Comparison of Stress Patterns in Edentulous Mandibular Bone Around Two Implant Retained, Four Implant Retained Overdenture and All-On-Four Concept-A 3 Dimensional Finite Element Analysis Hegde Puneeth1,*, Rodrigues Shobha2, Shenoy Satish3, Shetty Tilak4, Pai Umesh5, Saldhana Sharon5, Mahesh M.5 1Associate Professor, Department of Prosthodontics and Crown & Bridge, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal 2Professor & Head, Department of Prosthodontics and Crown & Bridge, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal 3Professor & Head, Department of Aeronautical and Automobile Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal 4Professor, Department of Prosthodontics and Crown & Bridge, Manipal College of Dental Sciences, Mangalore. Manipal Academy of Higher Education, Manipal 5Associate Professor, Department of Prosthodontics and Crown & Bridge, Manipal College of Dental Sciences, Manipal *Correspondng Author: Dr. Puneeth Hegde Associate Professor, Department of Prosthodontics and Crown & Bridge, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India. Light House Hill Road, Hampankatta, Mangalore-575001, India
Online published on 27 November, 2019. Abstract Recently the use of tilted implants has been considered as a preferable option in case of atrophic edentulous arches. The tilted longer implants can be of use to ward off the important anatomical structures while also permitting cantilever reduction. Since the load transfer mechanism of an implant can be altered significantly by the number of implants and its location in the edentulous ridge, the present study evaluates and compares the stress patterns in the edentulous mandibular bone around two implant retained, four implant retained over denture and all on four concepts under different loading conditions using finite element analysis. Purpose The biomechanical behaviour of the ‘All-On-Four’ system was compared with that of the two-implant-supported and four-implant supported mandibular overdenture using the three dimensional finite element method (FEM). Thereby evaluating the von Misses stresses induced on the implants under different loading simulations. Materials & Method Three dimensional models representing mandible restored with ‘All-On-Four’, two-implant-supported and four-implant-supported prosthesis were developed in the three dimensional design software and then transferred into FEM software. The models were then subjected to four different loading simulations (full mouth biting, canine disclusion, load on cantilever, load in the absence of cantilever). The maximum von Mises stresses were localized and quantified for comparison.1 Results Among the three models, under all loading simulations, the maximum stress concentrations were along the neck of the implant. The stress levels for full mouth loading simulation was highest for two implant supported overdenture design and the least for All-On-Four overdenture design. In all three designs, the least stress was when the implants were loaded in a lateral direction. The stress levels for cantilever and non-cantilevered designs were nearly the same for all the simulated designs. Conclusion When tested under different loading simulations, the three models showed similar location and distribution of stress patterns. Thus from the study it can be concluded that the All-On-Four Concept is a clinically applicable treatment option for the atrophic edentulous ridges and induces least amount of stresses on the edentulous ridges. Therefore the overall longevity of the prosthesis is greatly enhanced. Top Keywords Atrophic mandible, biomechanics, finite element analysis, implants supported prosthesis, tilted implants. Top |