Berna Derinpınar, Esra Tsakir Emin, Merve Özarslan, Öznur Özalp, Alper Sindel, Mehmet Mustafa Özarslan, Mehmet Ali Altay, Nurullah Türker
{"title":"应用有限元分析方法评估不同咬合条件下全对四和三叶概念加载对下颌骨造成的应力。","authors":"Berna Derinpınar, Esra Tsakir Emin, Merve Özarslan, Öznur Özalp, Alper Sindel, Mehmet Mustafa Özarslan, Mehmet Ali Altay, Nurullah Türker","doi":"10.1007/s00784-025-06522-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the maximum stresses on the bone, implant, and screw under four loading conditions in two implant-supported prosthesis concepts: Trefoil and All-on-Four.</p><p><strong>Materials and methods: </strong>Three-dimensional mandibular models were created based on the All-on-Four and Trefoil concepts. Maximum bite forces were applied under four conditions: maximum intercuspal position, canine-protected occlusion, group-function occlusion, and cantilever loading. The stresses on cortical bone, implants, and screws were calculated using finite element analysis.</p><p><strong>Results: </strong>The highest stresses under maximum bite forces occurred at the distal implants in the Trefoil model (393,9 MPa). The anterior implant (219,9 MPa), screw (171,1 MPa), and bone (29,7 MPa) in the Trefoil system experienced four times more stress than in the All-on-Four system (anterior implant 48,5 MPa, screw 50 MPa, bone 8,3 MPa). Canine-protected occlusion led to higher stresses on the working side. Stress concentrations were similar at the implant (trefoil right implant 23,7 MPa; middle 38 MPa; left 82,5 MPa; all on four right posterior implant 22,3 MPa; right anterior 12,7 MPa; left anterior 39,8 MPa; left posterior 86,8 MPa) and bone levels (trefoil right cortical bone 9,6 MPa; middle 2,07 MPa; left 11,1 MPa; all on four right posterior 7,5 MPa; right anterior 2,27 MPa; left anterior 1,8 MPa; left posterior 11,9 MPa) in both models, but higher stress was found around the screw of the central implant in the Trefoil system (53,8 MPa). Group-function occlusion resulted in higher stress at the implant (right 112,3 MPa; middle 124,6 MPa; left 776,2 MPa), screw (right 129,1 MPa; middle 239,9 MPa; left 474,3 MPa) and bone levels (right 66,1 MPa; middle 9,3 MPa; left 71,32 MPa) in the Trefoil model, with increased stress on the working side. Cantilever loading caused significant stress on abutment screws in the Trefoil model (right 42,2 MPa; middle 198,1 MPa; left 340,3 MPa), while the All-on-Four model (408,4 MPa) showed higher stress around the distal implants.</p><p><strong>Conclusions: </strong>Canine-protected occlusion is recommended to minimize stress in both systems. Further clinical trials are needed to determine the optimal occlusion for implant prostheses.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 10","pages":"456"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of stresses in the mandible caused by loading of all-on-four and trefoil concepts under different occlusion conditions using finite element analysis.\",\"authors\":\"Berna Derinpınar, Esra Tsakir Emin, Merve Özarslan, Öznur Özalp, Alper Sindel, Mehmet Mustafa Özarslan, Mehmet Ali Altay, Nurullah Türker\",\"doi\":\"10.1007/s00784-025-06522-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aimed to evaluate the maximum stresses on the bone, implant, and screw under four loading conditions in two implant-supported prosthesis concepts: Trefoil and All-on-Four.</p><p><strong>Materials and methods: </strong>Three-dimensional mandibular models were created based on the All-on-Four and Trefoil concepts. Maximum bite forces were applied under four conditions: maximum intercuspal position, canine-protected occlusion, group-function occlusion, and cantilever loading. The stresses on cortical bone, implants, and screws were calculated using finite element analysis.</p><p><strong>Results: </strong>The highest stresses under maximum bite forces occurred at the distal implants in the Trefoil model (393,9 MPa). The anterior implant (219,9 MPa), screw (171,1 MPa), and bone (29,7 MPa) in the Trefoil system experienced four times more stress than in the All-on-Four system (anterior implant 48,5 MPa, screw 50 MPa, bone 8,3 MPa). Canine-protected occlusion led to higher stresses on the working side. Stress concentrations were similar at the implant (trefoil right implant 23,7 MPa; middle 38 MPa; left 82,5 MPa; all on four right posterior implant 22,3 MPa; right anterior 12,7 MPa; left anterior 39,8 MPa; left posterior 86,8 MPa) and bone levels (trefoil right cortical bone 9,6 MPa; middle 2,07 MPa; left 11,1 MPa; all on four right posterior 7,5 MPa; right anterior 2,27 MPa; left anterior 1,8 MPa; left posterior 11,9 MPa) in both models, but higher stress was found around the screw of the central implant in the Trefoil system (53,8 MPa). Group-function occlusion resulted in higher stress at the implant (right 112,3 MPa; middle 124,6 MPa; left 776,2 MPa), screw (right 129,1 MPa; middle 239,9 MPa; left 474,3 MPa) and bone levels (right 66,1 MPa; middle 9,3 MPa; left 71,32 MPa) in the Trefoil model, with increased stress on the working side. Cantilever loading caused significant stress on abutment screws in the Trefoil model (right 42,2 MPa; middle 198,1 MPa; left 340,3 MPa), while the All-on-Four model (408,4 MPa) showed higher stress around the distal implants.</p><p><strong>Conclusions: </strong>Canine-protected occlusion is recommended to minimize stress in both systems. Further clinical trials are needed to determine the optimal occlusion for implant prostheses.</p>\",\"PeriodicalId\":10461,\"journal\":{\"name\":\"Clinical Oral Investigations\",\"volume\":\"29 10\",\"pages\":\"456\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Oral Investigations\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00784-025-06522-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Oral Investigations","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00784-025-06522-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Evaluation of stresses in the mandible caused by loading of all-on-four and trefoil concepts under different occlusion conditions using finite element analysis.
Objectives: This study aimed to evaluate the maximum stresses on the bone, implant, and screw under four loading conditions in two implant-supported prosthesis concepts: Trefoil and All-on-Four.
Materials and methods: Three-dimensional mandibular models were created based on the All-on-Four and Trefoil concepts. Maximum bite forces were applied under four conditions: maximum intercuspal position, canine-protected occlusion, group-function occlusion, and cantilever loading. The stresses on cortical bone, implants, and screws were calculated using finite element analysis.
Results: The highest stresses under maximum bite forces occurred at the distal implants in the Trefoil model (393,9 MPa). The anterior implant (219,9 MPa), screw (171,1 MPa), and bone (29,7 MPa) in the Trefoil system experienced four times more stress than in the All-on-Four system (anterior implant 48,5 MPa, screw 50 MPa, bone 8,3 MPa). Canine-protected occlusion led to higher stresses on the working side. Stress concentrations were similar at the implant (trefoil right implant 23,7 MPa; middle 38 MPa; left 82,5 MPa; all on four right posterior implant 22,3 MPa; right anterior 12,7 MPa; left anterior 39,8 MPa; left posterior 86,8 MPa) and bone levels (trefoil right cortical bone 9,6 MPa; middle 2,07 MPa; left 11,1 MPa; all on four right posterior 7,5 MPa; right anterior 2,27 MPa; left anterior 1,8 MPa; left posterior 11,9 MPa) in both models, but higher stress was found around the screw of the central implant in the Trefoil system (53,8 MPa). Group-function occlusion resulted in higher stress at the implant (right 112,3 MPa; middle 124,6 MPa; left 776,2 MPa), screw (right 129,1 MPa; middle 239,9 MPa; left 474,3 MPa) and bone levels (right 66,1 MPa; middle 9,3 MPa; left 71,32 MPa) in the Trefoil model, with increased stress on the working side. Cantilever loading caused significant stress on abutment screws in the Trefoil model (right 42,2 MPa; middle 198,1 MPa; left 340,3 MPa), while the All-on-Four model (408,4 MPa) showed higher stress around the distal implants.
Conclusions: Canine-protected occlusion is recommended to minimize stress in both systems. Further clinical trials are needed to determine the optimal occlusion for implant prostheses.
期刊介绍：
The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.
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