All-on-4 Konseptinde Altyapı ve Bruksizmin Biyomekanik Etkisi: Sonlu Elemanlar Analizi

Abstract

Bu çalışma, iki farklı yükleme kuvveti altında farklı protetik altyapılara sahip maksiller all-on-4 konseptlerindeki stres dağılımını sonlu elemanlar analizi kullanarak incelemeyi amaçlamıştır. Krom-kobalt, polietereterketon, titanyum ve zirkonya olmak üzere 4 farklı protetik altyapı materyali ile all-on-4 modeller tasarlandı (Sırasıyla model 1, model 2, model 3, model 4). Sağlıklı ve bruksist bireylerin ısırma kuvvetlerini temsil eden iki farklı yükleme koşulu altında kemik doku, implant elemanları ve protetik elemanlar üzerindeki stresler değerlendirildi. Peri-implant kemik, implant elemanları ve kronlar üzerindeki stresler model 2>model 3>model4>model 1 olarak sıralandı. Bruksist yükleme altında tüm modellerdeki ve sağlıklı yükleme altında model 2' deki kortikal kemikte oluşan baskı stresleri aşırı yükleme sınırını aştı. Kortikal kemikte oluşan gerilme stresi ve dayanaklardaki von Mises stres bruksist yükleme altındaki model 3’ te aşırı yükleme sınırını aştı. Model 2’ de, her iki yükleme koşulunda kortikal kemikte oluşan gerilme stresi ve bruksist yükleme altında implantlar, dayanaklar ve kronlardaki von Mises stresler aşırı yükleme sınırını aştı. Altyapılardaki stresler model 2>model 1>model 4>model 3 olarak sıralandı. Bruksist bireylerde all-on-4 konsepti planlanırken bu çalışmadaki kortikal kemikte oluşan aşırı yüklemeler göz önünde bulundurulmalıdır. PEEK altyapı kemik doku ve çevreleyen yapılar üzerinde polimerik olmayan altyapılara göre daha fazla stres oluşturduğundan polimerik olmayan altyapılar all-on-4 konsepti için daha uygun olabilir

Keywords

• All-on-4
• bruksizm
• dental implant
• protetik altyapı
• sonlu elemanlar analizi

Biomechanical Effect of Framework and Bruxism in All-on-4 Concept: A Finite Element Analysis

Abstract

This study aimed to examine the stress distribution in maxillary all-on-4 concepts with different prosthetic frameworks under two different loading forces using finite element analysis. All-on-4 models were prepared with 4 different prosthetic framework materials as chromium-cobalt, polyetheretherketone, titanium, and zirconia (Model 1, model 2, model 3, and model 4 respectively). The stress on the bone tissue, implant elements, and prosthetic elements was evaluated under two distinct loading conditions representing the bite forces of healthy and bruxist individuals. The stress on the peri-implant bone, implant elements, and crowns were ranked as model 2 > model 3 > model 4 > model 1. Compressive stresses in the cortical bone exceeded the overload limit in all models under bruxist loading, and in model 2 under healthy loading. Tensile stress in the cortical bone and von Mises stress in the abutments exceeded the overload limit in model 3 under bruxist loading. Tensile stress in the cortical bone under both loading conditions and von Mises stress in implants, abutments, and crowns under bruxist loading exceeded the overload limits in model 2. Peak stresses in the frameworks were ranked as model 2 > model 1 > model 4 > model 3. The overloads in the cortical bone in this study should be considered when planning the all-on-4 concept in bruxist individuals. Nonpolymeric frameworks may be more suitable for the all-on-4 concept, as the PEEK framework produced greater stress on the bone tissue and surrounding structures than nonpolymeric frameworks.

Keywords

• All-on-4
• bruxism
• dental implant
• prosthetic framework
• finite element analysis

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