Mechanical Behavior of Dental Restorations: A Finite Element Pilot Study of Implant-Supported vs. Multiunit-Supported Restorations

Round 1

Reviewer 1 Report

This study investigated the mechanical behavior of dental restorations: implant-supported restorations and multi-/unit-supported restorations through finite element analysis. In terms of the methodology to obtain the results in the paper, the relationship between the finite element model and the test is insufficient to prove the validity of the finite element model, and the results from the fatigue test should be applied to the finite element model to derive the results for the study to be meaningful. 

Therefore, a study that proves the validity of the finite element model itself and confirms the fatigue analysis through the validated model is needed. 

Additional review comments. 

1. The introduction is too long. It must be shortened to get to the point and show what you're trying to say. 

2. The company information of the specimen used should be filled in, which is considered unnecessary in the case of Table 1. 

3. In addition, the mesh size of the finite element model and the convergence of the meshing process must be verified. 

4. In Figure 1, we need to include information about where each part belongs. 

5. In ISO14801, the jig applying the load should be of type UNIVERSAL, but it doesn't look like it, please check. 

6. In the case of Fig. 3. it seems that it should be clearly mentioned which stress was used to check the MAP, e.g. von mises stress or equivalent stress. 

7. In general, it seems that for fatigue curves, the number of cycles versus load should be filled in through SN CURVE. It seems that the fatigue stress of the implant is not sufficiently discussed through Figure 4. 

8. It is necessary to illustrate the constraint, load and contact positions of the finite element model. 

9. I don't think there are enough studies to support the conclusion. It seems that there should be some pre-study to back this up. I don't think a simple mechanical test can support the conclusion.

There are a few typos and the English is not smooth to read. I recommend that you have it proofread if possible. 

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

An interesting article, touching on the issue of mechanical strength of implant work. As for the review, I only have a few minor comments:

Abstract

Line 13

 Some of the most frequent complications have been mechanical complications- Some of the most frequent complications are connected with mechanical properties of the fixing elements, or something similar to not to use the same word in one way.

You should provide as much numerical information as possible in the abstract to encourage the reader to read the entire article. What is the practical conclusion from your research?

introduction

Line 36

Moreover, excessive bone loss may lead to soft tissue recession, implant exposure and esthetic problems- The aesthetic problem is one of the minor problems, I would emphasize more the problems with the implants, inflammation in the hard tissues, etc.

And how can I put it before your tests? What do you expect?

Materials and methods

n IIPSCA4513 Interna Plus – country city of the producer, please add.

INPPTU44, INTMIPU20, CPMIUPU, TTMIR, Ansys Workbench® 19R1- producer country?

Figure 1. 3D Models of the two dental restorations.- Describe in more detail what a,b,c,d mean? So that the figure taken from the text is understandable to the reader

22. ISO. ISO 14801:2007 - Dentistry — Implants — Dynamic Fatigue Test for Endosseous Dental Implants; ISO: Geneva, 583Switzerland, 2007.- there is new version of the ISO standard from 2016

https://cdn.standards.iteh.ai/samples/61997/8d770e372d65445286e4f5d74f7ae2d8/ISO-14801-2016.pdf

line 249

n INSTRON E 3000 Electropuls fatigue bench mounted with a DYNACELLTM 2527-153 loadcell with a load range of ±5-kN- producer , city, country?

Figure 2- it would be good to expand the description of this drawing so that it is readable on its own. What does a a bo swelling b mean?

  Was any statistical analysis performed?

How many samples were used for testing? Figure 4 shows that the sample was broken, when did it happen?

What would you like to explore next? Good luck with your further research!

Khan, M.; Khan, M.A.; Hussain, U. CLINICAL CROWN LENGTH, WIDTH AND THE WIDTH/LENGTH RATIO IN THE 585 MAXILLARY ANTERIOR REGION IN A SAMPLE OF MARDAN POPULATION. 2015, 35.- small litters, missing the journal name

29 Gross, M.; Abramovich, I.; Weiss, E.I. Microleakage at the Abutment-Implant Interface of Osseointegrated Implants: A 599 Comparative Study. 2000- missing the journal name, number and pages.

15. Bressan, E.; Grusovin, M.G.; D’Avenia, F.; Neumann, K.; Sbricoli, L.; Luongo, G.; Esposito, M. The Influence of Repeated 567 Abutment Changes on Peri-Implant Tissue Stability: 3-Year Post-Loading Results from a Multicentre Randomised Controlled Trial. 568 Eur J Oral Implan missing the year, numebr of the journal and pages, please check the literature

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

The study carried out presents a valid and well-conducted methodology after a review of the state of the art. The images are of excellent quality. The results are well presented and the discussion is relevant. The conclusions are in line with the discussion held. However, there are small corrections that must be made:

experi-mentally – please correct

Lines 35, 39, 54,   - the references are missing

Authors should present a null hypothesis

Author Response

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Author Response File: Author Response.pdf

Reviewer 4 Report

Dear authors, thank you for submitting the manuscript "Mechanical behavior of dental restorations: implant-supported vs multi/unit-supported restorations, a finite element pilot study".  Overall, it is a very interesting article for the readers, and it is well-written, I just give you a few recommendations:

-I see several statements without a reference.

-Please provide references for the statements on first paragraph: line 34 "... high survival rate,...", line 36 "...increase risk of peri-implantitis", and line 39 "less than 0.2 mm annually thereafter".

-For third paragraph please mention some screw and cemented retained implant prostheses as references. I recommend to use this as one of them PMID: 34721855.

-Please do not make very short paragraphs like 4 (only 2 sentences) and 6 (only 1 sentence), you cam combine them.

-For the materials and methods, only mention the size/diameter of the implants, and then in parentheses ( ) place the name and brand of the implant. Also, do not make paragraphs with a single or two sentences, combine them and make them bigger.

-Describe figure 2 better, include information like frontal or lateral view and degree.angle for the fatigue. The more information the better for the reader.

-Why page 8 is empty ?

-It will be interesting if you take SEM images of failing component or at least photos with zoom (magnification) to se the fracture better.

-For discussion section, please discuss about the values obtained for the range of loads compared with loads obtained for patients with parafunctions and/or bruxism and regular occlusal forces. I see you cover some of them from lines 328 to 333 but you can expand more.

-You need to expand the limitations, such as you are only using an specific brand of implant and specific type of material, but nowadays clinicians have several options of brands/materials of implants and implant parts/components such as zirconia and different combinations of metals.

minor revision is needed

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Thank you for your diligence in answering the questions we have raised. We look forward to your further interest and research on dental finite element analysis in the future.