Tilted and Short Implants Supporting Fixed Prosthesis in an Atrophic Maxilla: A 3D‐FEA Biomechanical Evaluation

Abstract Purpose This study compared the biomechanical behavior of tilted long implant and vertical short implants to support fixed prosthesis in an atrophic maxilla. Materials and Methods The maxilla model was built based on a tomographic image of the patient. Implant models were based on micro‐computer tomography imaging of implants. The different configurations considered were M4S , four vertical anterior implants; M4T , two mesial vertical implants and two distal tilted (45°) implants in the anterior region of the maxilla; and M6S, four vertical anterior implants and two vertical posterior implants. Numerical simulation was carried out under bilateral 150 N loads applied in the cantilever region in axial ( L1 ) and oblique (45°) ( L2 ) direction. Bone was analyzed using the maximum and minimum principal stress (σ max and σ min ), and von M ises stress (σ vM ) assessments. Implants were analyzed using the σ vM . Results The higher σ max was observed at: M4T , followed by M6S / L1 , M6S / L2 , M4S / L2 , and M4S / L1 and the higher σ vM : M4T / L1 , M4T / L2 and M4S / L2 , M6S / L2 , M4S / L1 , and M6S / L1 . Conclusions The presence of distal tilted ( all‐on‐four ) and distal short implants ( all‐on‐six ) resulted in higher stresses in both situations in the maxillary bone in comparison to the presence of vertical implants ( all‐on‐four ).