Evaluation of "all-on-four" concept and alternative designs with 3D finite element analysis method

Abstract

Purpose: The aim of the present study was to evaluate the effect of the forces on the implant and supporting alveolar ridge in "all on four" concept and alternative designs using finite element analysis.

Materials and methods: Different treatment alternatives with various implant designs were performed in an edentulous mandible. In Design 1, implants were placed according to "All-on-Four" concept; Design 2, two long (13 mm long, 4 mm diameter) and two short (7 mm long, 4 mm diameter) implants; Design 3, four long and two short implants; and Design 4, two long and four short implants were placed vertically. A force of 100 N for each tooth, a total of 300 N load was applied. Finite element analysis was used to evaluate and compare the different designs.

Results: The stress concentration within the cortical bone was significantly higher than the trabecular bone around the neck of the implants. The maximum stress values were located around the cortical bone of the distal implant for all designs. The reduction in the number of implants did not diminish the success of the design.

Conclusions: In the presence of vertically resorbed posterior mandibula, although the "all on four" concept is a feasible approach clinically, short implants had decreased the amount of force transmitted to the supporting bone.

Keywords: dental implant-abutment design; finite element analysis; short implant; tilted implant; “All-on-Four” concept.