Farklı Ark Formuna Sahip Maksillada Uygulanan All On Four Tedavilerinde, Anterior Bölgedeki İmplant İhtiyacının Sonlu Elemanlar Analizi İle Değerlendirilmesi

Abstract

ÖZ Giriş ve Amaç: Bu çalışmanın amacı; farklı ark formuna sahip (üçgen, oval, kare) üst çenede yapılan all on four implantların üstüne planlanan protezlerde farklı yerlere uygulanan kuvvetlerin, sonlu elemanlar analizi ile implant ve çevre dokuda oluşturduğu stres farklarını belirlemektir. Gereç ve Yöntemler: Bu çalışmada 3 farklı ark formuna sahip maksilla modelleri tasarlandı. 2 farklı implant yerleştirme protokolü ile toplam 6 çalışma grubu elde edildi. Grup 1 üçgen ark formunda 4 implant yerleştirilen, Grup 2 üçgen ark formunda 5 implant yerleştirilen, Grup 3 oval ark formunda 4 implant yerleştirilen, Grup 4 oval ark formunda 5 implant yerleştirilen, Grup 5 kare ark formunda 4 implant yerleştilen, Grup 6 kare ark formunda 5 implant yerleştirilen çalışma grupları olmuştur. Tüm çalışma modellerinde üstüne yapılan rijit titanyum destekli sabit hibrit proteze 21 numaralı diş bölgesinden 30 derece bukko-palatinal açılı 100 N’luk oblik bir kuvvet, 26 numaralı diş bölgesinden ise santral fossa hizasından dik bir şekilde 100 N’luk kuvvet uygulanmıştır. İmplant etrafındaki kortikal ve spongioz kemiklerde ve aynı zamanda implantın üstünde oluşan stres değerleri sonlu elamanlar analizi ile incelenmiştir. Bulgular: Kortikal kemikteki çekme streslerine dik ve oblik kuvvet altında baktığımızda, ark formlarını sabit tutup implant sayısını arttırdığımızda en fazla stres azalma oranının üçgen ark formunda olduğu tespit edilmiştir. Kortikal kemikteki basma streslerine dik kuvvet altında baktığımızda, ark formlarını sabit tutup implant sayısını arttırdığımızda en anlamlı stres azalma oranının kare ark formunda olduğu, oblik kuvvet altında baktığımızda en fazla stres azalma oranının üçgen ark formunda olduğu tespit edilmiştir. Trabeküler kemikteki çekme streslerine dik kuvvet altında baktığımızda, ark formlarını sabit tutup implant sayısını arttırdığımızda en anlamlı stres azalma oranının oval ark formunda olduğu, oblik kuvvet altında baktığımızda en fazla stres azalma oranının üçgen ark formunda olduğu tespit edilmiştir. Trabeküler kemikteki basma streslerine dik kuvvet altında baktığımızda, ark formlarını sabit tutup implant sayısını arttırdığımızda en anlamlı stres azalma oranının üçgen ark formunda olduğu, oblik kuvvet altında baktığımızda en fazla stres azalma oranının oval ark formunda olduğu tespit edilmiştir. Sonuç: All on four tedavi planlaması yaparken hastanın ark formuna dikkat etmemiz gerektiğini ve üçgen ark formuna sahip hastalarda anteriora 1 implant fazla planlanması diğer ark formlarına göre daha fazla stresin azalmasına neden olmuştur. Bu stres azalma oranının en az kare ark formunda görüldüğü tespit edilmiştir. Anahtar Kelimeler: Sonlu Elemanlar Analizi (SEA), All On Four, Dental İmplant, Maksiller Ark.

Keywords

• Sonlu Elemanlar Analizi (SEA)
• All On Four
• Dental İmplant
• Maksiller Ark.

Evaluating the Implant Need in the Anterior Region in All on Four Treatments Applied on Maxillae with Different Arch Forms using Finite Element Analysis

Abstract

Abstract Aim; The aim of this study is to determine the stress differences created in the implants and surrounding tissues by applying forces to different locations on the prostheses planned on the all on four implants with different arch forms (triangular, oval, square) in the upper jaw using finite element analysis. Method; In this study, maxilla models with three different arch forms were designed, namely triangular, oval, and square. A total of 6 study groups were obtained by using 2 different implant placement protocols. Group 1 consisted of 4 implants placed in a triangular arch form, Group 2 consisted of 5 implants placed in a triangular arch form, Group 3 consisted of 4 implants placed in an oval arch form, Group 4 consisted of 5 implants placed in an oval arch form, Group 5 consisted of 4 implants placed in a square arch form, and Group 6 consisted of 5 implants placed in a square arch form. In all study models, an oblique force of 100 N with a 30-degree buccopalatal inclination was applied to the hybrid prosthesis rigidly supported on the model from tooth area 21, and a vertical force of 100 N was applied from the central fossa level of tooth area 26. The stress values created in the cortical and spongy bone surrounding the implants, as well as on the implants themselves, were analyzed using finite element analysis. Results; When we examined the tensile stresses in the cortical bone under vertical and oblique forces, it was determined that the highest stress reduction rate with increasing implant number while keeping the arch form constant was in the triangular arch form. When we examined the compressive stresses in the cortical bone under vertical forces, it was determined that the most significant stress reduction rate with increasing implant number while keeping the arch form constant was in the square arch form, and under oblique forces, the highest stress reduction rate was in the triangular arch form.When we examined the tensile stresses in the trabecular bone under vertical forces, it was determined that the most significant stress reduction rate with increasing implant number while keeping the arch form constant was in the oval arch form, and under oblique forces, the highest stress reduction rate was in the triangular arch form. When we examined the compressive stresses in the trabecular bone under vertical forces, it was determined that the most significant stress reduction rate with increasing implant number while keeping the arch form constant was in the triangular arch form, and under oblique forces, the highest stress reduction rate was in the oval arch form. Conclusion; When planning an all-on-four procedure, and in patients with a triangular arch form, planning one extra implant in the anterior region resulted in a greater reduction in stress compared to other arch forms. The arch form where the least reduction in stress was observed was identified as the square arch form. Keywords: Finite Element Analysis (FEA), All On Four, Dental Implant, Maxillary Arch.

Keywords

• Finite Element Analysis (FEA)
• All On Four
• Dental Implant
• Maxillary Arch.

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