion. The aim of this work was to determine if the occlusal scheme influences the biomechanical response in implant-supported dental prostheses. Searches were conduct is several databases (PubMed/MEDLINE, The Cochrane Library, Web of Science, Scopus, LILACS, and Opengrey). We found 632 publications and 521 studies remained after removing duplicates. After applying the inclusion criteria, five studies were used in this systematic review: one clinical trial, one retrospective clinical trial, one in vitro and two in silico. The results show the lack of clinical and laboratory studies about occlusion in implant-supported prostheses. Although there are several studies regarding implant occlusion schemes, there remains a lack of scientific evidence to support that one specific occlusal scheme is superior to another, or to help define the ideal occlusal scheme that improves the clinical outcome. It can be concluded, however, that the proper distribution of loads and the absence of occlusal interferences can increase implant longevity. Thus, more clinical and laboratory studies must be carried out to obtain an occlusal scheme that favors the clinical success of implant rehabilitation

Effect of Resin Cement at Different Thicknesses on the Fatigue Shear Bond Strength to Leucite Ceramic

Objectives This in vitro study was performed to evaluate fatigue survival by shear test in the union of leucite-reinforced feldspathic ceramic using different cement thicknesses. Materials and Methods Leucite-reinforced glass ceramics blocks were sectioned in 2-mm thick slices where resin cylinders were cemented. The samples were distributed in two experimental groups (n = 20) according to the cement thickness (60 and 300 μm). The specimens of each group were submitted to the stepwise fatigue test in the mechanical cycling machine under shear stress state, with a frequency of 2 Hz, a step-size of 0.16 bar, starting with a load of 31 N (1.0 bar) and a lifetime of 20,000 cycles at each load step. Results The samples were analyzed in a stereomicroscope and scanning electron microscopy to determine the failure type. There is no significant difference between the mean values of shear bond strength according to both groups. Log-rank (p = 0.925) and Wilcoxon (p = 0.520) tests revealed a similar survival probability in both cement layer thicknesses according to the confidence interval (95%). The fracture analysis showed that the mixed failure was the most common failure type in the 300-μm thickness group (80%), while adhesive failure was predominant in the 60-μm thickness group (67%). The different cement thicknesses did not influence the leucite ceramic bonding in fatigue shear testing; however, the thicker cement layer increased the predominance of the ceramic material failure. Conclusion The resin cement thicknesses bonded to leucite ceramic did not influence the long-Term interfacial shear bond strength, although thicker cement layer increased the ceramic material cohesive failure. Regardless the cement layer thickness, the shear bond strength lifetime decreases under fatigue