Comparison of tilted versus nontilted implant-supported prosthetic designs for the restoration of the edentuous mandible: a biomechanical study.
OBJECTIVE
The purpose of the study was to evaluate, using finite element analysis, the stress patterns induced in cortical bone by three distinct implant-supported prosthetic designs.


METHODS
The first two models consisted of a prosthesis supported by four implants, the distal two of which were tilted, with different cantilever lengths (5 mm and 15 mm). The third design consisted of a prosthesis supported by five conventionally placed implants and a 15-mm cantilever.


RESULTS
In the tilted model with 5-mm cantilever and in the nontilted model, the maximum value of compressive stress (-18 MPa) was found near the cervical area of the distal implant. Higher values for compressive stress were predicted near the cervical area of the distal implant in the tilted model with a 15-mm cantilever, as compared to the tilted model with the 5-mm cantilever. For the tilted model with the 5-mm cantilever, peak values of tensile stress were predicted near the cervical area of both the distal (1.25 MPa) and the mesial implants (2.5 MPa). For the nontilted model, the peak value was found near the cervical area of the in-between implant (5 MPa). For the tilted model with 15-mm cantilever, tensile stress values were higher than in the tilted model with 5-mm cantilever.


CONCLUSIONS
No significant difference in stress patterns between the tilted 5-mm and the nontilted 15-mm configuration was predicted. The tilted configuration with a 15-mm cantilever was found to induce higher stress values than the tilted configuration with a 5-mm cantilever.
Bellini
Chiara M
CM
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. chiara.bellini@polimi.it
Romeo
Davide
D
Galbusera
Fabio
F
Taschieri
Silvio
S
Raimondi
Manuela T
MT
Zampelis
Antonios
A
Francetti
Luca
L
D001696:Biomechanical Phenomena; D019245:Compressive Strength; D003198:Computer Simulation; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003799:Dental Stress Analysis / Q000379:methods; D003826:Denture, Complete, Lower; D020342:Finite Element Analysis; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D008334:Mandible / Q000601:surgery; D008954:Models, Biological; D011859:Radiography; D013718:Tensile Strength
D015921:Dental Implants