Biomechanical Stress in Obturator Prostheses: A Systematic Review of Finite Element Studies

• Published in: BioMed research international 2021, Vol.2021, p.6419774-12
• Main Authors: Mousa, Mohammed A., Abdullah, Johari Yap, Jamayet, Nafij B., Alam, Mohammad Khursheed, Husein, Adam
• Format: Article
• Language: English
• Subjects: Animals; Biomechanical Phenomena; Biomechanics; Compression; Defects; Dental implants; Dental materials; Dental prosthetics; Dental roots; Dentures; Design modifications; Design optimization; Finite Element Analysis; Finite element method; Health aspects; Humans; Imaging, Three-Dimensional - methods; Implants, Artificial; Literature reviews; Maxilla; Maxilla - pathology; Maxilla - surgery; Maxillofacial; Maxillofacial Prosthesis; Mechanical properties; Medical research; Medicine, Experimental; Patient outcomes; Prostheses; Prosthesis; Psychological aspects; Quality of life; Reconstruction; Rehabilitation; Research methodology; Review; Risk factors; Stress (Physiology); Stress analysis; Stress concentration; Stress distribution; Stress, Mechanical; Surgery; Systematic review; Teeth; Tensile stress
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2021/6419774

Aim. This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020. Results. 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation. Conclusion. Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.