Avaliação biomecânica de implantes curtos para suporte de próteses totais fixas em mandíbulas atróficas

Author(s)

Marcele Jardim Pimentel

• Document type: Doctoral Thesis
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2014-05-16

Examining board members

Altair Antoninha Del Bel Cury; Plinio Mendes Senna; Hugo Lemes Carlo; Karina Gonzales Silverio; Lourenço Correr Sobrinho

• Advisor: Altair Antoninha Del Bel Cury

Abstract

The aim of this study was to evaluate the biomechanical behavior of short implants to support fixed prostheses in atrophic mandible, and assess the influence of prosthesis-implant ratio in this behavior. For this, an "in vitro " study by photoelasticity method, and an "in silico" test, with the aid of software SolidWorks Premium 2013® and Ansys Workbench ® 14.0 for Finite Element Analysis, were conducted. The groups were divided according to the length (11.0, 9.0, 7.0 e 5.0mm) and diameter of the implants (conventional - Ci with 4.0 mm or wide - Wi with 5.0 mm) the groups division was: Ci9 (9.0x4.0mm), Ci7 (7.0x4.0mm ), Ci5 (5.0x4.0mm ), Wi9 (9.0x5.0mm ), Wi7 (7.0x5.0mm ) and Wi5 (5.0x5.0mm ) that was compared to CG (11.0x4.0mm). The influence of prosthesis-implant ratio was analyzed at four levels: 1.2:1; 1.7:1; 2.5:1 and 4.0:1. The models are made representing the anterior section of the mandible, with four cone Morse tape implants and prosthetic components (abutment, bar, retaining screw and dentures - when applicable). The cantilever extension (15mm) was equal for all groups, in both experiments. The load was applied at the end of the cantilever. For the "in vitro" study the shear stress was obtained in 5 peri-implant points around the distal (load side) and the subsequent implant using Fringes® software (load of 0.15 kgf). For the " in silico " test the Maximum Principal Stress was obtained for bone and von Mises stress for implants and prosthetic components using the Ansys Workbench® software (load 100N). The results showed that there is a greater transmission of stress to peri-implant area when smaller implants are used. Implants 5mm long showed different biomechanical behavior when compared to other groups, with higher levels of stress to the bone and implants. Implants with larger diameter decrease the stress in the bone tissue, increasing levels of stress on the prosthetic components. Short implants are responsible for the increase of the stress values in retention screws. The prosthesis-implant ratio favors the increase of stress concentration in the cortical bone, especially for extreme prosthesis-implant ratio (4:1/20:5 mm). Was conclude that despite the increased tension around the implants and prosthetic screws short implants represent an option for rehabilitation of atrophic jaws in order to eliminate grafting procedures, especially when associated with large-diameter implants, except for 5mm implants associated to extreme P:I ratio (AU)

• FAPESP's process: 11/21877-2 - Biomechanical evaluation of fixed protheses in atrophic jaws
• Grantee: Marcele Jardim Pimentel
• Support Opportunities: Scholarships in Brazil - Doctorate