Skip to main content
Top
Published in: Head & Face Medicine 1/2017

Open Access 01-12-2017 | Research

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Authors: Aysa Ayali, Kani Bilginaylar

Published in: Head & Face Medicine | Issue 1/2017

Login to get access

Abstract

Background

Rehabilitation using an implant supported overdenture with two implants inserted in the interforaminal region is the easiest and currently accepted treatment modality to increase prosthetic stabilization and patient satisfaction in edentulous patients. The insertion of implants to the weakend mandibular bone decreases the strength of the bone and may lead to fractures either during or after implant placement. The aim of this three dimensional finite element analysis (3D FEA) study was to evaluate the biomechanical effects of implant diameter in case of facial trauma (2000 N) to an edentulous atrophic mandible with two implant supported overdenture.

Methods

Three 3D FEA models were simulated; Model 1 (M1) is edentulous atrophic mandible, Model 2 (M2), 3.5x11.5 mm implants were inserted into lateral incisors area of same edentulous atrophic mandible, Model 3 (M3), 4.3x11.5 mm implants were inserted into lateral incisors area of same edentulous atrophic mandible.

Results

In M1 and M2 highest stress levels were observed in condylar neck, whereas highest stress values in M3 were calculated in symphyseal area.

Conclusions

To reduce the risk of bone fracture and to preserve biomechanical behavior of the atrophic mandible from frontal traumatic loads, implants should be inserted monocortically into spongious bone of lateral incisors area.
Literature
1.
go back to reference de Souza Batista VE, de Souza Batista FR, Vechiato-Filho AJ, Lemos CA de A, Pellizzer EP, Verri FR. Rehabilitation With Mandibular Implant-Retained Complete Overdenture Using the Association of Two Retention Systems. J Craniofac Surg. 2016;27:e620–2.CrossRefPubMed de Souza Batista VE, de Souza Batista FR, Vechiato-Filho AJ, Lemos CA de A, Pellizzer EP, Verri FR. Rehabilitation With Mandibular Implant-Retained Complete Overdenture Using the Association of Two Retention Systems. J Craniofac Surg. 2016;27:e620–2.CrossRefPubMed
2.
go back to reference Karbach J, Hartmann S, Jahn-Eimermacher A, Wagner W. Oral Health-Related Quality of Life in Edentulous Patients with Two- vs Four-Locator-Retained Mandibular Overdentures: A Prospective, Randomized, Crossover Study. Int J Oral Maxillofac Implants. 2015;30:1143–8.CrossRefPubMed Karbach J, Hartmann S, Jahn-Eimermacher A, Wagner W. Oral Health-Related Quality of Life in Edentulous Patients with Two- vs Four-Locator-Retained Mandibular Overdentures: A Prospective, Randomized, Crossover Study. Int J Oral Maxillofac Implants. 2015;30:1143–8.CrossRefPubMed
3.
go back to reference Almasri M, El-Hakim M. Fracture of the anterior segment of the atrophic mandible related to dental implants. Int J Oral Maxillofac Surg. 2012;41:646–9.CrossRefPubMed Almasri M, El-Hakim M. Fracture of the anterior segment of the atrophic mandible related to dental implants. Int J Oral Maxillofac Surg. 2012;41:646–9.CrossRefPubMed
4.
go back to reference Coskunses FM, Kocyigit ID, Atil F, Tekin U, Suer BT, Tuz HH, et al. Finite-Element Analysis of a New Designed Miniplate which is Used via Intraoral Approach to the Mandible Angle Fracture: Comparison of the Different Fixation Techniques. J Craniofac Surg. 2015;26:e445–8.CrossRefPubMed Coskunses FM, Kocyigit ID, Atil F, Tekin U, Suer BT, Tuz HH, et al. Finite-Element Analysis of a New Designed Miniplate which is Used via Intraoral Approach to the Mandible Angle Fracture: Comparison of the Different Fixation Techniques. J Craniofac Surg. 2015;26:e445–8.CrossRefPubMed
5.
go back to reference Torsiglieri T, Raith S, Rau A, Deppe H, Hölzle F, Steiner T. Stability of edentulous, atrophic mandibles after insertion of different dental implants. A biomechanical study. J Craniomaxillofac Surg. 2015;43:616–23.CrossRefPubMed Torsiglieri T, Raith S, Rau A, Deppe H, Hölzle F, Steiner T. Stability of edentulous, atrophic mandibles after insertion of different dental implants. A biomechanical study. J Craniomaxillofac Surg. 2015;43:616–23.CrossRefPubMed
6.
go back to reference Meijer HJA, Raghoebar GM, Visser A. Mandibular Fracture Caused by Peri-Implant Bone Loss: Report of a Case. J Periodontol. 2003;74:1067–70.CrossRefPubMed Meijer HJA, Raghoebar GM, Visser A. Mandibular Fracture Caused by Peri-Implant Bone Loss: Report of a Case. J Periodontol. 2003;74:1067–70.CrossRefPubMed
7.
go back to reference Raghoebar GM, Stellingsma K, Batenburg RH, Vissink A. Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:553–9.CrossRefPubMed Raghoebar GM, Stellingsma K, Batenburg RH, Vissink A. Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:553–9.CrossRefPubMed
8.
go back to reference Oh W, Roumanas ED, Beumer J. Mandibular fracture in conjunction with bicortical penetration, using wide-diameter endosseous dental implants. J Prosthodont. 2010;19:625–9.CrossRefPubMed Oh W, Roumanas ED, Beumer J. Mandibular fracture in conjunction with bicortical penetration, using wide-diameter endosseous dental implants. J Prosthodont. 2010;19:625–9.CrossRefPubMed
9.
go back to reference Gallas Torreira M, Fernandez JR. A three-dimensional computer model of the human mandible in two simulated standard trauma situations. J Craniomaxillofac Surg. 2004;32:303–7.CrossRefPubMed Gallas Torreira M, Fernandez JR. A three-dimensional computer model of the human mandible in two simulated standard trauma situations. J Craniomaxillofac Surg. 2004;32:303–7.CrossRefPubMed
10.
go back to reference Antic S, Vukicevic AM, Milasinovic M, Saveljic I, Jovicic G, Filipovic N, et al. Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study. J Craniomaxillofac Surg. 2015;43:870–8.CrossRefPubMed Antic S, Vukicevic AM, Milasinovic M, Saveljic I, Jovicic G, Filipovic N, et al. Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study. J Craniomaxillofac Surg. 2015;43:870–8.CrossRefPubMed
11.
go back to reference Vollmer D, Meyer U, Joos U, Vègh A, Piffkò J. Experimental and finite element study of a human mandible. J Cranio-Maxillofac Surg. 2000;28:91–6.CrossRef Vollmer D, Meyer U, Joos U, Vègh A, Piffkò J. Experimental and finite element study of a human mandible. J Cranio-Maxillofac Surg. 2000;28:91–6.CrossRef
12.
go back to reference Kilinç Y, Erkmen E, Kurt A. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part One: Superior Repositioning Surgery. J Craniofac Surg. 2016;27:32–5.CrossRefPubMed Kilinç Y, Erkmen E, Kurt A. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part One: Superior Repositioning Surgery. J Craniofac Surg. 2016;27:32–5.CrossRefPubMed
13.
go back to reference Li Q, Ren S, Ge C, Sun H, Lu H, Duan Y, et al. Effect of jaw opening on the stress pattern in a normal human articular disc: finite element analysis based on MRI images. Head Face Med. 2014;10:24.CrossRefPubMedPubMedCentral Li Q, Ren S, Ge C, Sun H, Lu H, Duan Y, et al. Effect of jaw opening on the stress pattern in a normal human articular disc: finite element analysis based on MRI images. Head Face Med. 2014;10:24.CrossRefPubMedPubMedCentral
14.
go back to reference Kan B, Coskunses FM, Mutlu I, Ugur L, Meral DG. Effects of inter-implant distance and implant length on the response to frontal traumatic force of two anterior implants in an atrophic mandible: three-dimensional finite element analysis. Int J Oral Maxillofac Surg. 2015;44:908–13.CrossRefPubMed Kan B, Coskunses FM, Mutlu I, Ugur L, Meral DG. Effects of inter-implant distance and implant length on the response to frontal traumatic force of two anterior implants in an atrophic mandible: three-dimensional finite element analysis. Int J Oral Maxillofac Surg. 2015;44:908–13.CrossRefPubMed
15.
go back to reference Ozan O, Ramoglu S. Effect of Implant Height Differences on Different Attachment Types and Peri-Implant Bone in Mandibular Two-Implant Overdentures: 3D Finite Element Study. J Oral Implantol. 2015;41:e50–9.CrossRefPubMed Ozan O, Ramoglu S. Effect of Implant Height Differences on Different Attachment Types and Peri-Implant Bone in Mandibular Two-Implant Overdentures: 3D Finite Element Study. J Oral Implantol. 2015;41:e50–9.CrossRefPubMed
16.
go back to reference Santos LS de M, Rossi AC, Freire AR, Matoso RI, Caria PHF, Prado FB. Finite-element analysis of 3 situations of trauma in the human edentulous mandible. J Oral Maxillofac Surg. 2015;73:683–91.CrossRef Santos LS de M, Rossi AC, Freire AR, Matoso RI, Caria PHF, Prado FB. Finite-element analysis of 3 situations of trauma in the human edentulous mandible. J Oral Maxillofac Surg. 2015;73:683–91.CrossRef
17.
go back to reference Takada H, Abe S, Tamatsu Y, Mitarashi S, Saka H, Ide Y. Three-dimensional bone microstructures of the mandibular angle using micro-CT and finite element analysis: relationship between partially impacted mandibular third molars and angle fractures. Dent Traumatol. 2006;22:18–24.CrossRefPubMed Takada H, Abe S, Tamatsu Y, Mitarashi S, Saka H, Ide Y. Three-dimensional bone microstructures of the mandibular angle using micro-CT and finite element analysis: relationship between partially impacted mandibular third molars and angle fractures. Dent Traumatol. 2006;22:18–24.CrossRefPubMed
18.
go back to reference Thomason JM, Feine J, Exley C, Moynihan P, Müller F, Naert I, et al. Mandibular two implant-supported overdentures as the first choice standard of care for edentulous patients--the York Consensus Statement. Br Dent J. 2009;207:185–6.CrossRefPubMed Thomason JM, Feine J, Exley C, Moynihan P, Müller F, Naert I, et al. Mandibular two implant-supported overdentures as the first choice standard of care for edentulous patients--the York Consensus Statement. Br Dent J. 2009;207:185–6.CrossRefPubMed
19.
go back to reference Thomason JM, Kelly SAM, Bendkowski A, Ellis JS. Two implant retained overdentures--a review of the literature supporting the McGill and York consensus statements. J Dent. 2012;40:22–34.CrossRefPubMed Thomason JM, Kelly SAM, Bendkowski A, Ellis JS. Two implant retained overdentures--a review of the literature supporting the McGill and York consensus statements. J Dent. 2012;40:22–34.CrossRefPubMed
20.
go back to reference Albrektsson T. A multicenter report on osseointegrated oral implants. J Prosthet Dent. 1988;60:75–84.CrossRefPubMed Albrektsson T. A multicenter report on osseointegrated oral implants. J Prosthet Dent. 1988;60:75–84.CrossRefPubMed
21.
go back to reference Flores-Hidalgo A, Altay MA, Atencio IC, Manlove AE, Schneider KM, Baur DA, et al. Management of fractures of the atrophic mandible: a case series. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119:619–27.CrossRefPubMed Flores-Hidalgo A, Altay MA, Atencio IC, Manlove AE, Schneider KM, Baur DA, et al. Management of fractures of the atrophic mandible: a case series. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119:619–27.CrossRefPubMed
22.
go back to reference Trivedi S. Finite element analysis: A boon to dentistry. J oral Biol craniofacial Res. 2014;4:200–3.CrossRef Trivedi S. Finite element analysis: A boon to dentistry. J oral Biol craniofacial Res. 2014;4:200–3.CrossRef
23.
go back to reference Tsouknidas A, Lympoudi E, Michalakis K, Giannopoulos D, Michailidis N, Pissiotis A, et al. Influence of Alveolar Bone Loss and Different Alloys on the Biomechanical Behavior of Internal-and External-Connection Implants: A Three-Dimensional Finite Element Analysis. Int J Oral Maxillofac Implants. 2015;30:e30–42.CrossRefPubMed Tsouknidas A, Lympoudi E, Michalakis K, Giannopoulos D, Michailidis N, Pissiotis A, et al. Influence of Alveolar Bone Loss and Different Alloys on the Biomechanical Behavior of Internal-and External-Connection Implants: A Three-Dimensional Finite Element Analysis. Int J Oral Maxillofac Implants. 2015;30:e30–42.CrossRefPubMed
24.
go back to reference Steiner T, Torsiglieri T, Rau A, Möhlhenrich SC, Eichhorn S, Grohmann I, et al. Impairment of an atrophic mandible by preparation of the implant cavity: a biomechanical study. Br J Oral Maxillofac Surg. 2016;54:619–24.CrossRefPubMed Steiner T, Torsiglieri T, Rau A, Möhlhenrich SC, Eichhorn S, Grohmann I, et al. Impairment of an atrophic mandible by preparation of the implant cavity: a biomechanical study. Br J Oral Maxillofac Surg. 2016;54:619–24.CrossRefPubMed
25.
go back to reference Klein MO, Schiegnitz E, Al-Nawas B. Systematic review on success of narrow-diameter dental implants. Int J Oral Maxillofac Implants. 2014;29(Suppl):43–54.CrossRefPubMed Klein MO, Schiegnitz E, Al-Nawas B. Systematic review on success of narrow-diameter dental implants. Int J Oral Maxillofac Implants. 2014;29(Suppl):43–54.CrossRefPubMed
26.
go back to reference Ortega-Oller I, Suárez F, Galindo-Moreno P, Torrecillas-Martínez L, Monje A, Catena A, et al. The influence of implant diameter on its survival: a meta-analysis based on prospective clinical trials. J Periodontol. 2014;85:569–80.CrossRefPubMed Ortega-Oller I, Suárez F, Galindo-Moreno P, Torrecillas-Martínez L, Monje A, Catena A, et al. The influence of implant diameter on its survival: a meta-analysis based on prospective clinical trials. J Periodontol. 2014;85:569–80.CrossRefPubMed
Metadata
Title
Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis
Authors
Aysa Ayali
Kani Bilginaylar
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Head & Face Medicine / Issue 1/2017
Electronic ISSN: 1746-160X
DOI
https://doi.org/10.1186/s13005-017-0139-z

Other articles of this Issue 1/2017

Head & Face Medicine 1/2017 Go to the issue