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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 11  |  Issue : 4  |  Page : 45-50

An investigation of effect of rigid and nonrigid connector designs on implant as pier abutment in implant tooth-supported fixed dental prosthesis with three-dimensional finite element analysis: An In vitro study


Department of Prosthodontics and Crown and Bridge, Sri Ramaswamy Memorial Dental College, Chennai, Tamil Nadu, India

Date of Submission31-Mar-2021
Date of Decision24-May-2021
Date of Acceptance30-Jul-2021
Date of Web Publication16-Oct-2021

Correspondence Address:
J Brintha Jei
Department of Prosthodontics and Crown and Bridge, Sri Ramaswamy Memorial Dental College, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aihb.aihb_55_21

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  Abstract 


Introduction: The effect and stress distribution of rigid and non-rigid connectors were evaluated on a 5-unit fixed partial denture (FPD) with an implant as pier abutment by finite element analysis. Materials and Methods: A three-dimensional (3D) computed tomography with Digital imaging and communications in medicine (DICOM) format output was made for a patient with the implant in the second pre-molar region of the maxilla and missing the first pre-molar and first molar. In the obtained 3D finite element method (FEM) model, the implant in the second pre-molar region acts as a pier abutment. The canine and second molar served as terminal natural teeth abutments. By using CATIA V.05, the features of the implant in the second pre-molar region of 13 mm length and 3.75-mm diameter and 5 unit FPD tooth implant-supported prosthesis with rigid and non-rigid connector FEM models were made with a static vertical occlusal load of 250N. The areas and locations of maximum and minimum concentration of stress were analysed using Von Mises stress values for all the models at 10 Mpa. Results: The analysis of the von mishes stress values exposed the maximum stress concentrations at the load areas of all models. For all models, the highest stress values were located at connectors and cervical regions of abutment teeth, especially at the pier abutment. Conclusion: The area of maximum stress concentration at the pier abutment was decreased using the non-rigid connector at the mesial surface of the pier abutment.

Keywords: Finite element analysis, implant pier abutment, non-rigid connector, rigid connector


How to cite this article:
Kumar S M, Jei J B, Krishnan M. An investigation of effect of rigid and nonrigid connector designs on implant as pier abutment in implant tooth-supported fixed dental prosthesis with three-dimensional finite element analysis: An In vitro study. Adv Hum Biol 2021;11:45-50

How to cite this URL:
Kumar S M, Jei J B, Krishnan M. An investigation of effect of rigid and nonrigid connector designs on implant as pier abutment in implant tooth-supported fixed dental prosthesis with three-dimensional finite element analysis: An In vitro study. Adv Hum Biol [serial online] 2021 [cited 2021 Dec 4];11:45-50. Available from: https://www.aihbonline.com/text.asp?2021/11/4/45/328400




  Introduction Top


Different treatment options are attainable to restore lost teeth based on the status and number of remaining teeth, the amount of space available, cost, sufficient bone support and patient acceptancy.[1] Dental implants are widely acknowledged as a prosperous clinical authenticity due to their property of osseointegration. The various benefits of implant and tooth-supported prosthesis are improved mechanoreception, splinting of the tooth with an implant and provides enhanced support for the overall load on the teeth. The disadvantages are there may be an increased need for repairing and maintaining connectors used in the prosthesis.[2] Periodontal ligament surrounds natural teeth, but implants are fixed rigidly with the bone. The implant and the natural tooth show differential response in static and dynamic load, so the rigid connection between the natural tooth and implant could be avoided. When the occlusal load is applied, dissimilar patterns of stress and strain can be seen in the region of the bone surrounding the implant and the tooth.[3] The healthy periodontal ligament permits mobility of natural tooth to about 50–200 μm, whereas the bone flexibility can permit only 10 μm movement for the implant.[4],[5]

Pier abutment denotes only a tooth, but with the usage of dental implants, it is necessary to study the effect of connector design on the implants as well.[6] When a five-unit fixed partial denture (FPD) fabricated with the non-rigid connector from the region of the canine to the second molar in the maxillary arch with an implant as a pier abutment, the possibility of concentration of excessive stress was minimised on the prosthesis. In an FPD supported with pier abutment, when occlusal force is applied, the pier abutment can function as a fulcrum

The pier abutment could function as a fulcrum when the load is applied in an occlusal direction, and this load will be transferred to the retainer on the side supported by pier abutment. Extrusive force is experienced during fulcrum action in the anterior and posterior abutment, whereas tensile force is produced in the abutment and retainer interface, which results in failure of retention of the prosthesis. Previous studies had shown higher debonding rates for rigid FPDs with pier abutments and resulted in marginal microleakage and caries when compared to short-span restorations.[7] Hence, alternatively, non-rigid connectors could be suggested as a solution to these problems. Connector size, shape and position control the longevity of FPD.[8] To replace the edentulous area, perfect dimensions are required to prevent destruction to vital parts. Hence, the cone-beam computed tomography (CT) could be used to evaluate the bone quantity and quality. In this study, a three-dimensional (3D) model has obtained from the patients CT images by using a contour interpolation tool algorithm with the process of matrix reduction.[9]

At any location of the mathematical model, the exhaustive data were quantitatively obtainedfrom finite element analysis (FEA). By knowing the basic hypothesis, procedure, function and restrictions of FEA in implantology, the clinician would be equipped to elucidate the findings of FEA to the clinical situation.[10],[11] Hence, in this study, the effect of non-rigid and the rigid connector was evaluated on the distribution of stress for five-unit FPD with an implant as pier abutment.


  Materials and Methods Top


Informed consent was obtained from the patient for 3D CT in accordance with Institutional Review Board guidelines. The various paces involved in preparing the FEA model were pre-modelling processing, meshing and post-modelling processing. In pre-modelling processing by using 3-D CT, the images were obtained in the format of DICOM. Then, the FEA models were obtained by using contour interpolation-tool algorithm with the process of matrix reduction and tessellation. The FEA consists of the dissection of every structure into confined elements which are then linked by their nodes to structure an interrelated mesh called the finite element mesh. The modelled materials Poisons ratio and Young's modulus of elasticity were specific for each component. So that it can imitate the factual situation and it could scrutinise the response of a component to certain loading conditions.

In the meshing procedure, the pre-processed models were subjected to processing by translation of geometrical information into graphical data by the software. This graphical data was then spliced into smaller parts known as elements by the procedure called meshing. A 3D cross-sectional finite element method (FEM) model [Figure 1] was prepared, which constituted edentulous area in the first pre-molar, second pre-molar and first molar maxillary arch to simulate graphically. The graphical model was of five-unit porcelain fused to metal FPD, in which the canine was the anterior abutment and the second molar represented the posterior abutment, which was reinforced by virtual alveolar bone and periodontal ligament structure and implant, which acts as a pier abutment in the second pre-molar region [Figure 2]. The models were fabricated as per the dimensions of the canine and maxillary second molar as interpreted from the CT scan. The scan of the maxilla 0.6 mm slice (SIEMENS SOMATOMEMOTION) by volume rendering technology provides a clear image at 130kv dosage. The CT scan data was converted into a mathematical IGS file using MIMICS software. By using CATIA V.05, the features of the implant (ADIN DENTAL IMPLANT SYSTEMS, AFULA, ISRAEL) in the second pre-molar region of 13 mm length and 3.75 mm diameter and designs to simulate the masticatory forces on a non-rigid connector (CEKA Extracoronal Preci Vertix P) measurement to the model and converted into FEM model by HYPER MESH V.10. So based on literature[4] to simulate the clinical situation, elastic modulus and Poisson's ratio of the ceramic was 82.8 GPa and 0.35 V, NiCr alloy was 206 GPa and 0.33 V, the periodontal ligament was 0.069 GPa and 0.45 V, Cortical bone (D2) 13.7 GPa and 0.3 V, Spongious bone (D4) 1.10 GPa and 0.3 V, for non-rigid attachment 110 GPa and 0.33 V and for titanium it was 114 GPa and 0.34 V. A total of five FEM models were made and were categorised as in [Table 1].
Figure 1: Three-dimensional finite element method model.

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Figure 2: Cross section of mesh model with implant as pier abutment.

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Table 1: Models with connector design and the nodes and elements applied

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In the post-processing stage, each and every model were subjected to a static occlusal vertical load of 250-N to simulate the clinical situation. It was implemented on each tooth for a constant duration of 2 s, and the distribution of stress was calculated. Three types of loading methods were applied to determine the stress distribution

  • To replicate maximum centric occlusion contacts, all the teeth were loaded
  • To simulate individual anterior contact, the canine was loaded
  • To simulate single posterior contact, the second molar was loaded.


Statistical analysis

This study was done using a 3-D FEM, and analysis was carried out by software ANSYS R.15 (ANSYS,Inc, Canonsburg). The areas and locations of maximum and minimum concentration of stress were analysed using Von Mises stress values for all the models at 10 Mpa.


  Results Top


In Model 1, in the canine, the stress was more apparent in the cuspal tip, and it was 4.26 Mpa. However, it was 0.1282 Mpa in the abutment teeth, which was loaded and 12.443 MPa at the mesial side of the pier abutment. A comparatively little stress concentration was obtained at the molar region. When the loading was done in the molar, stresses were evaluated at the tip of the cusp 2.25 MPa and at the surface of root 0.293 MPa of the abutment, which was loaded. When every single tooth was loaded, the greatest stress concentration was noticed at the tips of the cusp, in the connector region, and cervical parts of every abutment. The stress concentration areas 0.914 MPa were noticed at the contours of the root portion of the implant pier abutment and molar abutments. Maximum prime stress was observed in the implant pier abutment was 12.443 MPa at canine loading, 6.81 MPa for molar loading, and 5.38 MPa when each one of the teeth was loaded [Figure 3].
Figure 3: The equivalent von mishes stress values for Model 1 with Rigid connector.

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For model 2, when the canine was loaded, the non-rigid connector at the mesial surface of the implant pier abutment manifested minimal stress concentration. When the molar was loaded, a low-stress concentration of 0.24 MPa was observed at the implant pier abutment, and 0.457 Mpa of stress distributions was observed in the molar. When loading all the teeth, the concentration of stress was seen in the cusp tips, abutment cervical region and connector area was of 5.17 MPa, and in the surfaces of the root, it was 1.48 MPa for every three abutments. When loading all the teeth greatest prime stress was 1.30 MPa in the implant pier abutment, whereas for canine it was 0.45 MPa, and for molar, it was 0.26 MPa [Figure 4].
Figure 4: The equivalent von mishes stress values for model 2 with Matrix connector with non-rigid attachment on the mesial side of the pier abutment.

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In model 3, when the canine was loaded, there was no considerable stress concentration in the non-rigid connector area at the distal part of the implant pier abutment, and it was 1.96MPa [Figure 5]. However when each and every tooth were loaded, the greatest concentration of stress was 0.87MPa in the implant pier abutment region which was lesser than other types of designs, whereas comparatively elevated stress concentrations were seen at the mesial part of the molar root, which was of 14.8 MPa. Maximum prime stress was observed in the implant pier abutment, and it was around 3.17 MPa during canine loading, 6.89 MPa at the molar loading, and it was about 7.87 MPa when loading all of the teeth.
Figure 5: The von mishes stress values for model 3 with Matrix connector with non-rigid attachment on the distal side of the pier abutment.

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In model 4, when the canine has loaded, the distribution of stress was least when compared with the rigid connector. On posterior loading, the concentration of stress was seen surrounding the molar 27.40 MPa [Figure 6]. Simultaneously when loading all of the model teeth, the concentration of stress was equivalent to the model with rigid connectors, but in the meantime, stress values in the distal part of the root surface of implant pier abutment were 0.63 Mpa which was greater and extensive over a wider area. The highest prime stress was in the implant pier abutment region, and it was of 2.32 MPa during canine loading, 27.40 MPa on loading molar, and 2.24 MPa when loading was given to all of the teeth.
Figure 6: The equivalent von mishes stress values for model 4 with non-rigid attachment with matrix connector mesial to the posterior terminal abutment.

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For model 5, the non-rigid connector was placed in the distal part of the canine, so when loading, the canine stress distributions were varying from 2.03 Mpa to 2.74 Mpa when compared with the model with a rigid connector [Figure 7]. By loading all of the teeth, the stress was 1.17 MPa at the implant pier abutment root surface. When the coronal part of distal and mesial portions of the cervical area of the implant pier abutment, the stress concentration was 1.72 Mpa–1.73 Mpa. During loading of canine, the stress was maximum in the implant pier abutment 1.73 MPa, and for loading posterior teeth 1.72 MPa, and when loading was applied to all the teeth, the obtained stress value was 1.50 MPa.
Figure 7: The equivalent von mishes stress values for model 5 with non-rigid attachment with matrix connector distal to the anterior terminal abutment.

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  Discussion Top


The research of biomechanics of stress loaded in dentistry has been conducted widely by the 3D FEA model.[12] The present evaluation used by the FEA analysis in this study was restricted by the idealistic presumptions such as linear elastic, homogeneous and isotropic conditions for the tooth, periodontal ligament and bone. The analysis of stress distribution in five-unit FPDs determined the loading and its efficiency to withstand the stress, which plays an important role in the success of the prosthesis.[13],[14] When forces are applied to the occlusal surface, it persuades stress and strain within the implant-supported fixed prosthesis so that the remodelling of bone around the implants is disturbed.[15],[16] So, to accomplish an augmented biomechanical environment for implant-supported fixed prostheses, scrupulous thought of the biomechanical determinant that impacts the success of prostheses was essential.[17] Several methods had been used to study the stress and strain in dental implants and in the alveolar bone. Among this photo, elasticity contributes excellent qualitative knowledge relating to the stress location.[18],[19] Strain-gauge dimensions provide exact information concerning strains only at the precise position of the gauge. FEA is competent to provide comprehensive quantitative data at whichever spot within the confines of a mathematical model.[20] Hence, FEA has developed into a valued analytical tool in the appraisal of dental implant systems, and so it was used in this study.[21] The FEM outcome is obtained in von Mises stress values. These stress values rely on the complete stress area and which will be used as a measure for the viability in the occurrence of damage.[7] As the connector region characterise the highest stress concentration within FPDs, so the location of non-rigid connectors in the connector areas was suggested for the dissipation of the stresses.[22]

According to Moulding et al., the photoelastic stress investigation of supportive alveolar bone was adapted by non-rigid connectors, which depends on the non-rigid connector location, so that the stress areas changed and the rigid connectors distribute the stress even and vertically, the results of the present study coincide with this study.[23],[24] In accordance with this author's finding, the present study result also confirmed that when all the teeth were loaded, the stresses were dispersed uniformly with the rigid type of connector in FPD. So, it was evaluated an increased deformation of 10 Mpa in the first and second molar area and lingual surface of canine with a period of 5.3–6 min. The concentration of stress was more located in the non-rigid connector placed in the distal part of the canine and in the mesial part of the molar when each and every tooth were loaded. Several authors had stated that there was so much difference in the stress concentration of rigid and non-rigid connectors in relation to the supporting alveolar bone.[25],[26],[27] It was stated that when rigidly connected FPD with a pier abutment, then it performs as a lever and elevated stress concentrations might develop in pier abutments, and this leads to enormous displacements at the terminal abutments, ensuing abutment teeth damage.[28],[29] Hence, it was advised to have non-rigid connectors in the mesial part of the pier abutment to remove the fulcrum action and to minimize the stress of a pier abutment.[30]

In this study, ceka preci vertex type of attachment was used in four different positions to determine the maximum and minimum stress distributions in the models through the software. For rigid design, maximum deformation of about 10 Mpa at the 2nd molar region and first molar region and lingual aspect of a canine period of 5.3–6 min. Hence, maximum deformation observed at the occlusal aspect of the first and second pre-molar, followed by the lingual aspect of the canine. When correlating the implant with natural dentition during mastication, accumulation of stress will be seen around the implant and intrusion of natural teeth can happen. Furthermore, the centre of rotation in the implant is at the level of crestal bone that is greater than the natural dentition.

According to Melo et al., the consequence of non-rigid connectors in the quantity of stress accumulation was high in the bone surrounding the tooth/ implant supported fixed prosthesis (TIFPs), and they also evaluated that there was no reduction of stress.[31],[32] But Menicucci et al. stated the worsening effect was found in the static load when compared with the transitional one, and they also quantified that periodontal ligament is the important structure in distributing the force applied in the rigid connector area placed between the implant and the tooth.[5] For non-rigid design, maximum deformation of about 10 Mpa at the 2nd molar region and first pre-molar region and lingual aspect of a canine period of 5.15–6 min. To be more specific maximum deformation observed at the occlusal aspect of the first pre-molar and second molar, followed by the lingual aspect of the canine. The photoelastic study carried out by Nishimura et al. showed the stress on implant tooth-supported FPD was lessened by placing the non-rigid connector in the prosthesis.[33],[34] But the present study was contrary to Burak's study, where the distribution of stress was not the same in all the locations of the non-rigid connector.

The outcome of this study exhibited the lowest stress values during terminal loading conditions at the non-rigid connector area, and this was in correlation with former studies. Botelho and Dyson estimated the durability of increased-span resin-bonded FPD with a customised non-rigid connector and opted for retainer framework extension around the abutment.[35] They stated that by providing non-rigid connectors, the movement was seen between the retainers, and it was successful for a short period. Nevertheless, undue stress concentrations occurred at the terminal abutment of the anterior region by placing a non-rigid connector at the mesial part of the pier abutment and in the distal part of the anterior abutment. In the molar tooth, the periodontal membrane area is wider than the canine tooth and the only anchorage of the implant directly to bone in the second pre-molar region. Hence, it was not as advisable to have stress on the abutment teeth in the anterior region when compared to the abutment in the posterior region.

Clinical implications

In this FEM study, the model was made with various presumptions in regard to simulating structures; however, the living tissues are distinct. It is also important that the pattern of stress distribution may be different depending on the type of material and different attributes allocated to every single layer of the model. In this study, 250 N was selected as the occlusal force, but it was not compulsory for this force to counterpart in vivo environment precisely. Hence as with numerous in vitro investigations, it was challenging to extrapolate the outcome of this study in relation to the clinical scenario.

Further scope of the study

This study relays information regarding the non-rigid connector and its stress patterns in a mathematical model, which can be used in further studies with additional loading positions.


  Conclusion Top


  1. In rigid design, implant pier abutment showed maximum stresses in anterior loading than posterior and all tooth loading conditions
  2. Placing a non-rigid connector in the distal area of the implant pier abutment exhibited variant stress concentration while canine was loaded rather than other loading conditions
  3. By placing a non-rigid connector in the distal area of the canine, and if all the teeth were loaded, the concentration of stress was comparable to that of the model with rigid connectors
  4. Location of the non-rigid connector in mesial area of the implant pier abutment for a five-unit FPD showed minimum stress concentration in pier abutment in all loading conditions.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Shenoy VK, Rodrigue SJ, Prashanti E, Saldanha SJ. Tooth implant supported prosthesis: A literature review. J Interdiscip Dent 2013;3:143.  Back to cited text no. 1
    
2.
Gunne J, Astrand P, Lindh T, Borg K, Olsson M. Tooth-implant and implant supported fixed partial dentures: A 10-year report. Int J Prosthodont 1999;12:216-21.  Back to cited text no. 2
    
3.
Aparna N, Rajesh S. Tooth-implant connection: A critical review. J Dent Implants 2013;3:142.  Back to cited text no. 3
    
4.
Koosha S, Mirhashemi FS. An investigation of three types of tooth implant supported fixed prosthesis designs with 3D finite element analysis. J Dent (Tehran) 2013;10:51-63.  Back to cited text no. 4
    
5.
Menicucci G, Mossolov A, Mozzati M, Lorenzetti M, Preti G. Tooth-implant connection: Some biomechanical aspects based on finite element analyses. Clin Oral Implants Res 2002;13:334-41.  Back to cited text no. 5
    
6.
Savion I, Saucier CL, Rues S, Sadan A, Blatz M. The pier abutment: A review of the literature and a suggested mathematical model. Quintessence Int 2006;37:345-52.  Back to cited text no. 6
    
7.
Oruc S, Eraslan O, Tukay HA, Atay A. Stress analysis of effects of non-rigid connectors on fixed partial dentures with pier abutments. J Prosthet Dent 2008;99:185-92.  Back to cited text no. 7
    
8.
Monjula D, Jalan S, Bharali K. The use of non- rigid connectors in fixed partial dentures with pier abutment: A case report. J Dent Med Sci 2015;14:17-20.  Back to cited text no. 8
    
9.
Alamri HM, Sadrameli M, Alshalhoob MA, Sadrameli M, Alshehri MA. Applications of CBCT in dental practice: A review of the literature. Gen Dent 2012;60:390-400.  Back to cited text no. 9
    
10.
Reddy MS, Sundram R, Eid Abdemagyd HA. Application of finite element model in implant dentistry: A systematic review. J Pharm Bioallied Sci 2019;11:S85-91.  Back to cited text no. 10
    
11.
Modi R, Kohli S, Rajeshwari K, Bhatia S. A three-dimension finite element analysis to evaluate the stress distribution in tooth supported 5-unit intermediate abutment prosthesis with rigid and non-rigid connector. Eur J Dent 2015;9:255-61.  Back to cited text no. 11
[PUBMED]  [Full text]  
12.
Misch CM, Ismail YH. Finite element stress analysis of tooth-to-implant fixed partial denture designs. J Prosthodont 1993;2:83-92.  Back to cited text no. 12
    
13.
Jeng MD, Lin YS, Lin CL. Biomechanical evaluation of the effects of implant neck wall thickness and abutment screw size: A 3D nonlinear finite element analysis. Appl Sci 2020;10:3471.  Back to cited text no. 13
    
14.
Markley MR. Broken-stress principle and design in fixed bridge prosthesis. J Prosthet Dent 1951;1:416-23.  Back to cited text no. 14
    
15.
Lin CL, Wang JC, Kuo YC. Numerical simulation on the biomechanical interactions of tooth/implant-supported system under various occlusal forces with rigid/non-rigid connections. J Biomech 2006;39:453-63.  Back to cited text no. 15
    
16.
Tada S, Stegaroiu R, Kitamura E, Miyakawa O, Kusakari H. Influence of implant design and bone quality on stress/strain distribution in bone around implants: A 3-dimensional finite element analysis. Int J Oral Maxillofac Implants 2003;18:357-68.  Back to cited text no. 16
    
17.
Ramoglu S, Tasar S, Gunsoy S, Ozan O, Meric G. Tooth-implant connection: A review. ISRN Biomater 2012;20:1-7.  Back to cited text no. 17
    
18.
Sutherland JK, Holland GA, Sluder TB, White JT. A photoelastic analysis of the stress distribution in bone supporting fixed partial dentures of rigid and non-rigid design. J Prosthet Dent 1980;44:616-23.  Back to cited text no. 18
    
19.
Cho W, Kim CS, Jeon YC, Jeong CM. Effect of prosthetic designs and alveolar bone conditions on stress distribution in fixed partial dentures with pier abutments. J Korean Acad Prosthodont 2009;47:328-34.  Back to cited text no. 19
    
20.
Geng JP, Tan KB, Liu GR. Application of finite element analysis in implant dentistry: A review of the literature. J Prosthet Dent 2001;85:585-98.  Back to cited text no. 20
    
21.
Shetty P, Hegde AM, Rai K. Finite element method – An effective research tool for dentistry. J Clin Pediatr Dent 2010;34:281-5.  Back to cited text no. 21
    
22.
Banerjee S, Khongshei A, Gupta T, Banerjee A. Non-rigid connector: The wand to allay the stresses on abutment. Contemp Clin Dent 2011;2:351-4.  Back to cited text no. 22
[PUBMED]  [Full text]  
23.
Moulding MB, Holland GA, Sulik WD. Photoelastic stress analysis of supporting alveolar bone as modified by non-rigid connectors. J Prosthet Dent 1988;59:263-74.  Back to cited text no. 23
    
24.
Sudhir N, Taruna M, Suchita T, Bharat M. Indigenously fabricated non-rigid connector for a pier abutment. Indian J Dent Adv 2011;3:770-4.  Back to cited text no. 24
    
25.
Badwaik PV, Pakhan AJ. Non-rigid connectors in fixed prosthodontics: Current concepts with a case report. J Indian Prosthodont Soc 2005;5:99-102.  Back to cited text no. 25
  [Full text]  
26.
Chaturvedi S, Verma AK, Vadhvani P. Non-rigid connector: Relay the stress. Ind J Dent Sci 2012;4:53-5.  Back to cited text no. 26
    
27.
Kathuria N, Prasad R, Bhide SV, Gulati M, Gupta N. Effect of non rigid connectoron FPD with pier abutment: A case report. J Clin Case Rep 2012;2:68-70.  Back to cited text no. 27
    
28.
Gupta S, Sharma A, Jayna A, Arora A. Non rigid connector: A stress reliever – A case report. J Dent Spec 2014;2:76-9.  Back to cited text no. 28
    
29.
Ziada HM, Orr JF, Benington IC. Photoelastic stress analysis in a pier retainer of an anterior resin-bonded fixed partial denture. J Prosthet Dent 1998;80:661-5.  Back to cited text no. 29
    
30.
Akulwar RS, Kodgi A. Non-rigid connector for managing pier abutment in FPD: A case report. J Clin Diagn Res 2014;8:ZD12-3.  Back to cited text no. 30
    
31.
Rani P, Malhotra P. Breaking the stress with a non-rigid connector. Niger Postgrad Med J 2020;27:391-3.  Back to cited text no. 31
[PUBMED]  [Full text]  
32.
Melo C, Matsushita Y, Koyano K, Hirowatari H, Suetsugu T. Comparative stress analyses of fixed free-end osseointegrated prostheses using the finite element method. J Oral Implantol 1995;21:290-4.  Back to cited text no. 32
    
33.
Nishimura RD, Ochiai KT, Caputo AA, Jeong CM. Photoelastic stress analysis of load transfer to implants and natural teeth comparing rigid and semirigid connectors. J Prosthet Dent 1999;81:696-703.  Back to cited text no. 33
    
34.
Ozçelik T, Ersoy AE. An investigation of tooth/implant-supported fixed prosthesis designs with two different stress analysis methods: An in vitro study. J Prosthodont 2007;16:107-16.  Back to cited text no. 34
    
35.
Botelho MG, Dyson JE. Long-span, fixed-movable, resin-bonded fixed partial dentures: A retrospective, preliminary clinical investigation. Int J Prosthodont 2005;18:371-6.  Back to cited text no. 35
    


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