Abstract
In this study, different prosthetic designs that could be applied instead of advanced surgical techniques in atrophic maxilla were evaluated with finite element analysis. Atrophic posterior maxilla was modeled using computer tomography images and four models were prepared as follows: Model 1 (M1), two implants supporting a three-unit distal cantilever prosthesis; Model 2 (M2), two implants supporting a three-unit conventional fixed partial denture; Model 3 (M3), three implants supporting three connected crowns; and Model 4 (M4), two implants supporting two connected crowns. Implants 4 mm in width and 8 mm or 13 mm in length were used. A linear three-dimensional finite element programme was used for analysis. The maximum principle stress (tensile) and minimum principle stress (compressive) were used to display stress in cortical and cancellous bones. The von Mises criteria were used to evaluate the stress on the implants. M1 was found to be the most risky model. The short dental arch case (M4) revealed the lowest stresses among the models but is not recommended when one more implant can be placed because of the bending forces that could occur at the mesial implant. In M2 and M3, the distal implants were placed bicortically between the crestal and sinus cortical plates, causing a fall of the stresses because of the bicortical stability of these implants.
Highlights
Implant therapy based on the principle of implant osseointegration has been well documented and is widely accepted
The short dental arch case (M4) revealed the lowest stresses among the models but is not recommended when one more implant can be placed because of the bending forces that could occur at the mesial implant
By using a 3D finite element analysis method, four different types of fixed prostheses models supported by implants (M1, Model 2 (M2), Model 3 (M3) and Model 4 (M4)) were compared in terms of stress distribution in the maxillary posterior segment
Summary
Implant therapy based on the principle of implant osseointegration has been well documented and is widely accepted. Despite high dental implant success rates, biomechanical risk factors tend to compromise their long-term success [1,2]. The number and size of implants to be placed, and the masticatory and parafunctional habits of the patient are a few risk factors that come to mind [3,4]. The posterior areas of the maxilla and the mandible are subject to higher forces of mastication. Failure rates in the maxilla are reported to be higher than the mandible [5]. In the posterior maxilla, increased masticatory forces, as well as low bone density and decreased bone volume, compromise the placement of implants and increase the risk of failure [6]
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