Stress Distribution in Bone and Implants in Mandibular 6-Implant-Supported Cantilevered Fixed Prosthesis

Padhye, Omkar; Herekar, Manisha; Patil, Viraj; Mulani, Shahnawaz; Sethi, Megha; Fernandes, Aquaviva

doi:10.1097/id.0000000000000300

Cited by 13 publications

(6 citation statements)

References 18 publications

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“…The properties used for the designing of the framework were of Co-Cr alloy because according to Padhye et al (2015) [ 6 ], the cancellous bone, cortical bone and titanium implants all bore the least amount of stress with the Co-Cr framework bearing the most. Clinical long-term studies on the use of polyetheretherketone (PEEK) as a fixed implant-supported full arch framework are rare.…”

Section: Discussionmentioning

confidence: 99%

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Mandibular Flexure and Crestal Bone Stress Distribution on an Implant-Supported Fixed Full Arch Mandibular Prosthesis: Finite Element Analysis in Three Dimensions

Sharma,

Jain,

Gupta

et al. 2023

Cureus

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Aim This study's objective was to assess and analyze, using 3D Finite Element Analysis, the impact of four mandibular complete arch superstructures on the distribution of stress in the crestal bone during mandibular flexure. Materials and methods Four Finite element models of the mandible with different implant-retained framework designs have been developed. Three of these models had six axial implants placed at intervals of 11.8 mm, 18.8 mm and 25.8 mm from the midline, respectively. One model had two tilted implants and four axial implants splinted with a single piece of framework at intervals of 8.4 mm, 13.4 mm and 18.4 mm from the midline. For analyzing the stress distribution, the finished product was transferred to ANSYS R 18.1 software (Sirsa, Haryana, India) for finite element simulation, the models were constructed, the ends were restrained, and bilateral vertical loads of 50N, 100N and 150N were applied to the distal part of the framework. Results Bilateral loads were applied to each of the four 3D FEM and after assessment of Von Mises Stress and Total Deformation, a finding was made that the model with six axial implants supported by a single piece of framework underwent the highest total deformation and the model with four axial implants and two implants with distal tilts displayed most significant Von Mises stress. Conclusion Within the constraints of this 3D FEA, it was determined that mandibular flexure and peri-implant bone stress were affected by the way the framework is divided and the nature of mandibular movement. The three types of frames with the least bone stress are demonstrated by the mandibular deformation that results from two-piece frameworks on axial implants. Regardless of the number of implants, the single framework splinted with six implants shows a flexure in mandible with the highest bone stress around the implant irrespective of the angulation of the implant. Clinical significance When it comes to edentulous jaws, reducing stress in implant-supported restorative systems at varying degrees of the bone and implant interfaces and superstructures of prosthetics is one of the fundamental goals of implant treatment. A framework with proper design and a low modulus of elasticity reduces mechanical risk. Additionally, a larger number of implants helps to prevent cantilevers and spacing between the implants.

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Section: Discussionmentioning

confidence: 99%

“…The cortical and cancellous bones were modelled to have bone of the D2-type elastic characteristics. The relevant elastic properties, such as Young's modulus (E) and Poisson's ratio (µ), were calculated utilizing the literature (Table 2 ) [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

Mandibular Flexure and Crestal Bone Stress Distribution on an Implant-Supported Fixed Full Arch Mandibular Prosthesis: Finite Element Analysis in Three Dimensions

Sharma,

Jain,

Gupta

et al. 2023

Cureus

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“…Excessive loads occur at the cantilever area when occlusal force is applied to the cantilevers 39 . Also Padhye et al 40 showed that greatest amount of stress was seen around the distal-most region of the distal-most implant when implants were used to support cantilevered fixed restorations in mandible. They added that when extension of the cantilever extended beyond 15 mm, this led to a greater stress in the lingual cortical plate, which could eventually compromise the integrity of the implants.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional marginal bone loss around implants supporting metal ceramic and metal acrylic screw retained hybrid prosthesis for rehabilitation of atrophied mandible. A cone beam radiographic study

Mohamed

Emarah

2020

Egyptian Dental Journal

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Purpose: This clinical trial aimed to evaluate three-dimensional marginal bone loss around implants supporting metal ceramic and metal acrylic screw retained hybrid prosthesis for rehabilitation of atrophied mandible using cone beam computerized tomography (CBCT) after one year. Materials and methods: Ten completely edentulous patients with mandibular ridge atrophy were randomly assigned into 2 groups; Group I; included 5 patients who received Metal ceramic screw retained hybrid prosthesis, Group II; included 5 patients who received Metal acrylic screw retained hybrid prosthesis. All patients then received 4 implants in the inter-foraminal area of the mandible using the flapless surgical approach. After osteointegration, implants were loaded by the prostheses with a distal cantilever not exceeding a 1.5 antro-posterior spread. Vertical and horizontal bone resorption was assessed at mesial, distal, buccal and lingual aspect of anterior and posterior implants using cone beam computed tomography (CBCT) at time of prosthesis insertion (baseline), 6 months and one year later. Results: After 6 and 12 months, metal ceramic prosthesis showed significant higher vertical and horizontal bone resorption than metal acrylic prosthesis for anterior and posterior implants. Posterior implants showed significant higher vertical and horizontal bone resorption than anterior implants for metal ceramic group only and no difference in bone loss between anterior and posterior implants in metal acrylic group was noted. For both groups and implant positions, vertical and horizontal bone resorption at 12 months significantly increased compared to 6 months Conclusion: Within the limitations of this study, metal acrylic cantilevered prosthesis for screw retained hybrid restoration of edentulous atrophied mandible may be recommended than metal ceramic prosthesis as it was associated with lesser vertical and horizontal bone resorption around the implants (especially the posterior ones) after one year follow up period.

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“…The greater the length of the cantilever, the greater the surface deformation of the bone around the distal implant [5,29]. So keep the length of the cantilever arm to a minimum [5,6,28,30,31] or elimination in the prescription to the dental technician in implantsupported prostheses should be addressed when possible [31]. However, the height of the posterior mandibular bone after tooth loss, and the anatomical position of the inferior alveolar nerve may compromise or even impair conventional implant placement.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Bone-implant Interfacial Stress during Disocclusion in Complete Implant-supported Prosthesis: A Finite Element Study

Greco¹,

Pereira

Miranda³

et al. 2017

BJMMR

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Stress Distribution in Bone and Implants in Mandibular 6-Implant-Supported Cantilevered Fixed Prosthesis

Cited by 13 publications

References 18 publications

Mandibular Flexure and Crestal Bone Stress Distribution on an Implant-Supported Fixed Full Arch Mandibular Prosthesis: Finite Element Analysis in Three Dimensions

Mandibular Flexure and Crestal Bone Stress Distribution on an Implant-Supported Fixed Full Arch Mandibular Prosthesis: Finite Element Analysis in Three Dimensions

Three-dimensional marginal bone loss around implants supporting metal ceramic and metal acrylic screw retained hybrid prosthesis for rehabilitation of atrophied mandible. A cone beam radiographic study

Analysis of Bone-implant Interfacial Stress during Disocclusion in Complete Implant-supported Prosthesis: A Finite Element Study

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