在各种临床实践中，对采用不同材料的All-on-4种植体支持式框架进行生物力学分析。

Biomechanical analysis of All-on-4 implant supported framework using different materials across various clinical practice.

作者信息

Chen Xiaoxuan, Xu Zhengyi, Gai Kuo, Pei Xibo, Li Ruyi, Wan Qianbing

机构信息

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, Department of Dental Technology, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Peoples Road, Chengdu, 610041, Sichuan, China.

Stomatology Hospital, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, 310000, China.

出版信息

BMC Oral Health. 2025 Apr 12;25(1):552. doi: 10.1186/s12903-025-05928-0.

DOI:10.1186/s12903-025-05928-0

PMID:40221683

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11992848/

Abstract

BACKGROUND

With the global aging trend, the number of edentulous individuals is steadily increasing. All-on-4 implant restoration can greatly recovery masticatory function in edentulous patients. This study aims to determine the effect of framework material and cantilever length on the stress distribution in All-on-4 implant components using three-dimensional finite element analysis, thereby providing clinicians with insights into the design of All-on-4 superstructures to improve patient outcomes.

METHODS

Five framework models with cantilever lengths of 0 mm, 3 mm, 6 mm, 9 mm, and 12 mm were established, with the cantilever material selected as either titanium (Ti) or polyetheretherketone (PEEK). The jawbone, implant, and framework models were then assembled, with four implants placed in the jawbone according to the classic All-on-4 design and connected to the framework via abutments. Finally, occlusal forces were applied to the framework. Finite element analysis was used to obtain the stress and strain distribution in the jawbones, as well as the stress distribution within the implants and the frameworks.

RESULTS

Overall, the use of a PEEK framework demonstrated better stress distribution in the jawbone due to its elastic modulus, the maximum stress of which is 26% lower at most than Ti. Although PEEK frameworks showed lower stress overall, implant stress increased, particularly for cantilever lengths over 6 mm, reaching values up to 2.6 times higher than in titanium.

CONCLUSIONS

Cantilever length and framework material are interrelated factors that both influence the stress distribution in the All-on-4 system. A PEEK framework can serve as an alternative to titanium framework in short cantilever lengths (under 6 mm), offering slightly better mandibular protection. Titanium is preferable for lengths between 6 mm and 9 mm to reduce mechanical risk. Cantilever lengths exceeding 12 mm are discouraged due to increased stress.

TRIAL REGISTRATION

Not Applicable.

摘要

背景

随着全球老龄化趋势，无牙颌个体数量在稳步增加。全口4颗种植体修复可极大恢复无牙颌患者的咀嚼功能。本研究旨在通过三维有限元分析确定框架材料和悬臂长度对全口4颗种植体部件应力分布的影响，从而为临床医生提供关于全口4颗种植体上部结构设计的见解，以改善患者治疗效果。

方法

建立了5个悬臂长度分别为0毫米、3毫米、6毫米、9毫米和12毫米的框架模型，悬臂材料选择钛（Ti）或聚醚醚酮（PEEK）。然后将颌骨、种植体和框架模型进行组装，按照经典的全口4颗种植体设计在颌骨中植入4颗种植体，并通过基台与框架相连。最后，对框架施加咬合力。采用有限元分析获取颌骨中的应力和应变分布，以及种植体和框架内的应力分布。