ArticleBMC oral health2024
Comparative biomechanics of all-on-4 and vertical implant placement in asymmetrical mandibular: a finite element study.
Article in BMC oral health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Posterior implant angulation without cantilever reduction in mandibular All-on-4: a controlled finite element analysis of stress transfer and implant macrodesign effects.BMC oral health · 2026Article
- Effect of framework material and gyroid lattice design on the biomechanics of all-on-four full-arch prostheses.BMC oral health · 2026Article
- Microscale bone interlocking enhances osseointegration strength on the rough surface of 3D-printed titanium implants: experimental and finite element analysis.BMC oral health · 2025Article
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Authors and funding
7 authors.
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Abstract
backgroundClinical scenarios frequently present challenges when patients exhibit asymmetrical mandibular atrophy. The dilemma arises: should we adhere to the conventional All-on-4 technique, or should we contemplate placing vertically oriented implants on the side with sufficient bone mass? This study aims to employ three-dimensional finite element analysis to simulate and explore the biomechanical advantages of each approach.
methodsA finite element model, derived from computed tomography (CT) data, was utilized to simulate the nonhomogeneous features of the mandible. Three configurations-All-on-4, All-on-5-v and All-on-5-o were studied. Vertical and oblique forces of 200 N were applied unilaterally, and vertical force of 100 N was applied anteriorly to simulate different masticatory mechanisms. The maximum von Mises stresses on the implant and framework were recorded, as well as the maximum equivalent strain in the peri-implant bone.
resultsThe maximum stress values for all designs were located at the neck of the distal implant, and the maximum strains in the bone tissue were located around the distal implant. The All-on-5-o and All-on-5-v models exhibited reduced stresses and strains compared to All-on-4, highlighting the potential benefits of the additional implant. There were no considerable differences in stresses and strains between the All-on-5-o and All-on-5-v groups.
conclusionsWith the presence of adequate bone volume on one side and severe atrophy of the contralateral bone, while the "All-on-4 concept" is a viable approach, vertical implant placement optimizes the transfer of forces between components and tissues.
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