article · BMC Oral Health
This study employed finite element analysis to evaluate the biomechanical behaviour of implant-retained prostheses in the posterior maxilla. Researchers developed three-dimensional models representing fixed-fixed, mesial cantilever, and distal cantilever implant configurations, utilising either monolithic zirconia or polyetherketoneketone (PEKK) as prosthetic materials. After applying axial loads, von Mises stress values were computed for the prostheses, implants, and surrounding bone. The results showed that a fixed-fixed implant prosthesis, particularly when made from rigid zirconia, demonstrated better biomechanical behaviour and more favourable stress distribution around the bone and implants. In contrast, PEKK, a material with a lower elastic modulus, transmitted higher stress to the implants and surrounding bone, especially in a distal cantilever arrangement.
Understanding how different implant designs and materials distribute stress is crucial for the long-term success and stability of dental prostheses. This research helps dental professionals select optimal configurations to minimise stress on implants and bone, potentially reducing complications and improving patient outcomes.
This early-stage research, based on finite element analysis, provides insights for dental implant manufacturers and clinicians. The findings could inform the design and material selection for future implant-retained prostheses, aiming to improve their biomechanical performance and longevity. It suggests that specific combinations of design and material are more favourable for reducing stress on implants and bone.
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BACKGROUND: The aim of this study is to evaluate the biomechanical behavior of the mesial and distal off-axial extensions of implant-retained prostheses in the posterior maxilla with different prosthetic materials using finite element analysis (FEA). METHODS: Three dimensional (3D) finite element models with three implant configurations and prosthetic designs (fixed-fixed, mesial cantilever, and distal cantilever) were designed and modelled depending upon cone beam computed tomography (CBCT) images of an intact maxilla of an anonymous patient. Implant prostheses with two materials; Monolithic zirconia (Zr) and polyetherketoneketone (PEKK) were also modeled .The 3D modeling software Mimics Innovation Suite (Mimics 14.0 / 3-matic 7.01; Materialise, Leuven, Belgium) was used. All the models were imported into the FE package Marc/Mentat (ver. 2015; MSC Software, Los Angeles, Calif). Then, individual models were subjected to separate axial loads of 300 N. Von mises stress values were computed for the prostheses, implants, and bone under axial loading. RESULTS: The highest von Mises stresses in implant (111.6 MPa) and bone (100.0 MPa) were recorded in distal cantilever model with PEKK material, while the lowest values in implant (48.9 MPa) and bone (19.6 MPa) were displayed in fixed fixed model with zirconia material. The distal cantilever model with zirconia material yielded the most elevated levels of von Mises stresses within the prosthesis (105 MPa), while the least stresses in prosthesis (35.4 MPa) were recorded in fixed fixed models with PEKK material. CONCLUSIONS: In the light of this study, the combination of fixed fixed implant prosthesis without cantilever using a rigid zirconia material exhibits better biomechanical behavior and stress distribution around bone and implants. As a prosthetic material, low elastic modulus PEKK transmitted more stress to implants and surrounding bone especially with distal cantilever.
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DOI: 10.1186/s12903-024-04142-8
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