Different Treatment Modalities Using Dental Implants in the Posterior Maxilla: A Finite Element Analysis.

Altair Antoninha Del Bel Cury,Marco Aurélio de Carvalho,Priscilla Cardoso Lazari-Carvalho,Mariane Boaventura de Castro,Dimorvan Bordin,Anderson Macena de Araujo

doi:10.1590/0103-6440202103890

Altair Antoninha Del Bel Cury, Marco Aurélio de Carvalho + Show 4 more

Open Access

https://doi.org/10.1590/0103-6440202103890

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Abstract

The objective of this study was to compare the biomechanical behavior of peri-implant bone tissue and prosthetic components in two modalities of treatment for posterior region of the maxilla, using short implants or standard-length implants associated with bone graft in the maxillary sinus. Four 3D models of a crown supported by an implant fixed in the posterior maxilla were constructed. The type of implant: short implant (S) or standard-length implant with the presence of sinus graft (L) and type of crown retention: cemented (C) or screwed (S) were the study factors. The models were divided into SC- cemented crown on a short implant; SS- screwed crown on the short implant; LC- cemented crown on a standard-length implant after bone graft in the maxillary sinus and LS- crown screwed on a standard-length implant after bone graft in the maxillary sinus. An axial occlusal loading of 300 N was applied, divided into five points (60N each) corresponding to occlusal contact. The following analysis criteria were observed: Shear Stress, Maximum and Minimum Main Stress for bone tissue and von Mises Stress for the implant and prosthetic components. The use of standard-length implants reduced the shear stress in the cortical bone by 35.75% and the medullary bone by 51% when compared to short implants. The length of the implant did not affect the stress concentration in the crown, and the cement layer acted by reducing the stresses in the ceramic veneer and framework by 42%. Standard-implants associated with cemented crowns showed better biomechanical behavior.

Highlights

The rehabilitation of posterior maxilla with dental implants has been considered a challenging scenario [1]
The models were divided into SC- cemented restoration on a short implant; SS- screwed restoration on the short implant; LC- cemented restoration on a standard-length implant after bone graft in the maxillary sinus and LSrestoration screwed on a standard-length implant after bone graft in the maxillary sinus
The use of 3D finite element analysis may be possible to observe the internal stress caused by oclusal forces in different implant treatment modalities

Summary

Introduction

The rehabilitation of posterior maxilla with dental implants has been considered a challenging scenario [1]. Pneumatization of the maxillary sinus after tooth loss is a common finding and significant atrophy of the maxilla preclude implant placement in this region [2]. Sinus augmentation has been used to improve these sites for dental implant placement [2]. This technique is an effective and well-documented therapy and increase bone volume to allows the use of a standard-length implant with high success rate (90%) [4]. Additional surgical procedure is necessary which increases healing time, morbidity and add extra costs [5]

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