Finite Element-Optimized Biomechanical Framework for Angulated Implant Placement in Severely Resorbed Posterior Mandibular Ridges Using Platform-Switched Zirconia Abutments

Abstract

Severely resorbed posterior mandibular ridges present significant biomechanical challenges for osseointegrated implant systems, particularly regarding crestal bone stress distribution and long-term marginal bone stability. This study developed and validated a finite element analysis (FEA)-optimized placement protocol for angulated titanium implants (15°–25° off-axis) coupled with platform-switched zirconia abutments in class V–VI Cawood–Howell defect configurations. Forty-eight three-dimensional mandibular models were reconstructed from cone-beam computed tomography datasets and subjected to oblique and axial occlusal load simulations (150–400 N). Results demonstrated a statistically significant reduction in von Mises stress concentrations at the implant–abutment interface (p < 0.001) and a 31.4% decrease in periimplant cortical bone microdeformation compared to conventional non-angulated protocols. The proposed framework provides clinicians with quantitative angulation thresholds and abutment geometry parameters to optimize load distribution and minimize marginal bone resorption risk.