Background

Patients with severely atrophied jaws can be challenging in implantology. The All-on-4 treatment concept eliminates advanced augmentation procedures in highly resorbed ridges by preserving the relevant anatomic structures. In addition, the inclination of the distal implants enables the placement of longer implants. Hence, tilting the anterior implants allows longer implant placement, in line with the distal implants of the All-on-4 concept. This study compared the biomechanical aspects of the standard All-on-4 treatment concept with the M-4 and V-4 techniques.

Methods

A three-dimensional model of an edentulous maxilla was created to perform three-dimensional finite element analysis. Three different configurations (All-on-4, M-4, and V-4) were modeled by changing the tilt angle of the anterior implants. In each model, to simulate a foodstuff, a solid spherical material was placed on the midline of the incisors and the right first molar region, separately applying an occlusal load of 100 Newtons. The maximum principal stress and minimum principal stress values were acquired for cortical bone, and von Mises stress values were obtained for ductile materials.

Results

According to the present study's findings, although there were no considerable differences among the models, in general, the All-on-4 group demonstrated slightly higher stresses and the M-4 and V-4 group showed lower stresses.

Conclusion

M-4 or V-4 configurations may be used in cases of severely atrophied anterior maxillae to achieve better primary stabilization.

中文翻译：

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萎缩性上颌骨中All-on-4，M-4和V-4技术的生物力学比较：3D有限元分析。

背景

颌骨严重萎缩的患者在种植术方面可能具有挑战性。All-on-4治疗概念通过保留相关的解剖结构，消除了高吸收脊中的高级增强程序。另外，远端植入物的倾斜使得能够放置更长的植入物。因此，倾斜前植入物允许更长的植入物放置，与All-on-4概念的远端植入物一致。这项研究比较了标准All-on-4治疗概念与M-4和V-4技术的生物力学方面。

方法

创建无牙颌的三维模型以执行三维有限元分析。通过改变前植入物的倾斜角度，对三种不同的配置（全合4，M-4和V-4）进行建模。在每个模型中，为了模拟食品，将固体球形材料放在门齿的中线上和右第一磨牙区域，分别施加100牛顿的咬合负荷。获得了皮质骨的最大主应力和最小主应力值，而韧性材料获得了von Mises应力值。

结果

根据本研究的发现，尽管各模型之间没有显着差异，但总的来说，全4组的压力略高，而M-4和V-4组的压力低。

结论

M-4或V-4构型可用于严重萎缩的前上颌骨以达到更好的初级稳定度。