employee
Moskva, Moscow, Russian Federation
Moscow, Moscow, Russian Federation
employee
Moscow, Moscow, Russian Federation
Moscow, Moscow, Russian Federation
Subject. Various options for internal connections of implants, abutments and screws have biomechanical features that affect the success of implant treatment. All structures of the implant system, including the internal connection, are subjected to masticatory stress. The most favorable location of the implant is the position coaxial to the occlusal load. However, in many clinical cases, due to anatomical limitations and the presence of contraindications for osteoplastic surgery, it becomes necessary to install implants at an angle. At present, angular dental implants are being successfully introduced in dental practice - implants with an orthopedic platform located at an angle to the axis of the implant and a fixing screw shaft. A clear understanding of the features of stress distribution within various types of implant connections allows you to optimize planning and treatment, thereby reducing the risk of complications. Purpose. To study the features of stress distribution in implant systems with different designs of connections between an implant located at an angle, a screw and a suprastructure. Methods. A study of the stress-strain state of implant systems was carried out using the finite element analysis method when using straight and angled implants for dental orthopedic treatment using non-removable structures. Results. Peak stress values for models with a direct implant with different options for the direction of the occlusal load varied from 43 to 45 MPa. For the model with the use of an angled implant, the maximum stresses reached 70 MPa under a coaxial load, and 265 MPa under an angled load. Conclusions. It is shown that the different structure of the inner connection largely affects both the localization and the absolute value of the maximum stresses. In the case of a model with a straight implant, the maximum stress values are significantly lower than the fatigue failure limits; when considering a model with an angled implant, the maximum stress values and their localization are comparable to the fatigue strength value under certain load directions, which can potentially lead to damage in the internal connection of the implant.
implant and abutment connection, abutment, fixation screw, abutment screw, implant screw, mathematical modeling, finite element method
1. Aaron Yu-Jen Wu, Jui-Ting Hsu, Lih-Jyh Fuh, Heng-Li Huang. Biomechanical effect of implant design onfour implants supporting mandibular full-arch fixed dentures: In vitro test and finite element analysis // Journal of the Formosan Medical Association – 2019. doi: 10.1016/j.jfma.2020.11.011
2. Amanda Robau Porruaa, Yoan Pérez Rodríguezb, Laura M. Soris Rodrígueza, Osmel Pérez Acostab, Jesús E. Gonzálezc The effect of diameter, length and elasticmodulus of a dental im plant on stress and strain levels in peri-implant bone: a 3D finite element analysis // Bio-Medical - Materials and Engineering. – 2020. DOI: 10.3233/bme-191073
3. Daniel Augusto de Faria Almeida, Eduardo Piza Pellizzer, Fellippo Ramos Verri, Joel Ferreira Santiago, Paulo Ségio Perri de Carvalho Influence of tapered and external hexagon connections on bone stresses around tilted dental implants: three-dimensional finite element method with statistical analysis // Journal of Periodontology. – 2014;85(2):261-269. doi: 10.1902/jop.2013.120713.
4. Edmundo José Moreira de Melo, Jr, MD, MS, DDSa and Carlos Eduardo Francischone, PhDb. Three-dimensional finite element analysis of two angled narrow-diameter implant designs for an all-on-4 prosthesis // The journal of prosthetic dentistry. – 2019. doi: 10.1016/j.prosdent.2019.09.015.
5. Elias D.M., Valerio C.S., de Oliveira D.D., Manzi F.R., Zenóbio E.G., Seraidarian P.I. Evaluation of Different Heights of Prosthetic Crowns Supported // Ultra-Short Implant Using Three-Dimensional Finite Element Analysis. – 2020;33:81-90. doi: 10.11607/ijp.6247.
6. Iglesia M.A. Anteriorly Tilted Implants in Maxillary Tuberosity: Avoiding the Maxillary Sinus // CPOI. – 2012;3(1):6-16. Corpus ID: 137889837
7. Jingxiao Zhong, Massimiliano Guazzato, Junning Chen, Zhongpu Zhang, Guangyong Sun, Xintao Huo, Xinglong Liu, Rohana Ahmad, Qing Li. Effect of different implant configurations on biomechanical behavior of full-arch implant-supported mandibular monolithic zirconia fixed prostheses // Journal Pre-proof. – 2019. doi: 10.1016/j.jmbbm.2019.103490.
8. João-Paulo-Mendes Tribst, Vinicius-Aneas Rodrigues, Amanda-Maria-de Oliveira Dal Piva, Alexandre-Luiz-Souto Borges, Renato-Sussumu Nishioka. The importance of correct implants positioning and masticatory load direction on a fixed prosthesis // Journal section: Biomaterials and Bioengineering in Dentistry. – 2017:e81. doi: 10.4317/jced.54489.
9. Kaleli N., Sarac D., Külünk S., Öztürk Ö. Effect of different restorative crown and customized abutment materials on stress distribution in single implants and peripheral bone: A three-dimensional finite element analysis study // J Prosthet Dent. – 2018;119(3):437-445. doi: 10.1016/j.prosdent.2017.03.008.
10. Krishna Chaitanya Kanneganti, Dileep Nag Vinnakota, Srinivas Rao Pottem, Mahesh Pulagam. Comparative effect of implant-abutment connections, abutment angulations, and screw lengths on preloaded abutment screw using three-dimensional finite element analysis: An in vitro study // The Journal of Indian Prosthodontic Society. – 2018:161. doi: 10.4103/jips.jips_219_17.
11. Ricomini Filho A.P., Fernandes F.S., Straioto F.G., da Silva W.J., Del Bel Cury A.A. Preload loss and bacterial penetration on different implant-abutment connection systems // Braz Dent J. – 2010;21:123-129. doi: 10.1590/s0103-64402010000200006.
12. Shima Aalaei1, Zahra Rajabi Naraki, Fatemeh Nematollahi, Elaheh Beyabanaki, Afsaneh Shahrokhi Rad. Stress distribution pattern of screw-retained restorations with segmented vs. non-segmented abutments: A finite element analysis // Journal of Dental Research, Dental Clinics, Dental Prospects. – 2017. doi: 10.15171/joddd.2017.027.
13. Yang Y.Z., Tian X.H., Zhou Y.M. Effect of zirconia abutment angulation on stress distribution in the abutment and the bone around implant: a finite element study // Shanghai Kou Qiang Yi Xue. – 2015;24(4):447-450. PMID: 26383569
14. Olesova V.N., Dubinskiy S.I., Bronshteyn D.A., Magamedhanov Yu.M., Kaschenko P.V., Yuffa E.P. Sravnitel'noe matematicheskoe modelirovanie prochnostnyh i deformacionnyh parametrov metallokeramicheskih koronok s vintovoy i cementnoy fiksaciey k implantatam. Kubanskiy nauchnyy medicinskiy vestnik. 2013;6:141. [V.N. Olesova, S.I. Dubinsky, D.A. Bronstein, Yu.M. Magamedkhanov, P.V. Kashchenko, E.P. Yuffa Comparative mathematical modeling of strength and deformation parameters of metal-ceramic crowns with screw and cement fixation to implants. Kuban Scientific Medical Bulletin. 2013;6:141. (In Russ.)]. eLIBRARY ID:20311722
15. Dubova L.V., Malik M.V., Serikova Yu.S. Izuchenie napryazhenno-deformacionnogo sostoyaniya razlichnyh materialov vremennyh ortopedicheskih konstrukciy s oporoy na izoelastichnye implantaty iz poliefirefirketona metodom konechnyh elementov. Sovremennaya stomatologiya. Sbornik nauchnyh trudov, posvyaschennyy 125-letiyu osnovatelya kafedry ortopedicheskoy stomatologii KGMU professora Isaaka Mihaylovicha Oksmana. Kazan'. 2017:124-129. [L.V. Dubova, M.V. Malik, Yu.S. Serikova. The study of the stress-strain state of various materials of temporary orthopedic structures based on isoelastic implants made of polyetheretherketone using the finite element method. Modern dentistry. Collection of scientific papers dedicated to the 125th anniversary of the founder of the Department of Orthopedic Dentistry of KSMU Professor Isaak Mikhailovich Oksman. Kazan. 2017:124-129. (In Russ.)]. eLIBRARY ID:30020429
16. Grishin P.O., Saleev R.A., Ksembaev S.S. i dr. Konechno-elementnyy analiz implantatov sistemy Humana dental s innovacionnoy poverhnost'yu i dizaynom rez'by dlya vyyavleniya raspredeleniya napryazheniy v implantate, kostnoy tkani i v soedinenii abatment - implantat - kost'. Problemy stomatologii. 2022;18(1):99-107. [P.O. Grishin, R.A. Saleev, S.S. Ksembaev. Finite element analysis of Humana dental system implants with an innovative surface and thread design to detect stress distribution in the implant, bone tissue and in the abutment-implant-bone connection. Actual problems in dentistry. 2022;18(1):99-107. (In Russ.)]. DOI 10.18481/2077-7566-22-18-1-99-107.
17. Murashov M., Shorstov Ya., Venter I. Ispol'zovanie transskulovyh i uglovyh implantatov pri reabilitacii pacientov s atrofiey chelyustnyh kostey. Cifrovaya stomatologiya. 2018;8(1):95-99. [M. Murashov, Ya. Shorstov, I. Venter. The use of transzygomatic and angled implants in the rehabilitation of patients with atrophy of the jaw bones. Digital Dentistry. 2018;8(1):95-99. (In Russ.)]. eLIBRARY ID: 39198917
18. Chumachenko E.N., Arutyunov S.D., Volozhin A.I., Ibragimov T.I., Lebedenko I.Yu., Mal'ginov N.N., Yanushevich O.O., Levin G.G., Losev F.F., Olesova V.N. Sozdanie nauchnyh osnov, razrabotka i vnedrenie v klinicheskuyu praktiku komp'yuternogo modelirovaniya lechebnyh tehnologiy i prognozov reabilitacii bol'nyh s chelyustno-licevymi defektami i stomatologicheskimi zabolevaniyami. Moskva. 2010. [E.N. Chumachenko, S.D. Arutyunov, A.I. Volozhin, T.I. Ibragimov, I.Yu. Lebedenko, N.N. Malginov, O.O. Yanushevich, G.G. Levin, F.F. Losev, V.N. Olesova. Creation of scientific bases, development and introduction into clinical practice of computer modeling of medical technologies and forecasts of rehabilitation of patients with maxillofacial defects and dental diseases. Moscow. 2010. (In Russ.)]. eLIBRARY ID: 22007467
19. Bilhan H. An alternative method to treat a casewith severe maxillary atrophy by the use of angled implants instead of complicated augmentation procedures: a case report // Journal of Oral Implantology. – 2008;34(1):47-51. doi: 10.1563/1548-1336(2008)34[47:AAMTTA]2.0.CO;2.
20. Edmundo José Moreira de Melo, Jr, MD, MS, DDSa, Carlos Eduardo Francischone, PhDb. Three-dimensional finite element analysis of two angled narrow-diameter implant designs for an all-on-4 prosthesis // The journal of prosthetic dentistry. – 2019. doi: 10.1016/j.prosdent.2019.09.015.
