Multiple implants need to be placed in different regions of the mandible based on the remaining bone mass assessment and implantation procedure of different patients with complete edentulousness. However, little is known about the impact of the implant sites arrangement on framework, distal implant and surrounding bone stress. This paper was to explore the biomechanical behavior changes of the implant sites distribution on the framework in the axial design and compared with the inclined design. Arched mandible models with four different implant placement arrangements were built using 4 axial implants. Another alternative inclined design was generated for comparison with the axial design while maintaining an even distribution of the implant positions. A 300 N oblique load at 45° to the occlusal plane was applied to bilateral posterior-tooth area for finite element analysis. For the axial design, the maximum stress occurred in groups with multiple implants adjacently arranged, whereas the minimum peak stress occurred in groups with each implant evenly spaced. The inclined group exhibited lower stress levels on the distal implant and surrounding bone. For full-arch implant restorations, an inclined designed with 4 implants evenly distributed on the mandible is preferred to obtain optimal stress distribution.
The purpose of the present study is to evaluate the biomechanical differences between two implant-supported cement retained single crown, screw-retained single crown and screw-retained union crown in premolar area. Thus, three prosthetic restoration groups were established based on different abutment types and crown retention designs: 2 straight abutments and 2 single cement-retained crowns (T1), 2 screw-retained abutments and 2 single screw-retained crowns (T2), 2 screw-retained abutments and screw-retained union crown (T3). The finite element analysis (FEA) was performed to explore the stress distribution of prosthetic restoration. Further linear regression analysis was performed to study the effect of crown height (CH) on the maximum stress of the implant system. The FEA results demonstrated that T3 restorations model exhibited the lowest level of stress. The overall peak stress of the implant-abutment assembly in T3 model were reduced by 69.6%-92.9% compared with T1 and T2 models. Furthermore, increasing CH values will lead to a strong linear increase in the maximum equivalent stress of the implant-abutment assembly. In terms of biomechanical property, the screw-retained union crown design for the double implant-supported prostheses achieved the best load resistance and optimal stress distribution compared to the other two single crown designs. Besides, screw retained union crown with smaller CH value was preferred for implant-supported restorations.
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