Keywords
Dental implants
Denture, overlay
Finite element analysis.
Denture, overlay
Finite element analysis.
How to Cite
1.
Ferreira FF, Borges GA, Silva LDR, Velôso DV, Barbin T, Mesquita MF. Biomechanical behavior of overdentures supported by different implant position and angulation using Micro ERA® system: a finite element analysis study. Braz. J. Oral Sci. [Internet]. 2019 Nov. 18 [cited 2024 Jul. 17];18:e191667. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8657331
Abstract
Aim: The aim of this study was to investigate the biomechanical behavior of implant-retained mandibular overdentures using Micro ERA® system with different implant position and angulation by finite element analysis (FEA). Methods: Four 3D finite element models of simplified mandibular overdentures were constructed, using one Bränemark implant with a Micro ERA® attachment. The implant was positioned on the canine or lateral incisor area with an angulation of either 0º (C-0º; LI-0º) or 17º (C-17º, LI-17º) to the vertical axis. A 100 N axial load was applied in one side simultaneously, from first premolar to second molar. In all models it was analyzed the overdenture displacement, compressive/tensile stress in the bone-implant interface, and also the von Mises equivalent stress for the nylon component of the housing. The stresses were obtained (numerically and color-coded) for further comparison among all the groups. Results: The displacement on the overdenture was higher at the posterior surface for all groups, especially in the C-17º group. When comparing the compressive/tensile stress in the bone-implant interface, the lateral-incisor groups (LI-0º and LI-17º) had the highest compressive and lowest tensile stress compared to the canine groups (C-0º and C-17º). The von Mises stress on the nylon component generated higher stress value for the LI-0º among all groups. Conclusions: The inclination and positioning of the implant in mandibular overdenture interferes directly in the stress distribution. The results showed that angulated implants had the highest displacement. While the implants placed in the lateral incisor position presented lower compressive and higher tensile stress respectively. For the attachment the canine groups had the lowest stress.
References
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2. Al-Zubeidi MI, Alsabeeha NH, Thomson WM, Payne AG. Patient satisfaction and dissatisfaction with Mandibular two-implant overdentures using different attachment systems: 5-Year Outcomes Clin Implant Dent Relat Res. 2012 Oct;14(5):696-707. doi: 10.1111/j.1708-8208.2010.00306.x.
3. Geckili O, Bilhan H, Bilgin T. Impact of mandibular two-implant retained overdentures on life quality in a group of elderly Turkish edentulous patients. Arch Gerontol Geriatr. 2011 Sep-Oct;53(2):233-6. doi: 10.1016/j.archger.2010.11.027.
4. Vercruyssen M, Marcelis K, Coucke W, Naert I, Quirynen M. Long-term, retrospective evaluation (implant and patient-centred outcome) of the two-implants-supported overdenture in the mandible. Part 1: survival rate. Clin Oral Implants Res. 2010 Apr 1;21(4):357-65. doi: 10.1111/j.1600-0501.2009.01849.x.
5. Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Nascimento GG, Del Bel Cury AA. How fast can treatment with overdentures improve the masticatory function and OHRQoL of atrophic edentulous patients? A 1-year longitudinal clinical study. Clin Oral Implants Res. 2018 Feb;29(2):215-26. doi: 10.1111/clr.13101.
6. Harris D, Höfer S, O’Boyle CA, Sheridan S, Marley J, Benington IC, et al: A comparison of implant-retained mandibular overdentures and conventional dentures on quality of life in edentulous patients: a randomized, prospective, within-subject controlled clinical trial. Clin Oral Implants Res. 2013 Jan;24(1):96-103. doi: 10.1111/j.1600-0501.2011.02368.x.
7. Awad MA, Rashid F, Feine JS: Overdenture effectiveness study team consortium. The effect of mandibular 2-implant overdentures on oral health-related quality of life: an international multicentre study. Clin Oral Implants Res. 2014 Jan;25(1):46-51. doi: 10.1111/clr.12205.
8. Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, et al: The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Int J Oral Maxillofac Implants 2002 Jul-Aug;17(4):6012.
9. Topkaya T, Solmaz MY. The effect of implant number and position on the stress behavior of mandibular implant retained overdentures: A three-dimensional finite element analysis. J Biomech. 2015 Jul 16;48(10):2102-9. doi: 10.1016/j.jbiomech.2015.03.006.
10. Schmitt A, Zarb GA. The notion of implant-supported overdentures. J Prosthet Dent. 1998 Jan;79(1):60-5.
11. Sultana N, Bartlett DW, Suleiman M. Retention of implant-supported overdentures at different implant angulations: comparing Locator and ball attachments. Clin Oral Implants Res. 2017 Nov;28(11):1406-10. doi: 10.1111/clr.13003.
12. Hong HR, Pae A, Kim Y, Paek J, Kim HS, Kwon KR. Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis. Int J Oral Maxillofac Implants. 2012 Sep-Oct;27(5):e69-76.
13. Khadivi V. Correcting a nonparallel implant abutment for a mandibular overdenture retained by two implants: a clinical report. J Prosthet Dent 2004 Sep;92(3):216-9.
14. Lima Verde MA, Morgano SM, Hashem A. Technique to restore unfavorably inclined implants. J Prosthet Dent. 1994 Apr;71(4):359-63.
15. Yang TC, Maeda Y, Gonda T, Kotecha S. Attachment systems for implant overdenture: influence of implant inclination on retentive and lateral forces: retentive and lateral forces in implant inclination. Clin Oral Implants Res. 2011 Nov;22(11):1315-9. doi: 10.1111/j.1600-0501.2010.02137.x.
16. Walton JN, Huizinga SC, Peck CC. Implant angulation: a measurement technique, implant overdenture maintenance, and the influence of surgical experience. Int J Prosthodont. 2001 Nov-Dec;14(6):523-30.
17. Petropoulos VC, Smith W. Maximum dislodging forces of implant overdenture stud attachments. Int J Oral Maxillofac Implants 2002 Jul-Aug;17(4):526-35.
18. Chung KH, Chung CY, Cagna DR, Cronin RJ Jr. Retention characteristics of attachment systems for implant overdentures. J Prosthodont. 2004 Dec;13(4):221-6.
19. Cune M, Burgers M, van Kampen F, de Putter C, van der Bilt A. Mandibular overdentures retained by two implants: 10-year results from a crossover clinical trial comparing ball-socket and bar-clip attachments. Int J Prosthodont 2010 Jul-Aug;23(4):310-7.
20. van der Bilt A, van Kampen FMC, Cune MS. Masticatory function with mandibular implant-supported overdentures fitted with different attachment types. Eur J Oral Sci. 2006 Jun;114(3):191-6.
21. Presotto AGC, Bhering CLB, Mesquita MF, Barão VA. Marginal fit and photoelastic stress analysis of CAD-CAM and overcast 3-unit implant-supported frameworks. J Prosthet Dent. 2017 Mar;117(3):373-9. doi: 10.1016/j.prosdent.2016.06.011.
22. Pisani MX, Presotto AGC, Mesquita MF, Barão VAR, Kemmoku DT, Del Bel Cury AA. Biomechanical behavior of 2-implant– and single-implant–retained mandibular overdentures with conventional or mini implants. J Prosthet Dent. 2018 Sep;120(3):421-30. doi: 10.1016/j.prosdent.2017.12.012.
23. Warin P, Rungsiyakull P, Rungsiyakull C, Khongkhunthian P. Effects of different numbers of mini-dental implants on alveolar ridge strain distribution under mandibular implant-retained overdentures. J Prosthodont Res. 2018 Jan;62(1):35-43. doi: 10.1016/j.jpor.2017.05.002.
24. Branemark PI, Zarb GA, Albrektsson T. Tissue-integrated prostheses: osseointegration in clinical dentistry. J Prosthet Dent. 1985 Oct;54(4):611-2.
25. Barão VAR, Assunção WG, Tabata LF, de Sousa EA, Rocha EP. Effect of different mucosa thickness and resiliency on stress distribution of implant-retained overdentures-2D FEA. Comput Methods Programs Biomed. 2008 Nov;92(2):213-23. doi: 10.1016/j.cmpb.2008.07.009.
26. Liu J, Pan S, Dong J, Mo Z, Fan Y, Feng H. Influence of implant number on the biomechanical behaviour of mandibular implant-retained/supported overdentures: a three-dimensional finite element analysis. J Dent. 2013 Mar;41(3):241-9. doi: 10.1016/j.jdent.2012.11.008.
27. Chen J, Ahmad R, Suenaga H, Li W, Swain M, Li Q. A comparative study on complete and implant retained denture treatments – A biomechanics perspective. J Biomech. 2015 Feb 5;48(3):512-9. doi: 10.1016/j.jbiomech.2014.11.043.
28. da Silva DP, Cazal C, de Almeida FC, Dias RB, Ballester RY. Photoelastic stress analysis surrounding implant-supported prosthesis and alveolar ridge on mandibular overdentures. Int J Dent. 2010;2010:780670. doi: 10.1155/2010/780670.
29. Chun HJ, Park DN, Han CH, Heo SJ, Heo MS, Koak JY. Stress distributions in maxillary bone surrounding overdenture implants with different overdenture attachments. J Oral Rehabil. 2005 Mar;32(3):193-205.
30. Barão VAR, Delben JA, Lima J, Cabral T, Assunção WG. Comparison of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible – a computed tomography-based three-dimensional finite element analysis. J Biomech. 2013 Apr 26;46(7):1312-20. doi: 10.1016/j.jbiomech.2013.02.008.
31. El-Anwar MI, El-Taftazany EA, Hamed HA, ElHay MAA. Influence of number of implants and attachment type on stress distribution in mandibular implant-retained overdentures: finite element analysis. Open Access Maced J Med Sci. 2017 Mar 22;5(2):244-9. doi: 10.3889/oamjms.2017.047.
32. Kasani R, Rama Sai Attili BK, Dommeti VK, Merdji A, Biswas JK, Roy S. Stress distribution of overdenture using odd number implants – A Finite Element Study. J Mech Behav Biomed Mater. 2019 Oct;98:369-82. doi: 10.1016/j.jmbbm.2019.06.030.
33. Gulizio MP, Agar JR, Kelly JR, Taylor TD. effect of implant angulation upon retention of overdenture attachments. J Prosthodont 2005 Mar;14(1):3-11.
34. Oda K, Kanazawa M, Takeshita S, Minakuchi S. Influence of implant number on the movement of mandibular implant overdentures. J Prosthet Dent. 2017 Mar;117(3):380-5. doi: 10.1016/j.prosdent.2016.08.005.
35. Kimoto S, Pan S, Drolet N, Feine JS. Rotational movements of mandibular two-implant overdentures. Clin Oral Implants Res. 2009 Aug;20(8):838-43. doi: 10.1111/j.1600-0501.2009.01723.x.
36. Vogel RC. Implant overdentures: a new standard of care for edentulous patients current concepts and techniques. Compend Contin Educ Dent. 2008 Jun;29(5):270-6; quiz 277-8.
37. Borges Radaelli MT, Idogava HT, Spazzin AO, Noritomi PY, Boscato N. Parafunctional loading and occlusal device on stress distribution around implants: A 3D finite element analysis. J Prosthet Dent. 2018 Oct;120(4):565-72. doi: 10.1016/j.prosdent.2017.12.023.
38. Alvarez-Arenal A, Gonzalez-Gonzalez I, deLlanos- Lanchares H, Martin-Fernandez E, Brizuela-Velasco A, Ellacuria-Echebarria. Effect of implant- and occlusal load location on stress distribution in Locator attachments of mandibular overdenture. A finite element study. J Adv Prosthodont. 2017 Oct;9(5):371-80. doi: 10.4047/jap.2017.9.5.371.
39. Kurniawan D, Nor FM, Lee HY, Lim JY. Finite element analysis of bone–implant biomechanics: refinement through featuring various osseointegration conditions. Int J Oral Maxillofac Surg. 2012 Sep;41(9):1090-6. doi: 10.1016/j.ijom.2011.12.026.
40. Arat Bilhan S, Baykasoglu C, Bilhan H, Kutay O, Mugan A. Effect of attachment types and number of implants supporting mandibular overdentures on stress distribution: a computed tomography-based 3D finite element analysis. J Biomech. 2015 Jan 2;48(1):130-7. doi: 10.1016/j.jbiomech.2014.10.022.
41. Rodrigues RC, Faria AC, Macedo AP, Sartori IA, de Mattos Mda G, Ribeiro RF. An in vitro study of non-axial forces upon the retention of an O-ring attachment. Clin Oral Implants Res. 2009 Dec;20(12):1314-9. doi: 10.1111/j.1600-0501.2009.01742.x.
2. Al-Zubeidi MI, Alsabeeha NH, Thomson WM, Payne AG. Patient satisfaction and dissatisfaction with Mandibular two-implant overdentures using different attachment systems: 5-Year Outcomes Clin Implant Dent Relat Res. 2012 Oct;14(5):696-707. doi: 10.1111/j.1708-8208.2010.00306.x.
3. Geckili O, Bilhan H, Bilgin T. Impact of mandibular two-implant retained overdentures on life quality in a group of elderly Turkish edentulous patients. Arch Gerontol Geriatr. 2011 Sep-Oct;53(2):233-6. doi: 10.1016/j.archger.2010.11.027.
4. Vercruyssen M, Marcelis K, Coucke W, Naert I, Quirynen M. Long-term, retrospective evaluation (implant and patient-centred outcome) of the two-implants-supported overdenture in the mandible. Part 1: survival rate. Clin Oral Implants Res. 2010 Apr 1;21(4):357-65. doi: 10.1111/j.1600-0501.2009.01849.x.
5. Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Nascimento GG, Del Bel Cury AA. How fast can treatment with overdentures improve the masticatory function and OHRQoL of atrophic edentulous patients? A 1-year longitudinal clinical study. Clin Oral Implants Res. 2018 Feb;29(2):215-26. doi: 10.1111/clr.13101.
6. Harris D, Höfer S, O’Boyle CA, Sheridan S, Marley J, Benington IC, et al: A comparison of implant-retained mandibular overdentures and conventional dentures on quality of life in edentulous patients: a randomized, prospective, within-subject controlled clinical trial. Clin Oral Implants Res. 2013 Jan;24(1):96-103. doi: 10.1111/j.1600-0501.2011.02368.x.
7. Awad MA, Rashid F, Feine JS: Overdenture effectiveness study team consortium. The effect of mandibular 2-implant overdentures on oral health-related quality of life: an international multicentre study. Clin Oral Implants Res. 2014 Jan;25(1):46-51. doi: 10.1111/clr.12205.
8. Feine JS, Carlsson GE, Awad MA, Chehade A, Duncan WJ, Gizani S, et al: The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients. Int J Oral Maxillofac Implants 2002 Jul-Aug;17(4):6012.
9. Topkaya T, Solmaz MY. The effect of implant number and position on the stress behavior of mandibular implant retained overdentures: A three-dimensional finite element analysis. J Biomech. 2015 Jul 16;48(10):2102-9. doi: 10.1016/j.jbiomech.2015.03.006.
10. Schmitt A, Zarb GA. The notion of implant-supported overdentures. J Prosthet Dent. 1998 Jan;79(1):60-5.
11. Sultana N, Bartlett DW, Suleiman M. Retention of implant-supported overdentures at different implant angulations: comparing Locator and ball attachments. Clin Oral Implants Res. 2017 Nov;28(11):1406-10. doi: 10.1111/clr.13003.
12. Hong HR, Pae A, Kim Y, Paek J, Kim HS, Kwon KR. Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis. Int J Oral Maxillofac Implants. 2012 Sep-Oct;27(5):e69-76.
13. Khadivi V. Correcting a nonparallel implant abutment for a mandibular overdenture retained by two implants: a clinical report. J Prosthet Dent 2004 Sep;92(3):216-9.
14. Lima Verde MA, Morgano SM, Hashem A. Technique to restore unfavorably inclined implants. J Prosthet Dent. 1994 Apr;71(4):359-63.
15. Yang TC, Maeda Y, Gonda T, Kotecha S. Attachment systems for implant overdenture: influence of implant inclination on retentive and lateral forces: retentive and lateral forces in implant inclination. Clin Oral Implants Res. 2011 Nov;22(11):1315-9. doi: 10.1111/j.1600-0501.2010.02137.x.
16. Walton JN, Huizinga SC, Peck CC. Implant angulation: a measurement technique, implant overdenture maintenance, and the influence of surgical experience. Int J Prosthodont. 2001 Nov-Dec;14(6):523-30.
17. Petropoulos VC, Smith W. Maximum dislodging forces of implant overdenture stud attachments. Int J Oral Maxillofac Implants 2002 Jul-Aug;17(4):526-35.
18. Chung KH, Chung CY, Cagna DR, Cronin RJ Jr. Retention characteristics of attachment systems for implant overdentures. J Prosthodont. 2004 Dec;13(4):221-6.
19. Cune M, Burgers M, van Kampen F, de Putter C, van der Bilt A. Mandibular overdentures retained by two implants: 10-year results from a crossover clinical trial comparing ball-socket and bar-clip attachments. Int J Prosthodont 2010 Jul-Aug;23(4):310-7.
20. van der Bilt A, van Kampen FMC, Cune MS. Masticatory function with mandibular implant-supported overdentures fitted with different attachment types. Eur J Oral Sci. 2006 Jun;114(3):191-6.
21. Presotto AGC, Bhering CLB, Mesquita MF, Barão VA. Marginal fit and photoelastic stress analysis of CAD-CAM and overcast 3-unit implant-supported frameworks. J Prosthet Dent. 2017 Mar;117(3):373-9. doi: 10.1016/j.prosdent.2016.06.011.
22. Pisani MX, Presotto AGC, Mesquita MF, Barão VAR, Kemmoku DT, Del Bel Cury AA. Biomechanical behavior of 2-implant– and single-implant–retained mandibular overdentures with conventional or mini implants. J Prosthet Dent. 2018 Sep;120(3):421-30. doi: 10.1016/j.prosdent.2017.12.012.
23. Warin P, Rungsiyakull P, Rungsiyakull C, Khongkhunthian P. Effects of different numbers of mini-dental implants on alveolar ridge strain distribution under mandibular implant-retained overdentures. J Prosthodont Res. 2018 Jan;62(1):35-43. doi: 10.1016/j.jpor.2017.05.002.
24. Branemark PI, Zarb GA, Albrektsson T. Tissue-integrated prostheses: osseointegration in clinical dentistry. J Prosthet Dent. 1985 Oct;54(4):611-2.
25. Barão VAR, Assunção WG, Tabata LF, de Sousa EA, Rocha EP. Effect of different mucosa thickness and resiliency on stress distribution of implant-retained overdentures-2D FEA. Comput Methods Programs Biomed. 2008 Nov;92(2):213-23. doi: 10.1016/j.cmpb.2008.07.009.
26. Liu J, Pan S, Dong J, Mo Z, Fan Y, Feng H. Influence of implant number on the biomechanical behaviour of mandibular implant-retained/supported overdentures: a three-dimensional finite element analysis. J Dent. 2013 Mar;41(3):241-9. doi: 10.1016/j.jdent.2012.11.008.
27. Chen J, Ahmad R, Suenaga H, Li W, Swain M, Li Q. A comparative study on complete and implant retained denture treatments – A biomechanics perspective. J Biomech. 2015 Feb 5;48(3):512-9. doi: 10.1016/j.jbiomech.2014.11.043.
28. da Silva DP, Cazal C, de Almeida FC, Dias RB, Ballester RY. Photoelastic stress analysis surrounding implant-supported prosthesis and alveolar ridge on mandibular overdentures. Int J Dent. 2010;2010:780670. doi: 10.1155/2010/780670.
29. Chun HJ, Park DN, Han CH, Heo SJ, Heo MS, Koak JY. Stress distributions in maxillary bone surrounding overdenture implants with different overdenture attachments. J Oral Rehabil. 2005 Mar;32(3):193-205.
30. Barão VAR, Delben JA, Lima J, Cabral T, Assunção WG. Comparison of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible – a computed tomography-based three-dimensional finite element analysis. J Biomech. 2013 Apr 26;46(7):1312-20. doi: 10.1016/j.jbiomech.2013.02.008.
31. El-Anwar MI, El-Taftazany EA, Hamed HA, ElHay MAA. Influence of number of implants and attachment type on stress distribution in mandibular implant-retained overdentures: finite element analysis. Open Access Maced J Med Sci. 2017 Mar 22;5(2):244-9. doi: 10.3889/oamjms.2017.047.
32. Kasani R, Rama Sai Attili BK, Dommeti VK, Merdji A, Biswas JK, Roy S. Stress distribution of overdenture using odd number implants – A Finite Element Study. J Mech Behav Biomed Mater. 2019 Oct;98:369-82. doi: 10.1016/j.jmbbm.2019.06.030.
33. Gulizio MP, Agar JR, Kelly JR, Taylor TD. effect of implant angulation upon retention of overdenture attachments. J Prosthodont 2005 Mar;14(1):3-11.
34. Oda K, Kanazawa M, Takeshita S, Minakuchi S. Influence of implant number on the movement of mandibular implant overdentures. J Prosthet Dent. 2017 Mar;117(3):380-5. doi: 10.1016/j.prosdent.2016.08.005.
35. Kimoto S, Pan S, Drolet N, Feine JS. Rotational movements of mandibular two-implant overdentures. Clin Oral Implants Res. 2009 Aug;20(8):838-43. doi: 10.1111/j.1600-0501.2009.01723.x.
36. Vogel RC. Implant overdentures: a new standard of care for edentulous patients current concepts and techniques. Compend Contin Educ Dent. 2008 Jun;29(5):270-6; quiz 277-8.
37. Borges Radaelli MT, Idogava HT, Spazzin AO, Noritomi PY, Boscato N. Parafunctional loading and occlusal device on stress distribution around implants: A 3D finite element analysis. J Prosthet Dent. 2018 Oct;120(4):565-72. doi: 10.1016/j.prosdent.2017.12.023.
38. Alvarez-Arenal A, Gonzalez-Gonzalez I, deLlanos- Lanchares H, Martin-Fernandez E, Brizuela-Velasco A, Ellacuria-Echebarria. Effect of implant- and occlusal load location on stress distribution in Locator attachments of mandibular overdenture. A finite element study. J Adv Prosthodont. 2017 Oct;9(5):371-80. doi: 10.4047/jap.2017.9.5.371.
39. Kurniawan D, Nor FM, Lee HY, Lim JY. Finite element analysis of bone–implant biomechanics: refinement through featuring various osseointegration conditions. Int J Oral Maxillofac Surg. 2012 Sep;41(9):1090-6. doi: 10.1016/j.ijom.2011.12.026.
40. Arat Bilhan S, Baykasoglu C, Bilhan H, Kutay O, Mugan A. Effect of attachment types and number of implants supporting mandibular overdentures on stress distribution: a computed tomography-based 3D finite element analysis. J Biomech. 2015 Jan 2;48(1):130-7. doi: 10.1016/j.jbiomech.2014.10.022.
41. Rodrigues RC, Faria AC, Macedo AP, Sartori IA, de Mattos Mda G, Ribeiro RF. An in vitro study of non-axial forces upon the retention of an O-ring attachment. Clin Oral Implants Res. 2009 Dec;20(12):1314-9. doi: 10.1111/j.1600-0501.2009.01742.x.
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