The Influence of Custom-Milled Framework Design for an Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D-FEA Sudy.

João Paulo Mendes Tribst,Pietro Ausiello,Marco Antonio Bottino,Alexandre Luiz Souto Borges,Roberto Lo Giudice,Amanda Maria De Oliveira Dal Piva,Ettore Epifania

doi:10.3390/ijerph17114040

Abstract

The current study aimed to evaluate the mechanical behavior of two different maxillary prosthetic rehabilitations according to the framework design using the Finite Element Analysis. An implant-supported full-arch fixed dental prosthesis was developed using a modeling software. Two conditions were modeled: a conventional casted framework and an experimental prosthesis with customized milled framework. The geometries of bone, prostheses, implants and abutments were modeled. The mechanical properties and friction coefficient for each isotropic and homogeneous material were simulated. A load of 100 N load was applied on the external surface of the prosthesis at 30° and the results were analyzed in terms of von Mises stress, microstrains and displacements. In the experimental design, a decrease of prosthesis displacement, bone strain and stresses in the metallic structures was observed, except for the abutment screw that showed a stress increase of 19.01%. The conventional design exhibited the highest stress values located on the prosthesis framework (29.65 MPa) between the anterior implants, in comparison with the experimental design (13.27 MPa in the same region). An alternative design of a stronger framework with lower stress concentration was reported. The current study represents an important step in the design and analysis of implant-supported full-arch fixed dental prosthesis with limited occlusal vertical dimension.

Highlights

Implant-supported full-arch dental prosthesis (IFDP) is used as an alternative for total muco-supported prosthesis, achieving appropriate aesthetics, masticatory function and patient satisfaction [1,2]
A more homogeneous distribution was noted in the case of experimental design, with fewer strain values observed for all peri-implant tissue (Figure 3)
This study evaluated the mechanical response of an alternative design for manufacturing an implant-supported full-arch dental prosthesis (IFDP) with limited occlusal vertical dimension

Summary

Introduction

Implant-supported full-arch dental prosthesis (IFDP) is used as an alternative for total muco-supported prosthesis, achieving appropriate aesthetics, masticatory function and patient satisfaction [1,2] Sometimes this treatment cannot be performed due to anatomical and physiological alterations that make it impossible to correctly install the implants and the prosthesis [1]. In the case of inadequate inter-arch distance, the design of a milled titanium framework was proposed as an alternative to maintain the occlusal vertical dimension and to prevent the artificial teeth from wear, improving the system mechanical strength (Figure 1). Suc2hofa1n2 approach, together with a CAD/CAM (computer aided design/computer aided manufacturing) facility, enables the development of a better adapted infrastructure with a lower vertical misfit than tmhaetepriraolsftrhaectiucrea,bpurotmsthenetic[s4c,5re].wTlooosiennviensgtiagnadteevthene frbaomnew-imorpklafrnatctusyrestaerme ambyonmg ethaensmoosft caomthmreoendmiemcehnasniiocnaal lco(3mDp)laicnaatliyosniss,[1th,2e].Finite Element Analysis (FEA) method is commonly used [6]

Methods

Results

Discussion

Conclusion