Kaya İlhana, Tuğcu Fundab
aUşak University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Uşak, Turkey
bAnkara University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, Turkey
Summary
Background/Aim: The objective of this study was to evaluate the stress distribution on implants and supporting bone tissue in All-on-Four and conventional designs in edentulous mandible by using 3D finite element analysis. Material and Methods: The different five models were designed according to All-on-Four concept and conventional implant placement designs. While the first two models were involved in All-on-Four concept with two long implants, the remaining models were designed by conventional approaches with three implants in different location and length. After the modelling procedures, a load of masticatory force was applied and the stresses were evaluated. Results: It has been observed that principal stresses in both cortical and spongious bone tissue were concentrated in models of All-on-Four design. Less principal stress levels were found in models of conventional design. Similarly, von Mises stress values on implant surfaces were found to be higher in All-on-Four concept. Conclusions: In severely resorbed mandible, the use of conventional implant placement is recommended. Although All-on-Four design seems to be a reasonable alternative for edentulous mandible, evidence-based results of this approach should be supported by long-term follow-up studies.
Keywords: All-on-Four, conventional implant design; finite element analysis; tilted implants
Reference
Arlin, M.L. (2006) Short dental implants as a treatment option: Results from an observational study in a single private practice. Int J Oral Maxillofac Implants, 21: 769-776
Babbush, C.A., Kutsko, G.T., Brokloff, J. (2011) The All-on-Four Immediate Function Treatment Concept With NobelActive Implants: A Retrospective Study. Journal of Oral Implantology, 37(4): 431-445
Borcic, J., Braut, A. (2012) Finite element analysis in dental medicine. u: Ebrahimi F. [ur.] Finite element analysis: New trends and developments, InTech, 3-20
Brunski, J.B., Puleo, D.A., Nanci, A. (2000) Biomaterials and biomechanics of oral and maxillofacial implants: Current status and future developments. Int J Oral Maxillofac Implants, 15(1): 15-46
Das, N.F.D., Fones, D., Bernardes, S.R., Do, P.C.J., Neto, A.J. (2006) Short implants: An analysis of longitudinal studies. Journal of Prosthetic Dentistry, 96(4): 288-288
Devlin, H., Ferguson, M.W. (1991) Alveolar ridge resorption and mandibular atrophy: A review of the role of local and systemic factors. British Dental Journal, 170(3): 101-104
D’Souza, D., Dua, P. (2011) Rehabilitation strategies for partially edentulous-prosthodontic principles and current trends. Med J Armed Forces India, 67:296-298
Eraslan, O., Sevimay, M., Usumez, A., Eskitascioglu, G. (2005) Effects of cantilever design and material on stress distribution in fixed partial dentures: A finite element analysis. Journal of Oral Rehabilitation, 32(4): 273-278
Goené, R., Bianchesi, C., Hüerzeler, M., Del, L.R., Testori, T., Davarpanah, M., Jalbout, Z. (2005) Performance of Short Implants in Partial Restorations: 3-Year Follow-up of Osseotite® Implants. Implant Dentistry, 14(3): 274-280
Gultekin, B.A., Gultekin, P., Yalcin, S. (2012) Application of finite element analysis in implant dentistry. u: Ebrahimi F. [ur.] Finite element analysis: New trends and developments, InTech, 21-54
Hasan, I., Heinemann, F., Aitlahrach, M., Bourauel, C. (2010) Biomechanical finite element analysis of small diameter and short dental implant. Biomedizinische Technik / Biomedical Engineering, 55(6): 341-350
Holmes, D.C., Diaz-Arnold, A.M., Leary, J.M. (1996) Influence of post dimension on stress distribution in dentin. Journal of Prosthetic Dentistry, 75(2): 140-147
Holmgren, E.P., Seckinger, R.J., Kilgren, L.M., Mante, F. (1998) Evaluating Parameters of Osseointegrated Dental Implants Using Finite Element Analysis: A Two-Dimensional Comparative Study Examining the Effects of Implant Diameter, Implant Shape, and Load Direction. Journal of Oral Implantology, 24(2): 80-88
Horita, S., Sugiura, T., Yamamoto, K., Murakami, K., Imai, Y., Kirita, T. (2017) Biomechanical analysis of immediately loaded implants according to the ‘All-on-Four’ concept. Journal of Prosthodontic Research, 61(2): 123-132
Khatami, A.H., Smith, C.R. (2008) ‘All-on-Four’ Immediate Function Concept and Clinical Report of Treatment of an Edentulous Mandible with a Fixed Complete Denture and Milled Titanium Framework. Journal of Prosthodontics, 17(1):47-51
Klemetti, E. (1996) A review of residual ridge resorption and bone density. Journal of Prosthetic Dentistry, 75(5): 512-514
Knezović-Zlatarić, D., Čelebić, A., Lazić, B. (2002) Resorptive Changes of Maxillary and Mandibular Bone Structures in Removable Denture Wearers. Acta Stomatol Croat, 36: 261-265
Kourkouta, S., Dedi, K.D., Reside, G., Kontogeorgakos, V. (2009) Heterotropic ossification as a complication of iliac crest bone harvesting in a case of implant therapy. Int J Oral Maxillofac Implants, 24: 353-358
Kourtis, S., Madianos, P., Patras, M., Andrikopoulou, E. (2018) Rehabilitation of the edentulous mandible with implant-supported overdentures on telescopic abutments and immediate loading: A controlled prospective clinical study. Journal of Esthetic and Restorative Dentistry, 30(4): 369-377
Lopes, N., Oliveira, D.M., Vajgel, A., Pita, I., Bezerra, T., de Holanda, V.R.J. (2009) A New Approach for Reconstruction of a Severely Atrophic Mandible. Journal of Oral and Maxillofacial Surgery, 67(11): 2455-2459
Lozada, J.L., Al-Ardah, A.J., Rungcharassaeng, K., Kan, J.Y., Kleinman, A. (2004) Immediate Functional Load of Mandibular Implant Overdentures: A Surgical and Prosthodontic Rationale of 2 Implant Modalities. Journal of Oral Implantology, 30(5): 297-306
Malo, P., de Araújo, N.M., Lopes, A., Moss, S.M., Molina, G.J. (2011) A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. Journal of the American Dental Association, 142(3): 310-320
Maló, P., de Araújo, N.M., Petersson, U., Wigren, S. (2006) A Pilot Study of Complete Edentulous Rehabilitation with Immediate Function Using a New Implant Design: Case Series. Clinical Implant Dentistry and Related Research, 8(4): 223-232
Maló, P., Rangert, B., Nobre, M. (2003) ‘All-on-Four’ immediate-function concept with Brånemark System implants for completely edentulous mandibles: A retrospective clinical study. Clin Implant Dent Relat Res, 5 Suppl 1: 2-9
Maló, P., Friberg, B., Polizzi, G., Gualini, F., Vighagen, T., Rangert, B. (2003) Immediate and Early Function of Brånemark System® Implants Placed in the Esthetic Zone: A 1-Year Prospective Clinical Multicenter Study. Clinical Implant Dentistry and Related Research, 5: 37-46
Mohammed, S.D., Desai, H. (2014) Basic concepts of finite element analysis and its applications in dentistry: An overview. Oral Hyg Health, 2: 156-160
Motoyoshi, M., Ueno, S., Okazaki, K., Shimizu, N. (2009) Bone stress for a mini-implant close to the roots of adjacent teeth: 3D finite element analysis. International Journal of Oral and Maxillofacial Surgery, 38(4): 363-368
Naert, I., Koutsikakis, G., Quirynen, M., Duyck, J., van Steenberghe, D., Jacobs, R. (2002) Biologic outcome of implant-supported restorations in the treatment of partial edentulism: A longitudinal radiographic study. Clinical Oral Implants Research, Part 2, 13(4): 390-395
Neldam, C.A., Pinholt, E.M. (2012) State of the Art of Short Dental Implants: A Systematic Review of the Literature. Clinical Implant Dentistry and Related Research, 14(4): 622-632
Özdemir, D.D., Polat, N.T., Polat, S.T., Şeker, E., Gül, E.B. (2014) Evaluation of ‘All-on-Four’ Concept and Alternative Designs with 3D Finite Element Analysis Method. Clinical Implant Dentistry and Related Research, 16(4): 501-510
Pal, T.K. (2015) Fundamentals and history of implant dentistry. Journal of the International Clinical Dental Research Organization, 7(3): 6-12
Payne, A.G.T., Alsabeeha, N.H., Atieh, M.A., Esposito, M., Ma, S., Anas, E.M. (2018) Interventions for replacing missing teeth: Attachment systems for implant overdentures in edentulous jaws. Cochrane Database of Systematic Reviews, 11: 8001-8001
Ramoğlu, S., Ozan, O. (2014) Finite element methods in dentistry. J Dent Fac Atatürk Uni, 24: 175-180
Raviv, E., Turcotte, A., Harel-Raviv, M. (2010) Short dental implants in reduced alveolar bone height. Quintessence Int, 41: 575-579
Tepper, G., Haas, R., Zechner, W., Krach, W., Watzek, G. (2002) Three dimensional finite element analysis of implant stability in the atrophic posterior maxilla: A mathematical study of the sinus floor augmentation. Clin Oral Implants Res, 13: 657-665
Testori, T., Wiseman, L., Woolfe, S., Porter, S.S. (2001) A prospective multicenter clinical study of the Osseotite implant: Four-year interim report. Int J Oral Maxillofac Implants, 16(2): 193-200
Trivedi, S. (2014) Finite element analysis: A boon to dentistry. Journal of Oral Biology and Craniofacial Research, 4(3): 200-203
Balkan Journal of Dental Medicine, 2021, vol. 25, br. 1, str. 46-52