Abstract
STATEMENT OF PROBLEM: Recent advancements in digital technology have revolutionized implant dentistry, particularly with additively manufactured subperiosteal jaw implants (AMSJIs). These implants allow patient-specific designs that adapt to anatomical requirements. However, optimizing stress distribution remains a challenge. PURPOSE: This study evaluated the stress distribution in AMSJIs and surrounding bone by analyzing different framework materials (PEEK and Co-Cr), anterior wing designs (I- and Y-shaped), and cantilever extensions using three-dimensional finite element analysis. METHODS: A model was created from a patient with an atrophic, edentulous maxilla. Biomechanical evaluation of eight maxillary implant scenarios was performed under a 200 N force applied at a 45° oblique angle. Stress distribution in the bone, implants, screws, and prosthetic frameworks, as well as prosthetic displacement, was analyzed. RESULTS: The lowest implant stress (444.5 MPa) was observed in the Co-Cr group without a cantilever using an I-shaped design, whereas the highest stress (623.0 MPa) occurred in the Co-Cr group with a cantilever using a Y-shaped design. Prosthetic displacement was greater in cantilevered groups, with PEEK exhibiting more displacement than Co-Cr. CONCLUSIONS: The optimal stress distribution was achieved with the I-shaped design without a cantilever, using Co-Cr. Stress levels were significantly influenced by framework material, wing design, and cantilever presence, underscoring the importance of design and material selection. CLINICAL SIGNIFICANCE: While stress remained within physiological limits in all cases, avoiding cantilevers and selecting a rigid material can optimize Y-shaped designs. PEEK demonstrated favorable properties in cantilevered designs, but its long-term effects on soft tissue and implants warrant further clinical trials.