J Adv Prosthodont.  2018 Apr;10(2):138-146. 10.4047/jap.2018.10.2.138.

Three-dimensional finite element analysis of the splinted implant prosthesis in a reconstructed mandible

• Heo KH
• Lim YJ
• Kim MJ
• Kwon HB

• KMID: 2409634
• DOI: http://doi.org/10.4047/jap.2018.10.2.138

Abstract

PURPOSE
The purpose of this study was to analyze the effects of the splinted implant prosthesis in a reconstructed mandible using three-dimensional finite element analysis.
MATERIALS AND METHODS
Three-dimensional finite element models were generated from a patient's computed tomography data. The patient had undergone partial resection of the mandible that covered the area from the left canine to the right condyle. The mandible was reconstructed using a fibula bone graft and dental implants. The left mandibular premolars and molars remained intact. Three types of models were created. The implant-supported prosthesis was splinted and segmented into two or three pieces. Each of these models was further subcategorized into two situations to compare the stress distribution around normal teeth and implants. Oblique loading of 300 N was applied on both sides of the mandible unilaterally. The maximum von Mises stress and displacement of the models were analyzed.
RESULTS
The stress distribution of the natural mandible was more uniform than that of the reconstructed fibula. When the loading was applied to the implant prosthesis of reconstructed fibula, stress was concentrated at the cortical bone around the neck of the implants. The three-piece prosthesis model showed less uniform stress distribution compared to the others. Displacement of the components was positively correlated with the distance from areas of muscle attachment. The three-piece prosthesis model showed the greatest displacement.
CONCLUSION
The splinted implant prosthesis showed a more favorable stress distribution and less displacement than the separated models in the reconstructed mandible.

Keyword

Finite element analysis; Fibula; Mandible; Dental implant; Mandibular reconstruction

MeSH Terms

Bicuspid
Clothing
Dental Implants
Fibula
Finite Element Analysis*
Humans
Mandible*
Mandibular Reconstruction
Molar
Neck
Prostheses and Implants*
Splints*
Tooth
Transplants
Dental Implants

Figure

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  Fig. 1 Three-dimensional finite element model. (A) Reconstructed mandible, (B) Cortical bone, (C) Cancellous bone, (D) Posterior implant prosthesis, (E) Anterior implant prosthesis, (F) Implant fixture, gold screw, and abutment.

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  Fig. 2 Stress distributions on each model. (A) FB1, (B) FB2, (C) FB3, (D) MN1, (E) MN2, (F) MN3.

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  Fig. 3 Stress distributions in cortical and cancellous bones. (A) FB1, (B) FB2, (C) FB3, (D) MN1, (E) MN2, (F) MN3.

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  Fig. 4 Maximum von-Mises stress in the cortical bone.

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  Fig. 5 Stress distributions in implants and teeth. (A) FB1, (B) FB2, (C) FB3, (D) MN1, (E) MN2, (F) MN3.

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  Fig. 6 Maximum von-Mises stress in implants and teeth.

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  Fig. 7 The displacement tendency on each model. (A) FB1, (B) FB2, (C) FB3, (D) MN1, (E) MN2, (F) MN3.

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