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

Puneeth Hegde*, Shobha Rodrigues, Satish Shenoy, Tilak Shetty, Umesh Pai, Sharon Saldhana, M. Mahesh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)589-595
Number of pages7
JournalIndian Journal of Forensic Medicine and Toxicology
Volume14
Issue number3
Publication statusPublished - 01-07-2020

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Toxicology
  • Law
  • Health, Toxicology and Mutagenesis

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