Abstract
This study's aim was to evaluate the stress distribution in a mandibular implant-supported prosthesis and peri-implant bone considering implant quantity, diameter and position using linear 3-D finite element analysis. Models of an anterior jaw comprised 4 groups according to implant quantity, diameter, and position: control group C, 5 regular implants; R, 3 regular implants; W, 3 wide implants; and DTR, 3 regular implants with the distal ones tilted 30° distally. The cantilever was loaded with an axial load of 50 N. Data was evaluated using von Mises stress on implants and maximum principal stress and microstrain on the bone. The W group showed the lowest value of maximum principal stress in peri-implant bone of the loaded side (4.64 MPa) when compared to C (5.27 MPa), DTR (5.94 MPa), and R (11.12 MPa). Lower stress values in the loaded implants were observed in the experimental groups when compared to the C group. However, the unloaded implants presented opposite results. All the screws of the W group presented lower stress values when compared to the C group. However, the R and DTR groups presented an increase in stress values with the exception of the loaded screw. A reduction in the number of implants associated with wider implants reduced the stress in the bone and prosthetic components.
Highlights
Fixed implant-supported prostheses have shown clinical success and proven functional benefits for use in the edentulous mandible.[1,2] Changes in the original protocol have been proposed to simplify and optimize the rehabilitation of edentulous patients, increasing access to treatment.[3,4,5,6,7,8,9] Branemark et al.[3] initially proposed the use of 3 wide implants to support a fixed implant-supported prosthesis in the edentulous mandible, obtaining a success rate of 98% over 3 years of follow-up
Given the absence of experimental studies that support the clinical use of this configuration, the aim of this study was to use linear three-dimensional (3D) finite element (FE) analysis to evaluate the stress distribution in the peri-implant bone and prosthetic components with different implant configurations
A 3D modeling software (SolidWorks 2010, SolidWorks Corp., Concord, USA) was used to build a model of a severely resorbed jaw, with external hex titanium implants (10.0 mm length) between the mental foramens and a fixed implant-supported prosthesis seated on the implants by UCLA abutments and a titanium metal bar (5.0 mm diameter)
Summary
Fixed implant-supported prostheses have shown clinical success and proven functional benefits for use in the edentulous mandible.[1,2] Changes in the original protocol have been proposed to simplify and optimize the rehabilitation of edentulous patients, increasing access to treatment.[3,4,5,6,7,8,9] Branemark et al.[3] initially proposed the use of 3 wide implants to support a fixed implant-supported prosthesis in the edentulous mandible, obtaining a success rate of 98% over 3 years of follow-up. The unfavorable results were attributed to the angulation of the implants during the surgical procedure and the difficulty in obtaining a passive fit with the prefabricated metallic frameworks.[8,9]
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