The Effect of Mandibular Flexure on Stress Distribution in the All-on-4 Treated Edentulous Mandible: A Comparative Finite-Element Study Based on Mechanostat Theory

Shahriari, Shayan; Parandakh, Azim; Khani, Mohammad‐Mehdi; Azadikhah, Nima; Naraghi, Paniz; Aeinevand, Mahsa; Nikkhoo, Mohammad; Khojasteh, Arash

doi:10.1615/jlongtermeffmedimplants.2019030866

Cited by 5 publications

(4 citation statements)

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“…Four studies favored the mesial placement of the implants, claiming that this position allows the jaw to have greater flexibility along with lowering pressing efforts on the implants. On the other hand, three studies were in favor of placing the implants distally, because according to their study the peri-implant bone stress is lower in this position [ 18 , 24 , 25 , 28 , 29 , 30 , 31 , 32 , 33 ]. The mandibular elastic deformation is modified by the insertion of different types of fixed implant-supported restorations, creating a different influence on the mandibular flexure.…”

Section: Discussionmentioning

confidence: 99%

“…These effects are more significant in periodontally involved teeth and to a greater extent when it comes to patients with bruxism [ 5 , 18 , 19 , 20 ]. In implant-supported restorations, the two main parameters that contribute to the reduction in the efforts caused by mandibular flexion are the design of the restorative framework and distribution of implants in the mandible [ 18 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Influence of Mandibular Flexure on Oral Rehabilitation: Narrative Review

Mijiritsky

Shacham

Meilik

et al. 2022

IJERPH

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Aim: The current paper aims to review mandibular flexure and its clinical implications in the field of oral rehabilitation. Mandibular flexure is a deformity of the mandible, which occurs during jaw movements. Methods and Materials: An electronic database search was conducted using the PRISM model, with a total of 49 articles included. Results: Mandibular flexure affects various stages of oral rehabilitation treatments. Effects of mandibular flexure are more significant in periodontal patients, and in implant-supported restorations, compared to natural teeth, due to differences in the force absorption by the periodontal ligament. Various adjustments must be made to the prosthodontic framework to enable long-term survival of the restorative treatments. Conclusions: Dental practitioners should pay attention to the following: (1) digital impressions are preferred over conventional; (2) mouth opening should be kept to a minimum (as possible, up to 10–20 mm) while also avoiding any anterior movements of the mandible (protrusion); (3) the number of abutment teeth should be kept to a minimum; (4) structures in the lower jaw should be splitted; (5) non-rigid connectors should be used to reduce the effort exerted; (6) in periodontal patients, the preference is for short-span restorations and non-rigid connectors; (7) in implant-supported restorations, it is preferable to divide the framework into two or three segments, utilizing rigid materials with a low elastic modulus. There is no agreement in the literature about the preferred location of the implants in the jaw.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Influence of Mandibular Flexure on Oral Rehabilitation: Narrative Review

Mijiritsky

Shacham

Meilik

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Fully bonded contact was assumed between bone and implant [ 10 ]. To obtain a thorough understanding of stress distribution, Von Mises stress was analyzed [ 28 , 29 ]. Values of Von Mises stress were probed at evenly 60 layers (total 600 distributed sites) in regions of interest (ROI) of peri-implant bone.…”

Section: Methodsmentioning

confidence: 99%

Mechanobiologically optimized Ti–35Nb–2Ta–3Zr improves load transduction and enhances bone remodeling in tilted dental implant therapy

Mao

Jin

et al. 2022

Bioactive Materials

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“…Compared to models created by scanning traditional impressions, digital models created by intra-oral scanning have been shown to have higher dimensional accuracy: this is mainly related to the fact that, with oral scanning, errors that can arise from an incorrect water/dust ratio of the plaster material and deformation of the impression material are eliminated [88][89][90]. Furthermore, the pressure used to press down on the jaw when obtaining an imprint using conventional techniques may affect mandibular flexibility [70].…”

Section: Type Of Movement Performed During Measurementmentioning

confidence: 99%

Biomechanical Implications of Mandibular Flexion on Implant-Supported Full-Arch Rehabilitations: A Systematic Literature Review

Caggiano,

D’Ambrosio,

Acerra

et al. 2023

JCM

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Background: Mandibular flexion (MF) is a complex biomechanical phenomenon, which involves a deformation of the mandible, due mainly to the contraction of the masticatory muscles, and it can have numerous clinical effects. The deformation of the lower jaw caused by mandibular flexion is generally very small, and it is often overlooked and considered irrelevant from a clinical point of view by many authors; however, it should be important to remember that median mandibular flexure (MMF) has a multifactorial aetiology. The main aim of the current systematic review is to highlight the different factors that can increase MF in order to help clinicians identify patients to whom they should pay more attention. As a secondary outcome, we wanted to analyse the preventive measures and suitable techniques to be adopted to minimise the negative effects of this phenomenon on oral fixed rehabilitations. Methods: The review, which was carried out in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) flowchart, was recorded in the “International Prospective Register of Systematic Reviews” (PROSPERO). As research questions, “Patient/Population, Intervention, Comparison and Outcomes” (PICO) questions were employed. Using the ROBINS-I technique, the risk of bias in non-randomised clinical studies was evaluated. Results: The initial electronic search identified over 1300 potential articles, of which 54 studies were included in this systematic review. Information regarding the relationship between MF and individual factors, mandibular movements, impression taking, and fixed rehabilitations were obtained. Conclusions: The studies included in this systematic review showed that MF is greater during protrusive movements, in the posterior areas of the lower jaw, and in patients with brachial facial type, greater jaw length; small gonial angle; and less density, length, and bone surface of the symphysis. The biomechanical effects of mandibular flexion on fixed restorations are debated. Prospective clinical and radiological observational studies should be conducted to evaluate the potential short-, medium-, and long-term consequences of MF.

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The Effect of Mandibular Flexure on Stress Distribution in the All-on-4 Treated Edentulous Mandible: A Comparative Finite-Element Study Based on Mechanostat Theory

Cited by 5 publications

References 0 publications

Clinical Influence of Mandibular Flexure on Oral Rehabilitation: Narrative Review

Clinical Influence of Mandibular Flexure on Oral Rehabilitation: Narrative Review

Mechanobiologically optimized Ti–35Nb–2Ta–3Zr improves load transduction and enhances bone remodeling in tilted dental implant therapy

Biomechanical Implications of Mandibular Flexion on Implant-Supported Full-Arch Rehabilitations: A Systematic Literature Review

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