J Dent Res Dent Clin Dent Prospects. 2021;15(2): 106-110.
doi: 10.34172/joddd.2021.018
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Basic Research

Original Article

Biomechanical behavior of atrophic maxillary restorations using the all-on-four concept and long trans-sinus implants: A finite element analysis

Liliane Pacheco de Carvalho 1, Alexandre Marcelo de Carvalho 2*, Carlos Eduardo Francischone 3, Flavia Lucisano Botelho do Amaral 3, Bruno Salles Sotto-Maior 4 ORCID logo

1 Department of Prosthodontics, Faculty of Dentistry UNIFAGOC Institute and Research Center, Brazil
2 Department of Periodontology, Faculty of Dentistry UNIFAGOC Institute and Research Center, Brazil
3 Department of Implantology, Faculty of Dentistry, Dental Research Center of São Leopoldo Mandic, Brazil
4 Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Juiz de Fora, Brazil
*Corresponding author: Alexandre Marcelo de Carvalho, Email: bruno.sotto@ufjf.edu.br


Background. Maxillary bone atrophy with a considerable amount of pneumatization and anterior expansion of the maxillary sinus might be a situation limiting oral rehabilitation with osseointegrated implants. Therefore, the present study aimed to biomechanically evaluate two rehabilitation techniques for maxillary bone atrophy: all-on-four and long trans-sinus implants.

Methods. Two three-dimensional models consisting of atrophic maxilla with four implants were simulated. In the M1 model, two axially inserted anterior implants and two tilted implants, 15 mm in length, placed tangential to the maxillary sinus’s anterior wall were used. In the M2 model, two axially inserted anterior implants and two trans-sinus tilted implants, 24 mm in length, were used. For the finite element analysis (FEA), an axial load of 100 N was applied on the entire extension of the prosthesis, simulating a rehabilitation with immediate loading. The peri-implant bone and the infrastructure were analyzed according to the Mohr-Coulomb and Rankine criteria, respectively.

Results. The results were similar when the stresses on peri-implant bone were compared: 0.139 and 0.149 for models 1 and 2, respectively. The tension values were lower in the model with trans-sinus implants (27.99 MPa).

Conclusion. It was concluded that the two techniques exhibited similar biomechanical behavior, suggesting that the use of long trans-sinus implants could be a new option for atrophic maxilla rehabilitation.

Keywords: All-on-four, Atrophic maxilla, Finite element analysis, Long trans-sinus implants
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Submitted: 14 Jun 2020
Accepted: 21 Jan 2021
ePublished: 05 May 2021
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