Lingualized occlusion revisited

Purpose The aim of this study was to evaluate stress distributions on implants and alveolar bone due to occlusal load produced during chewing by prostheses prepared according to the All‐on‐Four concept with different occlusal schemes using a finite element analysis method. Materials and Methods On standard jaw models, teeth were set in accordance with the basic standards of canine‐guided occlusion, group function occlusion, bilateral balanced occlusion (BBO), lingualized occlusion, and monoplane occlusion schemes. Three‐dimensional (3D) images of these models were obtained using a surface scanner. Implants, superstructures, the maxilla, and mandible were modeled in the All‐on‐Four concept with 3D modeling software. Forces were defined on contacts formed in maximum intercuspation, lateral, and protrusive movement position for all 5 occlusion types. Stress outputs were recorded as maximum and minimum principal stresses (Pmax, Pmin) and von Mises stress values for the implants. Results The highest Pmax value for the maxilla was observed in cortical bone in the group function occlusion during lateral movement (15.56 MPa). For the mandible, the highest Pmax value was observed on the cortical bone in maximum intercuspation of lingualized occlusion (72.75 MPa). The highest Pmin value for the maxilla was observed during the lateral movement in group function and for the mandible in BBO (–29.23 and –86.31 MPa, respectively). The lowest stress values were observed with canine‐guided occlusion in all related conditions and on all structures. Conclusions With the limitations of this simulation study, considering stresses on alveolar bone and implants in All‐on‐Four applications, the use of canine‐guided occlusion may be suggested.

Section: Discussionmentioning

confidence: 99%

“…Therefore, second molar teeth were not included in tooth settings. For each of the occlusal concepts, occlusal scheme and cuspal contacts were established in accordance with the standards expressed in the literature . After wax modeling, all models were made ready for 3D scanning.…”

Section: Methodsmentioning

confidence: 99%

Finite Element Stress Analysis of Applied Forces to Implants and Supporting Tissues Using the “All‐on‐Four” Concept with Different Occlusal Schemes

Türker¹,

Büyükkaplan²,

Sadowsky

et al. 2018

“…Conversely, this design configuration is one of the main causes for cheek and/or tongue biting. Remarkably, there is limited literature available addressing this problem . A cross‐bite solution with its inherent transversal overbite of opposing cusps does not only reduce the risk for biting the adjacent mucosal tissues but also avoids an overcontoured fixed restoration that in turn would promote plaque accumulation and potentially lead to peri‐implant diseases (Fig D).…”

Section: Discussionmentioning

confidence: 99%

“…Remarkably, there is limited literature available addressing this problem. [15][16][17] A cross-bite solution with its inherent transversal overbite of opposing cusps does not only reduce the risk for biting the adjacent mucosal tissues but also avoids an overcontoured fixed restoration that in turn would promote plaque accumulation and potentially lead to peri-implant diseases (Fig 2D). Acute and chronic oral lesions are frequently developed after oral mucosal biting/chewing, known as morsicatio buccarum.…”

Section: Discussionmentioning

confidence: 99%

Prevention and Management of Cheek and/or Tongue Biting Related to Posterior Implant‐Supported Fixed Dental Prostheses (ISFDPs)

Afrashtehfar

Belser

2018

After the loss of several adjacent posterior teeth, bone resorption occurs that can lead to a marked occlusal discrepancy between arches. This discrepancy may originate from the more pronounced resorption at the facial portion of the alveolar bone crest, often resulting in a more palatal implant position. Therefore, establishing normal overbite and cusp-fossa relation may become difficult, namely causing inappropriate crown contours and emergence profiles. This manuscript describes a technique in which a different occlusal configuration is given to solve some problems that edge-to-edge occlusal configuration produces. For instance, patients may suffer from cheek and/or tongue biting after the delivery of a maxillary posterior implant-supported fixed dental prosthesis resulting in an edge-to-edge occlusal configuration. In instances of severe maxillary resorption in the posterior buccal zone, it is recommended to consider a distinct cross-bite occlusion and by this prevent the well-known discomfort and clinical signs associated with both an edge-to-edge interarch relationship or a so-called "stretched" transversal overbite.

“…It is important to consider a combination of axial and horizontal load on the assumption that an in vivo load of an overdenture prosthesis occurs in two directions, the horizontal force being approximately 50% of the axial force oriented either in a buccolingual or mesiodistal direction 14 . The load applied in this study was 35 N 15 directed axially 0° to the long axis of support at four areas selected with seven nodes included in the –z direction (Fig 6) (5 N on each node), following the concept of lingualized occlusion, 16 while a load of 17.5 N was applied in a horizontal direction parallel to the ±x ‐ axis on the same nodes selected for load applied in the z direction (2.5 N on each node).…”

Section: Methodsmentioning

confidence: 99%

A Three‐Dimensional Finite Element Analysis for Overdenture Attachments Supported by Teeth and/or Mini Dental Implants

Fatalla

Song

et al. 2012