Effect of implant number and height on the biomechanics of full arch prosthesis

  • João Paulo Mendes Tribst
  • Amanda Maria de Oliveira Dal Piva
  • Alexandre Luiz Souto Borges
  • Marco Antonio Bottino

Abstract




Aim: The goal of this study was to clarify the stress distribution in a full arch prosthesis according to the implant number and height in order to guide the clinical choice during planning.Methods: A computational analysis was performed to analyze the stress distribution in implants and bone tissue according to implant number (3, 4 or 5) and height (5, 8, 11 mm). A model of a jaw with polyurethane properties to simulate bone tissue was created through the Rhinoceros software (version 5.0 SR8, McNeel North America, Seattle, WA, USA). The titaniumbar was fixed to the implant through a retention screw. The final geometry was exported in STEP format to ANSYS (ANSYS 15.0, ANSYS Inc., Houston, USA) and all materialswere considered homogeneous, isotropic and linearly elastic. To assess distribution of stress forces, an axial load (200 N) was applied on the cantilever. Results in Von-Mises stress and strain criteria’s were obtained for implants and bone, respectively. Qualitative and quantitative evaluations were performed. Results: The implant number and heightinfluenced the prosthesis biomechanics, with more von-Mises stress and bone strain concentration for combination of 3 implants with 5 mm. Conclusion: It was concluded that higer length and more quantity of implant supporting a full arch prosthesis promoted less stress concentration during the simulated load. Decreasing the number of implants in rehabilitation is more harmful than decreasing their length for the stress and strain distribution.




References

1. Fu JH, Oh TJ, Benavides E, Rudek I, Wang HL. A randomized clinical trial evaluating the efficacy of the sandwich bone augmentation technique in increasing buccal bone thickness during implant placement surgery: I. Clinical and radiographic parameters. Clin Oral Implants Res. 2014 Apr;25(4):458-67. doi: 10.1111/clr.12171.
2. Rivaldo EG, Montagner A, Nary H, da Fontoura Frasca LC, Branemark PI. Assessment of rehabilitation in edentulous patients treated with an immediately loaded complete fixed mandibular prosthesis supported by three implants. Int J Oral Maxillofac Implants. 2012 May-Jun;27(3):695-702.
3. Silva-Neto JP, Pimentel MJ, Neves FD, Consani RL, Santos MB. Stress analysis of different configurations of 3 implants to support a fixed prosthesis in an edentulous jaw. Braz Oral Res. 2014;28:67-73.
4. Niedermaier R, Stelzle F, Riemann M, Bolz W, Schuh P, Wachtel H. Implant-supported immediately loaded fixed full-arch dentures: evaluation of implant survival rates in a case cohort of up to 7 years. Clin Implant Dent Relat Res. 2017;19(1):4-19.
5. 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]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2014 Jun;49(6):339-42. Chinese.
6. Yamaguchi S, Yamanishi Y, Machado LS, Matsumoto S, Tovar N, Coelho PG et al. In vitro fatigue tests and in silico finite element analysis of dental implants with different fixture/abutment joint types using computer-aided design models. J Prosthodont Res. 2010;62(1):24-30.
7. Tribst JPM, Morais DC, Alonso AA, Dal Piva AMO, Borges ALS. Comparative three-dimensional finite element analysis of implant-supported fixed complete arch mandibular prostheses in two materials. J Indian Prosthodont Soc. 2017;17(3):255-60.
8. Trakas T, Michalakis K, Kang K, Hirayama H. Attachment systems for implant retained overdentures. J Implant Dent. 2006 Mar;15(1):24-34.
9. Lad SE, Daegling DJ, McGraw WS. Bone remodeling is reduced in high stress regions of the cercopithecoid mandible. Am J Phys Anthropol. 2016 Nov;161(3):426-435. doi: 10.1002/ajpa.23041.
10. Tribst JPM, Dal Piva AMO, Rodrigues VA, Borges ALS, Nishioka RS. Stress and strain distributions on short implants with two different prosthetic connections – an in vitro and in silico analysis. Braz Dent Sci. 2017;20(3):101-9.
11. Himmlová L, Dostálová T, Kácovský A, Konvicková S. Influence of implant length and diameter on stress distribution: a finite element analysis. J Prosthet Dent. 2004 Jan;91(1):20-5.
12. Dimililer G, Kücükkurt S, Cetiner S. Biomechanical effects of implant number and diameter on stress distributions in maxillary implant-supported overdentures. J Prosthet Dent. 2018 Feb;119(2):244-9.
13. Yoda N, Sun J, Matsudate Y, Hong G, Kawata T, Sasaki K. Effect of configurations of implants supporting a four-unit fixed partial denture on loading distribution. Int J Prosthodont. 2017;30(1):68-70.
14. Yang TC, Chen YC, Wang TM, Lin LD. Influence of implant number and location on strain around an implant combined with force transferred to the palate in maxillary overdentures. Int J Prosthodont. 2017;30(3):286-8.
15. Gümrükçü Z, Korkmaz YT. Influence of implant number, length, and tilting degree on stress distribution in atrophic maxilla: a finite element study. Med Biol Eng Comput. 2018 Jun;56(6):979-989. doi: 10.1007/s11517-017-1737-4.
16. Tribst JPM, Dal Piva AMO, Borges ALS. Biomechanical tools to study dental implants: literature review. Braz Dent Sci. 2016;19(4):5-11.
17. Tribst JPM, Dal Piva AMO, Shibli JA, Borges ALS, Tango RN. Influence of implantoplasty on stress distribution of exposed implants at different bone insertion levels. Braz Oral Res. 2017 Dec 7;31:e96. doi: 10.1590/1807-3107bor-2017.vol31.0096.
18. Danza M, Palmieri A, Farinella F, Brunelli G, Carinci F, Girardi A, et al. Three dimensional finite element analysis to detect stress distribution in spiral implants and surrounding bone. Dent Res J (Isfahan). 2009 Fall;6(2):59-64.
19. Souza AC, Xavier TA, Platt JA, Borges AL. Effect of base and inlay restorative material on the stress distribution and fracture resistance of weakened premolars. Oper Dent. 2015 Jul-Aug;40(4):E158-66. doi: 10.2341/14-229-L.
20. Duyck J, Van Oosterwyck H, Vander Sloten J, De 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 Oct;11(5):465-75.
21. Saleh Saber F, Ghasemi S, Koodaryan R, Babaloo A, Abolfazli N. The Comparison of Stress Distribution with Different Implant Numbers and Inclination Angles In All-on-four and Conventional Methods in Maxilla: A Finite Element Analysis. Journal of Dental Research, Dental Clinics, Dental Prospects. 2015;9(4):246-53. doi:10.15171/joddd.2015.044.
22. 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 Oct;54(4):179-84. doi: 10.1016/j.jpor.2010.04.004.
23. Tribst JPM, Rodrigues VA, Borges ALS, Lima DR, Nishioka RS. Validation of a Simplified Implant-Retained Cantilever Fixed Prosthesis. Implant Dent. 2018 Feb;27(1):49-55.
doi: 10.1097/ID.0000000000000699.
24. Gümrükçü Z, Korkmaz YT. Influence of implant number, length, and tilting degree on stress distribution in atrophic maxilla: a finite element study. Med Biol Eng Comput. 2018 Jun;56(6):979-89. doi: 10.1007/s11517-017-1737-4.
25. Pohl V, Thoma DS, Sporniak-Tutak K, Garcia-Garcia A, Taylor TD, Haas R, et al. Short dental
implants (6 mm) versus long dental implants (11-15 mm) in combination with sinus floor elevation procedures: 3-year results from a multicentre, randomized, controlled clinical trial. J Clin Periodontol. 2017 Apr;44(4):438-45. doi: 10.1111/jcpe.12694.
26. Bataineh AB, Al-dakes Ala M. The influence of length of implant on primary stability: An in vitro study using resonance frequency analysis. J Clin Exp Dent. 2017 Jan 1;9(1):e1-e6. doi: 10.4317/jced.53302.
27. Lopez Torres JA, Gehrke SA, Calvo Guirado JL, Aristazábal LFR. Evaluation of four
designs of short implants placed in atrophic areas with reduced bone height: a three-year, retrospective, clinical and radiographic study. Br J Oral Maxillofac Surg. 2017 Sep;55(7):703-8. doi: 10.1016/j.bjoms.2017.05.012.
28. Toniollo MB, Macedo AP, Palhares D, Calefi PL, Sorgini DB, Mattos MDGCD. Morse taper implants at different bone levels: a finite element analysis of stress distribution. Braz J Oral Sci. 2012;11(4),440-4.
29. Rodrigues VA, Tribst JPM, de Santis LR, de Lima DR, Nishioka RS. Influence of angulation and vertical misfit in the evaluation of micro-deformations around implants. Braz Dent Sci. 2017;20(1),32-9.
30. Datte CE, Tribst JPM, Dal Piva AMO, Nishioka RS, Bottino MA, Evangelhista ADM et al. Influence of different restorative materials on the stress distribution in dental implants. J Clin Exp Dent. 2018 May 1;10(5):e439-44.
31. Tribst JP, Rodrigues VA, Dal Piva AO, Borges AL, Nishioka RS. The importance of correct implants positioning and masticatory load direction on a fixed prosthesis. J Clin Exp Dent. 2018 Jan 1;10(1):e81-7. doi: 10.4317/jced.54489.
32. Cury PR, Sendyk WR, Sallum AW. Factors associated with early and late failure of osseointegrated implant. Braz J Oral Sci. July/September 2016;2(6) 233-8.
33. Frost HM. Wolff’s Law and bone’s structural adaptations to mechanical usage:an overview for clinicians. Angle Orthod. 1994;64(3):175-88.
34. Trivedi S. Finite element analysis: A boon to dentistry. J Oral Biol Craniofac Res. 2014;4(3):200-3. doi:10.1016/j.jobcr.2014.11.008.
35. Hatano N, Yamaguchi M, Yaita T, Ishibashi T, Sennerby L. New approach for immediate prosthetic rehabilitation of the edentulous mandible with three implants: a retrospective study. Clin Oral Implants Res. 2011 Nov;22(11):1265-9.
Published
2018-12-03
How to Cite
TRIBST, João Paulo Mendes et al. Effect of implant number and height on the biomechanics of full arch prosthesis. Brazilian Journal of Oral Sciences, [S.l.], p. e18222, dec. 2018. ISSN 1677-3225. Available at: <https://www.fop.unicamp.br/bjos/index.php/bjos/article/view/1382>. Date accessed: 17 july 2019. doi: https://doi.org/10.20396/bjos.v17i0.8653837.
Section
Original Research