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Abstract
Statement of problem
The position and length of cantilever influence on the stress distribution of implants, superstructure and bone. In edentulous mandible, implant-supported cantilever prostheses that based 4 or 6 implants between mental foramens has been attempted. Excessive bite force loaded at cantilever prosthesis causes bone resorption and breakage of superstructure prosthesis around posterior implants. To complement the cantilever length of conventional prosthesis, In 1992, (McCartney) introduced "cantilever - rest - implant" and Malo reported "All-on-Four" in 2003.
Purpose
Analyze and compare the stress distribution of conventional cantilever prostheses with rest implant and Allon-Four TM implant prostheses.
Material and method
The external loads(300 N vertically, 75 N horizontally) are applied to first molar area. The stress value, stress distribution and aspect of stress dispersion are analyzed by three-dimensional finite element analysis program, ANSYS ver. 10.0.
Results
1. The rest implant and “ All-on-Four” implant system are superior to conventional cantilever prostheses to reduce stress on the bone and the superstructure around implants. 2. The rest implant was of the greatest advantage to stress distribution on bone, implant and superstructure. 3. With same number of implants, distally tilted implants are preferred to conventional cantilever prostheses for reducing the length of cantilever. (J Korean Acad Prosthodont 2009;47:70-81)
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Fig. 5.
Maximum equivalent stress of cortical bone. (Model A: conventional type, Model B: rest implant type, Model C: Allon-Four type)
Fig. 6.
Maximum equivalent stress of cortical bone. (Model A: conventional type, Model B: rest implant type, Model C: All-on-Four type)
Fig. 7.
Maximum equivalent stress of cancellous bone. (Model A: conventional type, Model B: rest implant type, Model C: Allon-Four type)
Fig. 8.
Maximum equivalent stress of cancellous bone. (Model A: conventional type, Model B: rest implant type, Model C: All-on-Four type)
Fig. 9.
Maximum equivalent stress of implants. (Model A: conventional type, Model B: rest implant type, Model C: Allon-Four type)
Fig. 10.
Maximum equivalent stress of implants. (Model A: conventional type, Model B: rest implant type, Model C: All-on-Four type)
Fig. 11.
Maximum equivalent stress of prosthesis. (Model A: conventional type, Model B: rest implant type, Model C: Allon-Four type)
Fig. 12.
Maximum equivalent stress of prosthesis. (Model A: conventional type, Model B: rest implant type, Model C: All-on-Four type)
Table I
Number of nodes and elements
| Model | Number of Node | Number of Element |
|---|---|---|
| A | 25675 | 21368 |
| B | 18677 | 15736 |
| C | 22389 | 18933 |
Table II
Mechanical properties of material
| Material | Young's modulus (GPa) | Poisson′ s ratio |
|---|---|---|
| Cortical bone | 20.0 | 0.3 |
| Cancellous bone | 2.0 | 0.2 |
| Titanium | 110.0 | 0.33 |
| Gold alloy | 80.0 | 0.33 |
| Resin composite | 7.0 | 0.2 |
| Resin | 2.7 | 0.35 |
Table III
Maximum equivalent stress of cortical bone (MPa)
Table IV
Maximum equivalent stress of cancellous bone (MPa)
Table V.
Maximum equivalent stress of implants (MPa)
Table VI
Maximum equivalent stress of prosthesis (MPa)
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