Tilting of splinted implants for improved prosthodontic support: A two-dimensional finite element analysis

Stress Distribution on Edentulous Mandible and Maxilla Rehabilitated by Full-Arch Techniques: A Comparative 3D Finite-Element Approach

“…Proposed numerical findings confirm that a rehabilitative full-arch technique should be chosen and/or designed by bearing in mind that the loading transmission features and the risks of bone resporption activation are strongly affected by cantilever configurations, as well as by morphological and mechanical bone properties. In detail, in agreement with many clinical (Aparicio et al, 2001;Calandriello & Tomatis, 2005;Capelli et al, 2007;Del Fabbro et al, 2010;Krekmanov et al, 2000;Malò et al, 2005;Sertgöz & Güvener, 1996;Shackleton et al, 1994;Testori et al, 2008;White et al, 1994), photoelastic (Begg et al, 2009), and numerical (Bellini, 2009;Bonnet et al, 2009;Carvalho Silva et al, 2010;Zampelis et al, 2007) evidences, an higher distal cantilever length has been proved to induce higher and dangerous stress concentrations on bone, mainly at the distal peri-implant regions. Therefore, proposed results confirm that the biomechanical rationale related to the use of tilted distal implants is effective for reducing cantilever mechanisms and generally for inducing more favourable load transmission characteristics.…”

“…In agreement with well-established studies (Baggi et al, 2008a;Bellini, 2009;Bonnet et al, 2009;Carvalho Silva et al, 2010;Chun et al, 2006;Kitagawa et al, 2005;Petrie & Williams, 2005;Van Staden et al, 2006;Zampelis et al, 2007), the Von Mises equivalent stress σ VM (always positive in sign) was used as a global stress indicator for characterizing the load transfer mechanisms, whereas principal stresses were employed as local risk measures of the bone-implant interfacial physiological failure and/or of the resorption process activation. Accordingly, by assuming the ultimate bone strength as a physiological limit, local overloading at the cortical bone occurs in compression when the maximum compressive principal stress (σ C ) exceeds 170-190 MPa in modulus, and in tension when the maximum tensile principal stress (σ T ) exceeds 100-130 MPa, as well as local overloading at the trabecular bone occurs when σ T and/or σ C exceeds 5 MPa (Guo, 2001;Natali et al, 2003), symbol σ C denoting the modulus of σ C .…”

“…In the last years the finite-element method has been widely applied in many fields of dentistry in order to analyze the influence of both mechanical and biological factors, as well as for improving clinical treatments and surgical protocols (e.g., Baggi et al, 2008a;Chun et al, 2006;Kitagawa et al, 2005;Maceri et al, 2007;Petrie & Williams, 2005;Van Staden et al, 2006). In this context, some recent numerical studies have compared the bone-implant mechanical interactions induced by distally-tilted and vertical implants, as well as numerical simulations based on simple geometrical models of Allon4 applications have been carried out (Bellini, 2009;Bonnet et al, 2009;Carvalho Silva et al, 2010;Zampelis et al, 2007). Nevertheless, the numerical analysis of full-arch rehabilitative techniques by using refined three-dimensional models can be still considered at an early stage and then as an actual and open important task.…”

Photoelastic analysis of all-on-four concept using different implants angulations for maxilla

“…The length reduction of cantilever associated with the fixed prosthetic design involving angulated implants probably plays a key role in reducing periimplant tension around the implants. 26 The higher the slope of the implant the smaller the cantilever, thus allowing greater distribution of forces and rehabilitation with more dental elements, favoring masticatory quality. 27 Under cantilever load the G35 had lower stress values while the G15 concentrated the stress in the apical region.…”

Transcrestal guided sinus lift without grafting materials: a 36 months clinical prospective study

“…Moreover, to achieve predictable results, the surgical experience along with a two-step procedure with delayed placement of implants is recommended (10,25,26). To overcome these limitations and potential complications of the sinus lift, the literature has suggested the use of inclined implants located in anatomical areas anteriorly or posteriorly to the sinus and, if it is present in the sinus septum, in the palate, and in pterygoid process to avoid implants endo-sinus (27)(28)(29)(30)(31)(32)(33)(34)(35)(36). The inclined positioning of the implants in those areas allows the choice of greater lengths, thus improving the bone anchoring, by increasing the inclination angle and therefore the support for the prosthesis, thus avoiding the need for bone grafting.…”