Comparative photoelastic stress analysis between all-on-four implant-supported cobalt-chromium framework and carbon fiber reinforced framework with varying cantilever lengths - An in vitro study

CONTEXT: In implant prosthodontics, metal frameworks are used to rigidly spilt the implants together to provide rigidity and stiffness to the prosthesis. However, due to the limitations associated with the metal framework fabrication, the recent advances have made it possible to fabricate metal-free implant-supported prostheses using fiber-reinforced composite frameworks. AIM: This study aimed to evaluate and compare photoelastic stresses between all-on-four implant-supported cobalt-chromium (Co-Cr) framework and the carbon fiber-reinforced composite (CFRC) framework at varying cantilever lengths. MATERIALS AND METHODS: Two photoelastic models of an edentulous mandible were fabricated according to the all-on-four concept. Following this, frameworks with a bilateral cantilever extension of 20 mm, one with CFRC and the other with Co-Cr, were fabricated and were subjected to a progressive load of 120–180 N with an interval of 20 N. The principal stresses (σ) were calculated using the mean maximum fringe order. STATISTICAL ANALYSIS: The quantitative analysis was performed using the Kruskal–Wallis test and Mann–Whitney U-test, P ≤ 0.05. RESULTS: The CFRC framework showed mean principal stress values significantly lower than the Co-Cr framework under all loading conditions; however, deformation of the framework was observed at the cantilever lengths of 15 mm and 20 mm. CONCLUSION: The study and its findings have indicated that the CFRC framework appears suitable for the fabrication of a framework for an “All-on-four” prosthesis. Within the confines of this study, the use of 10 mm as an arbitrary cantilever length recommendation for the CFRC framework and 15 mm for the Co-Cr framework seems reasonable.