Evaluation of Different Bar Materials in Terms of Stress Transmission in All-on-four and All-on-three Concepts: A Three-dimensional Finite Element Analysis
All-on-three, Bar material, Dental implant, Finite element analysis,All-on-four
Citation Information :
Türker N. Evaluation of Different Bar Materials in Terms of Stress Transmission in All-on-four and All-on-three Concepts: A Three-dimensional Finite Element Analysis. Int J Experiment Dent Sci 2019; 8 (2):42-46.
Aim: The aim of this study is to evaluate the effects of materials used in bar construction in all-on-four (AOF) and all-on-three (AOT) concepts on stress transmission by three-dimensional (3D) finite element analysis (FEA) method.
Materials and methods: Two models were designed to simulate the AOF and AOT concepts in the mandible. For the AOF concept, the mesial implants were placed at the canine teeth position and the distal implants were inclined 40° distally, with the neck portions protruding from the second premolar region on both sides. For the AOT concept, one of the implants was placed in the middle of the two incisors in the mandible and the other two implants were placed distally in the first premolar region. Bars and prostheses were designed and the model parts were combined. Four different bar materials were defined after creating four different models for both concepts. A force of 100 N was applied perpendicular to the long axis of the left first molar tooth from the central fossa. Elastic strain values of bar structures and bone tissue were obtained.
Results: The lowest strain values in both AOF concept and AOT concept were observed in the cobalt–chromium bar structure. In both concepts, the lowest strain values in bone tissue were observed in models produced with type IV gold alloy bars, while the highest strain values were observed in models produced with silver–palladium alloy bars.
Conclusion: In AOF and AOT concepts, the type of bar material affects the strains in the bar structure and bone tissue. The material with the lowest strain observed in the bar material and the material causing the lowest tension in the bone tissue are not the same.
Clinical significance: In the AOF and AOT concepts, which are fixed prosthetic treatment options with a less number of implants, the type of bar material used is important for the success of the treatment.
Jofre J, Cendoya P, Muñoz P. Effect of splinting mini-implants on marginal bone loss: a biomechanical model and clinical randomized study with mandibular overdentures. Int J Oral Maxillofac Implants 2010;25(6):1137–1144.
Tokuhisa M, Matsushita Y, Koyano K. In vitro study of a mandibular implant overdenture retained with ball, magnet, or bar attachments: comparison of load transfer and denture stability. Int J Prosthodont 2003;16:251–258.
Caetano CR, Mesquita MF, Consani RLX, et al. Overdenture retaining bar stress distribution: a finite-element analysis. Acta Odontol Scand 2015;73(4):274–279. DOI: 10.3109/00016357.2014.923111.
Abreu RT, Spazzin AO, Noritomi PY, et al. Influence of material of overdenture-retaining bar with vertical misfit on three-dimensional stress distribution. J Prosthodont 2010;19(6):425–431. DOI: 10.1111/j.1532-849X.2010.00612.x.
Malo P, de Araújo Nobre M, Lopes A, et al. A longitudinal study of the survival of all-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc 2011;142(3):310–320. DOI: 10.14219/jada.archive.2011.0170.
Maló P, de Araújo Nobre M, Lopes A, et al. “All-on-4” immediate-function concept for completely edentulous maxillae: a clinical report on the medium (3 years) and long-term (5 years) outcomes. Clin Implant Dent Relat Res 2012;14(Suppl 1):e139–e150. DOI: 10.1111/j.1708-8208.2011.00395.x.
Brånemark PI, Engstrand P, Öhrnell LO, et al. Brånemark Novum®: a new treatment concept for rehabilitation of the edentulous mandible. Preliminary results from a prospective clinical follow-up study. Clin Implant Dent Relat Res 1999;1(1):2–16. DOI: 10.1111/j.1708-8208.1999.tb00086.x.
Oliva J, Oliva X, Oliva JD. All-on-three delayed implant loading concept for the completely edentulous maxilla and mandible: a retrospective 5-year follow-up study. Int J Oral Maxillofac Implants 2012;27:1585–1592.
Ayna M, Sagheb K, Gutwald R, et al. A clinical study on the 6-year outcomes of immediately loaded three implants for completely edentulous mandibles: “the all-on-3 concept”. Odontology 2019; 1–10. DOI: 10.1007/s10266-019-00440-8.
Hatano N, Yamaguchi M, Yaita T, et al. New approach for immediate prosthetic rehabilitation of the edentulous mandible with three implants: a retrospective study. Clin Oral Implants 2011;22(11):1265–1269. DOI: 10.1111/j.1600-0501.2010.02101.x.
Beresford D, Klineberg I. A within-subject comparison of patient satisfaction and quality of life between a two-implant overdenture and a three-implant-supported fixed dental prosthesis in the mandible. Int J Oral Maxillofac 2018;33:1374–1382. DOI: 10.11607/jomi.6666.
Baker EW, Schulte E, Schumacher U. Head and neck anatomy for dental medicine, 2nd ed. New York: Thieme; 2010. pp. 2–22.
Archangelo CM, Rocha EP, Pereira JA, et al. Periodontal ligament influence on the stress distribution in a removable partial denture supported by implant: a finite element analysis. J Appl Oral Sci 2012;20(3):362–368. DOI: 10.1590/S1678-77572012000300012.
Mehdi G, Belarbi A, Mansouri B, et al. Numerical study of effect of elastomeric stress absorbers on stress reduction in bone-dental implant interface. J Appl Oral Sci 2015;23(1):87–93. DOI: 10.1590/1678-775720140086.
Ozan O, Ramoglu S. Effect of implant height differences on different attachment types and peri-implant bone in mandibular two-implant Overdentures: 3D finite element study. J Oral Implantol 2015;41(3):e50–e59. DOI: 10.1563/AAID-JOI-D-13-00239.
Silva GC, Mendonca JA, Lopes LR, et al. Stress patterns on implants in prostheses supported by four or six implants: a three-dimensional finite element analysis. Int J Oral Maxillofac Implants 2010;25(2):239–246.
Trivedi S. Finite element analysis: A boon to dentistry. J Oral Biol Craniofac Res 2014;4(3):200–203. DOI: 10.1016/j.jobcr.2014.11.008.
Isidor F. Influence of forces on peri-implant bone. Clin Oral Implants 2006;17(Suppl 1):8–18. DOI: 10.1111/j.1600-0501.2006.01360.x.
Spazzin AO, dos Santos MBF, Sobrinho LC, et al. Effects of horizontal misfit and bar framework material on the stress distribution of an overdenture-retaining bar system: a 3D finite element analysis. J Prosthodont 2011;20(7):517–522. DOI: 10.1111/j.1532-849X.2011.00759.x.
Fazi G, Tellini S, Vangi D, et al. Three-dimensional finite element analysis of different implant configurations for a mandibular fixed prosthesis. Int J Oral Maxillofac Implants 2011;26(4):752–759.
Almeida EO, Rocha EP, Júnior ACF, et al. Tilted and short implants supporting fixed prosthesis in an atrophic maxilla: a 3D-FEA biomechanical evaluation. Clin Implant Dent Relat Res 2015;17:e332–e342. DOI: 10.1111/cid.12129.
De Medeiros RA, Goiato MC, Pesqueira AA, et al. Stress distribution in an implant-supported mandibular complete denture using different cantilever lengths and occlusal coating materials. Implant Dent 2017;26:106–111. DOI: 10.1097/ID.0000000000000534.
Ebadian B, Mosharraf R, Khodaeian N. Effect of cantilever length on stress distribution around implants in mandibular overdentures supported by two and three implants. Eur J Dent 2016;10:333–339. DOI: 10.4103/1305-7456.184152.
Türker N, Büyükkaplan US, Sadowsky SJ, et al. Finite element stress analysis of applied forces to implants and supporting tissues using the “All-on-Four” concept with different occlusal schemes. J Prosthodont 2019;28(2):185–194.
Vervaeke S, Collaert B, Cosyn J, et al. A multifactorial analysis to identify predictors of implant failure and peri-implant bone loss. Clin Implant Dent Relat Res 2015;17(Suppl 1):e298–e307. DOI: 10.1111/cid.12149.
Soto-Peñaloza D, Zaragozí-Alonso R, Peñarrocha-Diago M, et al. The all-on-four treatment concept: systematic review. J Clin Exp Dent 2017;9(3):474–478. DOI: 10.4317/jced.53613.