Comportamento biomecânico de duas opções reabilitadoras em região anterior da maxila

Abstract

The anatomical configuration of the maxilla favors the installation of inclined implants, which makes prosthetic rehabilitation more challenging. The purpose of this study was to describe two rehabilitating situations for unit losses in the anterior maxilla, evaluating the influence of two implant installation inclinations and two prosthetic components with their respective prosthetic crowns. Two virtual models simulating the maxilla, implant and prosthetic components were created to analyze the two clinical situations: G1 - implant inserted in the long axis of the maxilla associated with the conventional cemented prosthesis with universal trunnion single body and G2 - Palatinate implant (with palatal approach) associated to the prosthetic crown screwed into single morse taper. The load considered was applied in one step with a load of 45N applied at 45 degrees to the prosthetic crown cingulate to simulate the beginning of dental contact during occlusion. The response variables were Principal Maximum Tension (σmax) in bone and ceramic, and von Mises (σe) for implant and prosthetic components. The σe for implants of 163.78MPa (G1) and 201.51MPa (G2) in the region of the cervical platform of the implant. Among the copings were observed in the order of 16,607MPa (G1) and 984,92MPa (G2). For prosthetic components 333.49MPa (G1) and 116.34MPa (G2). For the prosthetic screw in the G2 group was 288.21MPa. The σmax for the cortical bone was 27.589MPa (G1) and 82.816MPa (G2). For the trabecular bone was 10,088 MPa (G1) and 5,8198MPa (G2). In the porcelain prosthetic crown the σmax was 137.32MPa and 137.5MPa both in the cingulate region. The option for the palatal approach of the G2 implant presented critical areas of stress concentrations. Thus, the use of cemented crowns instead of the screwed ones can generate lower tension indices on bone, implant and prosthetic component.