498 EFFECTS OF ARCH SHAPE
Influence of Arch Shape and Implant
Position on Stress Distribution Around
Implants Supporting Fixed Full-Arch
Prosthesis in Edentulous Maxilla
Giray Sagat, DDS, PhD,* Serdar Yalcin, DDS, PhD,† B. Alper Gultekin, DDS, PhD,‡ and Eitan Mijiritsky, DMD§
ental implant success is evalu-
D ated according to the survival
rates of implants along with the
maintenance of periimplant tissue
health, functional needs, and patient
satisfaction with the esthetic appear-
ance of the implant restoration.1 The
number of evaluation criteria have in-
creased since Brånemark’s break-
through. Mobility, pain, radiographic
assessment, probing depth, gingival,
and bleeding indices are some of the
fundamental interpretation titles of
condition. The most important factor
for determining the success of os-
seointegration is the state of the peri-
implant bone. For this reason, early or
delayed bone resorption of periimplant
hard tissue has become a prime hazard
for the achievement and maintenance
of success. Clinicians should attempt
to inhibit bone resorption from surgery
through the prosthetic stage. Several
parameters can be controlled to im-
prove the environment of the periim-
plant bone region and manage stress
around and within dental implants.2
*Private Practice, Istanbul, Turkey.
†Professor, Department of Oral Implantology, Istanbul
University, Istanbul, Turkey.
‡Research Assistant, Department of Oral Implantology,
Istanbul University, Istanbul, Turkey.
§Private Practice, Tel-Aviv, Israel.
Reprint requests and correspondence to: B. Alper
Gultekin, DDS, PhD, Istanbul University Faculty of
Dentistry, Department of Oral Implantology, Fatih,
Istanbul 34093, Turkey, Phone: 90 212 5323218, Fax:
ⴙ90 212 5323254, E-mail: alpergultekin@hotmail.com/
syalcin@tnn.net
ISSN 1056-6163/10/01906-498
Implant Dentistry
Volume 19 • Number 6
Copyright © 2010 by Lippincott Williams & Wilkins
DOI: 10.1097/ID.0b013e3181fa4267
AND IMPLANT POSITION • SAGAT ET AL
Purpose: This finite element
analysis was conducted to determine
changes in stress concentration in
relation to different alveolar arch
shapes of the maxilla.
Materials and Methods: Five dif-
ferent maxillary alveolar arch shape
measurements coded as shortest ellip-
soid shape and medium width, longest
ellipsoid shape and narrow, U-shaped
long and narrow, U-shaped short and
wide, and U-shaped medium length
and medium width were obtained, and
5 different implant distribution strate-
gies coded on the basis of a tooth
number as 3,4,5; 2,3,4; 1,3,5; and
2,4,5 (total of 6 implants) and 2,3,4,5
(total of 8 implants) were plotted in
each of the 5 maxillary arch models.
The implants were assumed to support
a 12-unit bridge with first molars re-
gion being the cantilever area. Com-
bination of 5 different arch shapes, 5
different implant distributions, and 2
Prosthetic design is one of the major
influencing components that influ-
ences early bone resorption and re-
modeling after loading.3– 6
In contemplation of rehabilitation
of the edentulous maxilla, an implant-
supported fixed full-arch prosthesis can
definitely improve the prosthetic com-
fort of the patient. Adequate bone struc-
ture for maxillary implant placement
and proper treatment planning are nec-
essary to achieve long-term functional-
ity of an implant-supported prosthesis.7
different loading points (anterior
and posterior) led to 50 different
simulated scenarios that are all
solved and compared.
Results: In case of either anterior
or posterior loading, the most favor-
able implant distribution strategies for
the arch models are as follows: 2,4,5
and 2,3,4,5 for longest ellipsoid shape
and narrow; 2,4,5 and 2,3,4,5 for
shortest ellipsoid shape and medium
width; 1,3,5 and 2,3,4,5 for U-shaped
long and narrow; 2,3,4,5 and 2,4,5 for
U-shaped medium length and medium
width; and 1,3,5 and 2,3,4,5 for
U-shaped short and wide.
Conclusions: Distribution of im-
plants in 2,4,5 order seemed to be
fairly favorable for ideal stress distri-
bution in all simulated models. (Im-
plant Dent 2010;19:498 –508)
Key Words: 3D finite element model,
prosthesis design, maxilla, fixed
prosthesis
During implant placement in the eden-
tulous maxillae, clinicians often encoun-
ter difficult anatomical areas such as the
maxillary sinus and nasal cavities and
low density of trabecular bone; another
problem is economic situations.8 –11
These problems may severely restrict
the number, length, and width of im-
plants that are to be used, which, in turn,
affects the prosthetic design.
Long-term success rates as high as
95% for mandibular implants and 90%
for maxillary implants have been re-
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 6 2010 499

ported for fixed prosthesis.12 For this shapes rehabilitated with a fixed implants bilaterally); 2,3,4 (lateral inci-
reason, clinicians should plan prostheses full-arch prosthesis. sors, canines, first premolars; 6 implants
designs and implant positions very care- 2. The benefits of a 6- versus an bilaterally); 1,3,5 (central incisors, ca-
fully before placement of implants in the 8-implant-supported fixed prosthesis. nines, second premolars; 6 implants
maxilla and plan strategies for the pre- 3. The effect of the presence and bilaterally); 2,4,5 (lateral incisors, pre-
vention of failure.13,14 Distribution and length of a cantilever on stress con- molars; 6 implants bilaterally); 2,3,4,5
number of implants are crucial factors to centration in an implant-supported (lateral incisors, canines, premolars; 8
achieve sufficient anchorage and long- fixed prosthesis. implants bilaterally; Fig. 2) and plotted
term success of an implant-supported on each of the 5 arch models. The im-
fixed full-arch prosthesis in the edentu- MATERIALS AND METHODS plants were assumed to support a 12-
lous maxilla.4,15–23 unit bridge with the first molars region
The aim of this study was to ana- In this study, the maxillary arch being the cantilever area.
lyze the changes in stress concentra- models were obtained from models of The abbreviations of the alveolar
tion in relation to different alveolar 400 Turkish patients, measured milli- arch shapes and dimensions used in
arch shapes of the maxilla. This in- metrically by Bilgin et al24 Five different the study are listed in (Table 1). The
cluded implant distribution with can- maxillary arch shape measurements height and width of the maxillary bone
tilever prosthesis in loading conditions were obtained and coded as shortest el- were 15 and 5 mm, respectively, for
with a mathematical formula by using lipsoid shape and medium width all the 5 arch shapes.
three-dimensional (3D) finite element (SEMW), longest ellipsoid shape and In all simulated models, screw-
analysis (FEA) method. The research narrow (LEN), U-shaped long and nar- design titanium implants with a total
model was essentially developed to row (ULN), U-shaped short and wide length of 13 mm and diameter at the
clarify the following points: (USW), and U-shaped medium length collar 3.8 and at the apex 2.6 mm were
and medium width (UMLMW; Fig. 1). incorporated into the model. The length
1. The influence of the implant distri- Five different implant distribution strat- and diameter of the abutments were 3
bution on stress concentration in egies were coded on the basis of tooth
and 3.8 mm, respectively. The interface
different edentulous maxillary arch number as 3,4,5 (canines, premolars; 6
between the materials was assumed to
be 100% bonded or osseointegrated.
The materials used in the models were
considered to be homogenous, isotropic,
and linearly elastic.4,25–28
Simple arithmetic proportions
were developed to determine the dif-
ference between the interval among
Fig. 1. Five maxillary alveolar arch shapes. a, SEMW; b, LEN; c, ULN; d, UMLMW; e, USW. the implants and the cantilever length
(Formula 1). After dividing the arch
length by the average total size of the
maxillary dentition, it was multiplied
by the mesiodistal size of the average
total tooth area that was appropriate
for each implant. In this way, we
formed a compartment so that the im-
plant could be located in the middle of
it.29 When the arch length proportion
to the average dentition was multiplied
Fig. 2. Five different implant distribution models. a, 1,3,5 implant distribution; b, 2,3,4 implant by the average mesiodistal width of 6
distribution; c, 2,3,4,5 implant distribution; d, 2,4,5 implant distribution; e, 3,4,5 implant teeth, the cantilever length was ob-
distribution. tained. The boundary of the bridge
was determined by drawing the per-
pendiculars to the compartments on
Table 1. Abbreviations and Dimensions of Alveolar Arch Shapes
the arch.29 Consequently when the
length of the arch increased, the inter-
Length Width val between the implants, the cantile-
Abbreviations Arch Shapes (mm) (mm) ver length, and the anterior-posterior
SEMW Shortest ellipsoid shape and medium width 42.5 60 interval of the bridge increased pro-
LEN Longest ellipsoid shape and narrow 53 58 portionally. Furthermore, the shape of
ULN U-shaped long and narrow 57 55 the bridge changed with the shape of
UMLMW U-shaped medium length and medium width 51 62 the basal bone and was related to al-
USW U-shaped short and wide 46 65 veolar crest shape. According to this
500 EFFECTS OF ARCH SHAPE AND IMPLANT POSITION • SAGAT ET AL

after their distributions on the arch

were determined. In each model,
100-N static forces were applied ver-
tically and separately to the anterior
and posterior parts of the bridge. In
addition, to simulate the effects of
loading forces on all implants simul-
taneously, a 1-N/mm2 load pressure
was applied under the bridge.
The stress values were calculated in
terms of Von Mises stress values, which
are the most commonly reported in FEA
studies to summarize the overall stress
state at a point.4,5,25–27,40 – 44 Three vari-
ables were considered in this research:
Fig. 3. For each arch shape, the intervals between the centers of the implants and the length
of the cantilever. 1. Alveolar arch shape (5 types);
2. Implant distribution (5 types);
3. Loading point (anterior or posterior).
The resultant influence of the 3 vari-
ables on the stress concentration
around the periimplant bone was
analyzed.

Fig. 4. a, Implant inclinations in simulated model. b, Finite element model of alveolar arch form
and 1-piece fixed prosthesis.
Table 2. Selected Material Properties
Young’s
Poisson Modulus
Material Ratio (MPa)
Trabecular bone 0.30 1,500
Titanium metal 0.35 110,000
Nonprecious metal 0.35 210,000
simplified proportion calculation, the
distance between the implants was cal-
culated different from the others, and
each arch shape was proportional to its
own length.29 For each arch shape, the
interval between the centers of the im-
plants is shown in Figure 3. The for-
mula used to calculate the distance
between the implants and the cantile-
ver length is as follows:
Arch length ⫻ Mesiodistal diam-
eter of the natural tooth ⫽ Mesiodistal
distance for the implant (average arch
length in the natural dentition).
The ridge was inclined at 28, 26,
16, 5, and 6 degrees in the central inci-
sor, lateral incisor, canine, premolar, and
molar regions, respectively, to achieve a
realistic simulation of the maxilla (Fig.
4, a).30 –32 Maxillary bone tissue was
simulated by considering only trabecu-
lar bone.32,33 The bridge height and
width were 10 mm each. The anterior
part of the fixed prosthesis was inclined
proportional to the inclination of the al-
veolar ridge (Fig. 4, b). Nonprecious
metal properties were used for simula-
tion of the implant-supported fixed
prosthesis. The corresponding elastic
properties such as Young’s modulus and
Poisson’s ratio were determined from
values cited in the literature.34 –39 Table 2
presents the selected material properties.
A graphic software creating geo-
metric configurations of the model,
nodes (10-node tetrapyramids), and el-
ements (13,600) for a finite element
software program (ANSYS, Can-
onsburg, PA) was used to design the
mathematical models consisting of the
alveolar arch, implants, and fixed
prosthesis. The implants were placed
at the center of the maxillary crest
RESULTS
The distribution of the maximum
Von Mises stresses on each model is
depicted in Figure 5. According to the
amount of stresses around periimplant
region, different color figures were
also used (Fig. 6).
Stresses on the anterior and pos-
terior regions of 5 different maxillary
arch shapes with different implant dis-
tributions were evaluated according to
the maximum Von Mises stress values
from low to high. In other words, the
most favorable implant distribution
had the lowest maximum Von Mises
stress values, and on the contrast, the
most deleterious implant distribution
had the highest maximum Von Mises
stress values (Table 3).
DISCUSSION
FEA is a numerical stress analysis
technique that is widely used to study
engineering and biomechanical prob-
lems.19,45,46 FEA model is constructed by
dividing solid objects into a number of
discrete elements that are connected at a
common nodal point. Each element is
assigned appropriate material properties
corresponding to the properties of the
structure to be modeled.47 This method
allows simulated force application to
specific points in the system and pro-
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 6 2010 501

Fig. 5. Maximum Von Mises stress distribution for each alveolar arch model.

Fig. 6. a, Stress concentrations around periimplant sockets. b, LEN arch shape, 1,3,5 implant distribution model, stress concentrations after
posterior loading. c, Stress concentrations around 2,3,4 localized implants in ULN arch shape.

vides the resultant forces in the sur-
rounding structures. A comparison of
2D and 3D FEA studies showed that
only 3D FEA can realistically simulate
the stress pattern in space.46,48 So far, 3D
FEA of different arch forms with differ-
ent implant distributions in the maxilla
has not been previously reported in the
literature. The analysis allowed us to
determine the relationship of the amount
and distribution of the maximum Von
Mises stresses in the periimplant bone to
the alveolar arch form, implant distribu-
tion, and loading force.
When total edentulous maxillary
arches are planned to restore with
fixed prosthesis, clinicians on a regu-
lar basis are confronted with different
treatment choices. Generally, either 6
or 8 implants are placed to support a
fixed prosthesis in upper jaw. Results
of this study suggested dramatic bio-
mechanical advantages as related to
stress concentrations in periimplant
bone for distinct treatment methods in
the edentulous maxilla.
The most favorable implant distri-
bution for posterior loading in relation
to the maximum Von Mises stress val-
ues were 2,4,5 and 2,3,4,5 for the LEN
arch form. The 8 implants distribution
with canine localization did not
change the maximum Von Mises
502 EFFECTS OF ARCH SHAPE
Table 3. Findings of Maximum Von Mises Values Measured in the Junctional Bone
During Function on 5 Different Arch Shapes for Different Implant Distributions
LEN
FIDAL* 2,3,4,5
DIDAL† 3,4,5
FIDPL‡ 2,4,5; 2,3,4,5
DIDPL§ 2,3,4
* The most favorable implant distribution for anterior loading.
† The most deleterious implant distribution for anterior loading.
‡ The most favorable implant distribution for posterior loading.
§ The most deleterious implant distribution for posterior loading.
stress values considerably. The stress
concentration was more favorable
with the 2,4,5 and 2,3,4,5 implant dis-
tributions on the LEN arch form re-
ported in (Fig. 5). For anterior loading
in the LEN arch form, the central in-
cisor or lateral incisor localizations in-
stead of the canine localizations would
decrease the maximum Von Mises
stresses halfway around the anterior
implants.
For the ULN arch form, the cen-
tral incisor or lateral incisor localiza-
tion, instead of the canine localization,
would decrease the stress concentra-
tion to a third (1:3 ratio) on anterior
loading of the periimplant bone. As
we determined from the maximum
Von Mises stress values in the ULN
arch form with posterior loading, the
lowest stress values were detected
with the 6-implant (1,3,5) supported
fixed bridge rather than the 8-implant
(2,3,4,5) supported one (Fig. 5). In the
literature, there are studies that
strongly suggest to increase the num-
ber of implants to lower the periim-
plant bone stress concentration.4,49,50
However, our results indicate that in-
creasing the number of implants will
not always reduce the stress concen-
tration proportionally. The alveolar
arch form should also be considered
carefully when planning maxillary
implant-supported fixed bridges to
avoid excessive stress concentration
around periimplant bone.
For the SEMW arch form, the
high maximum Von Mises stress val-
ues around the posterior periimplant
bone on anterior loading were more
distant from the loading point for the
3,4,5; 2,3,4; and 2,3,4,5 implant distri-
butions instead of the anterior periim-
plant bone (Fig. 5). These findings
AND IMPLANT POSITION • SAGAT ET AL
ULN SEMW USW UMLMW
2,3,4,5 2,3,4,5 1,3,5 2,3,4,5
3,4,5 2,3,4 3,4,5 1,3,5
1,3,5 2,4,5 2,3,4,5 2,4,5
2,3,4 2,3,4 2,3,4 2,3,4
suggest that the alveolar arch form and
implant localization may change the
direction of the force. The maximum
Von Mises stress values with the
SEMW arch form were lower or as
close to those of the 8 implants design.
As previously mentioned in the case of
the LEN and ULN arch forms, place-
ment of 8 implants versus 6 implants
did not reduce the stress concentration
around the periimplant bone.
In the case of the USW arch form,
the maximum Von Mises stress values
measured around the periimplant bone
did not change considerably on poste-
rior loading except with the 2,3,4 and
2,4,5 implant distributions. The most
favorable implant distributions were
2,3,4,5 and 1,3,5 with little difference
from the viewpoint of the maximum
Von Mises stress values.
For the UMLMW arch form, the
maximum Von Mises stress values
measured around the junctional bone
did not change significantly on pos-
terior loading. All the stress values
were generally higher than those of
the other arch forms. The most fa-
vorable implant distributions were
2,3,4,5 and 2,4,5 from the stress con-
centration viewpoint.
The ULN and LEN arch forms
had almost the same length and width.
The only difference was the shape of
the arch form. This slight difference
changed the implant distributions and
attachment points of the prosthesis. In
turn, a difference was found in their
maximum Von Mises stress values.
Another important piece of infor-
mation successfully derived from this
analysis that, in almost every situation,
higher stress values are detectable on
posterior loading than anterior load-
ing. Therefore, posterior loading in the
cantilever region causes increased
stress concentration, confirming previ-
ous observations.51 On the basis of our
models and color-coded figures, the
maximum Von Mises stress values
around a 6- or an 8-implant supported
fixed full-arch prosthesis with cantile-
vers do not increase proportionally
with the cantilever length. The alveo-
lar crest shape affected the stress
values indirectly when the implant po-
sition was changed. In almost all the
6-implant supported models, lower
stress concentrations were found at the
middle implant than at the mesial and
distal implants. Similarly, in the
8-implant supported model, lower
stress occurred at the 2 middle im-
plants than the mesial and distal im-
plants. If a fixed prosthesis supported
by 6 or 8 implants is loaded anteriorly
or posteriorly, the closest implants to
the loading point would generally bear
most of the loading except for the
3,4,5—2,3,4 and 2,3,4,5 implant dis-
tributions in the SEMW arch form.
Co-Cr material was used in the
fixed prosthesis with cantilever. Different
materials may change stress concentra-
tion in the periimplant bone; therefore,
the most suitable prosthesis design
should be selected.52 One limitation of
this research is the loading condition.
Although cyclic loading conditions oc-
cur in the human jaw, only vertical
forces were used to facilitate the assess-
ments with the software, which may
also affect the results.
In this study, the model structures
were assumed to be homogenous, iso-
tropic, and linearly elastic. The cement
thickness layer for a fixed prosthesis
was ignored, and all interfaces be-
tween the materials were assumed to
be 100% bonded or osseointegrated.
These geometric simplifications, used
to reduce the computer time and mem-
ory, were assumed to have no effect
on the accuracy of computation from
stress distribution viewpoint, because
all the models were subjected to the
same simplifications.
Placement of implants in bone
with a thicker cortex reduces the stress
concentration and may result in less
micromovement, thereby increasing
implant stability and tissue integra-
tion.53 Therefore, the maxillary bone

was simulated to have trabecular bone
properties. The cortical thickness was
neglected. Because trabecular bone is
weaker and less resistant to deforma-
tion than the other types of bone, the
implant distribution and arch form se-
lection played a more important role in
our study than in other FEA studies of
the maxilla and implant stress concen-
tration. In the application of the FEA
method, the most common drawback
is overemphasis on the precise stress
values in a model. It should be noted
that the obtained results are extremely
sensitive to the assumptions regarding
the model parameters such as loading
forces, boundary conditions, and ma-
terial properties. Correlating the FEA
results with mechanical tests, conven-
tional model analysis, or actual clini-
cal data may help to validate this
research model.
CONCLUSIONS
1. The alveolar arch shape and dimen-
sions clearly influence the maximum
stress values around the periimplant
bone.
2. The use of 8 instead of 6 implants
is not advantageous in the case of
the LEN, ULN, and SEMW alveo-
lar arch shapes.
3. The alveolar arch shape is more
important than the cantilever length
and affects the linear proportional
relationship of the cantilever length
to the stress values.
4. The stress values are higher in the
posterior region than the anterior
region when the amount of force is
constant. The cantilever location is
critical for posterior loading.
5. The most favorable implant distri-
butions in relation to the stress
concentration in the 5 different al-
veolar arch shapes are as follows:
LEN shape: 2,4,5 and 2,3,4,5
ULN shape: 1,3,5 and 2,3,4,5
SEMW shape: 2,4,5 and 2,3,4,5
USW shape: 2,3,4,5; 1,3,5; and 2,4,5
UMLMW shape; 2,3,4,5 and 2,4,5
The 2,4,5 implant localizations
create sufficient equal stress distribu-
tion in almost all maxillary alveolar
arch shapes.
IMPLANT DENTISTRY / VOLUME 19, NUMBER 6 2010
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Abstract Translations
GERMAN / DEUTSCH
AUTOR(EN): Giray Sagat, DDS, PhD, Serdar Yalcin, DDS,
PhD, B. Alper Gultekin, DDS, PhD, Eitan Mijiritsky, DMD
Einfluss von Bogenform und Implantatposition auf die
Stressverteilung um Implantate herum, die zur Unterstüt-
zung einer kompletten Bogenprothese im zahnlosen Oberk-
iefer eingesetzt werden
ZUSAMMENFASSUNG: Zielsetzung: Diese Finite-
Element-Analyse wurde durchgeführt, um die Veränderun-
gen der Stresskonzentration im Verhältnis zu verschiedenen
alveolären Bogenformen des Oberkiefers zu bestimmen. Ma-
terialien und Methoden: Fünf unterschiedliche Messungen
der Bogenform im Oberkiefer wurden vorgenommen. Diese
wurden als SEMW (kürzeste Ellipsoidform und mittlere
Weite), LEN (längste Ellipsoidform und schmal), ULN (U-
Form lang und schmal), USW (U-Form kurz und breit),
UMLMW (U-Form mit mittlerer Länge und mittlerer Breite)
geschlüsselt. Fünf verschiedene Implantatverteilungsstrat-
egien wurden auf Basis der Zahnnummer als 3,
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 6 2010
4,5 – 2,3,4 – 1,3,5 – 2,4,5 (6 Implantate insgesamt) - 2,3,4,5
(8 Implantate insgesamt) für jedes der fünf Modelle des
Oberkieferkamms aufgesetzt. Die Implantate waren dazu ge-
dacht, eine aus 12 Einheiten bestehende Brücke, wobei der
Bereich der ersten Molaren das freitragende Areal darstellte.
Die Kombination von fünf verschiedenen Bogenformen, fünf
verschiedenen Implantatverteilungen sowie zwei ver-
schiedenen Belastungspunkten (vorderer Bereich und hinterer
Bereich) führte zur Ermittlung von 50 verschiedenen simuli-
erten Szenarien, die allesamt gelöst und verglichen wurden.
Ergebnisse: Bei sowohl vorderer als auch hinterer Belastung
lauteten die besten Implantatverteilungsstrategien für die Bo-
genmodelle wie folgt; 2,4,5 sowie 2,3,4,5 für LEN; 2,4,5
sowie 2,3,4,5 für SEMW; 1,3,5 sowie 2,3,4,5 für ULN;
2,3,4,5 sowie 2,4,5 für UMLMW; 1,3,5 sowie 2,3,4,5 für
USW. Schlussfolgerung: Die Verteilung von Implantaten in
der Anordnung 2,4,5 scheint für eine ideale Stressverteilung
bei allen simulierten Modellen recht günstig zu sein.
SCHLÜSSELWÖRTER: 3D Finite-Elemente-Modell, pro-
thetisches Design, Oberkiefer, feste Prothese
SPANISH / ESPAÑOL
AUTOR(ES): Giray Sagat, DDS, PhD, Serdar Yalcin, DDS,
PhD, B. Alper Gultekin, DDS, PhD, Eitan Mijiritsky, DMD
Influencia de la forma del arco y la posición del implante en la
distribución del estrés alrededor de implantes que soportan
próstesis fijas con arco completo en maxilares sin dientes
ABSTRACTO: Propósito: Se realizó el análisis finito de
elementos para determinar los cambios en la concentración
del estrés con relación a diferentes formas del arco alveolar
del maxilar. Materiales y métodos: Se obtuvieron cinco
mediciones diferentes de la forma del arco alveolar del max-
ilar codificadas como SEMW (forma elipsoide más corta y
ancho mediano), LEN (forma elipsoide más larga y angosta),
ULN (forma de U larga y angosta), USW (forma de U corta
y ancha), UMLMW (forma de U de longitud y ancho medi-
anos) y se contemplaron cinco estrategias diferentes de dis-
tribución de implantes, codificadas según los números del
diente como 3,4,5 – 2,3,4 – 1,3,5 – 2,4,5 (total de seis
implantes) - 2,3,4,5 (total de ocho implantes) en cada uno de
los cinco modelos del arco del maxilar. Se supuso que los
implantes soportarían un puente de 12 unidades en el que la
región de los primeros molares formaría la zona voladiza. La
combinación de cinco formas diferentes del arco, cinco dis-
tribuciones diferentes de implantes y dos puntos diferentes de
carga (anterior y posterior) llevaron a 50 simulaciones dife-
rentes resueltas y comparadas. Resultados: En el caso de la
carga anterior o posterior, las estrategias más favorables en la
distribución de implantes para los modelos de arco son las
siguientes; 2,4,5 y 2,3,4,5 para LEN; 2,4,5 y 2,3,4,5 para
SEMW; 1,3,5 y 2,3,4,5 para ULN; 2,3,4,5 y 2,4,5 para
UMLMW; 1,3,5 y 2,3,4,5 para USW. Conclusión: La distri-
505
bución de implantes en el orden 2,4,5 parece ser bastante
favorable para la distribución ideal del estrés en todos los
modelos simulados.
PALABRAS CLAVES: Modelo de elementos finitos tridi-
mensionales, diseño de prótesis, maxilar, prótesis fija
PORTUGUESE / PORTUGUÊS
AUTOR(ES): Giray Sagat, Cirurgião-Dentista, PhD, Serdar
Yalcin, Cirurgião-Dentista, PhD, B. Alper Gultekin, Cirurgião-
Dentista, PhD, Eitan Mijiritsky, Doutor em Medicina Dentária
Influência da Forma do Arco e Posição do Implante na
Distribuição de Tensão em Torno de Implantes Suportando
Prótese de Arco Total em Maxila Desdentada
RESUMO: Objetivo: Esta análise de elemento finito foi
conduzida para determinar mudanças na concentração de
tensão em relação a diferentes formas de arco alveolar da
maxila. Material e Métodos: Cinco medições da forma do
arco maxilar alveolar codificadas como SEMW (Forma elip-
soide mais curta e largura média), LEN (Forma elipsoide
mais longa e estreita), ULN (longa e estreita em forma de U),
USW (curta e larga em forma de U), UMLMW (comprimento
médio e largura média em forma de U) foram obtidas e cinco
diferentes estratégias de distribuição de implante codificadas
com base em um número de dente enquanto 3,4,5 – 2,3,4 –
1,3,5 – 2,4,5 (total de seis implantes) - 2,3,4,5 (total de oito
implantes) foram localizados em cada um dos cinco modelos
de arco maxilar. Supôs-se que os implantes suportavam uma
ponte de 12 unidades com a região dos primeiros molares
sendo a área de cantiléver. A combinação de cinco diferentes
formas de arco, cinco diferentes distribuições de implante e
dois diferentes pontos de carga (anterior e posterior) levou a
50 diferentes cenários simulados, todos resolvidos e com-
parados. Resultados: Em caso de carga anterior ou posterior,
as estratégias de distribuição de implante mais favoráveis
para os modelos de arco são como segue; 2,4,5 e 2,3,4,5 para
LEN; 2,4,5 e 2,3,4,5 para SEMW; 1,3,5 e 2,3,4,5 para ULN;
2,3,4,5 e 2,4,5 para UMLMW; 1,3,5 e 2,3,4,5 para USW.
Conclusão: A distribuição de implantes na ordem 2,4,5 pa-
receu ser razoavelmente favorável para distribuição ideal de
tensão em todos os modelos simulados.
PALAVRAS-CHAVE: modelo de elemento finito em 3D,
projeto de prótese, maxila, prótese fixa
RUSSIAN /

О: Giray Sagat, доко уг ско сооло-
г, доко флософ, Serdar Yalcin, доко
уг ско соолог, доко флософ, B. Alper
Gultekin, доко уг ско соолог, доко
флософ, Eitan Mijiritsky, доко соолог
л  фо дуг  оло  л  
с д л     окуг л о,
506 EFFECTS OF ARCH SHAPE AND IMPLANT POSITION • SAGAT ET AL

слу ооо дл ол ого с  ого о  КЛ$*"" СЛО
:    од л
 д  о    л!с ко  л  о, косук о ,  
лс,  с%  о 
"#$%". & л'. Д л  одо
ко  л  о оодлс дл о д л 
    ко     - TURKISH / TÜRKÇE
л о фо л оло дуг  
YAZARLAR: Giray Sağat, DDS, PhD, Serdar Yalçın, DDS,
лс. % л   од. Бл олу 
PhD, B. Alper Gültekin, DDS, PhD, Eitan Mijiritsky, DMD
 ул     л  фо Dişsiz Maksillada Ark Şeklinin ve İmplant Konumunun
л оло дуг   лс, Sabit Tam Ark Protezini Destekleyen İmplantların
обо  код: SEMW (к   дуг л- Etrafındaki Gerilme Dağılımı Üzerindeki Etkisi
лсодо фо с д ), LEN
(дл  дуг ллсодо фо, ук), ÖZET: Amaç: Bu sonlu eleman analizi, maksillanın değişik
ULN (U-об, дл  ук), USW (U- alveoler ark biçimleri için gerilme yoğunluğundaki değişik-
об, коок  ок), UMLMW (U- likleri saptamak amacıyla yapıldı. Gereç ve Yöntem: KEOG
об, с д дл  с д ), дл (En kısa elipsoit biçim ve orta genişlik), UED (En uzun
кдо  кооо бл бо  л - elipsoit biçim ve dar), UUD (U-şeklinde uzun ve dar), UKG
 с г с д л , коо бл (U-şeklinde kısa ve geniş), ve UOUOG (U-şeklinde orta
со  код  осо о  уб 3,4,5 – 2,3,4 uzunluk ve orta genişlik) şeklinde kodlandırılan beş farklı
– 1,3,5 – 2,4,5 (с го с ло) - 2,3,4,5 maksiller alveoler ark biçim ölçümleri alındı ve diş nu-
(с го ос  ло). ! долглос, о marasına bağlı olmak üzere beş maksiller ark modelinin her
л буду слу осоо дл ос  12 biri için beş değişik implant dağılım stratejisi kodlandırıldı:
д, гд косоло облс л с облс 3,4,5 – 2,3,4 – 1,3,5 – 2,4,5 (toplam altı implant) - 2,3,4,5
  оло. Бл ссо   с  50 (toplam sekiz implant). İmplantların, birinci azı dişi bölgesi
л  од лу  с  , олу  çıkma olmak üzere 12-birimli bir köprüyü desteklediği var-
  ул со   л  фо дуг, sayıldı. Beş değişik ark şekli, beş farklı implant dağılımı ve
 л  о с д л   ду - iki değişik yükleme noktası (anterior ve posterior) olmak
üzere 50 farklı simülasyon senaryosu oluşturuldu ve karşıla-
л  о к гук (  д  д ).
ştırıldı. Bulgular: Ark modelleri için anterior ve posterior
 ул'. " слу  кк   д , к  д
yükleme durumlarında en olumlu implant dağılım stratejileri
гук бол блго с г
şöyleydi: UED için 2,4,5 ve 2,3,4,5; KEOG için 2,4,5 ve
с д л  дл од л дуг лс
2,3,4,5; UUD için 1,3,5 ve 2,3,4,5; UOUOG için 2,3,4,5 ve
сл ду# : 2,4,5  2,3,4,5 дл LEN; 2,4,5  2,3,4,5 дл
2,4,5; ve UKG için 1,3,5 ve 2,3,4,5. Sonuç: Simülasyon
SEMW; 1,3,5  2,3,4,5 дл ULN; 2,3,4,5  2,4,5 дл
modellerinin tümünde 2, 4, 5 implant dağılımının ideal ger-
UMLMW; 1,3,5  2,3,4,5 дл USW. од. ilme dağılımı için olumlu olduğu görüldü.
$лу с д л    о с 
о од л досг с  ANAHTAR KELİMELER: 3-boyutlu sonlu eleman analizi,
соло  ло  одк 2,4,5. protez tasarımı, maksilla, sabit protez
 IMPLANT DENTISTRY / VOLUME 19, NUMBER 6 2010 507

JAPANESE /

CHINESE /
508 EFFECTS OF ARCH SHAPE AND IMPLANT POSITION • SAGAT ET AL

KOREAN /