The treatment modality for completely edentulous arches has shifted from complete dentures to dental implants during the last 15-20 years. Tilting of implants has reduced the concern of resorbed posterior ridges in completely edentulous patients with “All-on-four” and “All-on-six” concept of dental implants. The purpose of this study is to compare the biomechanical behaviour of the “All-on-four”, “All-on-six” models with tilted distal implants at different angulations of 30 and 45 ° with four parallel placed implant-supported fixed prosthesis, and six parallel placed implant-supported fixed prosthesis models as controls using three-dimensional finite element analysis. The results showed that in all the models, in cancellous bone, cortical bone, implant and prosthesis – “All-on-four” model with distal implants tilted at an angulation of 30° showed stress values less than or equivalent to all the other models except on the implant in the presence of cantilever and on prosthesis during full mouth biting load where maximum stresses were observed. The study shows that All-on-four concept with tilted distal implants at an angulation of 30° showed stress values favourable for the rehabilitation of completely edentulous maxilla, but the presence of cantilever remains an area of concern.
Voxel-based micro-finite element analysis of dental implants in a human cadaveric mandible: Tissue modulus assignment and sensitivity analyses