All-On-4 Protetik Restorasyonlarda Farklı Altyapı Ve Üst Yapı Materyallerinin Kemikteki Stres Dağılımına Etkisi

Year 2025, Volume: 26 Issue: 1, 117 - 128, 20.03.2025

Ege Çolak , Erhan Çömlekoğlu , Mehmet Sonugelen , Makbule Heval Şahan

https://doi.org/10.69601/meandrosmdj.1603483

Abstract

Amaç: Bu çalışma, All-on-4 protez restorasyonlarında farklı altyapı ve üst yapı malzemelerinin, implant çevresi kemiğe yük dağılımını etkileyip etkilemediğini incelemeyi amaçlamıştır.
Materyaller ve Yöntemler: All-on-4 konsepti uyarınca dört implant yerleştirildi, distal implantlar 30 derece açıyla yerleştirildi. Altyapı malzemeleri (kobalt-krom alaşımı, titanyum, PEEK, zirkonya) ve üst yapı malzemeleri (kompozit, zirkonya) sekiz kombinasyon oluşturdu. Rhinoceros 4.0 (3670 Woodland Park Ave N, Seattle, WA 98103 USA) ve VRMesh (VirtualGrid Inc, Bellevue City, WA, USA) kullanılarak 3D modeller tasarlandı ve daha sonra sonlu elemanlar analizi için Algor Fempro'ya (ALGOR, Inc. 150 Beta Drive Pittsburgh, PA 15238-2932 USA) aktarıldı. 150N'luk bir kuvvet, sol birinci molar ve premoların oklüzal yüzeylerine dik olarak uygulandı.
Bulgular: PEEK altyapı grubunda, uygulanan kuvvetin yakınındaki kortikal kemikte en yüksek maksimum asal stres (HMaxPS) değerleri gözlendi. Zirkonya üst yapı grubunda, kompozit gruba göre daha düşük maksimum asal stres değerleri gözlendi. Minimum asal stres (MinPS), kompozit üst yapıda zirkonya üst yapıya göre daha düşüktü. Kantilever grubunda, kortikal kemikteki minimum asal stres (MinPS) tepe değerleri altyapıların elastik modülü ile ters orantılıydı: PEEK > titanyum > Cr-Co > zirkonya.
Sonuçlar: PEEK altyapı ve kompozit üst yapı gruplarında, implantları çevreleyen kortikal kemikte daha yüksek çekme kuvvetleri gözlendi. En yüksek baskı değerleri sırasıyla PEEK altyapıda, ardından titanyum, Cr-Co ve zirkonya'da gözlendi. Kompozit üst yapıda zirkonya üst yapıya kıyasla kortikal kemikte daha fazla stres birikimi gözlendi.

Keywords

All-on-4, Altyapı, Sonlu Elemanlar Analizi

Impact of Different Substructure and Superstructure Materials on Bone Stress Distribution in All-on-4 Prosthetic Restorations

Abstract

Aim: This study aimed to examine whether different framework and superstructure materials in All-on-4 prosthetic restorations affect load distribution in peri-implant bone.
Materials and Methods: Four implants were placed according to the All-on-4 concept, with distal implants angled at 30 degrees. Framework materials (cobalt-chromium alloy, titanium, PEEK, zirconia) and superstructure materials (composite, zirconia) created eight combinations. 3D models were designed using Rhinoceros 4.0 and VRMesh, then imported into Algor Fempro for finite element analysis. A 150N force was applied perpendicular to the occlusal surfaces of the left first molar and premolar.
Results: The PEEK framework group showed the highest maximum principal stress values in the cortical bone near the applied force. The zirconia superstructure group exhibited lower maximum principal stress values than the composite group. Minimum principal stress was lower in the composite superstructure compared to the zirconia superstructure. For the cantilever section, the peak minimum principal stress values in the cortical bone were inversely proportional to the elastic modulus of the frameworks: PEEK > titanium > Cr-Co > zirconia.
Conclusions: The PEEK framework and composite superstructure groups generated higher tensile forces in the cortical bone surrounding the implants. The highest compression values were observed in the PEEK framework, followed by titanium, Cr-Co, and zirconia. Greater stress accumulation was found in the cortical bone with the composite superstructure compared to the zirconia superstructure.

Keywords

all-on-4, finite element analysis, framework

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