Influence of fibromucosa height and loading on the stress distribution of a total prosthesis: a finite element analysis


  • Tarcisio José de Arruda Paes Junior São Paulo State University (UNESP), Institute of Science and Technology. São José dos Campos Dental School, São José dos Campos.
  • João Paulo Mendes Tribst São Paulo State University (UNESP), Institute of Science and Technology. São José dos Campos Dental School, São José dos Campos
  • Amanda Maria de Oliveira Dal Piva São Paulo State University (UNESP), Institute of Science and Technology. São José dos Campos Dental School, São José dos Campos.
  • Viviane Maria Gonçalves de Figueiredo
  • Alexandre Luiz Souto Borges São Paulo State University (UNESP), Institute of Science and Technology. São José dos Campos Dental School, São José dos Campos.
  • Cristiane Mayumi Inagati São Paulo State University (UNESP), Institute of Science and Technology. São José dos Campos Dental School, São José dos Campos



Purpose: To evaluate the effect of fibromucosa height on the stress distribution and displacement of mandibular total prostheses during posterior unilateral load, posterior bilateral load and anterior guidance using the finite element analysis (FEA). Material and methods: 3D virtual models were made to simulate the stress generated during different mandibular movements in a total prosthesis. The contacts were simulated according to the physiology, being considered perfectly bonded between cortical and medullar bones; and between cortical bone and mucosa. Non-linear frictional contact was used for the total prosthesis base and fibromucosa, allowing the prosthesis to slide over the tissue. The cortical bone base was fixed and the 100 N load was applied as unilateral load, posterior bilateral load and anterior guidance simulation. The required results were for maximum principal stress (MPa), microstrain (mm/mm) and total displacement (mm). The numerical results were converted into colorimetric maps and arranged according to corresponding scales. Results: The stress generated in all situations was directly proportional to the fibromucosa height. The maximum principal stress results demonstrated greater magnitude for anterior guidance, posterior unilateral and posterior bilateral, respectively. Only posterior unilateral load demonstrated an increase in bone microstrain, regardless of the fibromucosa height. Prosthesis displacement was lower under posterior bilateral loading. Conclusion: Posterior bilateral loading is indicated for total prosthesis because it allows lower prosthesis displacement, lower stress concentration at the base of the prosthesis and less bone microstrain.



Finite element analysis; Occlusion; Total prosthesis.


Paniz G, Chierico A, Tomasi P, Cuel S. A technique for immediate occlusal implant loading of a completely edentulous mandible: a clinical report. J Prosthet Dent 2012; 107: 221-6. doi: 10.1016/S0022-3913(12)60064-X.

Zhao K, Mai QQ, Wang XD, Yang W, Zhao L. Occlusal designs on mastigatory ability and patient satisfaction with complete denture: A systematic review. J Dent 2013; 41:1036-42. doi: 10.1016/j.jdent.2013.07.016.

Owen PC. Appropriatech: prosthodontics for the many, not just for the few. Int J Prosthodont 2004; 17: 261-2.

Carlson GE, Omar R. The future of complete dentures in oral rehabilitation: A critical review. J Oral Rehabil 2010; 37:143-56. doi: 10.1111/j.1365-2842.2009.02039.x

Limpuangthig N, Somkotra T, Arksornnukit M. Modified retention and stability criteria for complete denture wearers: A risk assessment tool for impaired masticatory ability and oral health-related quality of life. J Prosthodont Dent 2017; 120:1-7. doi: 10.1016/j.prosdent.2017.09.010.

Sousa RM, Simamoto-Junior PC, Fernandes- Neto AJ, Sloten JV, Jaecques SV, Pessoa RS. Influence of conection types and implant number on the biomechanical behavior of mandibular full-arch rehabilitation. Int J Oral Maxillofac Implants 2016; 31: 750-60. doi: 10.11607/jomi.4785.

Fenlon MR, Sherriff M. Investigation of new complete denture quality and patients satisfaction with and use of dentures after two years. J Dent 2004; 32:327-33.

Yamaga E, Sato Y, Minakuchi S: A structural equation model relating oral condition, denture quality, chewing ability, satisfaction and oral healty- related quality of life in complete denture wearers. J Dent 2013; 41:710-7. doi: 10.1016/j.jdent.2013.05.015

Cerutti- Kopplin D, Enami E, Hilgert JB, Hugo FN, Rivaldo E, Padilha DMP. Predictors of satisfaction with dentures in a cohort of individuals wearing old dentures: functional quality or patient-reported measures? J Prosthodont 2017; 26:196-200. doi: 10.1111/jopr.12383.

Matsumaru Y. Influence of mandibular residual ridge resorption on objective masticatory measures of lingualized and fully bilateral balanced denture articulation. J Prosthodont Res 2010; 54:110-8. doi: 10.1016/j.jpor.2009.11.008.

Kimoto S, Gunji A, Yamakawa A, Ajiro H, Kanno K, Shinomiya M, et al. Prospective clinical trial comparing linguarized occlusion to bilateral balanced occlusion in complete dentures: a pilot study. Int J Prosthodont 2006; 19:103-9.

Lemos CAA, Verri FR, Gomes JML, Santiago Junior JF, Moraes SLD, Pellizzer EP. Bilateral balanced occlusion compared to other occlusal schemes in complete dentures: A systematic review. J Oral Rehabil 2018; 45:344-54. doi: 10.1111/joor.12607.

Peroz I, Leuenberg A, Haustein I, Lange LP. Comparison between balanced occlusion and canine guidance in complete denture wearers- a clinical, randomized trial. Quintessence Int 2003; 34:607-12.

Ogawa T, Sato Y, Kitagawa N, Nakatsu M. Relationship between retention forces and stress at the distal border in maxillary complete dentures: Measurement of retention forces and finite-element analysis in individual participants. J Prosthodont Dent 2017; 117: 524-31. doi: 10.1016/j.prosdent.2016.08.011.

Paulino MR, Alves LR, Gurgel BC, Calderon PS. Simplified versus traditional techniques for complete denture fabrication: a systematic review. J Prosthet Dent 2015; 113 (1): 12-6. doi: 10.1016/j.prosdent.2014.08.004.

Ceruti P, Mobilio N, Bellia E, Borracchini A, Catapano S, Gassino G. Simplified edentulous treatment: A multicenter randomized controlled trial to evaluate the timing and clinical outcomes of the technique. J Prosthet Dent 2017; 118(4): 462-7.

Cheng YY, Cheung WL, Chow TW. Strain analysis of maxillary complete denture with three-dimensional finit element method. J Prosthodont Dent 2010; 103: 309-18. doi: 10.1016/j.prosdent.2017.01.024.

Ramakrishnan H, Singh RG. Three dimensional finite element analysis of the stress distribution pattern in the design modifications of U- shaped palatal major connector. Indian J Dent Res 2010; 21:506-11. doi: 10.4103/0970-9290.74219.

Lima JB, Orsi IA, Borie E, Lima JH, Noritomi PH. Analysis of stress on mucosa and basal bone underlying complete dentures with different reliner material thicknesses: a three-dimensional finite element study. J Oral Rehabil 2013; 40:763-73. doi: 10.1111/joor.12086.

Borges Radaelli MT, Idogava HT, Spazzin AO, Noritomi PY, Boscato N. Parafunctional loading and occlusal device on stress distribution around implants: A 3D finite element analysis. J Prosthet Dent 2018; 120: 565-72. doi: 10.1016/j.prosdent.2017.12.023.

Schwitalla AD, Emara-Abou M, Spintig T, Lackmann J, Müller WD. Finite element analysis of the biomechanical effects of PEEK dental implants on the peri-implant bone. J Biomech 2015; 48:1-7. doi: 10.1016/j.jbiomech.2014.11.017.

Amaral CF, Gomes RS, Garcia RCMR, Del Bel Cury AA. Stress distribution of single-implant-retained overdenture reinforced with a framework: A finite element analysis study. J Prosthodont Dent 2017; 119:791-6. doi: 10.1016/j.prosdent.2017.07.016.

Chen J, Ahmad R, Li W, Swain M, Li Q. Biomechanics of oral mucosa. J R Soc Interface 2015; 12:1-20. doi: 10.1098/rsif.2015.0325.

Sadr K, Alipour J, Heidary F. Finite element analysis of soft-lined mandibular complete denture and its supporting structures. J Dent Res Dent Clin Dent Prospects 2012; 6: 37-41.

Nejatidanesh F, Peimannia E, Savabi O. Effect of labial frenum notch size and palatal vault depth on stress concentration in maxillary complete dentures: a finite element study. The Journal Contemp Dent Pract 2009; 10: 1-9.

Zunbuloglu E. Stress analysis of a complete maxillary denture under various drop impact conditions: a 3D finite element study. Comput Methods Biomech Biomed Engin 2015; 18:1543-54. doi: 10.1080/10255842.2014.927446.

Zmudzki J, Chladek G, Malara P. Use of finite element analysis for the assessment of biomechanical factors related to pain sensation beneath complete dentures during mastigation. J Prost Dent 2018; 120: 934- 41. doi: 0.1016/j.prosdent.2018.02.002.

Zmudzki J, Chladek G, Krawczyk C. Relevance of tongue force on mandibular denture stabilization during mastication. J Prosthodont 2019; 28: 27-33. doi: 10.1111/jopr.12719.

Zmudzki J, Chladek G, Kasperski J. The influence of a complete lower denture destabilization on the pressure of the mucous membrane foundation. Acta Bioeng Biomech 2012;14:67-73.

Shrivastava R, Chaturvedi S, Verma AK, Ali M, Nagendra A, Chatuverdi M. Stress distribution under commercial denture liners- A finite element and clinical analysis. J Clin Diag Res 2016; 10:14-8. doi: 10.7860/JCDR/2016/21466.9027.

El- Zawahry MM, El- Ragi AA, El- Anwar MI, Ibraheen EM. The biomechanical effect on different denture base materials on the articular disc in complete denture wearers: a finite element analysis. J Med Sci 2015; 3:455-61. doi: 10.3889/oamjms.2015.074.

Alsrouji MS, Ahmad R, Razak NHA, Shuib S, Kuntjoro W, Baba NZ. Premaxilla stress distribution and bone resorption induced by implant overdenture and conventional denture. J Prosthodont 2019; 28: 764-70. doi: 10.1111/jopr.12954.

Chen J, Ahmad R, Suenaga H, Li W, Swain W, Li Q. A comparative study on complete and implant retained denture treatments- a biomechanics perspective. J Biomech 2015; 48:512-9. doi: 10.1016/j.jbiomech.2014.11.043.






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