Biomechanical comparison of the All-on-4, M-4, and V-4 techniques in an atrophic maxilla: A 3D finite element analysis

Ayalı, Aysa; Altagar, Mazen; Ozan, Oğuz; Kurtulmuş-Yılmaz, Sevcan

doi:10.1016/j.compbiomed.2020.103880

Cited by 13 publications

(5 citation statements)

References 22 publications

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“…Similarly, the highest value for the maximum principal stress in the bone was recorded in the crest of the bone surrounding the posterior implants. The results of the current study for the model TP matches the results of several studies performed on the All-on-4® implant supported prosthesis as that published by Kucukkurt et al [ 39 ], Horita et al [ 40 ], Ayali et al [ 4 ], Moreira et al [ 5 ], Sannino et al [ 31 ], Lofaj et al [ 36 ], Liu et al [ 41 ] and Turker et al [ 42 , 44 ]. Regarding the stresses induced in the prosthetic screw, the maximum value for the Von Mises stress was recorded in the posterior screws for the model TP; matching the results of Ozan et al [ 6 ] and Oh et al [ 43 ].…”

Section: Discussionsupporting

confidence: 89%

“…Behring et al [ 2 ] also concluded that the biomechanical behavior of the All-on-4® concept becomes improved with increasing the rigidity of the implant framework. Furthermore, Ayali et al [ 4 ] reported no great differences in the maximum stress values between the different All-on-4® configurations as the M-4 and the V-4. The narrow and wide implant diameters showed a comparable biomechanical behavior when being used in the All-on-4® concept [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear finite element analysis study

2022

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Background Correct choice of the implant design and the occlusal scheme is important for the success of implant supported restorations. So, the aim of the current study was to find out the difference in the stresses induced by the one piece dental implants designed to be used in the All-on-4® concept and the conventional two piece ones under simulated lateral occlusal schemes using nonlinear finite element analysis. Methods Two finite element models of the maxilla, implants, and prostheses were designed according to the All-on-4® concept. In the model TP, two piece dental implants were placed while in the model OP one piece dental implants were used. Two loading scenarios were applied to each model; the first one simulated a group function occlusal scheme while the second scenario simulated a canine guided one. Results The highest stress value was recorded in the model TP with the group function occlusion and the lowest stress value was in the model OP with the canine guidance occlusion. Conclusion The one-piece dental implants can be concluded to induce less stress compared to the two piece dental implants when used in the All-on-4® implant supported prosthesis in the different lateral occlusal schemes. Canine guided occlusion can be concluded to cause lower stress values in comparison to the group function occlusal scheme.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear finite element analysis study

2022

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“…As seen on the stress distribution maps, noted stress values were peak values denoted at a specific position, however, in reality, these maximum stresses occur as a load transmitted at the bone-implant interface, not at a single point [47]. Although comparisons may be hindered by the different model characteristics set by researchers, our results have yielded similar tensile and compressive values in the same order to other previously published reports assessing stresses on mandibular bone tissue [4,21,36,37,46,[48][49][50]. The mandibular bone adapts to its loading and responds to stresses by bone formation or resorption, i.e., neither unloaded nor overloaded areas are desirable due to long-term consequences [51].…”

Section: Discussionsupporting

confidence: 82%

Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA)

Szabó,

Matusovits,

Slyteen

et al. 2023

Dentistry Journal

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The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1–LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1—where masticatory forces covered the entire mesio−distal surface of the denture, including the cantilever—was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97–15.87% and 87.96–94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance.

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“…On the other hand, one of the main problems associated with dental implant surgeries is the recovery of patients with extremely atrophic maxilla [ 21 ]. Clinical research related to the number of implants required for rehabilitation of the edentulous jaws discovered the use of four implants led to an equivalent success level to rehabilitation processes with more implants [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy of the Panoramic and Cone Beam Computed Tomography Imaging Methods in the Surgical Planning of the Maxillary All-On-4, M-4, and V-4

Tandogdu

Ayalı

Caymaz

2022

BioMed Research International

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This study is aimed at analyzing the difference between the measurements made according to certain anatomical signs of the maxillary jaw using panoramic radiography and cone beam computed tomography (CBCT) to decide whether to use all-on-4, M-4, or V-4 configuration to prevent complications caused by incorrect measurements during the presurgical planning stage of the placement of implants in the all-on-4 technique. A retrospective study was conducted with 50 patients with upper edentulous jaws suitable for the all-on-4 technique, who underwent preoperative panoramic radiography and cone beam computed tomography evaluation for dental implant surgery. The shortest vertical distances between anatomical structures were measured. Measurements were made independently by two oral and maxillofacial surgeons, one experienced and the other inexperienced. A statistically significant difference was found between the mean values according to gender (p=0.045). When the measurements made by the experienced surgeon and the inexperienced surgeon were compared, there was no significant difference between panoramic radiography and cone beam computed tomography. In situations where bone measurements are required for deciding on all-on-4 or one of its configurations (M-4 and V-4), it was found that panoramic radiography gives significantly incorrect results compared to cone beam computed tomography (p<0.05). Cone beam computed tomography is more reliable than panoramic radiography and eliminates the margin of error in the planning of all-on-4 or its variations to be made by either an experienced or an inexperienced oral surgeon.

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Biomechanical comparison of the All-on-4, M-4, and V-4 techniques in an atrophic maxilla: A 3D finite element analysis

Cited by 13 publications

References 22 publications

Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear finite element analysis study

Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear finite element analysis study

Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA)

Comparison of the Efficacy of the Panoramic and Cone Beam Computed Tomography Imaging Methods in the Surgical Planning of the Maxillary All-On-4, M-4, and V-4

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