Mandibular Flexure and Peri-Implant Bone Stress Distribution on an Implant-Supported Fixed Full-Arch Mandibular Prosthesis: 3D Finite Element Analysis

Abstract

Purpose The purpose of this study was to evaluate and compare the effect of three mandibular full-arch superstructures on the peri-implant bone stress distribution during mandibular flexure caused by mid-opening (27 mm) and protrusion mandibular movements. Materials and Methods Three-dimensional finite element models were created simulating six osseointegrated implants in the jawbone. One model simulated a 1-piece framework and the other simulated 2-piece and 3-piece frameworks. Muscle forces with definite direction and magnitude were exerted over areas of attachment to simulate multiple force vectors of masticatory muscles during mandibular protrusion and opening. Results During the movement of 27.5 mm jaw opening, the 1-piece and 3-piece superstructures showed the lowest values of bone stress around the mesial implants, gradually increasing towards the distal position. During the protrusion movement, bone stress increased compared to opening for any implant situation and for a divided or undivided framework. The 3-piece framework showed the highest values of peri-implant bone stress, regardless of the implant situation. Conclusions The undivided framework provides the best biomechanical environment during mandibular protrusion and opening. Protrusion movement increases the peri-implant bone stress. The most mesial implants have the lowest biomechanical risk.

Terminal dentition to functional esthetic full-mouth implant reconstruction: Evidence-based approach

“…Recently, Martin-Fernandez et al . [ 10 ] stated that the framework in a single piece exhibits a better biomechanical environment with lesser bone peri-implant stress for all implant locations. This result supports the theory that rigid splinting of complete mandibular arch can provide additional resistance, thus counteracting the flexure.…”

The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis

“…The primary aim of implant-supported fixed restorations is to achieve optimal biomechanical distribution both at the level of the prosthetic superstructure and implant ( Martin-Fernandez et al, 2018 ). In this study, the elastic flexion of the mandible is limited by the presence of a full-arch structure that rigidly connects the implants (0.47 and 0.57 in models 1, 4, and 7, respectively), while the division of the framework into separate bridges restores more natural flexibility (over 0.85) ( Fischman, 1976 ; Fischman, 1990 ; Hobkirk and Havthoulas, 1998 ).…”

“…Eight different 3D models were analyzed ( Figure 2 ; Table 3 ). The tetrahedral mesh was used for the mandible and the prosthesis, which can refine the mesh of complex areas and meet the basic requirements of static analysis ( Martin-Fernandez et al, 2018 ). The maximum mesh size and growth rate were 0.0018 m and 1.85, respectively.…”

“…For the design of implant-fixed dentures in the edentulous jaws, there are still a lot of controversies. Martin-fernandez et al (2018) concluded that an integrated superstructure provides an optimal biomechanical environment under different loading conditions. However, others advocated that ( Zarone et al, 2003 ) segmented superstructures did not restrict the physiological bending of the mandible, instead a more precise passive emplacement of the implant could be achieved.…”

A three-dimensional finite element analysis of Aramany class I obturator fabricated with different alloys

“…The location, shape, and size of the defect have a large impact on the retention and stability of the final prosthesis, and loss of the supporting and limiting structures also has a detrimental effect on the prognosis of the prosthetic treatment rendered. [56]…”