Biomechanical evaluation of hindraft implant anglulation in total implant-supported mandible rehabilitations through finite element method

Authors

  • Bruno Salles Sotto-Maior Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade Federal de Juiz de Fora
  • Breno Nogueira Silva Departamento de Cirurgia Oral e Maxilofacial , Faculdade de Odontologia, Universidade Federal de Juiz de Fora
  • Patrícia Zagoto Figueredo Instituto de Pesquisas São Leopoldo Mandic, Faculdade São Leopoldo Mandic, Área de Implantodontia, Campinas
  • Lucas Henriques Rosa Departamento de Pós-graduação, Faculdade de Odontologia, Universidade Federal de Juiz de Fora
  • Mateus Antunes Ribeiro Departamento de Pós-graduação, Faculdade de Odontologia, Universidade Federal de Juiz de Fora
  • Lucas Lactim Ferrarez Departamento de Pós-graduação, Faculdade de Odontologia, Universidade Federal de Juiz de Fora
  • Neuza Maria Souza Picorelli Assis Departamento de Cirurgia Oral e Maxilofacial , Faculdade de Odontologia, Universidade Federal de Juiz de Fora

DOI:

https://doi.org/10.34019/1982-8047.2019.v45.28675

Keywords:

Dental Implantation, Mandible, Mouth Rehabilitation

Abstract

Introduction: As a treatment option for mandibular edentulism, the All-on-4® concept was developed, an anchoring technique with the installation of four implants distributed in the anterior region of the edentulous mandible for total implant-supported rehabilitation. Objective: In this study, we analyzed by the finite element method the biomechanical behavior of implants and bone tissues. Material and methods: Three computerized three-dimensional models were used, each with 4 external hexagon 3.75x13mm implants in the mental interforam region, the anterior implants kept in the axial position and the variation occurred in the posterior implants: group 1, straight posterior implants; group 2, posterior implants inclined at 17° and group 3, posterior implants inclined at 30°. An axial load of 150 N was applied to the molars and 100 N to the premolars bilaterally. Results: After analysis, it was found that in the 17° (13.68Mpa, 34.76Mpa and 14.36Mpa groups for tensile, compressive and shear stresses respectively) and 30 ° (14.26Mpa, 23.14Mpa and 10.31Mpa for tensile, compressive and shear stresses respectively) presented lower stress peaks in the bone. The same pattern of stress distribution was observed for the implants, with reduction when the distal implants were tilted. Conclusion: The results showed that the angulation of the implants favored the distribution of stresses in the bone and implants, positively interfering in the biomechanical performance of the total implant-supported rehabilitations in edentulous jaws, considering that in the group of straight implants the stress values ​​were higher.

Downloads

Download data is not yet available.

References

Agliard E, Panigatti S, Clericò M, Villa C, Malò P. Immediate rehabilitation of the edentulous jaws whit full fixed protheses suportede by four implants: interim results of a single cohort prospective study. Clin Oral Implants Res. 2010; 21:459-65.

Branemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O et al. Osseointegrated implants in the treatment of the edentulous jaw: experience from a 10-year period. Scand J Plast Reconstr Surg Suppl. 1977; 16:1-132.

Francischone CE. Osseointegração na clínica multidisciplinar: estética e longevidade. Quintessence. 2016; 305-12.

Maló P, Nobre MA, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011; 142(3):310-20.

Maló P, Rangert B, Nobre M. "All-on-four" immediate-function concept with Brånemark System implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res. 2003; 5(1):2-9.

Zampelis A, Rangert B, Heijl L. Tilting of splinted implants for improved prosthodontic support: a two-dimensional finite element analysis. J Prosthet Dent. 2008; 99(3):169-72.

Maló P, Rangert B, Nobre M. All-on-4 immediate-function concept with Brånemark System implants for completely edentulous maxillae: a 1-year retrospective clinical study. Clin Implant Dent Relat Res. 2005; 7(1):88-94.

Isidor F. Loss of osseointegration caused by occlusal load of oral implants: a clinical and radiographic study in monkeys. Clin Oral Implants Res. 1996; 7(2):143-52.

Silva GCC, Fraga MT, Mendonça JAG. Adaptação passiva de próteses implantosuportadas: relação com indução de tensões e importância clínica. Implant News. 2008; 5(4):393-97.

Naini RB, Nokar S, Borghei H, Alikhasi M. Tilted or parallel implant placement in the completely edentulous mandible? A three-dimensional finite element analysis. Int J Oral Maxillofac Implants. 2011; 26:776-81.

Bayraktar HH, Morgan EF, Niebur GL, Morris GE, Wong EK, Keaveny TM. Comparison of the elastic and yield properties of human femoral trabecular and cortical bone tissue. J Biomech. 2004; 37(1):27-35.

MatWeb: Material Property Data. Dados do Titânio - CAS Number: 7440-32-6. 1996- [citado em 2019 Sep 30]. Disponível em: http://www.matweb.com/index.aspx

Carvalho WK. Efeito da angulação dos implantes e conexão protética em abordagens sem enxertia para a reabilitação de maxila atrófica: uma análise pelo método dos elementos finitos[tese]. Campinas: Centro de Pesquisas Odontológicas São Leopoldo Mandic; 2017.

Jensen OT, Adams MW, Cottam JR, Parel SM, Phillips WR 3rd. The All On 4 shelf: mandible. J Oral Maxillofac Surg. 2011; 69:175-81.

Butura CC, Galindo D, Jensen O. Mandibular All-on-four therapy using angled implants: a three- year clinical study of 857 implants in 219 jaws. Clin Implant Dent Relat Res. 2011; 55:795-811.

Francetti L, Romeo D, Corbella S, Taschieri S, Del Fabbro M. Bone level changes around axial and tilted implants in full-arch fixed immediate restorations. Interim results of a prospective study. Clin Implant Dent Relat Res. 2012; 14(5):646-54.

Francetti L, Agliardi E, Testori T, Romeo D, Taschieri S, Del Fabbro M. Immediate rehabilitation of the mandible with fixed full prosthesis supported by axial and tilted implants: interim results of a single cohort prospective study. Clin Implant Dent Relat. 2008; 10(4):255-63.

Fazi G, Tellini S, Vangi D, Branchi R. Three-dimensional finite element analysis of different implant configurations for a mandibular fixed prosthesis. Int J Oral Maxillofac Implants. 2011; 26(4):752-9.

Bevilacqua M, Tealdo T, Menini M, Pera F, Mossolov A, Drago C et al. The influence of cantilever length and implant inclination on stress distribution in maxillary implantsupported fixed dentures. J Prosthet Dent. 2011; 105(1):5-13.

Duyck J, van Oosterwyck H, Vander Sloten J, Cooman M, Puers R, Naert I. Magnitude and distribution of occlusal forces on oral implants supporting fixed prostheses: an in vivo study. Clin Oral Implants Res. 2000; 11(5):465-75.

Malhotra AO, Padmanabhan TV, Mohamed K, Natarajan S, Elavia U. Load transfer in tilted implants with varying cantilever lengths in an All-on-four situation. Aust Dent J. 2012; 57(4):440-5

Baggi L, Cappelloni I, Di Girolamo M, Maceri F, Vairo G. The influence of implant diameter and length on stress distribution of osseointegrated implants related to crestal bone geometry: a three-dimensional finite element analysis. J Prosthet Dent. 2008; 100(6):422-31

Kim YK, Kim SG, Park JY, Yi YJ, Bae JH. Comparison of clinical outcomes of sinus bone graft with simultaneous implant placement: 4-month and 6-month final prosthetic loading. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111(2):164-9.

Anitua E, Tapia R, Luzuriaga F, Orive G. Influence of implant length, diameter, and geometry on stress distribution: a finite element analysis. Int J Periodontics Restorative Dent. 2010; 30(1):89-95.

Jensen OT, Adams MW. All-on-4 Treatment of highly atrophic mandible with mandibular V-4: report of 2 cases. J Oral Maxillofac Surg. 2009; 67:1503-9.

Maló P, Nobre MA, Lopes A, Francischone C, Rigolizzo M. “All-on-4” immediate-function concept for completely edentulous maxillae: a clinical report on the medium (3 years) and long-term (5 years) outcomes. Clin Implant Dent Relat Res. 2012; 14(1):139-50.

Maló P, Nobre M De, Lopes A. Immediate loading of “All-on-4” maxillary prostheses using trans-sinus tilted implants without sinus bone grafting: a retrospective study reporting the 3-year outcome. Eur J Oral Implantol. 2013; 6(3):273–83.

Fortin Y, Sullivan RM. Terminal posterior tilted implants planned as a sinus graft alternative for fixed full-arch implant-supported maxillary restoration: a case series with 10- to 19-Year results on 44 consecutive patients presenting for routine maintenance. Clin Implant Dent Relat Res. 2016; 56–68.

Soto-Penaloza D, Zaragozi-Alonso R, Penarrocha-Diago M, Penarrocha-Diago M. The All-on-four treatment concept: systematic review. J Clin Exp Dent. 2017; 9(3):474-88.

Zheng X, Li X, Tang Z, Gong L, Wang D. Effect of the number and inclination of implant on stress distribution for mandibular full-arch fixed prosthesis. J Prosthet Dent. 2014; 49(6):339-42.

Aparicio C, Perales P, Rangert B. Tilted implants as an alternative to maxillary sinus grafting: a clinical, radiologic, and periotest study. Clin Implant Dent Relat Res. 2001; 3(1):39-49.

Del Fabro M, Testori T, Francetti L, Weinstein RL. Systematic review of survival rates for implants placed in grafted maxillary sinus. Int J Periodont Restor Dent. 2004; 24:565–77.

Capelli M, Zuffetti F, Fabbro MD, Testori T. Immediate rehabilitation of the completely edentulous jaw with fixed prostheses supported by either upright or tilted implants: a multicenter clinical study. Int J Oral Maxillofac Implants. 2007; 22(4):639-64.

Fortin T, Isidori M, Bouchet H. Placement of maxillary implants in partially edentulous patients with severe bone deficiency using CAD/CAN guidance to avoid sinus grafting: a clinical report of procedure. Int J Oral Maxillofac Implants. 2009; 24(1):96-102.

Bateli M, Woemer W. Tilted implants to support a maxillary removable dental prosthesis: a case report. Quintessence Int. 2012; 43(3):191-5.

Crespi R, Vinci R, Capaaré P, Romanos G, Gherlone E. A clinical study of edentulous patients rehabilitated according to the “All-on-four” immediate function protocol. Int J Oral Maxillofac Implants. 2012; 27(2):428-34.

Aparicio C, Weber H. Biomechanical aspects of two different implant-prosthetic concepts for edentulous maxillae. Int J Oral Maxillofac Implants. 2002; 10(2):188-98.

Testori T, Del Fabbro M, Capelli M, Zuffetti F, Francetti L, Weinstein RL. Immediate occlusal loading and tilted implants for the rehabilitation of the atrophic edentulous maxilla: 1-year interim results of a multicenter prospective study. J Prosthet Dent. 2008; 99(3):167.

Agliard EL, Francetti L, Romeo D, Deo Fabro M. Immediate loading in the fully edentulous maxilla without bone grafting: the V-II-V technique. Minerva Stomatol. 2008; 57(5):259-63.

Hinze M, Thalmair T, Bolz W, Wachtel H. Immediate loading of fixed provisional prostheses using four implants for the rehabilitation of the edentulous arch: a prospective clinical study. Int J Oral Maxillofac Implants. 2010; 25(5):1011-8.

Peñarrocha M, Carrillo C, Boronat A, Peñarrocha M. Maximum use of the anterior maxillary buttress in severe maxillary atrophy with tilted, palatally positioned implants: a preliminary study. Int J Oral Maxillofac Implants. 2010; 25:813-20.

Peñarrocha-Oltra D, Ata-Ali J, Candel-Marti ME, Peñarrocha-Diago MA. Oral rehabilitation with tilted dental implants: a metaanalysis. Med Oral Patol Oral Cir Bucal. 2012.

Takahashi T, Shimamura I, Sakurai K. Influence of number and inclination angle of implants on stress distribution in mandibular cortical bone with All-on-4 Concept. J Prosthodont Res. 2010; 54(4):179-84.

Downloads

Published

2019-11-28

How to Cite

1.
Sotto-Maior BS, Nogueira Silva B, Zagoto Figueredo P, Henriques Rosa L, Antunes Ribeiro M, Lactim Ferrarez L, Souza Picorelli Assis NM. Biomechanical evaluation of hindraft implant anglulation in total implant-supported mandible rehabilitations through finite element method. HU Rev [Internet]. 2019Nov.28 [cited 2024Jul.17];45(3):244-53. Available from: https://periodicos.ufjf.br/index.php/hurevista/article/view/28675

Issue

Vol. 45 No. 3 (2019): HU Revista 45 anos - Edição Comemorativa

Section

Artigos Originais

License

Cessão de Primeira Publicação à HU Revista

Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.

 

 

Most read articles by the same author(s)