As cerâmicas dentais são conhecidas pela sua excelência em reproduzir artificialmente os dentes naturais. No século XVIII foi empregada pela primeira vez na Odontologia como dente artificial para próteses totais. A partir do século XX passou a ser utilizada para a confecção de restaurações metalocerâmicas e mais recentemente, com o aprimoramento da tecnologia cerâmica, surgiram as restaurações livres de metal. As cerâmicas têm apresentado rápida evolução em âmbito científico com o intuito de melhorar suas propriedades físicas e mecânicas para suprir as necessidades estéticas que são cada vez mais exigidas pela sociedade moderna. Nesse contexto, é preciso conhecer cada sistema cerâmico disponível atualmente no mercado, desde suas principais características até suas limitações, para saber indicá-lo de modo correto em cada situação clínica específica.

The presence of distal tilted (all-on-four) and distal short implants (all-on-six) resulted in higher stresses in both situations in the maxillary bone in comparison to the presence of vertical implants (all-on-four).

The mechanical performance of cemented or screw-retained implant-supported crowns with an internal or external configuration is yet to be understood. This in vitro study evaluated the effect of screw-retained and cement-retained prostheses on internal and external implant-abutment connections. Thereby, the reliability and failure modes of crowns were investigated. Eighty-four implants (Emfils; Colosso Evolution system) were divided into four groups (n=21 each): screw-retained and internal connection (Si), screw-retained and external connection (Se), cement-retained and internal connection (Ci), and cement-retained and external connection (Ce). Ti-6Al-4V abutments were torqued (30 Ncm) to the implants, and maxillary central incisor metal crowns were torqued (30 Ncm) or cemented (Rely X Unicem; 3M-ESPE) and subjected to accelerated life-testing in water. Use-level probability Weibull curves and reliability for 50,000 cycles at 150 N were calculated. The β values for Si (1.72), Se (1.50), Ci (1.34), and Ce (1.77) groups indicated that fatigue/damage accumulation accelerated their failure. The Ci group presented the highest reliability, the Se group presented the lowest reliability, and Si and Ce groups presented intermediate reliability. Screw-retained restorations presented mainly abutment fracture. Cement-retained restorations resulted in failures of the screw in the Ce group, but implant/screw fracture in the Ci group.

Increasing the length of the implant had a great influence on the decrease of displacement and von Mises tension values. Increasing the diameter of the implant had a great influence on the decrease of von Mises tension values, but did not influence the displacement values. According to the results of this study, it is a good choice to use the greater and larger implant possible in the association between implant and distal extension removable partial denture.

The aim of this study was to compare the stress distribution induced by posterior functional loads on conventional complete dentures and implant-retained overdentures with different attachment systems using a two-dimentional Finite Element Analysis (FEA-2D). Three models representative of edentulous mandible were constructed on AutoCAD software; Group A (control), a model of edentulous mandible supporting a complete denture; Group B, a model of edentulous mandible supporting an overdenture over two splinted implants connected with the bar-clip system; Group C, a model of edentulous mandible supporting an overdenture over two unsplinted implants with the O-ring system. Evaluation was conducted on Ansys software, with a vertical force of 100 N applied on the mandibular left first molar. When the stress was evaluated in supporting tissues, groups B (51.0 MPa) and C (52.6 MPa) demonstrated higher stress values than group A (10.1 MPa). Within the limits of this study, it may be concluded that the use of an attachment system increased stress values; furthermore, the use of splinted implants associated with the bar-clip attachment system favoured a lower stress distribution over the supporting tissue than the unsplinted implants with an O-ring abutment to retain the mandibular overdenture.