Comparison of Full-Arch Mandibular Reconstruction With Dental Implants Using Completely Splinted or Segmentally Splinted Prostheses With Two Different Occlusal Schemes: A Finite-Element Analysis Publisher

Summary: Group function occlusal scheme reduces stress in mandibular implants, study finds, improving dental restoration outcomes. #DentalImplants #Prosthodontics

Abrishamkar S¹ ; Fathi A² ; Ghorbani M³ ; Mosharraf R²
Source: Journal of Prosthodontics Published:2024

Abstract

Purpose: This study aimed to comparatively analyze full-arch mandibular reconstruction using dental implants. It focused on two distinct prosthesis configurations: completely splinted and segmentally splinted. These configurations were evaluated under two different occlusal schemes—group function and canine guidance—utilizing finite element analysis (FEA). Materials and Methods: The methodology involved developing three-dimensional finite element models from computed tomography data acquired from an edentulous patient. Six dental implants were utilized to complete the mandibular reconstruction. Prosthetic reconstruction was conducted with completely and segmentally splinted prostheses, each employing group function and canine guidance occlusal schemes. Consequently, four distinct models were analyzed. Following meshing, a 200 N load was applied at a 30-degree angle. Subsequent evaluation encompassed stress, strain distribution, and the overall deformation of the implants, crowns, and underlying bone structure assessment. Results: The group function occlusal scheme generally exhibited lower stress values than the canine guidance occlusal scheme, with three-piece prostheses demonstrating even lower stress levels than one-piece prostheses. Conversely, the canine guidance occlusal scheme exhibited higher stress values overall. Conclusion: The findings of this study may assist clinicians in selecting the most effective occlusal scheme and prosthetic configuration for implant-supported mandibular restorations, potentially enhancing treatment outcomes and reducing the risk of mechanical complications. In summary, results indicated that group function loading, irrespective of prosthesis type, offers more uniform load distribution and lower stress values, making it a preferable choice over canine guidance. Within the group function occlusal scheme, three-piece prostheses demonstrated lower stress values than one-piece prostheses, but the clinical significance of this difference appears to be minimal. © 2024 by the American College of Prosthodontists.