Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study

Objective: To assess the biomechanical performance of cantilevered 2-unit implant-supported prostheses with zirconia and polyetherketoneketone (PEKK) under 3 loading conditions. Method: A cone beam computer tomography (CBCT) scan of an edentulous mandible was segmented using Mimics software and refi...

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Main Authors: Hatem S. Sadek, Noha M. Anany, Al-Hassan Diab, Mohamed I. El-Anwar, Abdulaziz Alhotan, Mostafa Aldesoki, Christoph Bourauel, Tarek M. Elshazly
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Dental Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S002065392500036X
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author Hatem S. Sadek
Noha M. Anany
Al-Hassan Diab
Mohamed I. El-Anwar
Abdulaziz Alhotan
Mostafa Aldesoki
Christoph Bourauel
Tarek M. Elshazly
author_facet Hatem S. Sadek
Noha M. Anany
Al-Hassan Diab
Mohamed I. El-Anwar
Abdulaziz Alhotan
Mostafa Aldesoki
Christoph Bourauel
Tarek M. Elshazly
author_sort Hatem S. Sadek
collection DOAJ
description Objective: To assess the biomechanical performance of cantilevered 2-unit implant-supported prostheses with zirconia and polyetherketoneketone (PEKK) under 3 loading conditions. Method: A cone beam computer tomography (CBCT) scan of an edentulous mandible was segmented using Mimics software and refined in 3-Matic software to create trabecular and cortical bone structures. Implant CAD files were integrated using SolidWorks software, generating 4 models with varying implant positions: M1 (first premolar implant supporting a second premolar), M2 (second premolar implant supporting a first premolar), M3 (second premolar implant supporting a first molar), and M4 (first molar implant supporting a second premolar). Prostheses were constructed from zirconia or PEKK. Finite element analysis (FEA) in ANSYS software simulated static loading: vertical (100 N) and oblique (30° and 45°, 50 N). von Mises stress and total deformation were analyzed. Results: Vertical loading showed the highest von Mises stress at cantilever connectors, with M3 displaying the highest cortical bone stress (117 MPa). Zirconia models had slightly higher prosthetic stress, while PEKK models exhibited greater implant and cortical bone stress. Oblique loading caused higher stress in implants and prostheses but remained below yield limits. Maximum deformation was under 25 micrometers for the implant and bone, and 65 micrometers for the prosthesis. Conclusion: Single implants can support 2-unit cantilevered prostheses when additional implants are unfeasible. The location of the cantilever has minimal impact compared to its size, as a larger cantilevered part increases stress. Zirconia better resists bending forces and reduces implant stress compared to PEKK. Clinical significance: This study guides prosthodontists in designing 2-unit implant-supported prostheses, emphasizing that multiple implants optimize stress distribution, and that zirconia is preferable for cantilevered designs.
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series International Dental Journal
spelling doaj-art-3f7c4419323c45bb81ab20fa23ea3e002025-08-20T03:09:11ZengElsevierInternational Dental Journal0020-65392025-06-017531913192010.1016/j.identj.2025.01.014Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element StudyHatem S. Sadek0Noha M. Anany1Al-Hassan Diab2Mohamed I. El-Anwar3Abdulaziz Alhotan4Mostafa Aldesoki5Christoph Bourauel6Tarek M. Elshazly7Oral Technology, Dental School, University Hospital Bonn, Bonn, GermanyDepartment of Operative Dentistry, Faculty of Dentistry, Ain shams University, Cairo, EgyptDepartment of Oral Medicine, Periodontology and Diagnosis, Faculty of Dentistry, British University in Egypt, Cairo, EgyptDepartment of Mechanical Engineering, National Research Centre, Giza, EgyptDepartment of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi ArabiaOral Technology, Dental School, University Hospital Bonn, Bonn, GermanyOral Technology, Dental School, University Hospital Bonn, Bonn, GermanyOral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Corresponding author. Oral Technology, University Hospital Bonn, Welschnonnenstr. 17, 53111 Bonn, GermanyObjective: To assess the biomechanical performance of cantilevered 2-unit implant-supported prostheses with zirconia and polyetherketoneketone (PEKK) under 3 loading conditions. Method: A cone beam computer tomography (CBCT) scan of an edentulous mandible was segmented using Mimics software and refined in 3-Matic software to create trabecular and cortical bone structures. Implant CAD files were integrated using SolidWorks software, generating 4 models with varying implant positions: M1 (first premolar implant supporting a second premolar), M2 (second premolar implant supporting a first premolar), M3 (second premolar implant supporting a first molar), and M4 (first molar implant supporting a second premolar). Prostheses were constructed from zirconia or PEKK. Finite element analysis (FEA) in ANSYS software simulated static loading: vertical (100 N) and oblique (30° and 45°, 50 N). von Mises stress and total deformation were analyzed. Results: Vertical loading showed the highest von Mises stress at cantilever connectors, with M3 displaying the highest cortical bone stress (117 MPa). Zirconia models had slightly higher prosthetic stress, while PEKK models exhibited greater implant and cortical bone stress. Oblique loading caused higher stress in implants and prostheses but remained below yield limits. Maximum deformation was under 25 micrometers for the implant and bone, and 65 micrometers for the prosthesis. Conclusion: Single implants can support 2-unit cantilevered prostheses when additional implants are unfeasible. The location of the cantilever has minimal impact compared to its size, as a larger cantilevered part increases stress. Zirconia better resists bending forces and reduces implant stress compared to PEKK. Clinical significance: This study guides prosthodontists in designing 2-unit implant-supported prostheses, emphasizing that multiple implants optimize stress distribution, and that zirconia is preferable for cantilevered designs.http://www.sciencedirect.com/science/article/pii/S002065392500036XProsthodonticZirconiaPEKKCAD/CAMFEMStress analysis
spellingShingle Hatem S. Sadek
Noha M. Anany
Al-Hassan Diab
Mohamed I. El-Anwar
Abdulaziz Alhotan
Mostafa Aldesoki
Christoph Bourauel
Tarek M. Elshazly
Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study
International Dental Journal
Prosthodontic
Zirconia
PEKK
CAD/CAM
FEM
Stress analysis
title Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study
title_full Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study
title_fullStr Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study
title_full_unstemmed Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study
title_short Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study
title_sort biomechanical evaluation of cantilevered 2 unit implant supported prostheses a 3d finite element study
topic Prosthodontic
Zirconia
PEKK
CAD/CAM
FEM
Stress analysis
url http://www.sciencedirect.com/science/article/pii/S002065392500036X
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