In Silico Mechanical Effort Analysis of the All-On-4 Design Performed With Platform-Switching Distal Short Dental Implants

Author(s)

Santana, Luis Carlos Leal ; Idogava, Henrique Takashi ; De Foggi, Camila Cristina ; Guastaldi, Fernando Pozzi Semeghini ; Noritomi, Pedro Yoshito ; dos Reis, Barbara Araujo ; Vaz, Luis Geraldo

• Document type: Journal article
• Source: JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME; v. 145, n. 9, p. 11-pg., 2023-09-01.

Abstract

Short dental implants with platform matching connection have been used for the rehabilitation of atrophic jaws whenever standard-length dental implants cannot be placed without prior bone augmentation. Yet, there remains a lack of data regarding the risk of technical failures when the all-on-4 configuration is performed in atrophic jaws with platform-switching distal short dental implants. Thus, the current study used the finite element method to evaluate the mechanical behavior at the level of the prosthetic components of the all-on-4 concept performed in atrophic mandible using short-length distal implants with platform switching (PSW) connection. Three models of the all-on-4 configuration were generated in human atrophic mandibles. The geometric models consisted of PSW connection tilted standard (AO4T; & theta; = 30 deg; 11 mm-length), straight standard (AO4S; & theta; = 0 deg; 11 mm-length) and straight short (AO4Sh; & theta; = 0 deg; 8 mm-length) distal implants. A resultant force of 300 N was performed obliquely in the left side and posterior region of the prosthetic bar. The von Mises equivalent stress (& sigma;(vm)) and maximum and minimum principal stresses (& sigma;(max) and & sigma;(min)) were performed at level of the prosthetic components/implants and peri-implant bone crest, respectively. The general displacement of the models was also evaluated. The stress analysis was performed on the side of load application. The AO4S configuration showed the lowest values of & sigma;(vm) in the mesial left (ML) and distal left (DL) abutments (37.53 MPa and 232.77 MPa, respectively) and dental implants (91.53 MPa and 231.21 MPa, respectively). The AO4Sh configuration showed the highest values of & sigma;(vm) in the bar screw (102.36 MPa), abutment (117.56 MPa), and dental implant (293.73 MPa) of the ML area. Among the models, the highest values of & sigma;(max) and & sigma;(min) were noticed in the peri-implant bone crest of the AO4T design (131.48 MPa and 195.31 MPa, respectively). All models showed similar values of general displacements, which were concentrated in the mandible symphysis. The all-on-4 configurations designed with PSW connection and tilted standard (AO4T; & theta; = 30 deg; 11 mm-length), straight standard (AO4S; & theta; = 0 deg; 11 mm-length) or straight short (AO4Sh; & theta; = 0 deg; 8 mm-length) distal implants were not associated with higher odds of technical failures. The AO4Sh design may be a promising option for the prosthetic rehabilitation of atrophic jaws. (AU)

• FAPESP's process: 14/16688-4 - Development and biological evaluation of a new calcium phosphate with and without fibrin sealant: an in vivo study in rabbits and in vitro study
• Grantee: Fernando Pozzi Semeghini Guastaldi
• Support Opportunities: Scholarships in Brazil - Post-Doctoral