The Effects of Frontal Trauma on 4 Interforaminal Dental Implants: A 3-Dimensional Finite Element Analysis Comparing Splinted and Unsplinted Implant Configurations

Edentulous mandible with four splinted interforaminal implants exposed to three different situations of trauma: A preliminary three‐dimensional finite element analysis

“…Thus, the initial hypothesis that the site of direct force application will also represent the site of the increased fracture risk has been confirmed again and the characteristics of an edentulous mandible without implants may thus also be used for edentulous mandibles with four interforaminal implants. 23,43,48 In accordance with previous findings of de Santos et al, 23 the results showed that a direct force application in the region of the mental foramen and in the region of the mandibular angle will invariably induce increased stress levels in the edentulous mandible with or without implants and be associated with an increased fracture risk in these regions. [42][43][44] As a striking feature, the area of particular risk in the case of a frontal application of force is shifted away from the symphyseal region toward the region of the mental foramen.…”

“…The kinetic energy of the trauma will be absorbed by the implant splinting and transmitted into the mandibular neck to a reduced extent. 21,23,48 Therefore, the stress level reduction found in the area of the mandibular neck may also indicate a reduction of the fracture risk for the mandibular neck. 48 It was interesting to note that at sites without external splinting, a direct force impact will still be associated with increased stress levels and an increased risk of fracture.…”

“…21,23,48 Therefore, the stress level reduction found in the area of the mandibular neck may also indicate a reduction of the fracture risk for the mandibular neck. 48 It was interesting to note that at sites without external splinting, a direct force impact will still be associated with increased stress levels and an increased risk of fracture. 23,47 Anterior implant splinting appears to have no effect on the force impact in the region of the mandibular body or the mandibular angle on account of the remote location of the external stabilization.…”

“…23,43,44 Thus, regardless of the site of the force application, it is especially the region of the mental foramen-in addition to the mandibular neck-that must be considered as a predominant risk area and as predilectional site of fracture. 44,48 Changes of fracture pattern and relocation of potential injuries to sites allowing for better surgical access and/or facilitated treatment procedures suggest specific advantages for both clinicians and patients. [48][49][50] Reducing the risk for condylar neck fracture with symphyseal frontal trauma application by splinted four interforaminal implants is also of clinical significance considering that condylar neck fractures will frequently require greater efforts for surgical interventions, recovery, and postoperative care.…”

“…44,48 Changes of fracture pattern and relocation of potential injuries to sites allowing for better surgical access and/or facilitated treatment procedures suggest specific advantages for both clinicians and patients. [48][49][50] Reducing the risk for condylar neck fracture with symphyseal frontal trauma application by splinted four interforaminal implants is also of clinical significance considering that condylar neck fractures will frequently require greater efforts for surgical interventions, recovery, and postoperative care. [20][21][22][23]47,51,52 Considering the limitations of the study, it must be pointed out that the present study had an experimental design that represented only changes in the objects being evaluated.…”