Biomechanical Evaluation of Cantilevered 2-Unit Implant-Supported Prostheses: A 3D Finite Element Study

To assess the biomechanical performance of cantilevered 2-unit implant-supported prostheses with zirconia and polyetherketoneketone (PEKK) under 3 loading conditions.

A cone beam computer tomography (CBCT) scan of an edentulous mandible was segmented using Mimics software and refined in 3-Matic software to create trabecular and cortical bone structures. Implant CAD files were integrated using SolidWorks software, generating 4 models with varying implant positions: M1 (first premolar implant supporting a second premolar), M2 (second premolar implant supporting a first premolar), M3 (second premolar implant supporting a first molar), and M4 (first molar implant supporting a second premolar). Prostheses were constructed from zirconia or PEKK. Finite element analysis (FEA) in ANSYS software simulated static loading: vertical (100 N) and oblique (30° and 45°, 50 N). von Mises stress and total deformation were analyzed.

Vertical loading showed the highest von Mises stress at cantilever connectors, with M3 displaying the highest cortical bone stress (117 MPa). Zirconia models had slightly higher prosthetic stress, while PEKK models exhibited greater implant and cortical bone stress. Oblique loading caused higher stress in implants and prostheses but remained below yield limits. Maximum deformation was under 25 micrometers for the implant and bone, and 65 micrometers for the prosthesis.

Single implants can support 2-unit cantilevered prostheses when additional implants are unfeasible. The location of the cantilever has minimal impact compared to its size, as a larger cantilevered part increases stress. Zirconia better resists bending forces and reduces implant stress compared to PEKK.

This study guides prosthodontists in designing 2-unit implant-supported prostheses, emphasizing that multiple implants optimize stress distribution, and that zirconia is preferable for cantilevered designs.