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ORIGINAL ARTICLE
Year : 2021  |  Volume : 11  |  Issue : 1  |  Page : 44-52

The analysis of the stress distribution around angulated and parallelly placed implants based on “all on 4 concept” and four implants placed parallel within the interforaminal distance in an edentulous mandible – An in vitro three-dimensional finite element analysis


1 Private Practitioner, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
2 Private Practitioner & Professor and Head of Department of Oro-facial Pain Clinic, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
3 Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Mounika Ayinala
Department of Prosthodontics, Rajarajeswari Dental College and Hospital, No. 14, Ramohalli Cross, Mysore Road, Kumbalgodu, Bengaluru - 560 074, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdi.jdi_28_20

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Purpose: The purpose of the study was to analyze and compare the stress distribution in the so-called All-on-Four concept where two anterior implants were placed parallel to each other and two posterior implants were tilted at 45° angle against the four parallelly placed implants within the interforaminal distance in an edentulous mandible. Materials and Methods: The three-dimensional finite element analysis models consisted of cancellous bone surrounded by the cortical bone, four dental implants positioned in two different designs – i.e., four parallelly placed implants (Model 1) and All-on-Four concept (Model 2) with hybrid superstructures comprising of a Hader bar. The vertical (60N, 130N, and 300N) and lateral (20N, 45N, and 100N) loading protocols were considered and von Mises stress values were determined. Results: On vertical and lateral loading, lower stress concentrations were observed in the peri-implant region in Model 2. However, there was higher stress concentration noticed on cortical, cancellous bone and bar attachment due to the tilting of implants in every condition. Conclusion: Within the limitations of the study, All-on-Four concept is an optimal and viable treatment option if executed accurately as it reduces the cantilever length, reduces stress concentrations in the peri-implant region, and is cost-effective.


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