1
|
Krennmair S, Malek M, Stehrer R, Stähler P, Otto S, Postl L. The effect of frontal trauma on the edentulous mandible with four different interforaminal implant-prosthodontic anchoring configurations. A 3D finite element analysis. Eur J Med Res 2023; 28:608. [PMID: 38115128 PMCID: PMC10729383 DOI: 10.1186/s40001-023-01580-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Abstract
PURPOSE The present three-dimensional (3D) finite element analysis (FEA) was aimed to assess the biomechanical effects and fracture risks of four different interforaminal implant-prosthodontic anchoring configurations exposed to frontal trauma. MATERIAL AND METHODS A symphyseal frontal trauma of 1 MPa was applied to four dental implant models with different configurations (two unsplinted interforaminal implants [2IF-U], two splinted interforaminal implants [2IF-S], four unsplinted interforaminal implants[ 4IF-U], four splinted interforaminal implants [4IF-S]. By using a 3D-FEA analysis the effective cortical bone stress values were evaluated in four defined regions of interest (ROI) (ROI 1: symphyseal area; ROI 2: preforaminal area; ROI 3: mental foraminal area; and ROI 4: condylar neck) followed by a subsequent intermodel comparison. RESULTS In all models the frontal traumatic force application revealed the highest stress values in the condylar neck region. In both models with a four-implant configuration (4IF-U, 4IF-S), the stress values in the median mandibular body (ROI 1) and in the condylar neck region (ROI 4) were significantly reduced (P <0.01) compared with the two-implant models (2IF-U, 2IF-S). However, in ROI 1, the model with four splinted implants (4IF-S) showed significantly (P < 0.01) reduced stress values compared to the unsplinted model (4IF-U). In addition, all models showed increased stress patterns in the area adjacent to the posterior implants, which is represented by increased stress values for both 2IF-U and 2IF-S in the preforaminal area (ROI 3) and for the four implant-based models (4IF-U, 4IF-S) in the mental foraminal area. CONCLUSION The configuration of four splinted interforaminal implants showed the most beneficial distribution of stress pattern representing reduced stress distribution and associated reduced fracture risk in anterior symphysis, condylar neck and preforaminal region.
Collapse
Affiliation(s)
- Stefan Krennmair
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria
- NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Michael Malek
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria
| | - Raphael Stehrer
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria
| | - Philip Stähler
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University Munich, Lindwurmstrasse 2a, 80337, Munich, Germany
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University Munich, Lindwurmstrasse 2a, 80337, Munich, Germany
| | - Lukas Postl
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria.
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University Munich, Lindwurmstrasse 2a, 80337, Munich, Germany.
| |
Collapse
|
2
|
Bilginaylar K, Ayali A. Biomechanical behavior of carbon fiber-reinforced polyetheretherketone as a dental implant material in implant-supported overdenture under mandibular trauma: A finite element analysis study. Niger J Clin Pract 2023; 26:1538-1546. [PMID: 37929532 DOI: 10.4103/njcp.njcp_239_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Context Implant-supported overdentures are well-known and widely accepted treatment modality to increase retention which is a crucial factor for determining patient satisfaction. The placement of two implants in the anterior region can be selected as a first-line treatment in patients with the atrophic mandibular ridge. Aims The purpose of this research was to assess the biomechanical effects of carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implant-supported overdenture in the event of 2,000 N forefront trauma to an atrophic edentulous mandible by using the finite element analysis method. Materials and Methods Three types of mandible models were simulated; the first one was an edentulous atrophic mandible model; in the second model, 3.5 × 11.5 mm CFR-PEEK implants; and in the third model, 4.3 × 11.5 mm CFR-PEEK implants were positioned in the region of the lateral incisor of the identical edentulous atrophic mandible. Results Maximum Von Misses stresses 979.261 MPa, 1,454.69 MPa, and 1,940.71 MPa and maximum principal stresses 1,112.74 MPa, 1,249.88 MPa, and 1,251.33 MPa have been detected at the condylar neck area and minimum principal stresses - 1,203.38 MPa, -1,503.21 MPa, and - 1,990.34 MPa have been recorded at the symphysis and corpus regions from M1 to M3, respectively. In addition, the M2 and M3 models showed low-stress distributions around the implant-bone interface, particularly where the implants were in contact with cancellous bone. Conclusions The results showed that the insertion of different diameters of CFR-PEEK implants led to low and homogenous stress distribution all around the implant-bone interface and stresses transferred directly to the condylar neck areas. Therefore, it was observed that CRF-PEEK implants did not change the basic behavior of the mandibula in response to frontal stresses.
Collapse
Affiliation(s)
- K Bilginaylar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Final International University, Nicosia, Mersin, Turkey
| | - A Ayali
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, European University of Lefke, Cyprus, Turkey
| |
Collapse
|
3
|
An Y, Xie L, Liu Y, Wu P, Li H, Jiang J, Zhang Z, Yang S. Research on skull trauma biomechanical stress distribution in case of dental implants existence. Technol Health Care 2022; 31:821-829. [PMID: 36442219 DOI: 10.3233/thc-220148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND: When the jaw bone is subjected to an external force, the stress is transmitted from the force point along the alveolar bone to the skull and skull base. In the case of a dental implant, the stress distribution is mainly dependent on the implant position, type, and mechanical properties. OBJECTIVE: To investigate the dental implant position influence on the stress distribution and transmission in case of facial frontal trauma. Furthermore, the correlation between facial trauma and skull trauma in the case of a dental implant exists. METHODS: In this study, a Finite Element Method (FEM) model was constructed based on a real skull shape, size, and anatomy. Dental implants were modeled based on imported CAD Data. Five cases were investigated including no dental implant and the replacement of teeth no. 18, 19 20 and 21. Facial trauma was mimicked by applying an external load on the lower frontal jaw. Finally, the stress distribution based on the bone geometry and implant position were evaluated and compared. RESULTS: Results suggested that a dental implant could significantly influence the stress distribution in the skull in case of facial trauma. In addition, the dental position greatly affects stress transmission from the mandible to the skull bones through the zygomatic arch. CONCLUSION: The position of the dental implant could have a significant role in stress transmission and distribution in case of facial or even brain trauma. Thus, increasing the possibility of a correlation between facial and brain trauma.
Collapse
Affiliation(s)
- Yang An
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Ling Xie
- Department of Stomatology, People’s Hospital of Tianfu New District, Chengdu, Sichuan, China
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Yu Liu
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Po Wu
- Department of Stomatology, People’s Hospital of Tianfu New District, Chengdu, Sichuan, China
| | - Hao Li
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Ji Jiang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Zhengrui Zhang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Shuyong Yang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| |
Collapse
|
4
|
Pieralli S, Spies BC, Schweppe F, Preissner S, Nelson K, Heiland M, Nahles S. Retrospective long-term clinical evaluation of implant-prosthetic rehabilitations after head and neck cancer therapy. Clin Oral Implants Res 2021; 32:470-486. [PMID: 33501694 DOI: 10.1111/clr.13716] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/24/2020] [Accepted: 01/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess clinical and patient-reported outcomes of implant-prosthetic rehabilitations in patients with a history of head-neck cancer (HNC), treated with tumor resection without (TR) or with adjuvant radiotherapy (TR/RT). A healthy cohort rehabilitated with the same reconstructive protocols served as control group (C). MATERIALS AND METHODS A total of 28 women and 29 men were considered in the present retrospective study. Participants received 322 implants, finally supporting 79 prosthetic reconstructions. Primary outcome was the assessment of implant and prosthetic survival rates. Furthermore peri-implant soft tissue parameters (attached peri-implant mucosa, AM; modified bleeding and plaque indices, mBI/mPI; probing depth, PD) and prosthetic technical complications were documented. Patient-reported outcome measures (PROMs) by means of visual analog scales (VAS) and the Oral Health Impact Profile German 14 form (OHIP G14) were collected. For statistical purposes Chi-square and Mann-Whitney-U-Test were adapted. RESULTS After a mean follow-up of 81.2 ± 50.3 months, implant survival rate was 98.1% (HNC-TR), 98.2% (HNC-TR/RT) and 100.0% (C), respectively (four implants failed in the HNC groups). HNC-TR/RT showed significant higher mPI and mBI compared to C. Within HNC-TR/RT, vestibuloplasty significantly reduced mBI and PD values. No failures occurred at the prosthetic level. Overall, higher VAS scores were reported for bar- compared with Locator-retained prostheses. Furthermore, increased OHIP G14 values resulted for HNC-TR/RT. CONCLUSIONS High survival rates on implant and prosthetic level were observed. The use of soft tissue grafts resulted in stabilization of the peri-implant mucosa in irradiated patients. In terms of retention and chewing ability, participants preferred bars over Locator attachments.
Collapse
Affiliation(s)
- Stefano Pieralli
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Felix Schweppe
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|