Evaluation of treatment options for atrophic mandible under trauma forces: a 3D finite element analysis treatment options for atrophic mandible under trauma forces

Objective: This study aimed to assess the stress distributions at different treatment options in edentulous and severely atrophic mandibula under trauma forces. Material and method: In this study, four different treatment methods were applied to a severely atrophic edentulous mandibular model. In Model 1, inferior alveolar nerve lateralization was performed, followed by the placement of six implants. Model 2 utilized the all-on-four approach with implants placed. Model 3 used subperiosteal implants made of PEEK, while Model 4 used titanium subperiosteal implants. Each subperiosteal implant model included 14 osteosynthesis screws positioned in key areas of the mandible. 2000 Newton trauma force was applied anterior side of the mandibula. The maximum principal stress (Pmax), minimum principal stress (Pmin), and Von Mises (VMs) stress values are measured as MPa. Results: In this study, Model 4 showed the highest Pmax in the symphysis region, while the other models had similar values. The mandibular condyle exhibited the highest Pmax in Model 1 and the lowest in Model 2. The Pmin values were comparable across all models in the symphysis region. Regarding VMs stress values, balanced stress was observed in the metal frameworks of all models. Model 3 had the most balanced and lowest VMs stress in abutments and abutment screws, while Model 4 had the highest. Conclusion: This FEA study found that both the all-on-4 and PEEK subperiosteal implants are more resistant under trauma forces compared to titanium subperiosteal implants and the 6-implant IANL approach. The PEEK subperiosteal implant offers a less invasive treatment option for fractured mandibles. © The Author(s) 2025.