Biomechanical analysis and systematic review involving narrow implants for unitary rehabilitations in the anterior maxillary region

Abstract

This research aims to evaluate biomechanically the use of small diameter implants in single restorations in the anterior region of the maxilla. The evaluation will compare biomechanically the use of 2.9 mm diameter implants with 3.5 mm implants through 3D finite element analysis. Twelve representative models of the maxillary anterior region with presence of central incisor and canine will receive an implant and crown simulating the right lateral incisor, varying the diameter (2.9 mm, 3.5 Mm) and its length (7.0mm, 8.5mm, 10.0mm, 11.5mm, 13.0mm and 15mm), always with 5mm thickness of the crestal bone. The 3D models will be constructed by tomographic recomposition using the software Invesalius and Rhinoceros 3D. The implants and components will be modeled from original format in the SolidWorks program and simplified in the Rhinoceros, as well as the simulated crown. The discretization of the models will be done in the software ANSYS 17.0, including material characterization, contacts, loading conditions (178N towards 0, 30 and 60 degrees in relation to the long axis of the implant) and restrictions (in the x, y, z direction at lateral sections of the models). After resolution, the results will be visualized by means of displacement, von Mises, maximum principal stress and microdeformation maps. Additionally, a systematic review will be performed (with meta-analysis if sufficient data is available), following the Cochrane Group model for the main outcome measures of the implant survival rate and peri-implant bone loss by: 1) Different implant diameters used in the maxillary anterior region; 2) length of the implants used in the maxillary anterior region. The results will be interpreted in order to improve the safer indication for implants of different sizes in the maxillary anterior region. (AU)