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Three-dimensional finite element analysis of buccally cantilevered implant-supported prostheses in a severely resorbed mandible

Journal of Advanced Prosthodontics 2021년 13권 1호 p.12 ~ 23
Alom Ghaith, 권호범, 임영준, 김명주,
소속 상세정보
 ( Alom Ghaith ) - Seoul National University School of Dentistry Department of Prosthodontics
권호범 ( Kwon Ho-Beom ) - Seoul National University School of Dentistry Department of Prosthodontics
임영준 ( Lim Young-Jun ) - Seoul National University School of Dentistry Department of Prosthodontics
김명주 ( Kim Myung-Joo ) - Seoul National University School of Dentistry Department of Prosthodontics

Abstract


PURPOSE: The aim of the study was to compare the lingualized implant placement creating a buccal cantilever with prosthetic-driven implant placement exhibiting excessive crown-to-implant ratio.

MATERIALS AND METHODS: Based on patient's CT scan data, two finite element models were created. Both models were composed of the severely resorbed posterior mandible with first premolar and second molar and missing second premolar and first molar, a two-unit prosthesis supported by two implants. The differences were in implants position and crown-to-implant ratio; lingualized implants creating lingually overcontoured prosthesis (Model CP2) and prosthetic-driven implants creatingan excessive crown-to-implant ratio (Model PD2). A screw preload of 466.4 N and a buccal occlusal load of 262 N were applied. The contacts between the implant components were set to a frictional contact with a friction coefficient of 0.3. The maximum von Mises stress and strain and maximum equivalent plastic strain were analyzed and compared, as well as volumes of the materials under specified stress and strain ranges.

RESULTS: The results revealed that the highest maximum von Mises stress in each model was 1091 MPa for CP2 and 1085 MPa for PD2. In the cortical bone, CP2 showed a lower peak stress and a similar peak strain. Besides, volume calculation confirmed that CP2 presented lower volumes undergoing stress and strain. The stresses in implant components were slightly lower in value in PD2. However, CP2 exhibited a noticeably higher plastic strain.

CONCLUSION: Prosthetic-driven implant placement might biomechanically be more advantageous than bone quantity-based implant placement that creates a buccal cantilever.

키워드

Dental prosthesis, Implant-supported; Bone resorption; Dental stress analysis; Finite element analysis

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