<p>Osseointegrated titanium implants have become a commonly used method in edentulous jaws and today there are success rates in the magnitude of 82 % in the lower jaw and 98 % in the upper. During first year after implantation a fully normal marginal bone loss of 1-2 mm occurs. If the bone loss continues there is a risk of implant failure. High tensions in bone and inflammation caused by bacteria are possible reasons for this problem. It has been shown that a leakage of bacterias occurs between the parts of the implant and there are theories that this has effects on the marginal bone loss.</p><p>The aim of this thesis has been to increase the knowledge about microbial leakage with help of in vitro tests and virtual simulations. The goal was to create a test method to measure differences of microbial leakage in two implant systems.</p><p>The developed test method includes an in vitro test of six implants and Finite Element Analysis. The test method is the product of a process with several small tests. The final test method measures leakage of a coloured fluid with a spectrophotometer. The results are then compared with the virtual simulations to draw conclusions and find explanations how the implants are functioning.</p><p>The result of test on six implants, four Ospol and two Nobel Replace, indicates that there are differences in the magnitude of microleakage in different implant systems in due to the implant-abutment interface. No conclusions can be drawn before the test method is refined and more implants are tested.</p>

Osseointegrated titanium implants have become a commonly used method in edentulous jaws and today there are success rates in the magnitude of 82 % in the lower jaw and 98 % in the upper. During first year after implantation a fully normal marginal bone loss of 1-2 mm occurs. If the bone loss continues there is a risk of implant failure. High tensions in bone and inflammation caused by bacteria are possible reasons for this problem. It has been shown that a leakage of bacterias occurs between the parts of the implant and there are theories that this has effects on the marginal bone loss. The aim of this thesis has been to increase the knowledge about microbial leakage with help of in vitro tests and virtual simulations. The goal was to create a test method to measure differences of microbial leakage in two implant systems. The developed test method includes an in vitro test of six implants and Finite Element Analysis. The test method is the product of a process with several small tests. The final test method measures leakage of a coloured fluid with a spectrophotometer. The results are then compared with the virtual simulations to draw conclusions and find explanations how the implants are functioning. The result of test on six implants, four Ospol and two Nobel Replace, indicates that there are differences in the magnitude of microleakage in different implant systems in due to the implant-abutment interface. No conclusions can be drawn before the test method is refined and more implants are tested.

Magister Chirurgiae Dentium (MChD) / Dental implants have proven to be a success in the past decades, however the inevitable presence of microgaps at the implant abutment interface leading to microleakage is still a distressing concern. Microbial leakage can lead to peri-implant disease and bone loss and reduces implants' success rates. Measures to decrease the effect of the microgap were introduced; amongst them is the application of silicone sealing gels, such as GapSeal®.

Magister Scientiae Dentium - MSc(Dent) / Lack of appropriate bone thickness is a common clinical limitation for tooth replacement, often requiring narrow implants, which have shown better results when combined with Morse taper connections. Little is known about the sealing of the abutment-implant interface of narrow implants with Morse taper connections against oral bacteria.

Magister Scientiae Dentium - MSc(Dent) / Background: The two-stage implant system has proven to be a successful technique in replacing missing teeth (Nascimento et al., 2008). Nevertheless, the presence of micro-gaps that could entrap microbes at the implant-abutment interface (IAI) is unavoidable. This microbial leakage has been considered as one of the causes of peri-implant infection and bone loss (Scarano et al., 2005). Several companies have attempted to manufacture an implant with a connection design that provides hermetic sealing against bacterial leakage. Studies indicated that implants with internal connection, in particular the conical (Morse taper) design, have better sealing capacity in the implant abutment interface than the external design (Koutouzis et al., 2011, Jaworski et al., 2012). An internal conical implant system with a novel connection design, known as the Grand Morse (GM) connection, is reported to offer secure connection against micro-leakage (Neodent® Implant Systems Inc., 2018). Aims: The aim of this study was to test the sealing ability against bacterial leakage in the implant-abutment interface provided by an implant with a novel deep internal conical (GM) connection design.

No description available.

O sucesso da terapia reabilitadora com implantes requer um equilíbrio entre fatores biológicos e mecânicos. Os fatores biológicos são inúmeros, já os mecânicos associam-se à instabilidade da interface implante-intermediário protético. Com base nestas informações, este estudo busca criar um aparelho com o qual será possível avaliar e comparar a resistência e a estabilidade da interface implante-intermediário protético em implantes de diferentes tipos de sistema de conexão e componentes protéticos, após a aplicação de carga simulada, que será realizada por meio de um ensaio dinâmico de fadiga rotacional, também conhecido como flexão rotativa. Para a criação deste aparelho, vários procedimentos com base em princípios de usinagem CNC (Controle Numérico Computadorizado), engenharia elétrica e física foram utilizados. Os futuros testes e resultados, utilizando-se esse aparelho para realizar o ensaio de fadiga, serão publicados em trabalhos futuros. Para o desenvolvimento dos modelos de corpos de prova a serem analisados na máquina de ensaio, foram utilizados implantes do tipo hexágono externo (Neodent) de 3,75mm de diâmetro x 11.5mm de comprimento. Ao término do desenvolvimento, obteve-se um aparelho confiável, resistente e extremamente versátil; podendo-se facilmente variar a carga exercida e a frequência de rotação, sendo assim possível executar inúmeras combinações de ensaios de fadiga. Esse estudo demonstrou a possibilidade e viabilidade de desenvolver um aparelho adequado para realizar um ensaio de fadiga, de pequena dimensão (portátil) e a um custo significativamente inferior do que comprar um aparelho próprio para tal fim. / The success of a rehabilitation therapy with implant fixtures requires a balance between biological and mechanical factors. The biological factors are innumerable, however the mechanics associate it whit instability of the implant-abutment interface. On the basis of these information, the aim of this study is to create a device which it will be possible to evaluate and to compare the resistance and the stability of the implant-abutment interface whith implants of different connection system and abutments, after the simulated load application, that will be carried through a dynamic assay of rotational fatigue load, also known as rotary bending. For the creation of this device, some procedures on the basis of principles of milling CNC (Computerized Numerical control), electric and physical engineering had been used. The future tests and results, using this device to carry through the fatigue assay, will be published in future works. For the development of the body test to be analyzed in the assay machine, implant fixtures of external hexagon type (Neodent) of 3,75mm of diameter x 11mm of length had been used. In the ending of the development, a trustworthy, resistant and extremely versatile device was gotten; being able itself easily to vary the exerted load and the frequency of rotation, being been thus possible to execute innumerable combinations of fatigue assays. This study demonstrated the possibility and viability of it developing an adequate device to carry through an assay of fatigue, of small dimension (portable) and the significantly inferior cost of what if to buy a proper device for such end.

Foi analisada a variação da pré-carga de parafusos durante os cinco primeiros minutos depois de cada uma de cinco seqüências aperto e desaperto de parafusos de implantes dentários com diferentes sistemas de retenção pilar/implante. Extensômetros foram colados no terço cervical de implantes com interface de hexágono externo, hexágono interno e cone Morse. Um procedimento controlado de aperto e desaperto dos parafusos permitiu o arquivo dos valores de torque reverso, em relação ao aperto, e o campo de tensões gerado sobre o terço cervical dos implantes resultante da pré-carga do parafuso para cada uma das seqüências. Foram estudadas 30 amostras de implantes/pilares, dividas em oito grupos: implantes de hexágono externo com intermediário Munhão Universal e parafusos de titânio (Neodent, Curitiba, Brasil) apertados a 32 N.cm (EH.Ti.32); hexágono externo, Munhão Universal, parafuso de titânio recoberto por DLC, 32 N.cm (EH.dlc.32); hexágono interno, Munhão Universal, parafuso de titânio, 20 N.cm (IH.Ti.20); cone Morse, Munhão Universal peça única, 20 N.cm (MT.OP.20); cone Morse, Munhão Universal peça única, 32 N.cm (MT.OP.32); Cone Morse, Munhão Universal parafuso passante, 10 N.cm (MT.TS.10); no sétimo grupo foram usados as mesmas amostras do grupo MT.TS.10 a 10 N.cm, porém o desaperto foi realizado pelo intermediário (MT.TS.10.A); para o último grupo foram usados as mesmas amostras do grupo MT.TS.10 e MT.TS.10.A, porém o aperto dos parafusos foi de 15 N.cm e o desaperto também se deu pelo o intermediário (MT.TS.15.A). Os valores médios e desvio padrão (dp) de pré-carga encontrados para todas as seqüências de cada grupo foram de: EH.Ti.32 (27,75; dp 7,70); EH.dlc.32 (40,17; dp 10,16); IH.Ti.20 (219,61; dp 75,47); MT.OP.20 (129,19; dp 116,71); MT.OP.32 (137,97; dp 47,53); MT.TS.10 (39,55; dp 13,96); MT.TS.10.A (126,72; dp 44,05); MT.TS.15.A (194,41; 68,48). Entre os diferentes sistemas de retenção pilar/implante estudados, pode-se concluir que: existem relações únicas entre o valor de torque aplicado no parafuso e a pré-carga gerada sobre o terço cervical do implante, essas são diretamente influenciados pelo desenho da interface pilar/implante, tipo de parafuso de retenção e valor de torque aplicado; não foi observada perda de pré-carga dos parafusos de pilares, nem perda de resistência à torção no sentido anti-rotacional dos parafusos depois de esperados 5 minutos em 5 seqüências de aperto/desaperto. / The preload screw variation for the first five minutes after each one of five torque/untorque sequences from different implant/abutment retention systems was evaluated. Strain gauges were attached over the cervical third of external hex, internal hex and Morse taper implants. A controlled torque/untorque procedure allowed the record from the preload and untorque values of the samples in each one of the sequences. Thirty implant/abutment samples, divided in eight groups were studied: external hex implants with Universal post and titanium screws (Neodent, Curitiba, Brazil) screwed to 32 N.cm (EH.Ti.32); external hex, Universal post, DLC covered screw, 32 N.cm (EH.dlc.32); internal hex, Universal post, titanium screw, 20 N.cm (IH.Ti.20); Morse taper, single piece Universal post, 20 N.cm (MT.OP.20); Morse taper, single piece Universal post, 32 N.cm (MT.OP.32); Morse taper, Universal post trespassing screw, 10 N.cm (MT.TS.10); the same samples from the MT.TS.10 group were used for the seventh group, screwed to 10 N.cm, but the untorque was performed by the abutment (MT.TS.10.A); the same samples used with the MT.TS.10 and the MT.TS.10.A were used for the last group, but the screws were tightened to 15 N.cm and the untorque remained by the abutment (MT.TS.15.A). The mean and the stardad deviation (DP) found for the preloss in all the five sequences were of: EH.Ti.32 (27.75; SD 7.70); EH.dlc.32 (40.17; SD 10.16); IH.Ti.20 (219.61; SD 75.47); MT.OP.20 (129.19; SD 116.71); MT.OP.32 (137.97; SD 47.53); MT.TS.10 (39.55; SD 13.96); MT.TS.10.A (126.72; SD 44.05); MT.TS.15.A (194.41; SD 68.48). For the retention systems studied, it could be concluded that: there are single relations between screw untorque and preload over the implant cervical third, these are directely influenced by the implant/abutment interface design, screw type and torque value; there were not found post screw preload loss, neither torque resistance at the anti-rotational direction from the screws after the first five minutes in five torque/untorque sequences.

O sucesso da terapia reabilitadora com implantes requer um equilíbrio entre fatores biológicos e mecânicos. Os fatores biológicos são inúmeros, já os mecânicos associam-se à instabilidade da interface implante-intermediário protético. Com base nestas informações, este estudo busca criar um aparelho com o qual será possível avaliar e comparar a resistência e a estabilidade da interface implante-intermediário protético em implantes de diferentes tipos de sistema de conexão e componentes protéticos, após a aplicação de carga simulada, que será realizada por meio de um ensaio dinâmico de fadiga rotacional, também conhecido como flexão rotativa. Para a criação deste aparelho, vários procedimentos com base em princípios de usinagem CNC (Controle Numérico Computadorizado), engenharia elétrica e física foram utilizados. Os futuros testes e resultados, utilizando-se esse aparelho para realizar o ensaio de fadiga, serão publicados em trabalhos futuros. Para o desenvolvimento dos modelos de corpos de prova a serem analisados na máquina de ensaio, foram utilizados implantes do tipo hexágono externo (Neodent) de 3,75mm de diâmetro x 11.5mm de comprimento. Ao término do desenvolvimento, obteve-se um aparelho confiável, resistente e extremamente versátil; podendo-se facilmente variar a carga exercida e a frequência de rotação, sendo assim possível executar inúmeras combinações de ensaios de fadiga. Esse estudo demonstrou a possibilidade e viabilidade de desenvolver um aparelho adequado para realizar um ensaio de fadiga, de pequena dimensão (portátil) e a um custo significativamente inferior do que comprar um aparelho próprio para tal fim. / The success of a rehabilitation therapy with implant fixtures requires a balance between biological and mechanical factors. The biological factors are innumerable, however the mechanics associate it whit instability of the implant-abutment interface. On the basis of these information, the aim of this study is to create a device which it will be possible to evaluate and to compare the resistance and the stability of the implant-abutment interface whith implants of different connection system and abutments, after the simulated load application, that will be carried through a dynamic assay of rotational fatigue load, also known as rotary bending. For the creation of this device, some procedures on the basis of principles of milling CNC (Computerized Numerical control), electric and physical engineering had been used. The future tests and results, using this device to carry through the fatigue assay, will be published in future works. For the development of the body test to be analyzed in the assay machine, implant fixtures of external hexagon type (Neodent) of 3,75mm of diameter x 11mm of length had been used. In the ending of the development, a trustworthy, resistant and extremely versatile device was gotten; being able itself easily to vary the exerted load and the frequency of rotation, being been thus possible to execute innumerable combinations of fatigue assays. This study demonstrated the possibility and viability of it developing an adequate device to carry through an assay of fatigue, of small dimension (portable) and the significantly inferior cost of what if to buy a proper device for such end.

Foi analisada a variação da pré-carga de parafusos durante os cinco primeiros minutos depois de cada uma de cinco seqüências aperto e desaperto de parafusos de implantes dentários com diferentes sistemas de retenção pilar/implante. Extensômetros foram colados no terço cervical de implantes com interface de hexágono externo, hexágono interno e cone Morse. Um procedimento controlado de aperto e desaperto dos parafusos permitiu o arquivo dos valores de torque reverso, em relação ao aperto, e o campo de tensões gerado sobre o terço cervical dos implantes resultante da pré-carga do parafuso para cada uma das seqüências. Foram estudadas 30 amostras de implantes/pilares, dividas em oito grupos: implantes de hexágono externo com intermediário Munhão Universal e parafusos de titânio (Neodent, Curitiba, Brasil) apertados a 32 N.cm (EH.Ti.32); hexágono externo, Munhão Universal, parafuso de titânio recoberto por DLC, 32 N.cm (EH.dlc.32); hexágono interno, Munhão Universal, parafuso de titânio, 20 N.cm (IH.Ti.20); cone Morse, Munhão Universal peça única, 20 N.cm (MT.OP.20); cone Morse, Munhão Universal peça única, 32 N.cm (MT.OP.32); Cone Morse, Munhão Universal parafuso passante, 10 N.cm (MT.TS.10); no sétimo grupo foram usados as mesmas amostras do grupo MT.TS.10 a 10 N.cm, porém o desaperto foi realizado pelo intermediário (MT.TS.10.A); para o último grupo foram usados as mesmas amostras do grupo MT.TS.10 e MT.TS.10.A, porém o aperto dos parafusos foi de 15 N.cm e o desaperto também se deu pelo o intermediário (MT.TS.15.A). Os valores médios e desvio padrão (dp) de pré-carga encontrados para todas as seqüências de cada grupo foram de: EH.Ti.32 (27,75; dp 7,70); EH.dlc.32 (40,17; dp 10,16); IH.Ti.20 (219,61; dp 75,47); MT.OP.20 (129,19; dp 116,71); MT.OP.32 (137,97; dp 47,53); MT.TS.10 (39,55; dp 13,96); MT.TS.10.A (126,72; dp 44,05); MT.TS.15.A (194,41; 68,48). Entre os diferentes sistemas de retenção pilar/implante estudados, pode-se concluir que: existem relações únicas entre o valor de torque aplicado no parafuso e a pré-carga gerada sobre o terço cervical do implante, essas são diretamente influenciados pelo desenho da interface pilar/implante, tipo de parafuso de retenção e valor de torque aplicado; não foi observada perda de pré-carga dos parafusos de pilares, nem perda de resistência à torção no sentido anti-rotacional dos parafusos depois de esperados 5 minutos em 5 seqüências de aperto/desaperto. / The preload screw variation for the first five minutes after each one of five torque/untorque sequences from different implant/abutment retention systems was evaluated. Strain gauges were attached over the cervical third of external hex, internal hex and Morse taper implants. A controlled torque/untorque procedure allowed the record from the preload and untorque values of the samples in each one of the sequences. Thirty implant/abutment samples, divided in eight groups were studied: external hex implants with Universal post and titanium screws (Neodent, Curitiba, Brazil) screwed to 32 N.cm (EH.Ti.32); external hex, Universal post, DLC covered screw, 32 N.cm (EH.dlc.32); internal hex, Universal post, titanium screw, 20 N.cm (IH.Ti.20); Morse taper, single piece Universal post, 20 N.cm (MT.OP.20); Morse taper, single piece Universal post, 32 N.cm (MT.OP.32); Morse taper, Universal post trespassing screw, 10 N.cm (MT.TS.10); the same samples from the MT.TS.10 group were used for the seventh group, screwed to 10 N.cm, but the untorque was performed by the abutment (MT.TS.10.A); the same samples used with the MT.TS.10 and the MT.TS.10.A were used for the last group, but the screws were tightened to 15 N.cm and the untorque remained by the abutment (MT.TS.15.A). The mean and the stardad deviation (DP) found for the preloss in all the five sequences were of: EH.Ti.32 (27.75; SD 7.70); EH.dlc.32 (40.17; SD 10.16); IH.Ti.20 (219.61; SD 75.47); MT.OP.20 (129.19; SD 116.71); MT.OP.32 (137.97; SD 47.53); MT.TS.10 (39.55; SD 13.96); MT.TS.10.A (126.72; SD 44.05); MT.TS.15.A (194.41; SD 68.48). For the retention systems studied, it could be concluded that: there are single relations between screw untorque and preload over the implant cervical third, these are directely influenced by the implant/abutment interface design, screw type and torque value; there were not found post screw preload loss, neither torque resistance at the anti-rotational direction from the screws after the first five minutes in five torque/untorque sequences.