{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:44:16Z","timestamp":1790689456699,"version":"4.1.0"},"reference-count":69,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1\u2013LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1\u2014where masticatory forces covered the entire mesio\u2212distal surface of the denture, including the cantilever\u2014was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97\u201315.87% and 87.96\u201394.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance.<\/jats:p>","DOI":"10.3390\/dj11110261","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T11:23:39Z","timestamp":1699356219000},"page":"261","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA)"],"prefix":"10.3390","volume":"11","author":[{"given":"\u00c1rp\u00e1d L\u00e1szl\u00f3","family":"Szab\u00f3","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danica","family":"Matusovits","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haydar","family":"Slyteen","sequence":"additional","affiliation":[{"name":"Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, M\u0171egyetem rkp. 3., 1111 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6149-9077","authenticated-orcid":false,"given":"\u00c9va Ilona","family":"Lakatos","sequence":"additional","affiliation":[{"name":"Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, M\u0171egyetem rkp. 3., 1111 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zolt\u00e1n","family":"Bar\u00e1th","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1177\/0022034517693566","article-title":"Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990\u20132015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors","volume":"96","author":"Kassebaum","year":"2017","journal-title":"J. Dent. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.4103\/jispcd.JISPCD_149_17","article-title":"Prosthetic Consideration in Implant-supported Prosthesis: A Review of Literature","volume":"7","author":"Gowd","year":"2017","journal-title":"J. Int. Soc. Prev. Community Dent."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e100042","DOI":"10.1016\/j.dentre.2022.100042","article-title":"Occlusal considerations for full-arch implant-supported prostheses: A guideline","volume":"2","author":"Yoon","year":"2022","journal-title":"Dent. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1080\/10255842.2017.1309394","article-title":"Stress distribution in cylindrical and conical implants under rotational micromovement with different boundary conditions and bone properties: 3-D FEA","volume":"20","author":"Meloto","year":"2017","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4103\/0974-6781.131001","article-title":"A 3-D finite element analysis of strain around end osseous threaded and non-threaded implant-opposing natural teeth with regular occlusion and altered occlusion: An in vitro study","volume":"4","author":"Reddy","year":"2014","journal-title":"J. Dent. Implant."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1563\/0-716a.1","article-title":"Alveolar ridge augmentation: A comparative longitudinal study between calvaria and iliac crest bone grafts","volume":"31","author":"Carinci","year":"2005","journal-title":"J. Oral Implantol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/j.1708-8208.2010.00318.x","article-title":"Implant placement in combination with sinus membrane elevation without biomaterials: A 1-year study on 15 patients","volume":"14","author":"Piero","year":"2012","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.jcms.2017.11.016","article-title":"Risk factors for post-operative complications after procedures for autologous bone augmentation from different donor sites","volume":"46","author":"Sakkas","year":"2018","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"87","DOI":"10.14219\/jada.archive.2003.0021","article-title":"Minimally invasive dentistry","volume":"134","author":"McLean","year":"2003","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1111\/cid.13113","article-title":"One-stage versus two-stage technique using two splinted extra-short implants: A multicentric split-mouth study with a one-year follow-up","volume":"24","author":"Menini","year":"2022","journal-title":"Clin. Implant Dent. Rel. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1708-8208.2003.tb00010.x","article-title":"\u201cAll-on-four\u201d immediate-function concept with Br\u00e5nemark system\u00ae implants for completely edentulous mandibles: A retrospective clinical study","volume":"5","author":"Rangert","year":"2003","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_12","first-page":"88","article-title":"All-on-4 immediate-function concept with Br\u00e5nemark System implants for completely edentulous maxillae: A 1-year retrospective clinical study","volume":"7","author":"Rangert","year":"2005","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/jopr.12228","article-title":"Double Full-Arch versus Single Full-Arch, Four Implant-Supported Rehabilitations: A Retrospective, 5-Year Cohort Study","volume":"24","author":"Nobre","year":"2015","journal-title":"J. Prosthodont."},{"key":"ref_14","first-page":"ZE16","article-title":"Prosthodontic Perspective to All-On-4\u00ae Concept for Dental Implants","volume":"8","author":"Taruna","year":"2014","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cattoni, F., Chirico, L., Merlone, A., Manacorda, M., Vinci, R., and Gherlone, E.F. (2021). Digital Smile Designed Computer-Aided Surgery versus Traditional Workflow in \u201cAll on Four\u201d Rehabilitations: A Randomized Clinical Trial with 4-Years Follow-Up. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18073449"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"27","DOI":"10.11607\/ijp.5804","article-title":"Immediate Versus Delayed Loading of Dental Implants Supporting Fixed Full-Arch Maxillary Prostheses: A 10-year Follow-up Report","volume":"32","author":"Pera","year":"2019","journal-title":"Int. J. Prostodont."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"657","DOI":"10.11607\/prd.1970","article-title":"Factors Affecting the Outcome in the Immediate Loading Rehabilitation of the Maxilla: A 6-year Prospective Study","volume":"34","author":"Pera","year":"2014","journal-title":"Int. J. Periodont. Restor. Dent."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"310","DOI":"10.14219\/jada.archive.2011.0170","article-title":"A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 Years of follow-up","volume":"142","author":"Lopes","year":"2011","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.4103\/njcp.njcp_273_18","article-title":"Maxillary and Mandibular All-on-Four Implant Designs: A Review","volume":"22","author":"Durkan","year":"2019","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Szab\u00f3, \u00c1.L., Nagy, \u00c1.L., L\u00e1szl\u00f3fy, C., Gajd\u00e1cs, M., Bencsik, P., K\u00e1rp\u00e1ti, K., and Bar\u00e1th, Z. (2022). Distally Tilted Implants According to the All-on-Four\u00ae Treatment Concept for the Rehabilitation of Complete Edentulism: A 3.5-Year Retrospective Radiographic Study of Clinical Outcomes and Marginal Bone Level Changes. Dent. J., 10.","DOI":"10.3390\/dj10050082"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.irbm.2021.06.008","article-title":"Fatigue Loading Effect in Custom-Made All-on-4 Implants System: A 3D Finite Elements Analysis","volume":"43","author":"Darwich","year":"2022","journal-title":"IRBM"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Li, J., Jansen, J.A., Walboomers, X.F., and van den Beucken, J.J.J.P. (2020). Mechanical aspects of dental implants and osseointegration: A narrative review. J. Mech. Behav. Biomed. Mater., 103.","DOI":"10.1016\/j.jmbbm.2019.103574"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/01.ID.0000091140.76130.A1","article-title":"Dental implant design and its relationship to long-term implant success","volume":"12","author":"Steigenga","year":"2003","journal-title":"Implant Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"264","DOI":"10.11607\/jomi.4797","article-title":"Biomechanical Behavior of the Dental Implant Macrodesign","volume":"32","author":"Carvalho","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_25","first-page":"384","article-title":"Effect of Implant Thread Geometry on Secondary Stability, Bone Density, and Bone-to-Implant Contact: A Biomechanical and Histological Analysis","volume":"24","author":"Trisi","year":"2015","journal-title":"Implant Dent."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Di Fiore, A., Montagner, M., Sivolella, S., Stelini, E., Yilmaz, B., and Brunello, G. (2022). Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods. J. Clin. Med., 11.","DOI":"10.3390\/jcm11164812"},{"key":"ref_27","first-page":"e474","article-title":"The all-on-four treatment concept: Systematic review","volume":"9","year":"2017","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Nagy, \u00c1.L., T\u00f3th, Z., Tarj\u00e1nyi, T., Pr\u00e1ger, N.T., and Bar\u00e1th, Z.L. (2021). Biomechanical properties of the bone during implant placement. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01442-1"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1067\/mpr.2001.115251","article-title":"Application of finite element analysis in implant dentistry: A review of the literature","volume":"85","author":"Geng","year":"2001","journal-title":"J. Prosthet. Dent."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jobcr.2014.11.008","article-title":"Finite element analysis: A boon to dentistry","volume":"4","author":"Trivedi","year":"2014","journal-title":"J. Oral Biol. Craniofacial Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.mri.2012.05.001","article-title":"3D Slicer as an Image Computing Platform for the Quantitative Imaging Network","volume":"30","author":"Fedorov","year":"2012","journal-title":"Magnetic Res. Imag."},{"key":"ref_32","first-page":"10","article-title":"[An Option for Guided Implantology: The SMART Guide]","volume":"144","author":"Freedman","year":"2020","journal-title":"Rev. Dent. Paciente"},{"key":"ref_33","unstructured":"Alpha-Bio Tec Ltd. (2023, January 29). Product Catalog. Available online: https:\/\/alpha-bio.net\/media\/10285\/product-catalog-2021-r17-english_mail.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1115\/1.3153645","article-title":"A Simple and Effective Pipe Elbow Element\u2014Linear Analysis","volume":"47","author":"Bathe","year":"1980","journal-title":"J. Appl. Mech."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"34","DOI":"10.13189\/ujme.2015.030202","article-title":"Experimental and Theoretical Study of Hardness and Grain Size Variation in Cold Upset for Pure Copper Cylinder","volume":"3","author":"Hassan","year":"2015","journal-title":"Univ. J. Mech. Eng."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1080\/10255842.2019.1572120","article-title":"Biomechanical comparison of implant inclinations and load times with the all-on-four treatment concept: A three-dimensional finite element analysis","volume":"22","author":"Liu","year":"2019","journal-title":"Comp. Methods Biomech. Biomed. Eng."},{"key":"ref_37","first-page":"239","article-title":"Stress patterns on implants in prostheses supported by four or six implants: A three-dimensional finite element analysis","volume":"25","author":"Silva","year":"2010","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_38","unstructured":"Branemark, P.I., Zarb, G.A., and Albrektsson, T. (1985). Tissue Integrated Prosthesis: Osseointegration in Clinical Dentistry, Quintessence."},{"key":"ref_39","first-page":"185","article-title":"Finite element stress analysis of applied forces to implants and supporting tissues using the \u201eAll-on-four\u201d concept with different occlusal scemes","volume":"18","author":"Sadowsky","year":"2019","journal-title":"J. Prosthodont."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1111\/j.1365-2842.2007.01817.x","article-title":"Effects of implant surface roughness and stiffness of grafted bone on an immediately loaded maxillary implant: A 3D numerical analysis","volume":"35","author":"Huang","year":"2008","journal-title":"J. Oral Rehabil."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jpor.2015.01.003","article-title":"A review of improved fixation methods for dental implants. Part II: Biomechanical integrity at bone-implant interface","volume":"59","author":"Shibata","year":"2015","journal-title":"J. Prosthodont. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e470539","DOI":"10.1155\/2014\/470539","article-title":"Material Properties of the Mandibular Trabecular Bone","volume":"2014","author":"Lakatos","year":"2014","journal-title":"J. Med. Eng."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.irbm.2018.10.006","article-title":"Quantitative Ultrasound Assessment of Cortical Bone Properties beyond Bone Mineral Density","volume":"40","author":"Grimal","year":"2019","journal-title":"IRBM"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"456","DOI":"10.4103\/njcp.njcp_471_19","article-title":"Effects of All-on-four implant designs in mandible on implants and the surrounding bone: A 3-D finite element analysis","volume":"23","author":"Deste","year":"2020","journal-title":"Nig. J. Clin. Pract."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1263\/jbb.104.363","article-title":"Effect of variation of root post in different layers of tooth: Linear vs. nonlinear finite element stress analysis","volume":"104","author":"Uddanwadiker","year":"2007","journal-title":"J. Biosci. Bioeng."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"161","DOI":"10.2209\/tdcpublication.50.161","article-title":"Stress distribution in mandible and temporomandibular joint by mandibular distraction: A 3-dimensional finite-element analysis","volume":"50","author":"Katada","year":"2009","journal-title":"Bull. Tokyo Dent. Coll."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1016\/j.medengphy.2009.03.004","article-title":"Biomechanical study of mandible bone supporting a four-implant retained bridge. Finite element analysis of the influence of bone anisotrophy and foodstuff position","volume":"31","author":"Bonnet","year":"2009","journal-title":"Med. Eng. Phys."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Ayali, A., Altagar, M., Ozan, O., and Kurtulmus-Yilmaz, S. (2020). Biomechanical comparison of the All-on-4, M-4, and V-4 techniques in an atrophic maxilla: A 3D finite element analysis. Comp. Biol. Med., 123.","DOI":"10.1016\/j.compbiomed.2020.103880"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1111\/cid.12630","article-title":"\u201cSimpli5y\u201d a novel concept for fixed rehabilitation of completely edentulous maxillary and mandibular edentulous arches: A 3-year randomized clinical trial, supported by a numerical analysis","volume":"20","author":"Chowdhary","year":"2018","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Liu, C., Xing, Y., Li, Y., Lin, Y., Xu, J., and Wu, D. (2022). Bone quality effect on short implants in the edentulous mandible: A finite element study. BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02164-8"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e23490","DOI":"10.1002\/dvg.23490","article-title":"Roles of osteoclasts in alveolar bone remodeling","volume":"60","author":"Omi","year":"2022","journal-title":"Genesis"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/cid.12769","article-title":"The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow-up","volume":"21","author":"Malo","year":"2019","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/S0278-2391(99)90437-8","article-title":"Mechanical properties of trabecular bone in the human mandible: Implications for dental implant treatment planning and surgical placement","volume":"57","author":"Misch","year":"1999","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Ruiz, J.A., S\u00e1nchez-Siles, M., Guerrero-S\u00e1nchez, Y., Pato-Mourelo, J., and Camacho-Alonso, F. (2021). Evaluation of Quality of Life and Satisfaction in Patients with Fixed Prostheses on Zygomatic Implants Compared with the All-on-Four Concept: A Prospective Randomized Clinical Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18073426"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Zincir, \u00d6.\u00d6., and Parlar, A. (2021). Comparison of stresses in monoblock tilted implants and conventional angled multiunit abutment-implant connection systems in the all-on-four procedure. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-02023-y"},{"key":"ref_56","first-page":"15","article-title":"Biomaterials and biomechanics of oral and maxillofacial implants: Current status and future developments","volume":"15","author":"Brunski","year":"2000","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1002\/(SICI)1097-4636(199822)43:2<192::AID-JBM14>3.0.CO;2-K","article-title":"Timing of loading and effect of micromotion on bone-dental implant interface: Review of experimental literature","volume":"43","author":"Salama","year":"1998","journal-title":"J. Biomed. Mater. Res."},{"key":"ref_58","first-page":"706","article-title":"Effects of cortical bone thickness and implant length on bone strain and interfacial micromotion in an immediately loaded implant","volume":"25","author":"Tu","year":"2010","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0022-3913(10)60182-5","article-title":"The influence of cantilever length and implant inclination on stress distribution in maxillary implant-supported fixed dentures","volume":"105","author":"Beviacqua","year":"2011","journal-title":"J. Prosthet. Dent."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/adj.12002","article-title":"Load transfer in tilted implants with various cantilever lengths in an all-on-four situation","volume":"57","author":"Malhotra","year":"2012","journal-title":"Austrailan Dent. J."},{"key":"ref_61","first-page":"51","article-title":"Three-dimensional finite element model of a human mandible incorporating six osseointegrated implants for stress analysis of mandibular cantilever prostheses","volume":"10","author":"Grundling","year":"1995","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e332","DOI":"10.1111\/cid.12129","article-title":"Tilted and short implants supporting fixed prosthesis in an atrophic maxilla: A 3D-FEA biomechanical evaluation","volume":"17","author":"Almeida","year":"2015","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1615\/JLongTermEffMedImplants.2021036788","article-title":"Evaluation of stress and strain magnitude in tapered and cylindrical implant surrounding bone, used for restoration of mandibular teeth: Finite element analysis in All-on-Four concept","volume":"31","author":"Hajizadeh","year":"2021","journal-title":"J. Long-Term Eff. Med. Implant."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1016\/j.jfma.2019.12.001","article-title":"Biomechanical effect of implant design on four implants supporting mandibular full-arch fixed dentures: In vitro test and finite element analysis","volume":"119","author":"Wu","year":"2020","journal-title":"J. Formosan Med. Assoc."},{"key":"ref_65","first-page":"383","article-title":"Dental implant thread pitch and its influence on the osseointegration process: An in vivo comparison study","volume":"27","author":"Orsini","year":"2012","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jpor.2016.08.002","article-title":"Biomechanical analysis of immediately loaded implants according to the \u201cAll-on-Four\u201d concept","volume":"61","author":"Horita","year":"2017","journal-title":"J. Prosthodont. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.msec.2016.07.059","article-title":"Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: A prototyping guided 3D-FEA study","volume":"69","author":"Bhering","year":"2016","journal-title":"Mat. Sci. Eng. C"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/cid.12573","article-title":"Micromotion analysis of different implant configuration, bone density, and crestal bone thickness in immediately loaded mandibular full-arch implant restorations: A nonlinear finite element study","volume":"20","author":"Sigiura","year":"2018","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.medengphy.2007.02.005","article-title":"A complete finite element model of a mandibular implant-retained overdenture with two implants: Comparison between rigid and resilient attachment configurations","volume":"30","author":"Daas","year":"2008","journal-title":"Med. Eng. Phys."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/11\/11\/261\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:18:36Z","timestamp":1760131116000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/11\/11\/261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,7]]},"references-count":69,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["dj11110261"],"URL":"https:\/\/doi.org\/10.3390\/dj11110261","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,7]]}}}