Stress Analysis of Endodontically Treated Tooth-Implant Different Connectors Designs in Maxillary Posterior Region: A Finite Element Analysis.

Abstract

Using finite element analysis (FEA), this study aimed to determine the effect of nonrigid connectors (NRCs) and their position on the success of tooth and implant-supported fixed prostheses in the maxillary posterior region. Three three-dimensional FEA models were designed, presuming maxillary second premolar and first molar to be extracted. Implant (replacing first molar), abutment, bone (spongious and cortical), first premolar (containing dentin, root cement, gutta-percha, and casting post and core), periodontal ligament, and three three-unit cemented porcelain-fused-to-metal prostheses (a rigid one and two nonrigid) were modeled. The NRC was once on the tooth side and once on the implant side. The prostheses were loaded twice. The first molar (180 N) and premolars (120 N) teeth were subjected to progressive vertical and oblique (12-degree) loads, and maximum von Mises stress and strain in teeth and connectors were calculated for each model. The findings of the current study showed evidence that tooth-implant design with an NRC has significantly increased the average stress in the tooth. The average stress in dentin was 769.02 for the mesial connector and 766.95 for the distal connector, and this was only 731.59 for rigid connector. Furthermore, it was observed that rigid connector has considerably minimized the stress within the tooth-implant-supported fixed partial denture. The average stress for the crown and metal frame is 346.22 and 526.41 in rigid connector, while it is 1,172.9 and 2,050.9 for the nonrigid mesial connector. Although distal NRC was more efficient than mesial NRC, using NRC will only reduce the stress applied to cortical bone and is not recommended in the posterior region of the maxilla.