BIOMECHANICAL EVALUATIONS OF IMPLANTO-PROSTHETIC RESTORATIONS

Aim of the study: This study aims to evaluate the biomechanical effects of various prosthetic configurations in cases of severe bone atrophy. Short dental implants (≤8 mm) and narrow diameter implants (NDI) ≤3.5 mm were proposed as alternatives to bone augmentation procedures, showing encouraging short-term survival rates. The implants were later restored with zirconia prostheses, using splinted or single crown designs. Dental implants of 4 mm, 6 mm, and 8 mm length, and diameters of 3.3 mm and 3 mm in atrophic posterior mandibular bone were discussed. Materials and methods: A systematic review and meta-analysis of studies published between 2000 and 2024 was conducted. Databases searched included PubMed, Cochrane Library, and Web of Science. Studies were selected based on specific inclusion and exclusion criteria, and data were extracted and analyzed using standard meta-analytic techniques. Results: The results indicated that implants restored with splinted crowns showed better results in Pmin and Pmax values compared to the group with non-splinted crowns. Ppartial prosthetics with splinted crowns and short dental implants have shown to have a profound effect on the magnitude and local distribution of stress in peri-implant regions. It is recommended to replace each missing tooth with an implant when bone support and costs allow. Finally, it has been demonstrated that the prosthetic design (splinted crowns versus non-splinted crowns), as well as the different lengths and loading directions of the implant, influence the distribution of tension and the local accumulation of stress in the implant/prosthesis systems and the surrounding bone. Conclusions: Conclusion is that reduced diameter implants can be successfully used under axial and oblique forces. It was demonstrated that splinted prosthetic devices absorb occlusal forces better, and reduced diameter implants have a success rate comparable to, or even higher than, conventional ones.