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. 2023 Mar-Apr;27(2):180-188.
doi: 10.4103/jisp.jisp_278_22. Epub 2023 Mar 4.

Comparison between all-on-four and all-on-six treatment concepts on stress distribution for full-mouth rehabilitation using three-dimensional finite element analysis: A biomechanical study

Aishwarya Pandey  1 , Farhan Durrani  1 , Sanjay Kumar Rai  2 , Nishant Kumar Singh  3 , Preeti Singh  1 , Rati Verma  2 , Jitendra Kumar  3
Affiliations

Comparison between all-on-four and all-on-six treatment concepts on stress distribution for full-mouth rehabilitation using three-dimensional finite element analysis: A biomechanical study

Aishwarya Pandey et al. J Indian Soc Periodontol. 2023 Mar-Apr.

Abstract

Purpose: The current study intended to provide a comparison of biomechanical behaviors of two different treatment concepts for full-mouth rehabilitation with dental implants placed according to the "All-on-four" concept and "All-on-six" concept with analysis of the stress patterns of the implant support system using three-dimensional finite element analysis (FEA).

Materials and methods: The edentulous mandible was treated with two different implant designs. "All-on-Four" implant placement concept was used in Model 1 with two central axial implants and two distally tilted implants at 17° and in Model 2, "All-on-Six" concept was applied with six vertically placed implants. Individual vertical and horizontal load of 100 N and oblique load of 141 N at 45° was applied to all implants. To evaluate and compare the results in terms of maximum principal stress, we used FEA.

Results: All-on-six showed smaller maximum principal stress values on the cortical bone and implants. However, maximum principal stress values obtained on trabecular bone was smaller in the All-on-four design for vertical and horizontal loading conditions.

Conclusions: The All-on-six approach showed more favorable biomechanical behavior.

Keywords: All-on-four; all-on-six; finite element analysis; maximum principal stress; tilted implants.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
3D model with measurements (frontal view). 3D – Three-dimensional
Figure 2
Figure 2
3D model with measurements (occlusal view). 3D – Three-dimensional
Figure 3
Figure 3
Adaptive remeshing
Figure 4
Figure 4
Local smoothing, removal of overlapping triangles and fixing of bad edges
Figure 5
Figure 5
Model depicting cortical and cancellous bone
Figure 6
Figure 6
Implant model (3.3 mm × 11.5 mm)
Figure 7
Figure 7
3D model with all-on-four concept. 3D – Three-dimensional
Figure 8
Figure 8
Meshing for model A (all on four)
Figure 9
Figure 9
3D model with all-on-six concept. 3D – Three-dimensional
Figure 10
Figure 10
Meshing for model B (All on six)
Figure 11
Figure 11
Loading conditions
Figure 12
Figure 12
(a) Right lateral view, (b) Left lateral view, (c) Frontal view
Figure 13
Figure 13
All-on-four (a) Frontal intra-oral view (b) Orthopantomogram
See this image and copyright information in PMC

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