title: A comparative study on complete and implant retained denture treatments: a biomechanics perspective.
abstract: Although implant-retained overdenture allows edentulous patients to take higher occlusal forces than the conventional complete dentures, the biomechanical influences have not been explored yet. Clinically, there is limited knowledge and means for predicting localized bone remodelling after denture treatment with and without implant support. By using finite element (FE) analysis, this article provides an in-silico approach to exploring the treatment effects on the oral mucosa and potential resorption of residual ridge under three different denture configurations in a patient-specific manner. Based on cone beam computerized tomography (CBCT) scans, a 3D heterogeneous FE model was created; and the supportive tissue, mucosa, was characterized as a hyperelastic material. A measured occlusal load (63N) was applied onto three virtual models, namely complete denture, two and four implant-retained overdentures. Clinically, the bone resorption was measured after one year in the two implant-retained overdenture treatment. Despite the improved stability and enhanced masticatory function, the implant-retained overdentures demonstrated higher hydrostatic stress in mucosa (43.6kPa and 39.9kPa for two and four implants) at the posterior ends of the mandible due to the cantilever effect, than the complete denture (33.4kPa). Hydrostatic pressure in the mucosa signifies a critical indicator and can be correlated with clinically measured bone resorption, pointing to severer mandibular ridge resorption posteriorly with implant-retained overdentures. This study provides a biomechanical basis for denture treatment planning to improve long-term outcomes with minimal residual ridge resorption.
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, NSW 2006, Australia.
authors.forename: Junning
authors.initials: J
authors.lastname: Chen
authors.affiliation: Unit of Prosthodontics, Faculty of Dentistry, Universiti Teknologi MARA, Shah Alam, Malaysia.
authors.forename: Rohana
authors.initials: R
authors.lastname: Ahmad
authors.affiliation: Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Suenaga
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, NSW 2006, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Faculty of Dentistry, the University of Sydney, NSW 2006, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Swain
authors.affiliation: School of Aerospace, Mechanical and Mechatronic Engineering, the University of Sydney, NSW 2006, Australia. Electronic address: qing.li@sydney.edu.au.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
mesh_terms: D001696:Biomechanical Phenomena; D001732:Bite Force; D019094:Dental Prosthesis, Implant-Supported / Q000295:instrumentation*; D003781:Denture Retention / Q000295:instrumentation*; D003828:Denture, Overlay; D004867:Equipment Design; D020342:Finite Element Analysis; D005500:Follow-Up Studies; D006801:Humans; D006874:Hydrostatic Pressure; D008334:Mandible; D008954:Models, Biological; D009061:Mouth Mucosa; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Heterogeneity; Hydrostatic pressure; Hyperelastic model; Mucosa and periosteum biomechanics; Residual ridge resorption