materials
Article
Analytical Modeling of the Interaction of a Four
Implant-Supported Overdenture with Bone Tissue
Bohdan Pelekhan 1 , Maciej Dutkiewicz 2, *, Ivan Shatskyi 3 , Andrii Velychkovych 4 , Mykola Rozhko 1
and Liubomyr Pelekhan 1






Citation: Pelekhan, B.; Dutkiewicz,
M.; Shatskyi, I.; Velychkovych, A.;
Rozhko, M.; Pelekhan, L. Analytical
Modeling of the Interaction of a Four
Implant-Supported Overdenture
with Bone Tissue. Materials 2022, 15,
2398. https://doi.org/10.3390/
ma15072398
Academic Editor: Gabriele Cervino
Received: 13 February 2022
Accepted: 21 March 2022
Published: 24 March 2022
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Copyright: © 2022 by the authors.
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distributed under the terms and
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Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
Materials 2022, 15, 2398. https://doi.org/10.3390/ma15072398
1 Department of Dentistry of Postgraduate Study Faculty, Ivano-Frankivsk National Medical University,
Halytska Str. 2, 76018 Ivano-Frankivsk, Ukraine; bpelechan@gmail.com (B.P.); rector@ifnmu.edu.ua (M.R.);
pelekhan.liubomir@gmail.com (L.P.)
2 Faculty of Civil and Environmental Engineering and Architecture, Bydgoszcz University of Science and
Technology, Kaliskiego 7, 85-796 Bydgoszcz, Poland
3 Laboratory of Modeling of Damping Systems, Pidstryhach-Institute for Applied Problems in Mechanics and
Mathematics of the National Academy of Sciences of Ukraine, Mykytynetska Str. 3,
76002 Ivano-Frankivsk, Ukraine; ipshatsky@gmail.com
4 Department of Construction and Civil Engineering, Ivano-Frankivsk National Technical University of Oil and
Gas, Karpatska Str. 15, 76019 Ivano-Frankivsk, Ukraine; a_velychkovych@ukr.net
* Correspondence: macdut@pbs.edu.pl
Abstract: Today, an interdisciplinary approach to solving the problems of implantology is key to the
effective use of intraosseous dental implantations. The functional properties of restoration structures
for the dentition depend significantly on the mechanical stresses that occur in the structural elements
and bone tissues in response to mastication loads. An orthopedic design with a bar fixation system
connected to implants may be considered to restore an edentulous mandible using an overdenture. In
this study, the problem of the mechanics of a complete overdenture based on a bar and four implants
was formulated. A mathematical model of the interaction between the orthopedic structure and
jawbone was developed, and a methodology was established for the analytical study of the stress
state of the implants and adjacent bone tissue under the action of a chewing load. The novelty of the
proposed model is that it operates with the minimum possible set of input data and provides adequate
estimates of the most significant output parameters that are necessary for practical application. The
obtained analytical results are illustrated by two examples of calculating the equivalent stresses in
implants and the peri-implant tissue for real overdenture designs. To carry out the final assessment of
the strength of the implants and bone, the prosthesis was loaded with mastication loads of different
localization. In particular, the possibilities of loading the prosthesis in the area of the sixth and
seventh teeth were investigated. Recommendations on the configuration of the distal cantilever
of the overdenture and the acceptable level and distribution of the mastication load are presented.
It was determined that, from a mechanical point of view, the considered orthopedic systems are
capable of providing long-term success if they are used in accordance with established restrictions
and recommendations.
Keywords: stress state; contact interaction; bar fixation system; overdenture; dental implant;
distal cantilever
1. Introduction
The restoration of integrity in edentulous areas using intraosseous dental implantation
allows the practitioner to achieve clearly predictable results in the complex functional and
aesthetic rehabilitation of the patient.
The effectiveness of orthopedic prostheses based on intraosseous dental implants is
higher than that of “traditional” orthopedic prostheses. The technique of dental implanta-
tion is advantageous since it allows for the individualization of the patient’s orthopedic
https://www.mdpi.com/journal/materials
Materials 2022, 15, 2398 2 of 24

treatment by making both removable and fixed overdentures that have more natural biome-
chanics, allowing the practitioner to save the patient’s own teeth [1]. The main advantage
of implant-supported overdentures is their method of distribution of the occlusal load: it is
more physiologically (homogeneously) distributed in the bone tissue of the jaw without
overloading the surrounding teeth and without adverse effects on the oral mucosa [2].
However, adequate qualitative and quantitative indicators of bone tissue are required for
the placement and sufficient primary stabilization of dental implants [3].
Currently, the most successful paradigm in implant treatment planning is a multi-
disciplinary approach. Before surgery, based on the anatomical features of the jaws and
occlusal planes, the dentist and the orthopedist draw up a treatment plan and determine
the required number and placement of dental implants [4].
It is known that with careful adherence to the protocol (technology) of dental im-
plantation, it is usually possible to achieve implant osseointegration; however, along with
this, one should be sure that the integrated implants and bone tissue can withstand the
occlusal load transferred to them during masticatory function. When using dental pros-
theses designed to treat edentulism, cross-stabilization is created; in this case, the force
vectors differ significantly from such vectors when using dental bridges, where there is
no stabilization. If there is a distal cantilever or a separate implant, lateral loading must
be considered. The more attention paid to such issues, the higher the effectiveness of the
implant treatment [5]. At first, it was believed that the functioning of intraosseous dental
implants was achieved using any type of dental prostheses. This, perhaps, limited the
period of effectiveness of implants that was reached—5–7 years. Today, the principles of
treatment planning as well as the methods used during the surgical stage of treatment have
changed, and methods for determining and analyzing occlusion at the stage of fixation and
its control in remote periods of time are being developed [6–8]. All this is important to
increase the effectiveness of the functional and aesthetic rehabilitation of patients using the
dental implantation technique.
It is recognized that the implant and bone tissue must be subjected to a limited
range of stress in order to maintain physiological homeostasis. Overloading can cause
bone resorption or a fatiguing fracture at the implant neck, while underloading can cause
atrophy and bone loss [9].
From the point of view of biomechanics, the successful functioning of dental implants
depends on how mechanical loads are transmitted to the implant and peri-implant tissues
and what values of stresses arise [10]. Multiple factors influence the occurrence of defor-
mations and stresses, including the place of application, the direction and magnitude of
the load, the number and location of the implants, the length and diameter of the implant,
the geometry of the implant and its surface structure, the quality of the environment and
bones, etc. Only by understanding which of these factors are significant and which are
secondary is it possible to develop the right orthopedic treatment strategies based on
dental implants.
The effectiveness of implant treatment protocols has been confirmed by evidence-
based medicine. In the edentulous mandible, an effective method of restoring the dentition
is the manufacture of a bar supported by dental implants and a completely removable
overdenture supported by a fixed bar [11–14].
In general, an implant-supported bar retaining overdenture system can be used to
restore maxillary or mandibular edentulousness with a removable overdenture. In one
study, a great deal of evidence for the successful functioning of this type of orthopedic
prosthesis was reported with its early assembly for 48 h to 3 months from the moment of
placement of four implants in the mandibular dentition or six implants in the maxilla [15].
Bar retaining overdentures have a number of advantages, for example, the removable
overdenture can be reliably fixed, the patient can easily remove and install the overdenture
on the bar, the hygienic care of the prosthesis and bar is simple; the conditionally removable
bar can be removed and replaced with a new one, the installed overdenture does not move
while eating, and thus does not cause discomfort and inconvenience [16,17]. Usually, an
Materials 2022, 15, 2398 3 of 24

orthopedic structure with a bar retaining system is placed in several clinical and laboratory
stages [18]: After planning the orthopedic treatment, implants are placed. Based on an
impression taken using the open tray method, a model is made with analogues of the im-
plants, on which the central ratio of the jaws and height are fixed. A bar is modeled digitally
and then cast; this will splint the implants and act as a retainer for a complete removable
overdenture. After fitting the bar, an individual cover prosthesis is made according to the
impression and the structure is fixed. Providing the patient with recommendations for
oral care [19] and rules for the removal and insertion of the overdenture is important for
maintaining its function.
The choice of dental implant configuration depends on a number of criteria, among
which the development of the future orthopedic structure and the anatomical features of
the patient are the most important. Biomechanical criteria are of paramount importance
and should be developed to increase the likelihood of implantation success, especially in
difficult clinical cases [20,21]. From the point of view of mechanics, the problem with the
interaction between an implant and the bone tissue is a contact problem of the interaction
of two bodies with different physical and mechanical characteristics. In general, contact
problems for elastic systems constitute an actual section of the mechanics of a deformable
solid body. Statements and methods for solving contact problems using continuum models
of a continuous medium have been developed [22–24]. The results described in such papers
reveal the general regularities of the contact interaction of rigid bodies. Here, we will briefly
note the main approaches related to the problem considered in this article. A number of
modern studies are devoted to contact problems for shell rod systems, taking into account
the energy dissipation during mutual slippage in contact pairs [25–27]. Analytical [28–30],
analytic-numerical [31–33], and experimental [34,35] approaches to the study of stresses in
composite, substantially inhomogeneous structures also deserve attention.
Since the rigidity of the implant is much greater than the rigidity of the bone tissue,
the implant in the bone can be considered as an absolutely rigid linear inclusion interacting
with an elastic body. Models and analytical methods for studying the behavior of thin in-
clusions in elastic media are considered in several monographs [36,37] and articles [38–40].
One publication [41], which proposed an approach to the analysis of stresses in an array
reinforced with an ensemble of rigid inclusions connected to a single framework, deserves
special attention. Separate problems regarding the inelastic interaction of a rigid linear
inclusion with a matrix were considered in [42,43].
Winkler’s hypothesis about the proportionality of stresses and discontinuities on the
model interface [22–24] is very fruitful in problems considering the conjugation of contin-
uums through a thin intermediate layer, and makes it possible to reduce the dimension
of the problem. Examples of the successful application of this model are found in [44–47]
for one-dimensional rod objects and [48–50] for two-dimensional structures. In particu-
lar, in dentistry, the Winkler layer can describe the behavior of periodontal tissues in the
interaction of the dental root with the jaw [51].
The cantilever effect caused by the localization of the mastication load on the molars
in the prosthetic version leads to a significantly off-center load on the implants. Some
approaches to the problem of centering linear objects are considered in [52–55]. The issues
surrounding the strength of plate structures under conditions of simultaneous tension
(compression) and bending, taking into account the closure of crack-like defects, were
studied in [56–58]; similar problems for cracked shallow shells were considered in [59]. In
this case, the model of partial contact along the line turned out to be quite effective [60–62].
The functional properties of the restoration structure of the dentition depend signif-
icantly on the mechanical stresses that occur in the structural elements and bone tissues
in response to mastication loads. Occlusal overload is one of the main causes of failure in
dental implant treatment [63–65]. Therefore, to select an adequate method for tooth restora-
tion and the parametric optimization of the restoration structure, a careful calculation of
the indicators of its stress–strain state is required. The insufficient study of this issue by
Materials 2022, 15, x FOR PEER REVIEW 4 of 27

failure in dental implant treatment [63–65]. Therefore, to select an adequate method for
Materials 2022, 15, 2398 4 of 24
tooth restoration and the parametric optimization of the restoration structure, a careful
calculation of the indicators of its stress–strain state is required. The insufficient study of
this issue by analytical means and the inconvenience of the practical application of the
analytical
existing means
results were and the inconvenience
the main motivation forofour
the study.
practical application of the existing results
were the main motivation for our study.
The aim of this work was to build analytical estimates of the stress state of implants
and the The aim of
adjacent thistissue,
bone work was to build
as well as toanalytical estimates of the stress
develop recommendations state
on the of implants
acceptable
and the adjacent bone tissue, as well as to develop recommendations on the acceptable
level and distribution of the mastication load. To do this, the main tasks outlined in the
level and distribution of the mastication load. To do this, the main tasks outlined in the
article, organized in this way, are solved. First, the problem of the mechanics of a com-
article, organized in this way, are solved. First, the problem of the mechanics of a complete
plete four implant-supported overdenture is formulated; then, a mathematical model of
four implant-supported overdenture is formulated; then, a mathematical model of the
the interaction of a rigid frame with the jawbone is developed, and the methodology for
interaction of a rigid frame with the jawbone is developed, and the methodology for
an analytical study of the stress state of implants and their adjacent bone tissue under a
an analytical study of the stress state of implants and their adjacent bone tissue under
mastication load is described. The analytical results obtained in the next section are il-
a mastication load is described. The analytical results obtained in the next section are
lustrated by two examples of the calculation of equivalent stresses in real prosthesis de-
illustrated by two examples of the calculation of equivalent stresses in real prosthesis
signs. We also provide some guidelines for distal cantilever configuration. A brief dis-
designs. We also provide some guidelines for distal cantilever configuration. A brief
cussion and conclusions conclude the publication.
discussion and conclusions conclude the publication.
2. Materials andand
2. Materials Methods
Methods
2.1.2.1.
Formulation of the
Formulation of Problem of the
the Problem of Mechanics of a of
the Mechanics Four Implant-Supported
a Four Overdenture
Implant-Supported Overdenture
TheThe
design of the
design orthopedic
of the orthopedicstructure based
structure on four
based implants
on four is shown
implants in Figure
is shown 1. 1.
in Figure
Four intraosseous
Four implants
intraosseous were
implants wereplaced in the
placed edentulous
in the edentulous mandible. A metal
mandible. bar bar
A metal waswas
mounted
mountedon on
them, combining
them, combining thetheimplants
implantsintointoaasingle
single orthopedic
orthopedic structure. On On the
thebar,
bar,through
throughaasystem
systemofof attachments
attachments or directly with slight slight tension,
tension,aacomplete
completeremova-
removable
ble overdenture
overdenture was
was fixed—an
fixed—an imitator
imitator of of the
the dental
dental arch.
arch.

Figure 1. 1.Four
Figure Fourimplant-retained mandibularbar
implant-retained mandibular bar overdenture
overdenture scheme:
scheme: 1—implant;
1—implant; 2—bar;2—bar;
3—screw;
3—screw; 4—removable overdenture; H and d are the length and the diameter of implant.
4—removable overdenture; H and d are the length and the diameter of implant.

Note thatthat
Note the the
removable
removableoverdenture
overdenture (4) is
(4)fixed rigidly
is fixed to the
rigidly bar bar
to the with the the
with helphelp
of aof a
metal socket
metal (Figure
socket 2). Due
(Figure to the
2). Due factfact
to the thatthat
the the
spatial geometry
spatial geometry of the secondary
of the secondary frame
frame
in the overdenture
in the overdenture (Figure 2b)2b)
(Figure corresponds
corresponds totothe
thebar
bargeometry
geometry(Figure
(Figure2a),
2a), forming
forming aa so-
so-called
called lock when connected,
lock when connected,thetheoverdenture
overdentureisissecurely
securely fixed
fixed in in
thethe
oraloral cavity.
cavity. Mas-
Mastication
tication forces are transmitted through the artificial teeth of the overdenture to
forces are transmitted through the artificial teeth of the overdenture to the metal prosthetic the metal
prosthetic socket
socket and and further
further to the supporting
to the supporting elements elements
(bar and(bar and implants).
implants).
Therefore, the overdenture is placed under a given vertical mastication load. The
distribution of stresses and displacements in the implants and the surrounding bone must
be assessed.

2.2. Mathematical Model of the Interaction of a Four-Implant Overdenture with Bone Tissue
Research Methodology
2.2.1. Basic Assumptions of the Model
In order to obtain results in an analytical form, we accepted the following main
hypotheses:
Materials 2022, 15, 2398 5 of 24

(1) The metal structure, including 4 implants, a unifying polygonal bar, and an arched
base of the dentition, is a solid and absolutely rigid spatial frame;
(2) The bone in the vicinity of the implant is modeled by a homogeneous elastic Winkler
Materials 2022, 15, x FOR PEER REVIEW layer [22,51,66]; 5 of 27
(3) The mechanical contact between the components is considered perfect.

(a)

(b) (c)
Figure 2. Individual components of the bar structure during the manufacturing process: (a) bar,
Figure 2. Individual components of the bar structure during the manufacturing process: (a) bar,
(b) secondary overdenture frame, and (с) removable overdenture.
(b) secondary overdenture frame, and (c) removable overdenture.

Therefore, the overdenture

The first assumption is placed of
is a consequence under a given
the fact vertical
that the modulusmastication load.ofThe
of elasticity the
distribution
metal frame is two orders of magnitude higher than the modulus of elasticity of the bone
of stresses and displacements in the implants and the surrounding bone
must
tissue.beInassessed.
addition, from the point of view of kinematics, a solid and absolutely rigid object
has a limited number of degrees of freedom.
2.2. Mathematical Model of theallowed
The second assumption Interaction of ause
us to Four-Implant Overdenture
the simplest traditional with
modelBone Tissue
of the contact
Research Methodology
interaction of a solid body (implant) with a deformable body (bone). To simplify the
2.2.1. Basic
analysis, weAssumptions of the
also considered theModel
bone to be uniform in height with an average modulus of
elasticity of thetocortical
In order obtainand trabecular
results layers.
in an analytical form, we accepted the following main
Finally,
hypotheses: the third assumption meant that we did not take into account the phenomenon
of bone resorption at areas in contact with the implant.
(1) The metal structure, including 4 implants, a unifying polygonal bar, and an arched
base of the dentition, is a solid and absolutely rigid spatial frame;
(2) The bone in the vicinity of the implant is modeled by a homogeneous elastic Win-
kler layer [22,51,66];
(3) The mechanical contact between the components is considered perfect.
The first assumption is a consequence of the fact that the modulus of elasticity of
the metal frame is two orders of magnitude higher than the modulus of elasticity of the
bone tissue. In addition, from the point of view of kinematics, a solid and absolutely
rigid object has a limited number of degrees of freedom.
 Materials 2022, 15, x FOR PEER REVIEW 6 of 27

the analysis, we also considered the bone to be uniform in height with an average mod-
the analysis,
ulus we of
of elasticity also
theconsidered
cortical andthetrabecular
bone to be uniform in height with an average mod-
layers.
Materials 2022, 15, 2398 ulus Finally,
of elasticity of theassumption
the third cortical andmeant
trabecular layers.
that we did not take into account the phenom- 6 of 24
Finally, the third assumption meant
enon of bone resorption at areas in contact with the implant.that we did not take into account the phenom-
enon of bone resorption at areas in contact with the implant.
2.2.2.Coordinate
2.2.2. CoordinateSystems Systemsand andSome
SomeVector
Vector Operations
Operations
2.2.2.Without
Coordinate Systems and Some Vector Operations
Without a aloss lossofofgenerality,
generality,we weassume
assume thatthe
that thelength
lengthofofall allimplants
implantsisisthe
thesame:
same:
H
Hi = = H ,
Without i = 1a,...,
4
loss of generality,
i H, i = 1, . . . , 4.. In addition,
addition, we we assume
we consider that
consider that
thatallthe length
allimplants of
implantsare all implants is
areperpendicular the
perpendiculartotosame:
the
the
H i =
horizontal
horizontalH , i =
plane 1 ,...,
planeand 4 .
andareIn addition,
arelocated we consider
locatedsymmetrically that
symmetricallyononthe all implants
thesides
sidesofofthe are
the perpendicular
sagittal plane.
sagittal plane. to the
horizontal planeand
InInmodeling
modeling and are located
andanalysis,
analysis, wesymmetrically
we will
willuse
usethree on the sides
threecoordinate
coordinate of the sagittal plane.
systems.
systems.
First
In of all,
modeling for the
and “terrain association”
analysis, we will usewe select
three the original
coordinate
First of all, for the “terrain association” we select the original coordinate
systems. system OXYZ,
coordinate system
with the beginning in the middle of the dentition, the
OXYZ , with the beginning in the middle of the dentition, the upward axis
First of all, for the “terrain association” we upward
select theaxis Z, and
original the X, ZY, axes
coordinate in
system
and the
theOXYZ
distal
X , Y axes and
, with oral
in the directions,
the beginning respectively
distal and oralin the (Figures 3
middle ofrespectively
directions, and
the dentition, 4). the upward
(Figures axis Z , and the
3 and 4).
X , Y axes in the distal and oral directions, respectively (Figures 3 and 4).

Figure3.3.Calculation
Figure Calculation scheme
scheme of
of the
the force
force interaction
interaction of
of the
theelements
elementsofofthe
thebar
barstructure
structureasasanan
as-
Figure 3.
sembly Calculation scheme of the force interaction of the elements of the bar structure as an as-
(implants–bar–overdenture).
assembly (implants–bar–overdenture).
sembly (implants–bar–overdenture).

Figure4.4.Original
Figure Originalcoordinate system
coordinate system OZ axis
(the(the OZ isaxis
directed at the reader):
is directed red—implants,
at the reader): blue—pole.
red—implants,
Figure 4.
blue—pole. Original coordinate system (the OZ axis is directed at the reader): red—implants,
Let us denote: ( Xi , Yi ), i = 1, . . . , 4 as the implant coordinates in the original coordinate
blue—pole.
system; and ( X p , Yp ) as the coordinates of the application point (pole) of the mastication
Let us denote: ( Xi ,Yi ) , i = 1,..., 4 as the implant coordinates in the original coor-
load, modeled by the vertical(XXi ,,YYi )force P.
Letsystem;
us denote: , ias= 1the
,..., 4coordinates
as the implant coordinates
applicationinpoint the original
(pole) ofcoor-
dinate
Therefore, the i-th(implant
and p p ) occupies the segmentof ( Xthe
i , Yi , Z ), Z ∈ [− H, 0]. In addition,
the
dinate system; and ( X ,
p by Y ) as the
p the vertical coordinates of the application point (pole) of the
we introduce load,
mastication the central
modeled coordinate system Cxyz P.
force (Figures 3 and 5). To do this, we find the
mastication
original load,
coordinates
Therefore, themodeled
ofi the by the
center
-th implant vertical
ofoccupies force
mass (center ofPrigidity)
the segment . ( Xofi ,the
Yi , Zfour-implant
) , Z ∈ [ − H , 0system by
] . In addi-
Equation (1):
tion, Therefore,
we introducethethei -th implant
central occupiessystem
coordinate the segment ( Xi ,Yi , Z3)and
Cxyz (Figures
, Z ∈5).[ −To ] . In
H , 0do addi-
this, we
4 4
1 1 1
C = ∑ Xi , YC = ∑ Yi , ZC = − H.
tion, we introduce the X central coordinate system Cxyz (Figures 3 and 5). To do this,
(1)we
4 i =1 4 i =1 2
 find the original coordinates of the center of mass (center of rigidity) of the four-implant
system by Equations (1):
4 4
1 1 1
 Yi ,
Materials 2022, 15, 2398 7 of 24
XC = Xi , YC = ZC = − H . (1)
4 4 2
i =1 i =1

Figure 5. Central coordinate system (the Cz axis is directed at the reader): red—implants,
Figure 5. Central coordinate system (the Cz axis is directed at the reader): red—implants, blue—pole.
blue—pole.
From here, to reduce the record, we will omit the indexes in the sign of the sum,
From here,
4 to reduce the record, we will omit the indexes in the sign of the sum,
assuming that: ∑ t4i =∑ ti .
 
i =1
assuming
Thus, instead i = expressions
that: of tthe ti . in Equation (1), we have the following:
i=1
1 1 1 the following:
Thus, instead of the = ∑ Xi , YinC Equation
XCexpressions = ∑ Yi ,(1),
ZCwe
=− have
H. (2)
4 4 2
1 1 1
XC = of theXisystem
As a result of the symmetry 
, YC = with Yrespect
4 OX, OY, and2 OZ.
axes Cx, Cy, and Cz are parallel to4the original axes,

i , ZC =to− the
H plane
. YZ, the central(2)

The
Astransformation of the coordinate
a result of the symmetry system with
of the system occurs according
respect to thetoplane YZ , thelaw:
the following central
axes Cx , Cy , and Cz are parallel to the original axes, OX , OY , and OZ .
x = X − XC , y = Y − YC , z = Z − ZC . (3)
The transformation of the coordinate system occurs according to the following law:
Thus, z ∈ [− H/2, H/2].x Then, =X −X xi =, Xyi =−YX−CY, yi, =z = YiZ−−YZC are the implant coordi-(3)
C C C.
nates in the central coordinate system, and the corresponding coordinates of the pole are
Thus, z ∈ [ − H / 2, Н / 2] . Then, xi = Xi − XC , yi = Yi − YC are the implant coordi-
as follows:
x = X p − XC , y p = Yp − YC (4)
nates in the central coordinatep system, and the corresponding coordinates of the pole are
as follows:
Finally, to describe local phenomena in each implant, we introduce a local coordinate
system Oi ξ i ηi ζ i (i = 1, . . . , 4) with the center in the middle of the implant and the axis ζ i
x = X p − XC , y p = Yp − YC
along its line. The Oi ξ i and Oi ηi axesp are parallel to the central axes. (4)
With eachto
Finally, coordinate
describe localsystem, we will associate
phenomena three mutually
in each implant, perpendicular
we introduce unit
a local coordi-
vectors, which we will call the base. In the original system, these will be vectors I, J, K;
innate
the central
Oiξiηiζivectors
system system, ( i = 1,...,
i,4j,) with
k; andtheincenter in the
the local middlevectors
system, of the implant
ii , ji , kiand thean
. Then axis
ζ i along
arbitrary its line.
vector, The
a, in Oiξi and
a given Oiηi axes
coordinate systemare can
parallel to the central
be represented asaxes.
a setup for base
vectors.With
For example, for the central
each coordinate system,coordinate system: three mutually perpendicular unit
we will associate
vectors, which we will call the base. In the original system, these will be vectors I , J , K ;
a = a x i + ay j + az k. (5)
in the central system, vectors i , j, k ; and in the local system, vectors ii , ji , ki . Then an
arbitrary a , ainz are
a x , ay , and
Valuesvector, the coordinates
a given coordinate of the vector
system can be inrepresented
the base i, j,ask.a setup for base
Sometimes,
vectors. instead for
For example, of Equation
the central (5),coordinate
we will use the designation of a vector quantity in
system:  
ax
the form of a column or a transposed row, a = as + a y j + aazk=.  a  = ( a , a , a )T .
axifollows: (5)
y x y z
az
Values ax , ay , and az are the coordinates of the vector in the base i , j, k .
Sometimes, instead of Equation (5), we will use the designation of a vector quantity
Materials 2022, 15, 2398 8 of 24

When modeling, the operation of the vector product of two vectors will also be applied,
denoted by a third-order determinant, as follows:
 
 i j k 
 
a × b =  a x ay az  = ( a y bz − a z by ) i + ( a z b x − a x bz ) j + ( a x by − a y b x ) k =

 bx by bz 
  (6)
a y bz − a z by
=  a z b x − a x bz  .
a x by − a y b x

2.2.3. Key Equations of the Model

Kinematics
We will work in the central coordinate system. A rigid frame as the only absolutely
rigid body in the general case has 6 degrees of freedom: 3 displacements—∆ x , ∆y , and
∆z —of the center C in the direction of the coordinate axes, and 3 rotations—Θx , Θy , and
Θz —around the coordinate axes. Thus, we are dealing with two vectors:

∆ = ∆ x i + ∆y j + ∆z k, Θ = Θx i + Θy j + Θz k. (7)

Then, the small displacement of any point of the rigid structure will be the superposi-
tion of the small displacement of the center and the small rotation around the center, as
shown in Equation (8):
u( x, y, z) = ∆ + Θ × r, (8)
where r( x, y, z) = x i + y j + z k is the radius vector of a point with coordinates ( x, y, z).
The symbol × denotes the vector product operation.

Statics
Let us construct vector equilibrium equations. Let qi = q xi i + qyi j + qzi k be the vector
of the force interaction of the i-th implant with a bone. P = − Pk is the vector of the vertical
mastication load, ri = xi i + yi j + zk is a radius vector of the implant axis, and r p = x p i + y p j
is a radius vector of the pole.
The equilibrium of the system will be ensured if the main vector and the main moment
of all forces are equal to zero:
Z Z
∑ Fi = ∑ qi dz + P = 0, ∑ m0 (Fi ) = ∑ ri × qi dz + r p × P = 0. (9)
L L

Here, L = [− H/2, H/2] is the integration contour, which is the same for all implants;
thus, the index i is omitted.
Two vector Equation (9) give 6 scalar equations in the coordinate notation, namely:

yi qzi − zqyi − yi P
           
Z q xi 0 0 Z 0
∑  qyi dz +  0  =  0 , ∑  zq xi − xi qzi dz +  xi P  =  0 . (10)
L qzi −P 0 L xi qyi − yi q xi 0 0

Physical Relations
Let us consider the issues of interaction between the implant and bone tissue in more detail. We
propose that a rigid cylindrical implant is conjugated with the bone through a thin intermediate layer
(Figure 6).
Such a calculation model is justified due to the fact that the implant material is much more
rigid than the bone. The properties of the intermediate layer embody the properties of a thread in
imperfect contact with fragments of regenerated young bone tissue. Under conditions of a small layer
thickness h relative to the implant diameter d(h << d), we take into account Winkler’s hypothesis,
Materials 2022, 15, 2398 9 of 24

Materials 2022, 15, x FOR PEER REVIEW 9 of 27

by which the contact normal σn and tangential στ stresses will be proportional to the transverse un
and vertical uτ displacement of the implant relative to the bone [51], as shown in Equation (11):
Physical Relations
n u b E τ u
Let us consider the issues − Einteraction
σn = of , στ = −between , (11)
b
h 2(1 + νb ) the
h implant and bone tissue in
more detail. We propose that a rigid cylindrical implant is conjugated with the bone
where Eb and
through νb are
a thin the height-averaged
intermediate Young’s 6).
layer (Figure modulus and Poisson’s ratio of the bone, respectively.

Figure6.6.Scheme
Figure Schemeofofthe
theinteraction
interactionofofthe
theimplant
implantwith
with bone
bone h ishsmall
tissue:
tissue: is small
layer layer thickness,
thickness, d is the
d is the implant diameter
implant diameter.

Suchgiven
Then, a calculation
that: model is justified due to the fact that the implant material is
much more rigid than the bone. The
q x = πdσ properties
x, q y = πdσy , qof
z =the πdσintermediate
τ, layer embody(12)
the
properties of a thread in imperfect contact with fragments of regenerated young
the physical relationships between contact forces and the displacements of implants can be repre-bone
follows:conditions of a small layer thickness h relative to the implant diameter
tissue.asUnder
sented
d (h<<d) , we take into account qi +Winkler’s
Cui = 0, i = 1, . . . , 4,
hypothesis, (13)
by which the contact normal
σn στ0 stresses will be proportional to the transverse u and vertical
 
Cn 0
and tangential nEb πd
where C =  0 Cn 0  is the rigidity matrix, and Cn = Eb πd
h and Cτ = 2(1+νb ) h are the
uτ displacement 0 of
0 theCτimplant relative to the bone [51], as shown in Equation (11):
bed rigidity coefficients [51].
u
n σ = −E n , σ = − Eb uτ ,
b τ (11)
Equation of Statics in Displacement h 2(1 +ν b ) h
Bringing together Equations (8), (9), and (13), we obtain a system of two vector equations for
where
two unknown and νb∆ are
Eb vectors, Θ: height-averaged Young’s modulus and Poisson’s ratio of
and the
the bone, respectively.
Z Z
− ∑ C(∆ + Θ × ri )dz + P = 0, −∑ ri × C(∆ + Θ × ri )dz + r p × P = 0.
Then, given that: (14)
L L
q = πdσ
In the coordinate notation, thexsystem xin, (14)
q = πdσ
= πdσbey a, system
qy will z τ , scalar equations for finding
of six (12)
six unknown values: ∆ x , ∆y , ∆z and Θx , Θy , Θz .
the physical relationships between contact forces and the displacements of implants can
be represented
Stress as Scheme
Calculation follows:

i +Cui = 0, i = 1,..., 4 ,
By solving the system in Equationq(14) using Equation (8), we can find the displacement(13)of
an implant:
 Cn 0 0  ui = ∆ + Θ × ri , i = 1, . . . , 4; (15)
Therefore,
  π d
where C = according
0 Cn to 0Equation
 is (12),
thethe linear forces matrix,
rigidity in each layer
andare as follows:
C n = Eb and
 0  h
 0 Cτ  qi = −C(∆ + Θ × ri ), i = 1, . . . , 4; (16)
E πd
Cτ =Let us bproceed toarethethe bed rigidity
consideration coefficients
of the [51].
stress state of the implant. The integral force factors
2(1 + ν bcan
in the implant ) hbe found from the differential equations of equilibrium of the rod as a system with
distributed parameters, which is under tension to the vertical axis ζ i and bilateral bending in the
(Equation
ξ i , ζ i ) and (of
ηi ,Statics in Displacement
ζ i ) planes. In vector form, this can be written as follows:
Bringing dQtogether Equations
dMi (8), (9), and (13), we obtain a system of two vector
i
equations for two unknown + Qi ×Δk =
+ qi = 0, vectors, and : . . . , 4, ζ ∈ [− H/2, H/2].
= 1,
0, i Θ (17)
dζ dζ
Materials 2022, 15, 2398 10 of 24

Since the implants are parallel and have the same length, the index i in ζ i is omitted. In
Equation (17), Qi = ( Qξ i , Qη i , Qζ i )T is the force vector, Qξ i and Qη i are the transverse forces,
Qζ i is the longitudinal force, Mi = ( Mξ i , Mη i , Mζ i )T is the moment vector, Mξ i and Mη i are the
bending moments, and Mζ i is the torque.
The system in Equation (17) should be solved under the initial conditions, which means that the
recessed end of the implant is free from contact load, as shown below:

Q i (− H/2) = 0, M i (− H/2) = 0, i = 1, . . . , 4. (18)

From Equation (16), it can be seen that due to the linear dependence between ri and ζ, the vector
functions qi also depend linearly on ζ; therefore, integration the system in (17) under the conditions
of (18) does not cause fundamental difficulties.
Based on the integral characteristics found, one can find the stress in the implants as a linear
function of the transverse coordinates. Normal axial stresses are calculated by the following formula:

Qζi (ζ ) Mηi (ζ )ξ i Mξi (ζ )ηi

σζ i (ξ i , ηi , ζ ) = + + . (19)
S0 Jηi Jξi
2 4
Here, S0 = πd πd
4 is the cross-sectional area of the implant, and Jξi = Jηi = 64 are the moments
of inertia of a circular cross section.
In particular, in the outer fibers of the implant, which are located in the plane of bending, the
axial stresses can be written as follows:
q
2 + M2
Mξi
Q ηi
σζ±i (ζ ) =
ζi
± , (20)
S0 W
J J 3
where W = d/2 ξi ηi
= d/2 = πd
32 is the moment of resistance of the cross section of the implant.
The stress in the bone in the vicinity of the implant is interpreted as stress in the intermediate
Winkler layer. This can be easily found if the distribution along the length of the implant qi is known.
From Equation (13), the expressions for normal and tangential stresses in the bone are as follows:
q
q2ξi + q2ηi qζi
σni (ζ ) = ; στi (ζ ) = . (21)
πd πd

Strength Conditions
Based on the standard theories of strength used in the science of the strength of materials [67],
expressions (20) and (21) can be used to estimate the load capacity of the “implant-bone” system
under consideration. For implants subjected to compression with a bend, we will accept the first
theory of strength, according to which the normal stresses with the highest modulus should not
exceed the stress allowed for the implant material. For bone tissue (in fact, for the interface), we
will use the fourth (energy) theory of strength, according to which the von Mises stresses in the
intermediate layer should not exceed the value allowed for bone tissue. In symbolic notation, such
conditions are written in terms of equivalent stresses:
impl
max max σeqi (ζ ) ≤ [σ]impl , (22)
i ζ

bone
max max σeqi (ζ ) ≤ [σ]bone . (23)
i ζ
n   o
impl
Here, σeqi (ζ ) ≡ max σζ+i , σζ−i  is the equivalent stress in the implant; σeqi
p
    bone ( ζ ) ≡ σn2 + 3στ2
is the equivalent stress in the bone; and [σ]impl and [σ]bone are the allowable stress values for the
implant and bone materials, respectively.

3. Results and Analysis

3.1. Analytical Solution
Note that as a result of the symmetrical arrangement of implants relative to the plane X = 0,
the introduced central axes will also be the principal axes of inertia. Under such conditions, the
Materials 2022, 15, 2398 11 of 24

solution to the problem is greatly simplified. In particular, the system of vector equations of statics in
displacements (14) in coordinate notation takes the following form:

∆x
 
Cn 4H 0 0 0 0 0 0
  
 0 Cn 4H 0 0 0 0  ∆   0
  y   
 ∆z   − P 

 0 0 C τ 4H 0 0 0   

=  − Py p . (24)
Cτ a2x H Θx 

0 0 0 0 0
 
    

0 0 0 0 2
Cτ a H 0  Θy   − Px p 

 y
0 0 0 0 0 Cn a2z H Θz 0

Here:
a2x = ∑ y2i + γH2 /3, a2y = ∑ xi2 + γH2 /3, a2z = ∑ xi2 + ∑ y2i , (25)
Cn
γ= = 2(1 + νb ). (26)
Cτ
A very remarkable feature of the system of the linear algebraic Equation (24) is the diagonality
of the matrix. This allows us to immediately write down the analytical solution, namely:

P
∆ x = 0, ∆y = 0, ∆z = − ;
4Cτ H
Py p Px p
Θx = − , Θy = , Θz = 0. (27)
Cτ a2x H Cτ a2y H
Note that due to the lack of horizontal components in the mastication load, there are no
horizontal movements of the frame, and its rotation is around the vertical axis.
Thus, the displacements and rotations of the frame as a rigid whole are known. We used these
results to search for implant displacements, force characteristics, and stresses.
Using Equation (8), we can express the vector of the displacements of the i-th implant through
non-zero displacements and angles of rotation as follows:
 
Θy ζ
ui ( ζ ) =  −Θx ζ . (28)
∆ z + Θ x y i − Θy x i

Taking into account the results of Equations (27) and (28), we finally obtain the followed:
 
xp ζ
a2y
P  yp ζ

ui ( ζ ) =

a2
.

(29)
Cτ H 

y p yxi x p xi

− 14 − a2x
− a2y

By substituting the results of (28) and (29) into Equation (12), we can find the distribution of the
loads on each of the implants as follows:
 
x ζ
− γ ap2
−Cn Θy ζ
 
y
=P
 
y ζ
qi ( ζ ) =  Cn Θx ζ −γ ap2 .

(30)
H

x
−Cτ (∆z + Θx yi − Θy xi ) y p yi x p xi

1
4 + a2
+ a2 x y

Let us write the vector differential equations in a coordinate-wise form as follows:

dQξi dQηi dQζi

+ qξi = 0, + qηi = 0, + qζi = 0;
dζ dζ dζ

dMξi dMηi dMζi

 
H H
+ Qηi = 0, − Qξi = 0, = 0, z ∈ − , . (31)
dζ dζ dζ 2 2
Taking Equation (30) into account, we can integrate these Equation (31) under the initial
conditions (18). We obtain the following expressions for the vectors of the forces and moments:
Materials 2022, 15, 2398 12 of 24

 
xp ζ 1
 2

ζ 2 − H4
  2
 

Qξi
 Cn Θy 21 − H4
ζ2 
γ
a2y 2  
P

y ζ 2
γ ap2 12 ζ 2 − H4
  2
 
−Cn Θx 12 ζ 2 − H4

Qi (ζ ) =  Qηi  = 

= 

x
, (32)
H   
Qζi
    
H y y x x
Cτ (∆z + Θx yi − Θy xi ) ζ + − 41 + ap2 i + ap2 i ζ+ H
 
2 x y 2

 2  
 2 
xp 1

H H

Mξi
 Cn Θx 16 ζ+ (ζ − H ) 
2
− γ a2y 6
ζ + 2 ( ζ − H )

2 P 2

Mi (ζ ) =  Mηi  =  = . (33)
 
yp 1
   
1 H H
Cn Θy 6 ζ + 2 (ζ − H )  
H  γ a2x 6 ζ + 2 (ζ − H ) 

Mζi

0 0

Finally, according to the results of (30), (32), and (33) from Equation (20), we can find the
distribution of the axial stresses in the outermost fibers of the i-th implant as follows:
v 
( ! u !2  2  2  
x x y y Hx Hy

± P 1 p i p i ζ 1 4 H u p p ζ 1 ζ 
σζi (ζ ) = − + 2 + 2 + ± γ t 2
+ 2
+ −1 , (34)
S0 4 ay ax H 2 3 d ay ax H 2 H 


Based on Equation (21), the stress in the bone at the interface can be calculated as follows:
v
!2  !
Hy p 2 ζ
u
Hx p x p xi y p yi

P u P 1
σni (ζ ) = γ t + , σ (ζ ) = + 2 + 2 . (35)
Sl a2y a2x H τi Sl 4 ay ax

Here, Sl = πdH is the area of the lateral surface of the implant.

Finally, to calculate the equivalent stresses in the system, we obtain the following expressions:
 
impl  ± 
σeqi (ζ ) = σζi (ζ ), (36)
v
u   !2  !2
2 2
Hx p Hy p x x y y

P +3 1 + p i + p i
u
bone u γζ 
σeqi (ζ ) = t + . (37)
Sl H a2y a2x 4 2
ay a2x

From Equations (34), (36) and (37), it can be seen that the highest values of the equivalent
stresses are achieved when ζ = H/2, i.e., at the upper end of the implant (in the area of the neck of
the implant).      
impl H   − H 
maxσeqi = max σζ+i

, σ ,
ζ 2   ζi 2 
 v 
 u !2  2 
x p xi y p yi Hx p Hy p 
 
± H P 1 2 H
 u
σζi =− + 2 + 2 ± γ t 2
+ . (38)
2 S0 
4 ay ax 3 d ay a2x 


The same is true on the surface of the bone:

v  
u !2  2 !2
P
u 2 Hx Hy x x y y
maxσeqibone
= t 
u γ p
+
p
+3 1 + p i + p i . (39)
ζ Sl 4 a2y a2x 4 a2y a2x

Note that the final expressions for stresses obviously do not contain the values of the bed
coefficients. The results of the stresses depend only on the parameter γ, which characterizes the ratio
of these coefficients (see Equation (26)).

3.2. Examples of Calculation

In this paragraph, we will give examples of calculating stresses in an overdenture with four
implants with a length H = 10 mm and a thickness d = 4 mm, loaded with a vertical force P = 100 N.
In this case, S0 = 12.6 mm2 and Sl = 125.7 mm2 . In addition, in the calculations we used νb = 0.35;
therefore, γ = 0.27 [9,68].

3.2.1. Example 1
Let us consider the configuration shown in Figure 7. The sequence of calculations is as follows.
x
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p Xone
coordinate
system:and pYX
system:
system:
of of system:
system:
and
pare
pthe andYX
YpXteeth
the
pand
pare ofpXand
pY
are
first
the Y pand
the
twoare
first
pare
the
coordinate system: X p and Yp are the first two lines in Table 2.
two
the Y
Yfirst
p are are
the
ptwo
the
first the
first
first
two
overdenture. two
Wefirst
two two
digitized
lineslines
in lines
Tablein2.lines
inlines
Table Table in2.lines
in2.lines
Table inthe
2.Table
Table 2. 2.of the pole in the original coordinate system: X p and Yp are the first two
inlocation
2.Table
lines1.inCoordinates
Table Table 2. of implants in the original and central coordinate system (the first variant of
Table 1.Table
Table Coordinates
1.Table 1.Table
1.Table
Coordinates Table
Coordinates of1.implants
of1.implants Coordinates
1.implants
Coordinates
in
Coordinates
of
Coordinates
implant of the
in of of original
of original
implants
the
implants
placement). in implants
implants
in original
the and in original
central
and
in original
the the
and the
in original
the
central
and original
and and
coordinate
central and
central
coordinate
central central
central
coordinate
system system
system
coordinate coordinate
coordinate
(the first
coordinate
(the (the
system system
variant
system
first first system
of (the
variant
(the
variant
(the first (the
first
of first
of first
variant
variant of variant
variant
of of of
implant implant
placement).
implant implant
implant
placement).
implant
placement).
implant placement).
placement).
placement).
placement).
Table 1. Coordinates of implants in the original and central coordinate system (the first variant of
Implant
implant No.
placement). 1 2 3 4
Implant
ImplantImplant
No. No.
Implant No.Implant
Implant No. Implant
No. 1 No. 1 No.1 1 12 12 12 2 23 23 23 3 34 34 34 4 4 4 4
Xmm
iX, mm −21 −12 12 21
X i , mm X i , mm
X i , mm X i , Implant
X i , mm
X i , mm −21 i , −21
mm −21 −21 −21
No. −12−21
−12−21
−12 12−12
1 −12 −12 12 −12
122 12 12211221612213 21 21 21 21
Yi , mm 17 6 17 4
Yi ,xmm Yi ,Xmm
Yi , mm Yi , mm
Yi , mm Yi , mmYi , mm 17
i , mm
17 17 17 176−17
i , mm 216 17−21
6 6 6 6 6−6126 −12 6 6 617 61712617 12 17 17 17 17
2121
x i , mm x i , mm
x i , mm x i ,ymm
x i , mm
x i , mm x
−21 , mm
−21 −21 −21 −12
−21 −21
−12−21
−12 −12 12
−12 −12
−12 −12
12 12 21
12 12−
21 1221 21 21 21
i , i mm Yi , mm 5.5 17 5.5 6 5.5 6 21 5.517
y i , mm y i , mm
y i , mm y i , mm
y i , mm
y i , mm y5.5 , mm 5.5 5.5 5.5 5.5 5.5
−5.5−5.5−5.5 −5.5−5.5
−5.5−5.5−5.5 −5.5−5.5
5.5 5.5 5.5 5.5 5.521
i x 5.5
i , mm −21−5.5−5.5 −12−5.5−5.5 12 5.5 5.5
i y , mm 5.5 in the original−5.5 −5.5 system. 5.5
Table
Table Coordinates
2.Coordinates ofpole
thepole
pole(tooth)
(tooth) andcentral
central coordinate
Table 2. Table
Table 2.Table 2.Table
Coordinates
2.Table
Coordinates
of2.the
Coordinates of2.pole
of2.pole
Coordinates
Coordinates
Coordinatesthe the
(tooth)
of pole in of
of pole
the
(tooth)
the the
(tooth)
the
pole
in of
thethe
original
in in(tooth)
the
(tooth)
(tooth) original
and
original
the central
and incoordinate
and
inoriginal
the the
in original
the original
original
central
central
and and and and
central
coordinate
system.
central
coordinate
central coordinate
coordinate
system.
coordinate
system.
coordinate system.
system. system.
system.
Table 2. Coordinates of the pole (tooth) in the original and central coordinate system.
Tooth
Tooth No.
Tooth
Tooth
No. No. No.
Tooth
Tooth Tooth
Tooth
1 No.
1 No. 12 No.
1 No. 12 12 321 32 32 324 34 34 345 54 45 546 56 56 756 76 76 76 7 7 7
X , mm X , mm X ,Xmm , mm
Tooth No.
9 939 39 15 93 1 15 9 15 9 2 15
19 15
19 233 19
25 423
15
19 25 23 285 25
23 28 628 28 28
28 25
25 287
Xp, mm p X p , mm p X p ,3
3Xmm p ,3mm p 3 p 3 15
9 15 19 19 19
23 2319 23
23 25 25 28 25
Yp , Y
mm p , mm
Y p , Y
mm p , mm
Y , Y
mm , Y
mm ,
p 11 p 1 p 1 X 1
Y
mm p , mm
3p , 3mm 1
13 13 37 3 37 737 133 7 13
7 913 7 13
13
20 20 7
13 29 20
201513
2919
13 20
20
20 20
29 29
402329
40 2929 29 40
40 40 2540 40 40 28
xp, mm
x p , mm x p , xmm
x p , mm p ,33x p , 3mm
mm x p ,3
x p , 3mm mm 93 9 39 15 9 15
93 115 9 15 9 315 19 19
19 15
19 15
19 23
25 23 23 28 25 28 2928 28 28
28 25
25 28 40
Y9p , mm 15 19 23 2323 719
2513
19 23
23 25 25
282025
yp, mm
y , mmy , mm y , ymm−10.5 y , mm
, mm y p , mm
y p , mm −8.5−10.5−10.5 −−8.5
4.5 −8.5 1.5
−4.5−4.5
1.5 1.5 8.5 8.5 8.5 17.5
17.5 17.5 28.528.5
28.5
p p p −10.5
p −10.5
−10.5
p −8.5
x p −10.5
−10.5 ,−8.5
mm −8.5−4.5
−8.5−8.5
−4.5
3 −4.5 1.5
−4.5−4.5
91.5 1.5 8.5 1.5
8.5
1.515 8.5 17.5
8.5198.5
17.517.528.517.5 28.5
28.5 28.525
17.523 28.5 28
y p , mm −10.5 −8.5 −4.5 1.5 8.5 17.5 28.5
According According
According to According
AccordingEquation to According
to According
Equation Equation
to (1),
to (1),
Equation
According toweto to
Equation
(1),
Equation we Equation
calculated
we
(1),
Equation (1),
calculated
we (1),
calculated
we (1),
the we we
coordinates
calculated
the
calculated
(1), we the calculated
calculated
coordinates
calculated the the the
coordinates
of the
the
coordinates
of
coordinates
the coordinatesthecoordinates
coordinates
ofcenter
the
of of
center
of theС:of
center
the the ofcenter
С:the
center
center the
С:C: С:XCcenter
center С:
С:= С:0 mm,
X C X= C0 mm
X= C0 X,mm
= 0
Y
C С ,
mm = X,
= C=0 13
13
X= C0YСmm . 5Y =
X
mmY
,
mm
С 0
= =
,
mm
13
.C5Ymm
C =
, .Z13.5
0
5 ,
mm,
mm
С =YAccording
С .Z
13
С =Y ,
mm,
−
13
5 mm
С
,5=ZY,
mm
С . 5 mm
Z
13 .=5
− 5Zmm
С C .=
13
,
mm
−
Сto
.
5−5.
mm,
5
mm mm.
Z.
5=mm , =
Z
С− 5 mm
=Z С−Equation . −
С 5 =.
mm− 5 .
mm .
(1), we calculated the coordinates of the center С:
According According
According to to
to Equations
EquationsEquations (3) (3)the
andcoordinates
(3)
and and(4), (4),
(4), we listed
we the
listed coordinates
the of poles
of coordinates implants ofandand poles
implants in
andthepoles
central
According According
According to Equations toXEquations
According
to Equations
According to (3)to and
(3)
Equations
C = 0 mm
(3)
(4),
Equations
and
, and
we
(4),
(3) (4),
listed
(3)
we
and
YС = 13 .5 mm andwe
listed
(4), , listed
weZ С = −the
(4), we
the
listed 5we
listed
coordinates
mmthelisted
coordinates
of
. the the coordinates
implants
coordinates
of
coordinates implants
implantsofand ofand ofandimplants
implants
implants polespoles and and
polespoles poles
coordinate
in the central system.
coordinateThe resultssystem.are listed
The in the
results third and
are fourth lines of Tables 1 and 2.
in the central
in the in the
centralcentral
in the in the in the
coordinate
central central
coordinate central
coordinate
system. coordinate
system.
coordinate
coordinatesystem.
According The results
The
system. The
system.
to system.
results
Theresults
are
Equations The
are The
listed
results are
results
listed
(3) results
inlisted
are
and theare
in the
listed
(4), are
third
in the
listed
we and
third
in theinlisted
listed
third in
fourth
the
and
thirdandin
the
third
fourth the
andthird
lines
fourth
andthird
ofand
lines
fourth and
lines
fourthfourth
ofof fourth
oflines
lines oflines
oflines of
of poles
Having accepted the specified input data, the listed the
stress state coordinates
of the implants implants
and and
the nearby bone
Tables
Tables1Tables
and 2.1Tables
1Tables
and and 2.1Tables
2.1Tables
and and
2. 1
in the
tissue
and
2. 1 and
2.
wascentral
2.
calculated coordinate
at different system.
positions The of theresults are listed
mastication in the third
load according and fourth
to Equations lines
(34) and of
(35).
Having Having Having
accepted
Having Having
accepted Having
accepted
the Having
specified
the
accepted
Tables the
accepted
The accepted
specified
the
1highest
and accepted
specified
input
the the
specified
2. modulo the
data,
input
specified
input data,specified
specified
the
input
values data,
input
the input
stress the
ofdata,
the input
state
data,
stress the
normal data,
stress thedata,
of
state
stressthe
state
the
stressthe
stress
ofstate
stresses the stress
implants
of ofstate
the
instate
implants
each of
the state
ofand
implants
and
the of
the the
and
implants
implants
implant were implants
implants
the
and theand
and
achieved the
at and
their the
theupper
nearby
nearby nearby
bone tissue
bone
nearby bone
nearby nearby
was
tissue
bone nearby
tissue
bone
was bone
calculated
tissue
end was bone
tissue tissue
calculated
(in was
the
Having tissue
calculated
at
was
region was
at
calculated was
different
ofdifferent
accepted the calculated
calculated
at different
calculated positions
at
implant
the atpositions
different
different
neck;
specified atpositions
atpositions
different
ofζ= different
the
ofpositions
the
H/2).
input ofpositions
ofpositions
mastication
the ofthe
mastication
the
Detailed
data, of
mastication
theload of
the the
accord-
load
mastication
load
mastication
information
stress mastication
masticationaccord-
accord-
state ofload
load
about load load
accord-
accord-
thethe magnitude
implants accord-
accord- of the
and the
ing ing
to Equations
ing to Equations
to Equations
ing to (34)
ing ing
Equations ing
and
to (34) to
tomaximum
(34)
Equations (35).
and Equations
Equationsand
(35).
(34) (35).
(34)
and (34)
and
(35).
equivalent (34)
and
(35). and
(35).
stresses (35). in the implants,
nearby bone tissue was calculated at different positions of the mastication load accord- depending on the location of the mastication load,
ising
given in the diagrams
to Equations shown
(34) and in Figure 8. Finally, Figure 9 provides a summary of comparative
(35).
information on the maximum equivalent stresses in the implants.
 The highest modulo values of the normal stresses in each implant were achieved at
The highest modulo values of the normal stresses in each implant were achieved at
their upper end (in the region of the implant neck; ζ = H /2 ). Detailed information about
their upper end (in the region of the implant neck; ζ = H /2 ). Detailed information about
the magnitude of the maximum equivalent stresses in the implants, depending on the
the magnitude of the maximum equivalent stresses in the implants, depending on the
Materials 2022, 15, 2398 location of the mastication load, is given in the diagrams shown in Figure 8. Finally,
14 of 24
location of the mastication load, is given in the diagrams shown in Figure 8. Finally,
Figure 9 provides a summary of comparative information on the maximum equivalent
Figure 9 provides a summary of comparative information on the maximum equivalent
stresses in the implants.
stresses in the implants.

Figure8.8.Dependence
Dependenceofofthe the maximum
maximum equivalent
equivalent stresses
stresses in implants
in implants on the
on the location of mastica-
the mas-
Figure
Figure 8. Dependence of the maximum equivalent stresses in implants on location of the
the location of the mas-
tication load (the first variant of implant placement).
tion load (the
tication loadfirst
(thevariant of implant
first variant placement).
of implant placement).

Figure 9. Comparative analysis of maximum equivalent stresses in implants at different mastica-

Figure9. 9. Comparative analysis
Comparative of maximum equivalent stresses in implants at different mastica-
Figure
tion load locations (theanalysis of maximum
first variant equivalent
of implant stresses
placement). in implants at different mastication
tion load locations (the first variant of implant
load locations (the first variant of implant placement).placement).

The distribution of equivalent stresses in the bone tissue adjacent to each of the im-
Thedistribution
The distribution of equivalent
of equivalent stresses
stresses in bone
in the the bone
tissuetissue adjacent
adjacent toofeach
to each the of the im-
implants
plants indicates that the most problematic area for the bone is the near-surface zone
plants indicates
indicates that
that the most the most area
problematic problematic area
for the bone fornear-surface
is the the bone is theζ near-surface
zone zone
= H/2. The effect
of the position of the load pole on the value of the highest equivalent stress in the bone near each
implant is shown in Figure 10. In turn, Figure 11 allows us to compare the levels of the stresses near
different implants.
Materials 2022, 15, x FOR PEER REVIEW 17 of 27
Materials 2022, 15, x FOR PEER REVIEW 17 of 27

ζ = H /2 . .The effect of the position of the load pole on the value of the highest equivalent
Materials 2022, 15, 2398 ζ = H /2 The effect of the position of the load pole on the value of the highest equivalent
15 of 24
stress
stressin
inthe
thebone
bonenear
neareach
eachimplant
implantisisshown
shownininFigure
Figure10.
10.In
Inturn,
turn,Figure
Figure11
11allows
allowsus
usto
to
compare the levels of the stresses near different implants.
compare the levels of the stresses near different implants.

Figure 10. Dependence of maximumequivalent

equivalentstresses
stressesininbone
bonetissue
tissue
onon
thethe location of the mas-
Figure
Figure10.10.Dependence
Dependenceofofmaximum
maximum equivalent stresses in bone tissue on location
the of the
location mastica-
of the mas-
tication load (the first variant of implant placement).
tication
tion loadload
(the (the
first first variant
variant of implant
of implant placement).
placement).

Figure 11. Comparative analysis of maximum equivalent stresses in bone tissue at different locali-
Figure11.
Figure 11.Comparative
Comparativeanalysis
analysisofofmaximum
maximumequivalent
equivalentstresses
stresses
inin bone
bone tissue
tissue at at different
different locali-
localiza-
zations of mastication load (the first variant of implant placement).
zations of mastication load (the first variant of implant placement).
tions of mastication load (the first variant of implant placement).

]impl [σ
[σ]150
impl
Taking
Taking
Taking into
into account
account
into that [that
account σthat = ==150
]implMPa, MPa
MPa,on
150based , based on
onthethe information
the information
based presented
presented in Figures
information 8 andin
presented 9,
in
we affirmed
Figures that the holding capacity of the metal frames at a given load level was provided with a
Figures88andand9,9,we weaffirmed
affirmedthat thatthe theholding
holdingcapacity
capacityof ofthe
themetal
metalframes
framesatataagiven
given
significant
load margin of safety. The life cycle of an “overdenture-jaw” structure is determined by the hold-
loadlevel
levelwas
wasprovided
providedwith withaasignificant
significantmargin
marginof ofsafety.
safety.The
Thelifelifecycle
cycleof
ofan
ing capacity of the bone tissue adjacent to the implants. Here, as can be seen from Figures 10 and 11, an“over-
“over-
this depends on the location of the load application. The bone feels least comfortable in the vicinity of
the fourth (supporting) implant, especially when biting with teeth 5, 6, and 7. This trend is explained
by the lever effect (the removal of the load pole from the supporting fourth implant). However, even
 tion of the load application. The bone feels least comfortable in the vicinity of the fourth
(supporting) implant, especially when biting with teeth 5, 6, and 7. This trend is ex-
plained by the lever effect (the removal of the load pole from the supporting fourth im-
plant). However, even in this situation, if we accept that [σ ]bone = 3 MPa , it can be ar-
Materials 2022, 15, 2398 gued that the strength of the jaw under load ( P = 100 N ) is provided regardless16of of the
24
location of the mastication load, because the strength condition of Equation (23) is al-
ways met (even when loading the seventh tooth). In other words, we have the right to
indesign a full-fledged
this situation, if we accept that [σ]bone containing
overdenture 14 teeth.
= 3 MPa, it can be argued that the strength of the jaw under
In the case of a weak bone with a smaller
load (P = 100 N) is provided regardless of the location of [σ ]the value, it load,
bone mastication is necessary either
because the to re-
strength
condition of Equation (23) is always met (even when loading the seventh tooth).
duce the mastication load or to abandon the load of the seventh tooth (or even tooth In other words, we
have the right to design a full-fledged overdenture
number 6), for example, by shortening the cantilever. containing 14 teeth.
In the case of a weak bone with a smaller [σ]bone value, it is necessary either to reduce the
mastication load or2 to abandon the load of the seventh tooth (or even tooth number 6), for example,
3.2.2. Example
by shortening the cantilever.
Let us now consider the configuration of a four-implant overdenture, shown in
Figure 12. As 2in the previous example, the implants were located at the vertices of an
3.2.2. Example
equilateral trapezoid;
Let us now however,
consider the the trapezoid
configuration is smaller.
of a four-implant overdenture, shown in Figure 12. As in
The coordinates
the previous example, the of the implants
implants in the
were located original
at the and
vertices central
of an coordinate
equilateral systems
trapezoid; are
however,
included
the trapezoidinisTable 3. The pole coordinates are still presented in Table 2.
smaller.

Figure12.
Figure 12.Numbering
Numberingscheme
schemeandanddetermination
determinationofofthe
thecoordinates
coordinatesofofthe
theteeth
teethofofa aremovable
removable
overdenture
overdenture (the
(the second
second variant
variant of implant
of implant placement):
placement): red—implant
red—implant number, white—tooth
number, white—tooth number.
number.
The coordinates of the implants in the original and central coordinate systems are included in
Table
Table 3. 3.
TheImplant coordinates
pole coordinates areinstill
thepresented
original and central
in Table 2. coordinate system (the second variant of
implant placement).
Table 3. Implant coordinates in the original and central coordinate system (the second variant of
No. of Implant 1 2 3 4
implant placement).
X i , mm −16 −6 6 16
Y i , mm
No. of Implant 1 11 2 4 3 4 4 11
x i , mm
Xi , mm −16 −16 −6 −6 6 6 1616
y i , mm
Yi , mm 11 3.5 4 −3.5 4 –3.5 113.5
xi , mm −16 −6 6 16
yThe
i , mmresults of the 3.5
calculations of the−highest
3.5 –3.5
equivalent 3.5
stresses in the implants and
bone tissue are presented in Figures 13–16.
The results of the calculations of the highest equivalent stresses in the implants and bone tissue
are presented in Figures 13–16.
Based on the analysis of this graphic material, the following should be noted: As before, the
inequality in Equation (22) is satisfied for all implants, i.e., the integrity of the implants is ensured
regardless of the place of application of the mastication load. At the same time, the equivalent stress
in the bone near the fourth implant when the seventh tooth is loaded may exceed the allowable stress
level: 3.5 MPa > [σ]bone = 3 MPa.
This is a manifestation of the lever effect, which increases with a decrease in the size of the
trapezium at the implant’s location. In such a situation, it is recommended to either limit the
mastication load, taking, for example, P = 80 N, or to allow the overdenture to be loaded no further
than the sixth tooth; that is, to shorten the prosthetic dentition.
 Materials 2022, 15, 2398 17 of 24
Materials 2022, 15, x FOR PEER REVIEW 19 of 27
Materials 2022, 15, x FOR PEER REVIEW 19 of 27

Figure 13.
13. Dependence
Dependence ofofmaximum
maximum equivalent stresses
equivalent in implants
stresses on the the
in implants localization of the
ofmas-
Figure
Figure 13. Dependence of maximum equivalent stresses in implants on theonlocalization
localization the
of the mas-
tication load (the second variant of implant placement).
mastication
tication loadsecond
load (the (the second variant
variant of implant
of implant placement).
placement).

Figure 14. Comparative analysis of maximum equivalent stresses in implants at different localiza-
Figure 14. Comparative
Comparative analysis of maximum equivalentstresses
stressesininimplants
implantsatat different localiza-
Figure
tions of14.
the masticationanalysis ofsecond
load (the maximum equivalent
variant of implant placement). different localizations
tions of the mastication load (the second variant of implant placement).
of the mastication load (the second variant of implant placement).
Materials 2022,
Materials 15, x2398
2022, 15, FOR PEER REVIEW 2018ofof 27
24

Materials 2022, 15, x FOR PEER REVIEW 20 of 27

Figure 15. Dependence of maximum equivalent stresses in bone tissue on the location of the mas-
Figure 15.
Figure Dependenceof
15. Dependence ofmaximum
maximumequivalent
equivalentstresses
stresses in bone tissue on the location of the mastica-
tication load (the second variant of implant placement).in bone tissue on the location of the mas-
tion load
tication (the(the
load second variant
second of of
variant implant placement).
implant placement).

. .
Figure
Figure 16. Comparativeanalysis
16. Comparative analysisofofmaximum
maximumequivalent
equivalentstresses
stresses
inin bone
bone tissue
tissue at at different
different localiza-
locali-
Figure 16. Comparative analysis of maximum equivalent stresses in bone tissue at different locali-
zations of
tions ofof the
the mastication
mastication load
load (the
(the second
second variant
variant of implant
ofof
implant placement).
placement).
zations the mastication load (the second variant implant placement).
4. Discussion
Based on the analysis of this graphic material, the following should be noted: As
Based on the analysis of this graphic material, the following should be noted: As
before,
Thethe inequality
rapid in Equation
development (22) istechnology
of computer satisfied for
andallcomputational
implants, i.e.,methods
the integrity of theprob-
for solving
before, the inequality in Equation (22) is satisfied for all implants, i.e., the integrity of the
implants is ensured
lems has not bypassed regardless
the sphereofofthe place of application
biomechanics of the mastication
and bioengineering load.digital
[69]. Recently, At thetech-
implants
nologies is ensured
have regardless ofthe
significantly theclinical
place practice
of application of the mastication load. surgery,
At the
same time, the equivalentchanged
stress in the bone near the of fourth
diagnosis, orthopedic
implant whenplanning,
the seventh
same time, the equivalent stress in the bone near the fourth implant when the seventh
tooth is loaded may exceed the allowable stress level: 3.5 MPa > [σ ]bonebone
and implant-supported restoration. With the advent of specialized software for clinicians and dental
= 3 MPa .
technicians,
tooth it has
is loaded become
may possible
exceed to visualize
the allowable results3and
finallevel:
stress .5 MPa > [σ ] the =
improve 3 MPa . between
interaction
Materials 2022, 15, 2398 19 of 24

the doctor and the patient, as well as the cooperation between the orthopedic dentist, surgeon, and
dental technician, achieving a better quality final result.
An approach to the analysis of dental problems based on the use of advanced simulation
packages is increasingly used in modern orthopedics. This approach usually includes the following
steps [70–73]:
− A computed tomography (CT) analysis of the state of the jaw and dentition;
− The identification of the mechanical properties of bone tissue and teeth according to the estab-
lished CT density distribution;
− The development of a solution to the problem of jaw interaction with an overdenture variant
based on finite element analysis using ANSYS, SolidWorks, or ABACUS software systems;
− Overdenture design based on the results of the numerical analysis.
This approach provides sufficiently comprehensive and detailed information on the spatial
distribution of the stress–strain state in heterogeneous bone tissue, teeth, and the overdenture; how-
ever, it is quite expensive and is usually associated with additional biological losses for patients [74].
First, it requires certified software products, certified hardware, and certified users. Secondly, and
most importantly, obtaining detailed and reliable initial information is always associated with the
need to specify a large amount of sufficiently accurate input data regarding the spatial configuration
and physical and mechanical properties of the objects under study. Moreover, the more accurate the
mathematical model, the more verified input information it needs. As a result, the research process is
overgrown with unnecessary details, since not all factors affect the final result in the same way. The
art of modeling consists of building a model that operates on the smallest possible set of input data
and at the same time provides adequate estimates of the most significant output parameters.
This approach was used in our study to build a mechanical and mathematical model of the
interaction of a four implant-supported overdenture with the mandible.
The distribution of the loads and stresses in dental structures attached to the jaw with the
help of implants has been studied in many works, and general approaches to such problems can
be divided into three global areas. The first direction is based on analytical methods [75–79], the
works of the second direction are based on the finite element method and the setting of a virtual
experiment [80–84], and the third direction uses the means of model and field experiments [85–89].
Our article develops the first analytical line of research.
Bibliosemantic and content analyses have shown that currently, the analytical direction is the
least developed and is the least represented in the research literature. In particular, the analytical pre-
diction of the forces and moments that occur on dental implants, as well as the problems surrounding
the safe loading of the overdenture, are considered in [75]. In another study [76], an analytical model
of the interaction of a single implant with bone tissue was used for the further calculation of fatigue
strength. Another article [77] proposed a simple mathematical model for determining the rigidity of
the dental implant–bone system. The work in [78] considers the classical problem of the theory of
elasticity with regard to the contact interaction between the implant and the jawbone and studies
the stress–strain state of the cancellous jawbone near a single implant under an occlusal load. An
analytical determination of the optimal torque for the installation of a screw dental implant was
carried out in [79]. At the same time, analytical studies of the dependences of equivalent stresses in
the ensemble of implants and adjacent bone tissue on the coordinates of the location of the implants
and on the localization of the mastication load have not been carried out. Our approach helps to
overcome this theoretical gap and, in this sense, stakes a claim to novelty.
The simplicity and transparency of the analytical model, which allows one to quickly assess
the stress and limit state of the prosthetic structure, is certainly very attractive. However, another
important point that necessarily accompanies each study is the question of the adequacy of the
model and the reliability of the results. In order to compare our analytical results with computer FE
simulation data, among many well-known publications, we selected articles [90,91], in which the
layout of implants, as well as the magnitude and localization of the mastication load, are most similar
to our examples. This is how the authors of [90] considered the transfer of a vertical load of 100 N
from a four-implant overdenture to the jawbone. Three types of loads were applied: at the central
incisor area, at the premolar region, and at the molar area. According to Table 3 and Figure 8 in [90],
in the case of loading the incisors, the peak values of the von Mises stresses in the implants were
approximately 70 MPa, and in the trabecular bone were 2–3 MPa. Under the action of a load in the
molar region, the corresponding stress values for the implants were 80–100 MPa, and for bone were
2–3 MPa. Our results (Figures 13–16) indicate that when the overdenture was loaded in the area of
the first four teeth, the highest equivalent stresses for the implants were in the range of 10–20 MPa,
and, for bone, 0.5–1 MPa. The load of the overdenture in the area of the sixth tooth gave a value
Materials 2022, 15, 2398 20 of 24

of 67.9 MPa for the implant and 2.56 MPa for the bone. Thus, we can appreciate the coincidence
of the orders of the results of analytical and computer simulations, as well as the correct display of
stress growth trends when the location of the pole changes in the distal direction. We explain some
quantitative differences by the fact that our model did not take into account the stress concentration
in the hollows of thread. Similar results are obtained by comparing our results acquired at a load
of 100 N with the half-sum of the stress values under vertical forces of 60 N and 130 N, obtained by
numerical analysis in [91].

5. Conclusions
In this article, a mechanical and mathematical model of the interaction of a completely removable
bar-retaining four implant-supported overdenture system with the bone tissue of the mandibula was
developed. This model makes it possible to analytically assess the stress level of implants and nearby
bone tissue under a given mastication load.
The key hypotheses of the model are the interpretation of the “implants–bar–overdenture”
system as an absolutely rigid spatial frame and the description of the mechanical properties of the
“implant–bone” interface using Winkler’s hypothesis. In addition, bone resorption is not taken
into account.
The model operates with a minimum set of input parameters that must be specified: implant
size, implant location coordinates at the vertices of an equilateral trapezoid, overdenture tooth
coordinates to which the mastication load will be applied, Poisson’s ratio and the allowable tension
for the bone tissue, the amount of mastication load, and the desired length of the dentition.
For the first time, the analytical dependences of equivalent stresses in implants (38) and nearby
bone tissue (39) on the coordinates of the location of the implants and the coordinates of the application
of the mastication load were obtained. These expressions, with a fixed geometry of the implant
location, allow one to find the allowable mastication load for a given length of the dentition of the
overdenture or to set the dimensions of the overdenture (the maximum number of loaded teeth) for a
given mastication load.
Two examples of calculations with greater and lesser distance between the anterior and posterior
implants were considered here. It was established that in both cases, under real mastication loads,
the integrity of the titanium implants was ensured.
In the case of a large distance between the implants for “healthy” bone with a medium allowable
stress [σ]bone = 3 MPa, a load P = 100 N is safe if applied to any tooth (from the first to the seventh).
This gives us permission to use a full-length overdenture.
With a small distance between the anterior and posterior implants, when the connecting bar is
almost straight, a load of 100 N, applied to the seventh tooth, can be problematic and can disrupt the
integrity of the bone near the supporting (fourth) implant.
The comparison of our analytical results with numerical analysis data from the literature
confirms the ability of the analytical approach to correctly describe the qualitative patterns of the
behavior of a multi-support overdenture under load.
With the help of the developed technique, it is also possible to estimate the influence of implant
sizes on the stress state of the “overdenture–bone” system. In addition, the arbitrary location of the
implants (at the vertices of an irregular quadrangle), their different sizes and orientations, and the
inhomogeneity of the bone at depth can be taken into account.

Author Contributions: Conceptualization, M.D., I.S. and M.R.; methodology, B.P., M.D. and I.S.;
software, A.V.; validation, B.P., A.V. and L.P.; formal analysis, M.D., I.S. and A.V.; investigation, B.P.
and L.P.; resources, M.D. and I.S.; visualization, B.P. and A.V.; supervision, M.D. and M.R.; project
administration, M.D. and M.R.; funding acquisition, I.S. and M.D. All authors have read and agreed
to the published version of the manuscript.
Funding: This research received no targeted external funding.
Institutional Review Board Statement: Not applicable.
Informed Consent Statement: Not applicable.
Data Availability Statement: Data are contained within the article.
Acknowledgments: Authors express their gratitude to the reviewers for valuable recommendations
that have been taken into account to improve significantly the quality of this paper.
Conflicts of Interest: The authors declare no conflict of interest.
Materials 2022, 15, 2398 21 of 24

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