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. 2023 Nov 7;11(11):261.
doi: 10.3390/dj11110261.

Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA)

Árpád László Szabó  1 , Danica Matusovits  1 , Haydar Slyteen  2 , Éva Ilona Lakatos  2 , Zoltán Baráth  1
Affiliations

Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA)

Árpád László Szabó et al. Dent J (Basel). .

Abstract

The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1-LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1-where masticatory forces covered the entire mesio-distal surface of the denture, including the cantilever-was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97-15.87% and 87.96-94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance.

Keywords: dental implants; dental occlusion; dental stress analysis; edentulism; finite element analysis; implant-supported.

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Conflict of interest statement

The authors declare no conflict of interest, monetary or otherwise. The authors alone are responsible for the content and writing of this article.

Figures

Figure 1
Figure 1
Cone-beam CT (CBCT) image corresponding to the patient’s baseline state.
Figure 2
Figure 2
Panoramic radiograph of the patient 4 years post-implant placement.
Figure 3
Figure 3
Creation of the simplified denture during the modeling process.
Figure 4
Figure 4
Finite element mesh of the implant-denture and the mandible models.
Figure 5
Figure 5
Load cases (LC1–4) used in the study. The red line represents the distributed load applied in the finite element analyses (FEA).
Figure 6
Figure 6
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for the S1 LC1 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
Figure 7
Figure 7
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for the S2 LC1 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
Figure 8
Figure 8
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for the S1 LC2 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
Figure 9
Figure 9
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for the S2 LC2 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
Figure 10
Figure 10
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for the S1 LC3 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
Figure 11
Figure 11
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for the S2 LC3 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
Figure 12
Figure 12
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for the S1 LC4 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
Figure 13
Figure 13
Maximum (Pmax, A) and minimum (Pmin, B) principal stress distributions in the cortical bone segment of the mandible for S2 LC4 case. The heatmap shows the distribution of stresses according to the color scale, while the maximum and minimum values for stresses are also denoted (e.g., 8E3 corresponds to 8 × 10³).
See this image and copyright information in PMC

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