Influence of Framework Material and Posterior Implant Angulation in Full-Arch All-on-4 Implant-Supported Prosthesis Stress Concentration

João Paulo Mendes Tribst, Dayana Campanelli de Morais, Jefferson David Melo de Matos, Guilherme da Rocha Scalzer Lopes, Amanda Maria de Oliveira Dal Piva, Alexandre Luiz Souto Borges, Marco Antonio Bottino, Antonio Lanzotti, Massimo Martorelli*, Pietro Ausiello

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


This study evaluated the influence of distal implants angulation and framework material in the stress concentration of an All-on-4 full-arch prosthesis. A full-arch implant-supported prosthesis 3D model was created with different distal implant angulations and cantilever arms (30° with 10-mm cantilever; 45° with 10-mm cantilever and 45° with 6-mm cantilever) and framework materials (Cobalt–chrome [CoCr alloy], Yttria-stabilized tetragonal zirconia polycrystal [Y-TZP] and polyetheretherketone [PEEK]). Each solid was imported to computer-aided engineering software, and tetrahedral elements formed the mesh. Material properties were assigned to each solid with isotropic and homogeneous behavior. The contacts were considered bonded. A vertical load of 200 N was applied in the distal region of the cantilever arm, and stress was evaluated in Von Misses (σVM) for prosthesis components and the Maximum (σMAX) and Minimum (σMIN) Principal Stresses for the bone. Distal implants angled in 45° with a 10-mm cantilever arm showed the highest stress concentration for all structures with higher stress magnitudes when the PEEK framework was considered. However, distal implants angled in 45° with a 6-mm cantilever arm showed promising mechanical responses with the lowest stress peaks. For the All-on-4 concept, a 45° distal implants angulation is only beneficial if it is possible to reduce the cantilever’s length; otherwise, the use of 30° should be considered. Comparing with PEEK, the YTZP and CoCr concentrated stress in the framework structure, reducing the stress in the prosthetic screw.

Original languageEnglish
Article number12
Pages (from-to)1-15
Number of pages15
JournalDentistry Journal
Issue number1
Early online date14 Jan 2022
Publication statusPublished - Jan 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Dental implants
  • Finite element analysis
  • Polymers
  • Prosthodontics


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