Finite element stress analysis of the influence of staggered versus straight placement of dental implants.

Bending moments resulting from non-axial overloading of dental implants may cause stress concentrations exceeding the physiologic supporting capacity of cortical bone, leading to various kinds of failures. The aim of this study was to evaluate the effect of staggered (offset, tripodization) implant placement configuration and placement of wider-diameter implants in a straight-line configuration in mandibular posterior edentulism. A mandibular Kennedy Class II partially edentulous finite element model was constructed. Seven different partial fixed prostheses supported by 3 implants were designed according to 2 main configurations: straight-line or staggered implant placement. In 5 of the designs, implants with various diameters and length were placed along a straight line. In the other 2 models, offset placement of the middle implant buccally and lingually was simulated. A 400 N static load was applied perpendicular to the buccal inclination of the buccal cusps on each unit. Tensile and compressive stress values on cortical bone in the cervical region of the implants were evaluated. Lower stress values were recorded for the configuration with wider implants placed in a straight line. Other configurations, including staggered implant placement, produced similar stress values. Despite the offset implant placement, the stresses were not decreased; however, straight placement of wider implants may decrease bending moments.