Effect of Implant Position, Angulation, and Attachment Height on Peri-Implant Bone Stress Associated with Mandibular Two-Implant Overdentures: A Finite Element Analysis.
AUTHOR
-- BY Hong HR, Pae AR, Kim YS, Paek JH, Kim hs, Kwon KR.
Purpose: The aim of this
study was to analyze and compare the level and distribution of peri-implant
bone stresses associated with mandibular two-implant overdentures with
different implant positions.
Materials and methods: Mathematical models of mandibles and overdentures were designed
using finite element analysis software. Two intraosseous implants and ball
attachment systems were placed in the interforaminal region. The overdenture,
which was supported by the two implants, was designed to withstand bilateral
and unilateral vertical masticatory loads (total 100 N). In all, eight types of
models, which differed according to assigned implant positions, height of
attachments, and angulation, were tested: MI (model with implants positioned in
the lateral incisor sites), MC (implants in canine sites), MP (implants in
premolar sites), MI-Hi (greater height of attachments), MC-M (canine implants
placed with mesial inclination), MC-D (canine implants placed with distal
inclination), MC-B (canine implants placed with buccal inclination), and MC-L
(canine implants placed with lingual inclination).
Results: Peri-implant
bone stress levels associated with overdentures retained by lateral incisor
implants resulted in the lowest stress levels and the highest efficiency in
distributing peri-implant stress. MI-Hi showed increased stress levels and
decreased efficiency in stress distribution. As the implants were inclined,
stress levels increased and the efficiency of stress distribution decreased.
Among the inclined models, MC-B showed the lowest stress level and best
efficiency in stress distribution.
Conclusion: The lowest stress and the best stability
of implants in mandibular two-implant overdentures were obtained when implants
were inserted in lateral incisor areas with shorter attachments and were placed
parallel to the long axes of the teeth.
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