Startseite Medizin Biomechanical effects of inclined implant shoulder design in all-on-four treatment concept: a three-dimensional finite element analysis
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Biomechanical effects of inclined implant shoulder design in all-on-four treatment concept: a three-dimensional finite element analysis

  • Taha Aktas und Nurettin Diker ORCID logo EMAIL logo
Veröffentlicht/Copyright: 7. Juni 2023

Abstract

Objectives

The aim of the present study was to assess the biomechanical behaviour of using a posterior implant design with inclined shoulder designs in all-on-four treatment via three-dimensional finite element analysis.

Methods

Implants with standard and inclined shoulder designs were modelled for posterior implants. Implants were positioned into the maxilla and mandible models according to the all-on-four concept. Compressive stresses in the peri-implant bone, the von Mises stresses in the different components of the prosthetic restoration, and movement of the prosthesis were obtained.

Results

The compressive stresses of the models with inclined shoulder design resulted in 15–58 % decrease compared with standard shoulder design. The von Mises stresses in the posterior implants reduced 18–47 %, stresses in the implant body increased 38–78 %, stresses in the abutment screw reduced 20–65 %, stresses in the framework of prosthesis reduced 1–18 % and deformation of the prosthesis was reduced 6–37 % in the models of inclined shoulder design compared with models of standard shoulder design. The compressive and von Mises stresses were generally higher in the mandible models than in the maxilla models for standard and inclined shoulder designs.

Conclusions

All evaluated components of the simulated treatment except for posterior abutment bodies showed better biomechanical behaviour with inclined shoulder design. The clinical success of all-on-four treatment maybe enhanced by using posterior implants with an inclined shoulder design.


Corresponding author: Nurettin Diker, Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Türkiye, Phone: +90 212 523 2288, Fax: +90 212 621 7578, E-mail:

Funding source: Bezmialem Vakif University

Award Identifier / Grant number: 9450

  1. Research funding: The present study was supported by Scientific Research Projects Coordination Unit of Bezmialem Vakif University (Project No: 9450).

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: This study was approved by the human research ethics committee of Bezmialem Vakif University.

References

1. Bhering, CLB, Mesquita, MF, Kemmoku, DT, Noritomi, PY, Consani, RLX, Barão, VAR. Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: a prototyping guided 3D-FEA study. Mater Sci Eng C 2016;69:715–25. https://doi.org/10.1016/j.msec.2016.07.059.Suche in Google Scholar PubMed

2. Lofaj, F, Kučera, J, Németh, D, Minčík, J. Optimization of tilted implant geometry for stress reduction in all-on-4 treatment concept: finite element analysis study. Int J Oral Maxillofac Implants 2018;33:1287–95. https://doi.org/10.11607/jomi.6371.Suche in Google Scholar PubMed

3. Malmstrom, H, Gupta, B, Ghanem, A, Cacciato, R, Ren, Y, Romanos, GE. Success rate of short dental implants supporting single crowns and fixed bridges. Clin Oral Implants Res 2016;27:1093–8. https://doi.org/10.1111/clr.12693.Suche in Google Scholar PubMed

4. Esposito, M, Grusovin, MG, Kwan, S, Worthington, HV, Coulthard, P. Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment. Aust Dent J 2009;54:70–1. https://doi.org/10.1111/j.1834-7819.2008.01093.x.Suche in Google Scholar

5. Krekmanov, L, Kahn, M, Rangert, B, Lindström, H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants 2000;15:405–14.Suche in Google Scholar

6. Maló, P, Rangert, B, Nobre, M. All-on-four” immediate-function concept with brånemark system® implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res 2003;5:2–9. https://doi.org/10.1111/j.1708-8208.2003.tb00010.x.Suche in Google Scholar PubMed

7. Soto-Peñaloza, D, Zaragozí-Alonso, R, Peñarrocha-Diago, M, Peñarrocha-Diago, M. The all-on-four treatment concept: systematic review. Int J Exp Dent Sci 2017;9:e474–488. https://doi.org/10.4317/jced.53613.Suche in Google Scholar PubMed PubMed Central

8. Pera, P, Menini, M, Pesce, P, Bevilacqua, M, Pera, F, Tealdo, T. Immediate versus delayed loading of dental implants supporting fixed full-arch maxillary prostheses: a 10-year follow-up report. Int J Prosthodont 2018;32:27–31. https://doi.org/10.11607/ijp.5804.Suche in Google Scholar PubMed

9. Maló, P, Nobre, MDA, Lopes, A. The rehabilitation of completely edentulous maxillae with different degrees of resorption with four or more immediately loaded implants: a 5-year retrospective study and a new classification. Eur J Oral Implantol 2011;4:227–43.Suche in Google Scholar

10. Duyck, J, Rønold, HJ, Van Oosterwyck, H, Naert, I, Sloten, JV, Ellingsen, JE. The influence of static and dynamic loading on marginal bone reactions around osseointegrated implants: an animal experimental study. Clin Oral Implants Res 2001;12:207–18. https://doi.org/10.1034/j.1600-0501.2001.012003207.x.Suche in Google Scholar PubMed

11. Altiparmak, N, Akdeniz, SS, Diker, N, Bayram, B, Uckan, S. Comparison of success rate of dental implants placed in autogenous bone graft regenerated areas and pristine bone. J Craniofac Surg 2020;31:1572–7. https://doi.org/10.1097/scs.0000000000006401.Suche in Google Scholar PubMed

12. Chang, SH, Lin, CL, Hsue, SS, Lin, YS, Huang, SR. Biomechanical analysis of the effects of implant diameter and bone quality in short implants placed in the atrophic posterior maxilla. Med Eng Phys 2012;34:153–60. https://doi.org/10.1016/j.medengphy.2011.07.005.Suche in Google Scholar PubMed

13. Türker, N, Büyükkaplan, US, Sadowsky, SJ, Özarslan, MM. Finite element stress analysis of applied forces to implants and supporting tissues using the “all-on-four” concept with different occlusal schemes. J Prosthodont 2019;28:185–94. https://doi.org/10.1111/jopr.13004.Suche in Google Scholar PubMed

14. ASM material data sheet for titanium grade 4nd. http://asm.matweb.com/search/SpecificMaterial.asp?bassnum=mtu040 [Accessed 24 Jan 2022].Suche in Google Scholar

15. ASM material data sheet for titanium grade 5nd. http://asm.matweb.com/search/SpecificMaterial.asp?bassnum=mtp641 [Accessed 24 Jan 2022].Suche in Google Scholar

16. Ozan, O, Kurtulmus-Yilmaz, S. Biomechanical comparison of different implant inclinations and cantilever lengths in all-on-4 treatment concept by three-dimensional finite element analysis. Int J Oral Maxillofac Implants 2018;33:64–71. https://doi.org/10.11607/jomi.6201.Suche in Google Scholar PubMed

17. Vajgel, A, Camargo, IB, Willmersdorf, RB, de Melo, TM, Laureano, F, Vasconcellos, R. Comparative finite element analysis of the biomechanical stability of 2.0 fixation plates in atrophic mandibular fractures. J Oral Maxillofac Surg 2013;71:335–42. https://doi.org/10.1016/j.joms.2012.09.019.Suche in Google Scholar PubMed

18. Maló, P, de Araújo Nobre, M, Lopes, A, Ferro, A, Gravito, I. All-on-4® treatment concept for the rehabilitation of the completely edentulous mandible: a 7-year clinical and 5-year radiographic retrospective case series with risk assessment for implant failure and marginal bone level. Clin Implant Dent Relat Res 2015;17:e531–41. https://doi.org/10.1111/cid.12282.Suche in Google Scholar PubMed

19. Gümrükçü, Z, Korkmaz, YT. Influence of implant number, length, and tilting degree on stress distribution in atrophic maxilla: a finite element study. Med Biol Eng Comput 2018;56:979–89. https://doi.org/10.1007/s11517-017-1737-4.Suche in Google Scholar PubMed

20. Li, X, Cao, Z, Qiu, X, Tang, Z, Gong, L, Wang, D. Does matching relation exist between the length and the tilting angle of terminal implants in the all-on-four protocol? Stress distributions by 3D finite element analysis. J Adv Prosthodont 2015;7:240–8. https://doi.org/10.4047/jap.2015.7.3.240.Suche in Google Scholar PubMed PubMed Central

21. Capelli, M, Zuffetti, F, Fabbro, MD, Testori, T. Immediate rehabilitation of the completely edentulous jaw with fixed prostheses supported by either upright or tilted implants: a multicenter clinical study – PubMed. Int J Oral Maxillofac Implants 2007;22:639–44.Suche in Google Scholar

22. Liu, T, Mu, Z, Yu, T, Wang, C, Huang, Y. Biomechanical comparison of implant inclinations and load times with the all-on-4 treatment concept: a three-dimensional finite element analysis. Comput Methods Biomech Biomed Eng 2019;22:585–94. https://doi.org/10.1080/10255842.2019.1572120.Suche in Google Scholar PubMed

23. dos Santos, MBF, Meloto, GDO, Bacchi, A, Correr-Sobrinho, L. Stress distribution in cylindrical and conical implants under rotational micromovement with different boundary conditions and bone properties: 3-D FEA. Comput Methods Biomech Biomed Eng 2017;20:893–900. https://doi.org/10.1080/10255842.2017.1309394.Suche in Google Scholar PubMed

24. de Souza Batista, VE, Verri, FR, Almeida, DADF, Santiago Junior, JF, Lemos, CAA, Pellizzer, EP. Finite element analysis of implant-supported prosthesis with pontic and cantilever in the posterior maxilla. Comput Methods Biomech Biomed Eng 2017;20:663–70. https://doi.org/10.1080/10255842.2017.1287905.Suche in Google Scholar PubMed

25. Takano-Yamamoto, T. Osteocyte function under compressive mechanical force. Jpn Dent Sci Rev 2014;50:29–39. https://doi.org/10.1016/j.jdsr.2013.10.004.Suche in Google Scholar

26. Nurettin, D, Burak, B. Feasibility of carbon-fiber-reinforced polymer fixation plates for treatment of atrophic mandibular fracture: a finite element method. J Cranio-Maxillofacial Surg 2018;46:2182–9. https://doi.org/10.1016/j.jcms.2018.09.030.Suche in Google Scholar PubMed

27. Sevimay, M, Usumez, A, Eskitascioglu, G. The influence of various occlusal materials on stresses transferred to implant-supported prostheses and supporting bone: a three-dimensional finite-element study. J Biomed Mater Res Part B Appl Biomater 2005;73B:140–7. https://doi.org/10.1002/jbm.b.30191.Suche in Google Scholar PubMed

28. Kaleli, N, Sarac, D, Külünk, S, Öztürk, Ö. Effect of different restorative crown and customized abutment materials on stress distribution in single implants and peripheral bone: a three-dimensional finite element analysis study. J Prosthet Dent 2018;119:437–45. https://doi.org/10.1016/j.prosdent.2017.03.008.Suche in Google Scholar PubMed

29. Brozović, J, Demoli, N, Farkaš, N, Sušić, M, Alar, Ž, Gabrić Pandurić, D. Properties of axially loaded implant-abutment assemblies using digital holographic interferometry analysis. Dent Mater 2014;30:e17–27. https://doi.org/10.1016/j.dental.2013.12.005.Suche in Google Scholar PubMed

30. Gupta, S, Gupta, H, Tandan, A. Technical complications of implant-causes and management: a comprehensive review. Natl J Maxillofac Surg 2015;6:3–8. https://doi.org/10.4103/0975-5950.168233.Suche in Google Scholar PubMed PubMed Central

31. Goodacre, CJ, Kan, JY, Rungcharassaeng, K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999;81:537–52. https://doi.org/10.1016/s0022-3913(99)70208-8.Suche in Google Scholar PubMed

32. Horita, S, Sugiura, T, Yamamoto, K, Murakami, K, Imai, Y, Kirita, T. Biomechanical analysis of immediately loaded implants according to the “All-on-Four” concept. J Prosthodont Res 2017;61:123–32. https://doi.org/10.1016/j.ijom.2017.02.904.Suche in Google Scholar

Received: 2023-01-03
Accepted: 2023-05-23
Published Online: 2023-06-07
Published in Print: 2023-12-15

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