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Examination of stresses created by zygomatic and dental implants applied in combined form and implants placed with the “All-on-Four” technique in bilateral atrophic maxilla by finite element analysis

Year 2024, Volume: 25 Issue: 3, 86 - 91, 19.09.2024
https://doi.org/10.70509/dicledentj.1538267

Abstract

Aims: In severely atrophic posterior maxillae, there is usually not enough bone to place conventional dental implants. Dental implants and zygomatic implants placed with the “All-on-Four” technique have frequently been preferred in recent years because they eliminate the need for grafting, shorten the treatment time, and reduce the morbidity rate. The aim of our study was to select the most accurate surgical planning according to the stress values resulting from the forces applied to the combined zygomatic and dental implants and dental implants placed with the “All-on-Four” technique in the models we created.
Methods: In the present study, 2 group models were established. In group 1 model, one dental implant was placed in the canine and second premolar tooth regions with the “All-on-Four” technique. In the group 2 model, one dental implant was placed in the canine tooth region and one zygomatic implant was placed in the 1st molar region. In the prosthetic superstructure, a force of 150 N was applied vertically from the region of teeth 4-5-6 and 100 N was applied obliquely at an angle of 30o.
Results: In the present study, when the von Mises stress values on the implants were analyzed, it was found that the highest stress occurred in group 2 under vertical forces and in group 1 under oblique forces.
Conclusion: Based on these results, it is concluded that the most ideal planning in the rehabilitation of bilateral atrophic maxilla is group 1 with dental implants placed with the “All-on-Four” technique under vertical forces and group 2 with zygoma and dental implants under oblique forces.

References

  • Plischka G. Implantology in dentistry. Zahnarztl Prax. 1960; 21(16):181-183.
  • Alghamdi HS. Methods to Improve osseointegration of dental implants in low quality (type-IV) bone: an overview. J Funct Biomater. 2018;9(1):7.
  • Van Steenberghe D, Naert I, Andersson M, et al. A custom template and definitive prosthesis allowing immediate implant loading in the maxilla: a clinical report. Int J Oral Maxillofac Implants. 2002;17(5):663-670.
  • Pi Urgell J, Revilla Gutiérrez V, Gay Escoda CG. Rehabilitation of atrophic maxilla: a review of 101 zygomatic implants. Med Oral Patol Oral Cir Bucal. 2008;13(6):E363-E370.
  • Gongloff RK, Cole M, Whitlow W, Boyne PJ. Titanium mesh and particulate cancellous bone and marrow grafts to augment the maxillary alveolar ridge. Int J Oral Maxillofac Surg. 1986;15(3): 263-268.
  • Isaksson S, Ekfeldt A, Alberius P, Blomqvist JE. Early results from reconstruction of severely atrophic (Class VI) maxillas by immediate endosseous implants in conjunction with bone grafting and Le Fort I osteotomy. Int J Oral Maxillofac Surg. 1993; 22(3):144-148.
  • Weischer T, Schettler D, Mohr C. Titanium implants in the zygoma as retaining elements after hemimaxillectomy. Int J Oral Maxillofac Implants. 1997;12(2):211-214.
  • Aparicio C, Branemark PI, Keller EE, Olive J. Reconstruction of the premaxilla with autogenous iliac bone in combination with autogenous iliac bone in combination with osseointegrated implants. Int J Oral Maxillofac Implants. 1993;8(1):61-67.
  • Malo P, Rangert B, Nobre M. All-on-Four” immediate-function concept with Brånemark system implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res. 2003;5(1):2-9.
  • Malo P, Rangert B, Nobre M. “All-on-4” immediate-function concept with Branemark System implants for completely edentulous maxilla: a 1-year retrospective clinical study. Clin Implant Dent Relat Res. 2005;7(1):88-94.
  • Van Staden RC, Guan H, Loo YC. Application of the finite element method in dental implant research. Comput Methods Biomech Biomed Engin. 2006;9(4):257-270.
  • Keyak JH, Fourkas MG, Meagher JM, Skinner HB. Validation of an automated method of three-dimensional finite element modelling of bone. J Biomed Eng. 1993;15(6):505-509.
  • Weinstein AM, Klawitter JJ, Anand SC, Schuessler R. Stress analysis of porous rooted dental implants. J Dent Res. 1976;55(5): 772-777.
  • Lombardo G, Dagostino A, Trevisiol L, et al. Clinical, microbiologic and radiologic assessment of soft and hard tissues surrounding zygomatic implants: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2016;122(5):537-546.
  • Davo R, Pons O, Rojas J, Carpio E. Immediate function of four zygomatic implants: a 1-year report of a prospective study. Eur J Oral Implant. 2010;3(4):323-334.
  • Maló P, de Sousa ST, De Araújo Nobre M, et al. Individual lithium disilicate crowns in a full-arch, implant-supported rehabilitation: a clinical report. J Prosthodont. 2014;23(6):495-500.
  • Maló P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-Four implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011; 142(3):310-320.
  • Malo P, Nobre M, Lopes A. 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(1):139-150.
  • Maló P, de Araújo NM, Lopes A, Ferro A, Nunes M. The All-on-4 concept for full-arch rehabilitation of the edentulous maxillae: a longitudinal study with 5-13 years of follow-up. Clin Implant Dent Relat Res. 2019;21(4):538-549.
  • Maló P, de Araújo NM, Lopes A, Ferro A, Botto J. The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: a longitudinal study with 10 to 18 years of follow-up. Clin Implant Dent Relat Res. 2019;21(4):565-577.
  • Michael HC, Nudell YA. All-on-4 concept update. Dent Clin N Am. 2021;65(1):211-227.
  • Kim KS, Kim YL, Bae JM, Cho HW. Biomechanical comparison of axial and tilted implants for mandibular full-arch fixed prostheses. Int J Oral Maxillofac Implants. 2011;26(5):976-984.
  • Bevilacqua M, Tealdo T, Pera F, et al. Three-dimensional finite element analysis of load transmission using different implant inclinations and cantilever lengths. Int J Prosthodont. 2008;21(6): 539-542.
  • Wen H, Guo W, Liang R. Finite element analysis of three zygomatic implant techniques for the severely atrophic edentulous maxilla. J Prosthet Dent. 2014;111(3):203-215.
  • Migliorança R, Sotto-Maior B, Senna P, Francischone C, Cury A. Immediate occlusal loading of extrasinus zygomatic implants: a prospective cohort study with a follow-up period of 8 years. Int J Oral Maxillofac Surg. 2012;41(9):1072-1076.
  • Çetindağ A, Belgin G. Atrofik dişsiz maksilla rehabilitasyonunda farklı planlamalarla uygulanan zigomatik ve dental implantların çevre dokularda oluşturduğu streslerin sonlu elemanlar analizi ile incelenmesi. Dicle Üniversitesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı. Uzmanlık Tezi. Diyarbakır, 2019.
  • Di Pietro N, Ceddia M, Romasco T, et al. Finite element analysis (FEA) of the stress and strain distribution in cone-morse implant-abutment connection implants placed equicrestally and subcrestally. Appl Sci. 2023;13(14):8147.
  • Callea C, Ceddia M, Piattelli A, Specchiulli A, Trentadue B. Finite element analysis (FEA) for a different type of cono-in dental implant. Appl Sci. 2023;13(9):5313.
Year 2024, Volume: 25 Issue: 3, 86 - 91, 19.09.2024
https://doi.org/10.70509/dicledentj.1538267

Abstract

References

  • Plischka G. Implantology in dentistry. Zahnarztl Prax. 1960; 21(16):181-183.
  • Alghamdi HS. Methods to Improve osseointegration of dental implants in low quality (type-IV) bone: an overview. J Funct Biomater. 2018;9(1):7.
  • Van Steenberghe D, Naert I, Andersson M, et al. A custom template and definitive prosthesis allowing immediate implant loading in the maxilla: a clinical report. Int J Oral Maxillofac Implants. 2002;17(5):663-670.
  • Pi Urgell J, Revilla Gutiérrez V, Gay Escoda CG. Rehabilitation of atrophic maxilla: a review of 101 zygomatic implants. Med Oral Patol Oral Cir Bucal. 2008;13(6):E363-E370.
  • Gongloff RK, Cole M, Whitlow W, Boyne PJ. Titanium mesh and particulate cancellous bone and marrow grafts to augment the maxillary alveolar ridge. Int J Oral Maxillofac Surg. 1986;15(3): 263-268.
  • Isaksson S, Ekfeldt A, Alberius P, Blomqvist JE. Early results from reconstruction of severely atrophic (Class VI) maxillas by immediate endosseous implants in conjunction with bone grafting and Le Fort I osteotomy. Int J Oral Maxillofac Surg. 1993; 22(3):144-148.
  • Weischer T, Schettler D, Mohr C. Titanium implants in the zygoma as retaining elements after hemimaxillectomy. Int J Oral Maxillofac Implants. 1997;12(2):211-214.
  • Aparicio C, Branemark PI, Keller EE, Olive J. Reconstruction of the premaxilla with autogenous iliac bone in combination with autogenous iliac bone in combination with osseointegrated implants. Int J Oral Maxillofac Implants. 1993;8(1):61-67.
  • Malo P, Rangert B, Nobre M. All-on-Four” immediate-function concept with Brånemark system implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res. 2003;5(1):2-9.
  • Malo P, Rangert B, Nobre M. “All-on-4” immediate-function concept with Branemark System implants for completely edentulous maxilla: a 1-year retrospective clinical study. Clin Implant Dent Relat Res. 2005;7(1):88-94.
  • Van Staden RC, Guan H, Loo YC. Application of the finite element method in dental implant research. Comput Methods Biomech Biomed Engin. 2006;9(4):257-270.
  • Keyak JH, Fourkas MG, Meagher JM, Skinner HB. Validation of an automated method of three-dimensional finite element modelling of bone. J Biomed Eng. 1993;15(6):505-509.
  • Weinstein AM, Klawitter JJ, Anand SC, Schuessler R. Stress analysis of porous rooted dental implants. J Dent Res. 1976;55(5): 772-777.
  • Lombardo G, Dagostino A, Trevisiol L, et al. Clinical, microbiologic and radiologic assessment of soft and hard tissues surrounding zygomatic implants: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2016;122(5):537-546.
  • Davo R, Pons O, Rojas J, Carpio E. Immediate function of four zygomatic implants: a 1-year report of a prospective study. Eur J Oral Implant. 2010;3(4):323-334.
  • Maló P, de Sousa ST, De Araújo Nobre M, et al. Individual lithium disilicate crowns in a full-arch, implant-supported rehabilitation: a clinical report. J Prosthodont. 2014;23(6):495-500.
  • Maló P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-Four implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011; 142(3):310-320.
  • Malo P, Nobre M, Lopes A. 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(1):139-150.
  • Maló P, de Araújo NM, Lopes A, Ferro A, Nunes M. The All-on-4 concept for full-arch rehabilitation of the edentulous maxillae: a longitudinal study with 5-13 years of follow-up. Clin Implant Dent Relat Res. 2019;21(4):538-549.
  • Maló P, de Araújo NM, Lopes A, Ferro A, Botto J. The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: a longitudinal study with 10 to 18 years of follow-up. Clin Implant Dent Relat Res. 2019;21(4):565-577.
  • Michael HC, Nudell YA. All-on-4 concept update. Dent Clin N Am. 2021;65(1):211-227.
  • Kim KS, Kim YL, Bae JM, Cho HW. Biomechanical comparison of axial and tilted implants for mandibular full-arch fixed prostheses. Int J Oral Maxillofac Implants. 2011;26(5):976-984.
  • Bevilacqua M, Tealdo T, Pera F, et al. Three-dimensional finite element analysis of load transmission using different implant inclinations and cantilever lengths. Int J Prosthodont. 2008;21(6): 539-542.
  • Wen H, Guo W, Liang R. Finite element analysis of three zygomatic implant techniques for the severely atrophic edentulous maxilla. J Prosthet Dent. 2014;111(3):203-215.
  • Migliorança R, Sotto-Maior B, Senna P, Francischone C, Cury A. Immediate occlusal loading of extrasinus zygomatic implants: a prospective cohort study with a follow-up period of 8 years. Int J Oral Maxillofac Surg. 2012;41(9):1072-1076.
  • Çetindağ A, Belgin G. Atrofik dişsiz maksilla rehabilitasyonunda farklı planlamalarla uygulanan zigomatik ve dental implantların çevre dokularda oluşturduğu streslerin sonlu elemanlar analizi ile incelenmesi. Dicle Üniversitesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı. Uzmanlık Tezi. Diyarbakır, 2019.
  • Di Pietro N, Ceddia M, Romasco T, et al. Finite element analysis (FEA) of the stress and strain distribution in cone-morse implant-abutment connection implants placed equicrestally and subcrestally. Appl Sci. 2023;13(14):8147.
  • Callea C, Ceddia M, Piattelli A, Specchiulli A, Trentadue B. Finite element analysis (FEA) for a different type of cono-in dental implant. Appl Sci. 2023;13(9):5313.
There are 28 citations in total.

Details

Primary Language English
Subjects Dental Materials and Equipment
Journal Section Research Article
Authors

Murat Özler 0000-0002-1470-4960

Belgin Gülsün 0000-0002-2456-7381

Publication Date September 19, 2024
Submission Date August 24, 2024
Acceptance Date September 15, 2024
Published in Issue Year 2024 Volume: 25 Issue: 3

Cite

AMA Özler M, Gülsün B. Examination of stresses created by zygomatic and dental implants applied in combined form and implants placed with the “All-on-Four” technique in bilateral atrophic maxilla by finite element analysis. Dicle Dent J. September 2024;25(3):86-91. doi:10.70509/dicledentj.1538267