BIOMECHANICAL OPTIMIZATION OF IMPLANT-SUPPORTED PROSTHETIC REHABILITATION: EVIDENCE FROM FINITE ELEMENT ANALYSIS.

Background: Implant-supported prosthetic rehabilitation involves complex biomechanical interactions in which stress distribution is governed by implant design, restorative materials, prosthetic configuration, and the condition of supporting tissues. Direct clinical assessment of internal stress remains limited; therefore, finite element analysis (FEA) has become a key tool for investigating these relationships. Objective: To synthesize current finite element evidence and evaluate how implant geometry, material properties, prosthetic design, and clinical scenarios influence biomechanical performance in implant-supported prostheses. Methods: A focused narrative review of published three-dimensional FEA studies was conducted. Evidence was analyzed thematically, with emphasis on implant macrodesign, framework and superstructure materials, implant positioning, and prosthetic configurations across clinically relevant scenarios, including short implants in D4 bone, zygomatic implant rehabilitation, socket shield techniques, implant-assisted removable partial dentures, and mandibular full-arch prostheses. Primary outcomes included von Mises stress, strain, displacement, and micromovement. Results:Across the reviewed studies, implant macrodesign significantly influenced peri-implant biomechanics, particularly in compromised bone. Wider platform-switched short implants and square thread geometries consistently reduced stress, strain, and micromovement. Framework material stiffness also played a critical role: rigid materials such as zirconia, cobalt–chromium, and titanium decreased stress within implants and prosthetic components, whereas more flexible materials increased load transfer to these structures. In full-arch models, graphene frameworks demonstrated lower peri-implant stress compared with titanium. Implant positioning in distal-extension removable partial dentures showed comparable biomechanical behavior between premolar and molar sites. In socket shield models, increasing root fragment thickness led to progressive increases in stress and strain in both the retained root and surrounding bone. Conclusions: Biomechanical performance in implant-supported prosthetic rehabilitation is governed by the combined interaction of implant geometry, material stiffness, prosthetic design, and anatomical context rather than by any single factor. Finite element analysis provides valuable comparative insight into stress di