Haroun Feras, Ozan Oguz
Department of Prosthodontics, Faculty of Dentistry, Near East University, Near East Boulevard, Nicosia 99138, Mersin 10, Turkey.
Materials (Basel). 2021 Aug 1;14(15):4308. doi: 10.3390/ma14154308.
The long-term success of dental implants is greatly influenced by the use of appropriate materials while applying the "All-on-4" concept in the edentulous jaw. This study aims to evaluate the stress distribution in the "All-on-4" prosthesis across different material combinations using three-dimensional finite element analysis (FEA) and to evaluate which opposing arch material has destructive effects on which prosthetic material while offering certain recommendations to clinicians accordingly. Acrylic and ceramic-based hybrid prosthesis have been modelled on a rehabilitated maxilla using the "All-on-4" protocol. Using different materials and different supports in the opposing arch (natural tooth, and implant/ceramic, and acrylic), a multi-vectorial load has been applied. To measure stresses in bone, maximum and minimum principal stress values were calculated, while Von Mises stress values were obtained for prosthetic materials. Within a single group, the use of an acrylic implant-supported prosthesis as an antagonist to a full arch implant-supported prosthesis yielded lower maximum (Pmax) and minimum (Pmin) principal stresses in cortical bone. Between different groups, maxillary prosthesis with polyetheretherketone as framework material showed the lowest stress values among other maxillary prostheses. The use of rigid materials with higher moduli of elasticity may transfer higher stresses to the peri implant bone. Thus, the use of more flexible materials such as acrylic and polyetheretherketone could result in lower stresses, especially upon atrophic bones.
在无牙颌应用“All-on-4”理念时,种植体的长期成功很大程度上受到合适材料使用的影响。本研究旨在通过三维有限元分析(FEA)评估不同材料组合的“All-on-4”修复体中的应力分布,并评估哪种对颌弓材料会对哪种修复材料产生破坏作用,同时据此为临床医生提供一定建议。基于丙烯酸和陶瓷的混合修复体已按照“All-on-4”方案在修复后的上颌骨上进行建模。在对颌弓中使用不同材料和不同支撑(天然牙、种植体/陶瓷以及丙烯酸树脂),施加了多向量载荷。为测量骨中的应力,计算了最大和最小主应力值,同时获得了修复材料的冯·米塞斯应力值。在同一组内,使用丙烯酸树脂种植体支持的修复体作为全牙弓种植体支持修复体的对抗物时,皮质骨中的最大(Pmax)和最小(Pmin)主应力较低。在不同组之间,以聚醚醚酮为框架材料的上颌修复体在其他上颌修复体中应力值最低。使用具有较高弹性模量的刚性材料可能会将更高的应力传递到种植体周围骨。因此,使用丙烯酸树脂和聚醚醚酮等更具柔韧性的材料可能会导致更低的应力,尤其是在骨萎缩的情况下。
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