Análise tridimensional por elemento finito do comportamento biomecânico de próteses totais fixas implantossuportadas : efeito do tipo de conexão protética, cargas oclusais e número de implantes / Three-dimensional finite element analysis of biomechanics of implant-supported fixed prostheses : effect of connection system, occlusal load, and number of implants

Andreza Dayrell Gomes da Costa

The purpose of this study was to analyze the stress and strain distribution by three-dimensional finite element method in implant supported fixed prostheses and peri-implantar bone region, using two types of implant-abutment connection internal and external, correlated to the effect of axial loadings and number of implants. Virtual models were developed by simulating a mandibular implant supported fixed prostheses, according to the Branemark protocol, with study factors: implant-abutment connection Morse taper (MT) and External hexagon (EH); four or five implants; bilateral axial loadings 100 N, bilateral and unilateral axial loadings 300 N. The analysis conditions were: 1. Fixed prostheses with internal connection Morse taper interface (MT) simulating six experimental conditions, making the models M1, M2 and M3 with four implants and loads of 100 N and 300 N, respectively; models M4, M5, M6 with five implants and similar conditions; 2. Fixed prostheses with external connection External hexagon interface (EH), submitted to same conditions; 3. Comparison between the two connection systems. The results of von Mises stress and bone strain, under effect of 100 N axial loadings, were distributed evenly for all implants for groups with MT, focused mainly on the distal implants for groups with EH. Under effect of 300 N axial loadings, the stress and strain distribution followed the same tendency, with values increased of 1.5-2 times for the MT group and 3 times for EH groups. Within the analysis conditions the study concluded that: 1. under effect of axial loadings of 100 N, the use of two implant-abutment connections MT and EH can be well indicated; 2. under effect of axial loadings of 300 N, the Morse taper connection provides a better indication; 3. Five implants do not represent relevant benefit over four; 4. with Morse taper connection system, the mechanical stress is distributed for all implants and bone area, with the External hexagon, focuses on the distal region and surrounding bone; 5. the stress distribution in prosthetic infrastructure is similar with the two connection systems and the mechanical strength is satisfactory for groups with prosthetic connection EH and 100 N axial loadings, and insufficient for both prosthetic connections under effect of 300 N axial loadings.

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