Abstract

Statement of problemAlthough the concept of angulated dental implants has been used for the rehabilitation of the completely edentulous maxilla, its use has yet to be validated with narrow-diameter implants. Proper estimation of narrow-diameter implant dimensions and angulations is essential for the correct use of these implants. PurposeThe purpose of this 3D finite element analysis study was to compare the stress levels and distributions of 2 narrow-diameter angled implant arrangements supporting a maxillary fixed complete prosthesis. Material and methodsTwo commercially available narrow-diameter implants (3.5×11.5 mm, Unitite Prime; 2.9×11.5 mm, Unitite Slim) were compared for their performances under axial and oblique loading (masticatory force: 100 N) in simulated situations of all-on-4 treatment (2 parallel anterior implants perpendicular to the bone crest and 2 posterior implants angled at 30 degrees). An edentulous maxilla model generated from computed tomography and a prosthesis parametric computer-aided design (CAD) model were combined with computational models of implants and prosthetic components to represent implant-supported maxillary fixed complete prostheses. A condition of complete osseointegration was assumed. Peri-implant bone was analyzed by the Mohr-Coulomb criterion. Implants, abutments, and screws were analyzed by the von Mises criterion, and frameworks by the Rankine criterion. ResultsThe 3.5-mm model showed higher axial load values for peri-implant bone, implants, and abutments than the 2.9-mm model. As for oblique load, values were higher for right-sided peri-implant bone, implants, abutments, and frameworks in the 3.5-mm model than in the 2.9-mm model. The 3.5-mm model had a 16% lower risk of peri-implant bone loss for the axial load and 4% for the oblique load. ConclusionsThe biomechanical behavior of an angled 2.9-mm implant was comparable with that of a 3.5-mm implant for an all-on-4 prosthesis. However, despite a lower risk of peri-implant bone loss, the 3.5-mm model had higher peak stress on implants and abutments than the 2.9-mm model.

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