Background: Severe mandibular atrophy presents a challenge for dental implant placement, often necessitating inferior alveolar nerve lateralization (IANL).
Purpose: This study aimed to evaluate stress distribution in atrophic mandibles following IANL and dental implant insertion, comparing stress distribution across residual mandibular heights and implant configurations after simulated IANL using FEA method.
Materials and Method: Three-dimensional mandibular models derived from computed tomography (CT) scans were used to simulate implant placement after IANL in residual mandibular height models of 15 mm and 20 mm (20 mm included as a comparative reference). Stress distribution was analyzed under a static 100 N vertical (axial) occlusal load with the inferior mandibular border fixed, comparing splinted versus non-splinted prosthetic designs (three-implant splinted configuration versus two-implant bridge-supported configuration) and monocortical versus bicortical implant engagement.
Results: At a mandibular height of 20mm, stress distribution was consistent across configurations. However, at 15mm, stress concentrated along the crestal ridge, mental foramen, and osteotomy margins, exhibiting a broader distribution. A bridge-supported prosthesis demonstrated more favorable stress distribution than three individually fixed implants in the 15mm height models. Bicortical insertion did not significantly alter stress patterns.
Conclusion: IANL facilitates implant placement in severely atrophic mandibles. Implant configuration selection may influence stress concentration in reduced mandibular height models; in the 15 mm models, the bridge-supported configuration showed more favorable stress distribution than the three-implant configuration.