Biomechanical comparison of four treatment models for the totally edentulous maxilla: a finite element analysis

Abstract

The aim of this study is to evaluate by finite element analysis different techniques of totally edentulous maxilla rehabilitation, considering implants, bone tissue, metallic infra-structure, and prosthetic abutments characteristics, by means of a three-dimensional model. Stress distribution on bone tissue, implants, and abutments was analyzed with four configurations (six implants axially installed, all-on-four technique, M-4 technique, and four conventional implants with two zygomatic implants). Greater tension on bone tissue were found around distal implants, in all treatment groups, but not exceeding resistance limits of cortical bone. Von Mises stress was higher on the distal region of distal implants of all-on-four and M-4 techniques. Higher stress concentration was seen on angled abutments of zygomatic implants. The highest values of minimal compression stresses were concentrated on peri implant-bone tissue, especially in the model of All-on-4. Therefore, the present finite element analysis revealed that the four configurations of treatment (six implants axially installed, all-on-four technique, M-4 technique, and four conventional implants with two zygomatic implants) for the totally edentulous maxilla are feasible and safe, from a biomechanical point of view.

Biomechanical Comparison of Asymmetric Implant Configurations for All-on-Four Treatment Using Three-Dimensional Finite Element Analysis

“…Although the exact stimulus for bone response is unknown, overload posed a risk of bone loss around the implants. Moreira de Melo et al stated that there may be a lower risk of peri-implant bone loss with the use of an implant with a larger (3.5 mm) rather than a narrower (2.9 mm) diameter [11]. The use of asymmetrically placed implants could be preferable to symmetrical but narrower implants.…”

“…In this respect, finite element analysis has been a widely accepted tool that can be used to gain insight into the biomechanical behavior of the analyzed structures, allowing for estimation of implant position, dimensions, and angulations to determine safe parameters for their clinical use in all-on-four treatments. In the literature, many studies used finite element analysis to examine the effect of changing implant positions, dimensions, and angulations on bone and prosthetic parts [2,4,[6][7][8][9][10][11][12].…”