Evaluation of the structural behavior of three and four implant-supported fixed prosthetic restorations by finite element analysis

Biomechanical behavior of all-on-4 concept and alternative designs under different occlusal load configurations for completely edentulous mandible: a 3-D finite element analysis

The aim of this study was to evaluate the effect of the All-on-4 design and 4 alternative implant-supported fixed prosthesis designs on stress distribution in implants, peri-implant bone, and prosthetic framework in the edentulous mandible under different loading conditions using three-dimensional finite element analysis (3D-FEA).Five different experimental finite element models (Model A (unsplinted 6), Model B (splinted 6), Model C (All-on-4), Model D (axial; 2 anterior, 2 posterior), and Model E (4 interforaminal)) were created. Three different loading conditions were applied (canine loading, unilateral I-loading, and unilateral II-loading). The highest minimum (Pmin) and the maximum (Pmax) principal stress values were acquired for cortical and trabecular bones; the highest von Mises (mvM) stress values were obtained for implants and metal frameworks. Model B and Model D showed the most favorable stress distribution. The All-on-4 design (Model C) also showed acceptable stress values close to those of Model B and Model D in the cortical and trabecular bones. In accordance with the stress values in the bone structure, the lowest stress values were measured in the implants and Co-Cr framework in Model B and Model D. The highest stress values in all structures were measured for unilateral loading- II, while the lowest values were found for canine loading. It was concluded that Model B and Model D experimental models showed better biomechanical performance in all structures. Furthermore, the use of a splinted framework, avoiding cantilevers, results in lower stress transmission. On the other hand, canine loading and unilateral loading-I exhibited the best loading conditions.

Biomechanical comparison of all-on-4 and all-on-5 implant-supported prostheses with alteration of anterior-posterior spread: a three-dimensional finite element analysis

Introduction: The all-on-4 concept is widely used in clinical practice. However, the biomechanical changes following the alteration of anterior-posterior (AP) spread in all-on-4 implant-supported prostheses have not been extensively studied. Methods: Three-dimensional finite element analysis was used to compare the biomechanical behavior of all-on-4 and all-on-5 implant-supported prostheses with a change in anterior-posterior (AP) spread. A three-dimensional finite element analysis was performed on a geometrical mandible model containing 4 or 5 implants. Four different implant configurations were modeled by varying the angle of inclination of the distal implants (0°and 30°), including all-on-4a, all-on-4b, all-on-5a, and all-on-5b, and a 100 N force was successively applied to the anterior and unilateral posterior teeth to observe and analyze the differences in the biomechanical behavior of each model under the static influence at different position. Results: Adding an anterior implant to the dental arch according to the all-on-4 concept with a distal 30° tilt angle implant exhibited the best biomechanical behavior. However, when the distal implant was implanted axially, there was no significant difference between the all-on-4 and all-on-5 groups. Discussion: In the all-on-5 group, increasing the AP spread with tilted terminal implants showed better biomechanical behavior. It can be concluded that placing an additional implant in the midline of the atrophic edentulous mandible and increasing the AP spread might be beneficial in improving the biomechanical behavior of tilted distal implants.

A comparative evaluation of stress distribution between an All-on-Four implant-supported prosthesis and the Trefoil implant-supported prosthesis: A three-dimensional finite element analysis study

Aim

The primary aim of this study is to analyse the stress distribution between an ALL ON FOUR implant supported prosthesis and the TREFOIL implant supported prosthesis with 3D finite element models.

Settings and Design

An in vitro perspective.

Materials and Methods

Two mandibular three-dimensional Finite Element Models were constructed by the CREO version 5 software, in which Model A depicts a mandible with ALL ON FOUR implant supported prost hesis and Model B will depict TREFOIL implant supported prosthesis. Model A contains four implants, two anterior straight and posterior tilted implants (30°), a bar and denture containing acrylic teeth. In Model B, it contains three straight implants and a prefabricated compensatory bar with standardised dimensions. To evaluate and compare the stress distribution between the bone and implant interface, one deleterious cantilever load of upto 300 N is applied on the second molar bilaterally and simultaneously. Another full bite biting load of 150 N is given bilaterally and simultaneously on the central groove of premolars and molars.

Statistical Analysis Used

The results of the simulations obtained were analysed in terms of Von Mises equivalent stress levels at the bone -implant interface.

Results

The results of loading 1 showed that the maximum Von Mises stress was recorded in the anterior implant region of the Trefoil system (Model B) when compared to All on four concept. The results of loading 2 showed that the maximum Von Mises stress were recorded in the anterior implant region Trefoil system (Model B) when compared to All on four concept.

Conclusion

This invitro study concludes that All on Four implant supported prosthesis showed better stress distribution when compared to the Trefoil concept.

Comparison of stresses in monoblock tilted implants and conventional angled multiunit abutment-implant connection systems in the all-on-four procedure

Background

The All-on-four dental implant method is an implantology method designed to provide a comfortable prosthetic treatment option by avoiding advanced surgical procedures. This research aims to compare and evaluate the stress and tension values in conventional angled multiunit abutment-implant connection systems and monoblock dental implants used in the all-on-four procedure with finite element analysis.

Methods

Two master models were created by placing four implants connected to multiunit abutments (group A) in the interforaminal region of a completely edentulous mandible and four monoblock implants (group B) in the same region of another completely edentulous mandible. Group A implants were classified according to their diameter as follows: 3.5 mm (M1A), 4.0 mm (M2A), and 4.5 mm (M3A). Similarly, group B implants were classified as M1B, M2B, and M3B. In the six models rehabilitated with acrylic fixed prostheses, a 100 N force was applied to the anterior implant region, and a 250 N force was applied to the posterior cantilever in both axial and 30° oblique directions. Von Mises stresses were analyzed in the bone and implant regions of all models.

Results

M1A and M1B, M2A and M2B, and M3A and M3B were compared with each other under axial and oblique forces. The maximum Von Mises stresses in the bone around implants and the prosthesis screws, and the maximum and minimum principal stresses in the cortical and trabecular bone in group A models were significantly higher than those in group B models.

Conclusions

In monoblock implant systems under axial and oblique forces, higher stress is accumulated in the bone, prosthesis screw and implant compared to multiunit abutment-implant connection systems.

Mechanical analysis of prosthetic bars and dental implants in 3 and 4 implant-supported overdenture protocols using finite element analysis

In some clinical situations, the installation of four or more dental implants may be infeasible. Therefore, the installation of protocol-type prostheses with only three implants may be necessary. The mechanical failures can hinder the success of the rehabilitation treatment.

OBJECTIVE

To evaluate and compare the mechanical stress of the metallic prosthetic bar when installed over protocol-type prostheses of three and four implants, and to evaluate the stress on the dental implants.

METHODOLOGY

Two three-dimensional human jaw models were created. In one model, four dental implants (P4) were designed and in the other model three dental implants (P3) were designed. In both models, according to the arrangement of the dental implants, prosthetic bars were designed. In a finite element analysis software, compressive forces were applied to the ends of both prosthetic bars, simulating the force application during mastication. Tension and stress dissipation were analyzed on the prosthetic bar and dental implants.

RESULTS

Both P4 and P3 protocol-type prostheses supported the force efficiently without breaking the bar or the implants. Force dissipation along the bar was more homogeneous in the P3 prosthetic bar than in P4. In addition, P3 implants received a higher concentration of stress in relation to P4 implants.

CONCLUSIONS

Prosthetic bars and dental implants withstand the stress of load application in both four and three implant protocol-type prostheses. Three-implants protocol showed more satisfactory force dissipation than the four-implant protocol.

Biomechanical development and evaluation of a new framework for all-on-four rehabilitation

Abstract Introduction For complete rehabilitation of fully edentulous mandibles, the option for immediate loading determines the use of temporary prostheses that splint the installed implants. Although temporary prostheses with reinforcement provide rehabilitations with biomechanical benefits, the non-adoption of this recommendation coexists in different studies on immediate restorations. Objective This study evaluates a type of prosthesis to restore jaws by the all-on-four concept. Material and method: The mechanical behavior of prostheses with the modified framework was evaluated in vitro, under a cantilever mechanical unilateral bending test. Two representative groups were included in the all-on-four concept, with a G1 test group (n = 10) containing modified frameworks and a G2 control group (n = 10) that included full acrylic prostheses. The samples were submitted to thermal cycling with 500 cycles (5° ± 2 °C for 30 s, and 55° ± 2° for 30 s) and to the mechanical bending test on the cantilever. Result The Mann-Whitney test revealed a significant difference between G1 and G2 (p <0.001). In the descriptive evaluation, G1 averaged 830.50 N until the initial resin fracture, while the control group presented a mean of 403.58N. The maximum resistance until complete fracture was recorded in G1, with a mean of 903.03N, while in G2, a mean of 435.20N was recorded. The linear vertical component of the flexion was 0.68 mm and 0.39 mm until the initial fracture of the bar, respectively for G1 and G2. Conclusion The modified framework for the all-on-four protocol determined better mechanical performance when compared to the same full acrylic prosthesis model.

A comparative study on the stress distribution around dental implants in three arch form models for replacing six implants using finite element analysis

Background

Dental implant is a method to replacement of missing teeth. It is important for replacing the missed anterior teeth. In vitro method is a safe method for evaluation of stress distribution. Finite element analysis as an in vitro method evaluated stress distribution around replacement of six maxillary anterior teeth implants in three models of maxillary arch.

Materials and Methods

In this in vitro study, using ABAQUS software (Simulia Corporation, Vélizy-Villacoublay, France), implant simulation was performed for reconstruction of six maxillary anterior teeth in three models. Two implants were placed on both sides of the canine tooth region (A model); two implants on both sides of the canine tooth region and another on one side of the central incisor region (B model); and two implants on both sides of the canine tooth region and two implants in the central incisor area (C model). All implants evaluated in three arch forms (tapered, ovoid, and square). Data were analyzed by finite analysis software.

Results

Von Mises stress by increasing of implant number was reduced. In a comparison of A model in each maxillary arch, the stress created in the cortical and cancellous bones in the square arch was less than ovoid and tapered arches. The stress created in implants and cortical and cancellous bones in C model was less than A and B models.

Conclusions

The C model (four-implant) reduced the stress distribution in cortical and cancellous bones, but this pattern must be evaluated according to arch form and cost benefit of patients.

Influence of implant number, length, and tilting degree on stress distribution in atrophic maxilla: a finite element study

This study aims to evaluate the stress values, created in peri-implant region as a consequence of loading on fixed hybrid dentures that was planned with different implant numbers, lengths, or tilting angulations. Thirteen three-dimensional (3D) finite element analysis models were generated with four, five, or seven implants (group A, B, and C). Except the distal implants, all implants were modeled at 4.1 mm (diameter) and 11.5 mm (length) in size. Distal implants were configured to be in five different lengths (6, 8, 11.5, 13, and 16 mm) and three different implant inclination degrees (0°, 30°, and 45°). A 150-N load was applied vertically on prosthesis. Released stresses were evaluated comparatively. The lowest von Mises stress values were found in group C, in the 11.5-mm implant model. Tilting the distal implants 30° caused higher stress values. In 45°-tilting implant models, lower stress values were recorded according to the 30°-tilting models. The ideal implant number is seven for an edentulous maxilla. Tilting the implants causes higher stress values. A 45° inclination of implant causes lower stress values according to the 30° models due to a shorter cantilever. The ideal implant length is 11.5 mm.

COMPARATIVE STRESS ANALYSIS OF LINGUALIZED AND CONVENTIONAL BALANCED OCCLUSION SCHEMES IN A FULL-ARCH FIXED IMPLANT PROSTHESIS USING FINITE ELEMENT ANALYSIS

This study compares the biomechanical behavior of a mandibular full-arch fixed implant prosthesis with four implants under lingualized and conventional balanced occlusion schemes. The acrylic resin denture was supported by four titanium cylindrical implants and connected via a titanium prosthetic rectangular bar. Orthotropic material was used for the cortical and cancellous bones. The applied loadings were vertical and bilateral: 100[Formula: see text]N on first molar and 50[Formula: see text]N on first and second premolars each. For the lingualized balanced occlusion, the loadings were applied in central fossae of the posterior teeth, whereas for the conventional balanced occlusion the loadings were applied in central fossae and buccal cusps. The maximum von-Mises stresses for the lingualized and conventional balanced schemes were 301[Formula: see text]MPa and 25[Formula: see text]MPa, respectively, and were located at the neck of the posterior implants. In the denture teeth, the highest stress was located at the beginning of the cantilever extension. In the cortical bone, according to Tsai–Wu criterion, the failure index for the lingualized balanced occlusion was 1.10 and for the conventional balanced occlusion was 0.83. Thus, the conventional balanced occlusion demonstrated more favorable stress distribution in the implants and the cortical bone than the lingualized balanced occlusion.

Does matching relation exist between the length and the tilting angle of terminal implants in the all-on-four protocol? stress distributions by 3D finite element analysis

PURPOSE

To explore whether there is matching relation between the length and the tilting angle of terminal implants in the All-on-Four protocol by studying the effects of different implant configurations on stress distributions of implant, bone, and framework.

MATERIALS AND METHODS

Four implants were employed to support a full-arch fixed prosthesis and five three-dimensional finite element models were established with CT images, based on the length (S and L) and distal tilt angle (0°, 30° and 45°) of terminal implants for an edentulous mandible, which named: Tilt0-S, Tilt30-S, Tilt30-L, Tilt45-S and Tilt45-L. An oblique 240 N was loaded at second molar. The von Mises Stresses were analyzed. The implants were consecutively named #1 to #4 from the loading point.

RESULTS

1) Tilt0-S had the greatest stress on the implants, with the other groups exhibiting variable reductions; the four implants of Tilt45-L demonstrated the greatest reduction in stress. 2) Tilt0-S had the greatest stress at bone around #1 implant neck, and Tilt45-L exhibited the least stress, which was a 36.3% reduction compared to Tilt0-S. 3) The greatest stress in the framework was found on the cantilevers distal to #1 implant. Tilt45-S exhibited the least stress.

CONCLUSION

Matching different length and tilting angle of the terminal implants led to variable stress reductions on implants, bone and the superstructure. By optimizing implant configuration, the reduction of stress on implants and surrounding bone could be maximized. Under the present condition, Tilt45-L was the preferred configuration. Further clinical testings are required.

A comparative finite elemental analysis of glass abutment supported and unsupported cantilever fixed partial denture

OBJECTIVE

The purpose of this study was to investigate and compare the load distribution and displacement of cantilever prostheses with and without glass abutment by three dimensional finite element analysis. Micro-computed tomography was used to study the relationship between the glass abutment and the ridge.

METHODS

The external surface of the maxilla was scanned, and a simplified finite element model was constructed. The ZX-27 glass abutment and the maxillary first and second premolars were created and modified. The solid model of the three-unit cantilever fixed partial denture was scanned, and the fitting surface was modified with reference to the created abutments using the 3D CAD system. The finite element analysis was completed in ANSYS. The fit and total gap volume between the glass abutment and dental model were determined by Skyscan 1173 high-energy spiral micro-CT scan.

RESULTS

The results of the finite element analysis in this study showed that the cantilever prosthesis supported by the glass abutment demonstrated significantly less stress on the terminal abutment and overall deformation of the prosthesis under vertical and oblique load. Micro-computed tomography determined a gap volume of 6.74162 mm(3).

SIGNIFICANCE

By contacting the mucosa, glass abutments transfer some amount of masticatory load to the residual alveolar ridge, thereby preventing damage to the periodontal microstructures of the terminal abutment. The passive contact of the glass abutment with the mucosa not only preserves the health of the mucosa covering the ridge but also permits easy cleaning. It is possible to increase the success rate of cantilever FPDs by supporting the cantilevered pontic with glass abutments.