Stress analysis of a fixed implant-supported denture by the finite element method (FEM) when varying the number of teeth used as abutments

Number of dental abutments influencing the biomechanical behavior of tooth‒implant-supported fixed partial dentures: A finite element analysis

Background. Local or systemic issues might prevent installing a sufficient number of dental implants for fixed prosthetic rehabilitation. Splinting dental implants and natural teeth in fixed dentures could overcome such limitations. Therefore, this study aimed to evaluate the influence of the number of dental abutments in the biomechanics of tooth‒implant-supported fixed partial dentures (FPDs). The null hypothesis was that increasing the number of abutment teeth would not decrease the stress over the abutments and surrounding bone. Methods. Left mandibular lateral incisor, canine, premolars, and molars were reconstructed through computed tomography and edited using image processing software to represent a cemented fixed metal‒ceramic partial denture. Three models were set to reduce the number of abutment teeth: 1) lateral incisor, canine, and first premolar; 2) canine and first premolar; 3) the first premolar. The second premolar and first molar were set as pontics, and the second molar was set as an implant abutment in all the models. Finite element analyses were performed under physiologic masticatory forces with axial and oblique loading vectors. Results. After simulation of axial loads, the stress peaks on the bone around the implant, the bone around the first premolar, and prosthetic structures did not exhibit significant changes when the number of abutment teeth decreased. However, under oblique loads, decreasing the number of abutment teeth increased stress peaks on the surrounding bone and denture. Conclusion. Increasing the number of dental abutments in tooth‒implant-supported cemented FPD models decreased stresses on its constituents, favoring the prosthetic biomechanics.

Application of bioengineering devices for stress evaluation in dentistry: the last 10 years FEM parametric analysis of outcomes and current trends

INTRODUCTION

Dentistry, therefore implantology, prosthetics, implant prosthetics or orthodontics in all their variants, are medical and rehabilitative branches that have benefited greatly from these methods of investigation to improve the predictability of rehabilitations. We will examine the Finite Element Method and Finite Element Analysis in detail. This method involves the simulation of mechanical forces from an environment with infinite elements, the real one, to a simulation with finite elements.

EVIDENCE ACQUISITION

The study searched MEDLINE databases from 2008 to 2018. Human use of FEM in vitro studies reported a contribution on oral rehabilitation through the use of FEM analysis. The initial search obtained 296 citations. After a first screening, the present revision considered the English-language works referred to human application of the FEM published in the last 10 years. Finally, 34 full texts were available after screening.

EVIDENCE SYNTHESIS

The ultimate aim of this review is to point out all the progress made in the field of bioengineering and therefore, thanks to this, in the field of medicine. Instrumental investigations such as FEM are an excellent tool that allows the evaluation of anatomical structures and any facilities for rehabilitation before moving on to experimentation on animals, so as to have mechanical characteristics and satisfactory load cycle testing.

CONCLUSIONS

FEM analysis contributes substantially to the development of new technologies and new materials in the biomedical field, being able to perform a large number of simulations without the need for patients or to perform human tests. Thanks to the 3D technology and to the reconstructions of both the anatomical structures and eventually the alloplastic structures used in the rehabilitations it is possible to consider all the mechanical characteristics, so that they can be analyzed in detail and improved where necessary. It is possible thanks to these methods to know what are the ideal characteristics of a material to promote an oral rehabilitation, so we know the characteristics, it remains only to take a step in the field of the industry for the construction of materials close to these characteristics.

Biomechanical effect of inclined implants in fixed prosthesis: strain and stress analysis

Abstract Introduction Implant inclinations can be corrected using mini abutments at different angulations. Objective To analyze the influence of external hexagon implants in different inclinations (3 levels) on the microstrain distribution generated around three implants. Method A geometric bone model was created through Rhinoceros CAD software (version 5.0 SR8, Mcneel North America, Seattle, WA, USA). Three implants (4.1 × 13 mm) were modeled and inserted inside the substrate at three different inclinations: 0º, 17º and 30º. Next, all groups received mini conical abutments, fixation screws and a simplified prosthesis. The final geometry was exported in STEP format to analysis software and all materials were considered homogeneous, isotropic and linearly elastic. An axial load (300N) was applied on the center of the prosthesis. An in vitro study was conducted with same conditions and groups for validating the tridimentional model. Result Stress was concentrated on the external area of the implants, in contact with the cortical bone and external hexagon. For the bone simulator, the strain increased in the peri-implant region according to the increase in the implant’s inclination. The difference between groups was significant (p = 0.000). The 30º group presented higher stress and strain concentration. Conclusion The microstrain and stress increase around implants directly proportional to the increase of the installation angle.

Numerical Evaluation of Biomechanical Stresses in Dental Bridges Supported by Dental Implants

The number of supporting dental implants is an important criterion for the surgical outcome of dental bridge fixation, which has considerable impact on biomechanical load transfer characteristics. Excessive stress at the bone–implant interface by masticatory loading may result in implant failure. The aim of this study was to evaluate the impact of the number of implants supporting the dental bridge on stress in neighboring tissues around the implants. Results of the study will provide useful information on appropriate surgical techniques for dental bridge fixation. In this study, osseointegrated smooth cylindrical dental implants of same diameter and length were numerically analyzed, using three-dimensional bone–implant models. The effect of the number of supporting implants on biomechanical stability of dental bridge was examined, using two, three and four supporting implants. All materials were assumed to be linearly elastic and isotropic. Masticatory load was applied in coron-apical direction on the external part of dental bridge. Finite Element (FE) analyses were run to solve for von Mises stress. Maximum von Mises stresses were located in the cervical line of cortical bone around dental implants. Peak von Mises stress values decreased with an increase in the number of implants that support the dental bridge. Results of this study demonstrate the importance of using the correct number of supporting implants to for dental bridge fixation.

FEM and Von Mises Analysis on Prosthetic Crowns Structural Elements: Evaluation of Different Applied Materials

The aim of this paper is to underline the mechanical properties of dental single crown prosthodontics materials in order to differentiate the possibility of using each material for typical clinical condition and masticatory load. Objective of the investigation is to highlight the stress distribution over different common dental crowns by using computer-aided design software and a three-dimensional virtual model. By using engineering systems of analyses like FEM and Von Mises investigations it has been highlighted the strength over simulated lower first premolar crowns made by chrome cobalt alloy, golden alloy, dental resin, and zirconia. The prosthodontics crown models have been created and put on simulated chewing stresses. The three-dimensional models were subjected to axial and oblique forces and both guaranteed expected results over simulated masticatory cycle. Dental resin presented the low value of fracture while high values have been recorded for the metal alloy and zirconia. Clinicians should choose the better prosthetic solution for the teeth they want to restore and replace. Both prosthetic dental crowns offer long-term success if applied following the manufacture guide limitations and suggestions.

Biomechanical outcomes of tooth-implant-supported fixed partial prostheses (FPPs) in periodontally healthy patients using root shape dental implants

Background: Connecting an osseointegrated implant and a natural tooth is a treatment alternative for partially edentulous patients in some clinical situations. The main issue of a connected tooth-implant system is derived from the dissimilar mobility patterns of the osseointegrated fixtures and natural abutments causing potential biomechanical problems within the entire system. Purpose: The aim of this review was to multilaterally analyze and discuss the main biomechanical factors that may question the reliability of splinted tooth-implant system and the long-term success of fixed partial prostheses (FPPs) supported by both teeth and implants with an emphasis on the disparity of mobility of these two different abutments. Material and methods: An electronic MEDLINE (PubMed) search supplemented by manual searching was performed to retrieve relevant articles. An assessment of the identified studies was performed, the most valuable articles were selected and biomechanical outcomes of tooth-implant splinting system were analyzed. Results: 3D FEM stress analyses and photoelastic studies show uneven load distribution between the tooth and the implant and stress concentration in the crestal bone around the implant neck when connected to a natural tooth by FPPs. However, clinical studies demonstrate good results for both the implants and FPPs supported by splinted implant-tooth abutments. Conclusion: Connecting implants to natural teeth is not a preferable treatment option because of possible inherent biomechanical complications. Whenever possible, this treatment option should be avoided.

Combined implant-residual tooth supported prosthesis after tooth hemisection: A finite element analysis

Tooth hemisection preserves partial tooth structure and reduces the resorption of alveolar bone. The aim of this study was to analyze the feasibility of preserving a molar after hemisection and inserting a dental implant with different prosthetic superstructures by means of finite element analysis. First, the distance between the root of the mandibular second premolar and the distal root of the first molar were measured in 80 cone beam computed tomography (CBCT) data sets. Based on these data, the lower right posterior jaw segment was reconstructed and the geometries of the appropriate implant were imported. Four models were created: (1) Hemi-1: An implant (3.7×9mm) replaced the mesial root of the molar, and a single crown was placed on the implant and residual tooth. (2) Hemi-2: Two separate crowns were generated for the implant and the residual tooth. (3) Single: An implant (5.5×9mm) with crown replaced the whole molar. (4) FPD: A 3-unit fixed partial denture combined the distal residual part of the molar and premolar. The results indicated that stresses in the cortical bone and strains in the majority region of the spongious bone were below the physiological upper limits. There were higher stresses in implant with the Hemi-1 and Single models, which had the same maximum values of 45.0MPa. The FPD models represented the higher values of stresses in the teeth and strains in PDL compared to other models. From a biomechanical point of view, it can be concluded that a combination of an implant and residual molar after tooth hemisection is an acceptable treatment option.