Comparative Evaluation of the Stresses on the Terminal Abutment and Edentulous Ridge in Unilateral Distal Extension Condition when Restored with Different Prosthetic Options: An FEA Analysis
Citation Information :
Girotra M, Yadav B, Ritwal P, Singh D, Madan R. Comparative Evaluation of the Stresses on the Terminal Abutment and Edentulous Ridge in Unilateral Distal Extension Condition when Restored with Different Prosthetic Options: An FEA Analysis. Int J Prosthodont Restor Dent 2023; 13 (2):58-64.
Purpose: The purpose of this finite element analysis (FEA) was to evaluate and compare the stresses on the terminal abutment and edentulous ridge in unilateral distal extension conditions when restored with different prosthetic options.
Materials and methods: A finite element model of a unilateral maxillary edentulous arch distal to the second premolar was fabricated. The second premolar was used as a terminal abutment for three different treatment modalities, namely cast partial denture, semiprecision attachment, and flexible dentures. Three levels of loading (150, 250, and 350 N) were applied from two directions, that is, vertically (90°) and obliquely (60°), on the central fossa of the first and second molars of the prosthesis. The maximum von Mises stress distribution was recorded at two regions, that is, the terminal abutment (cervically) and the edentulous ridge. The data was divided into three groups according to the type of prosthesis. An independent t-test was used to compare the values of the three groups. Analysis of variance (ANOVA) was used to test the differences between the loading directions.
Results: The highest level of stress on the terminal abutment and edentulous ridge was noted with the flexible denture (71.39 and 93.29 MPa), followed by cast partial dentures (8.63 and 3.69 MPa), and the least stress was noted with the semi-precision attachment (3.15 and 1.57 MPa, respectively). The difference in stress levels on both abutment and ridge when the flexible denture was compared with cast partial denture and semi-precision attachment was statistically significant (p < 0.05). However, the stress levels between cast partial and semi-precision attachment were not statistically significant (p > 0.05). The stress levels increased by increasing the forces from 150 to 350 N and changing the direction of forces from vertical to oblique in all three prostheses on both the abutment and edentulous ridge.
Conclusion: Semi-precision attachment and cast partial denture did not depict any significant changes in stress levels on abutment teeth and edentulous ridge. However, flexible dentures show the highest stress levels. Hence, within the confines of the study, semi-precision attachment seems to be the most recommended treatment option, followed by cast partial dentures. Clinicians should limit flexible dentures to only provisional prostheses.
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