Effect of anchorage systems and extension base contact on load transfer with mandibular implant-retained overdentures.
BACKGROUND
Controversy exists regarding the effect of anchorage systems and extension base contact on stress transfer to multiple implants by mandibular overdentures.


OBJECTIVE
This simulation study measured photoelastically the biologic behavior of 4 implants retaining a mandibular overdenture. The purpose of the investigation was to compare the load transfer characteristics of different mandibular-retained overdenture designs, with and without edentulous ridge contact.


METHODS
A photoelastic model of a human edentulous mandible was fabricated having 4 screw-type implants (3.75 x 10 mm) embedded in the parasymphyseal area. Substructure designs utilizing a cantilevered bar, spark erosion framework, noncantilevered bar, and solitary anchors were fabricated. A vertical load of 30 lb was applied to the first molar unilaterally on each of the 4 standardized overdenture prostheses, with and without a silicone tissue spacer, for a total of 8 tested conditions. Stresses that developed in the supporting structure were monitored photoelastically and recorded photographically.


RESULTS
Without the simulated tissue contact on the posterior edentulous ridge, the cantilevered bar framework caused the highest stresses to the terminal implant, followed by spark erosion framework, non-cantilevered bar, and solitary anchor design. With simulated tissue contact under the extension base, stress transfer to the distal implant was uniformly reduced to a low level.


CONCLUSIONS
Without intimate extension base contact with the posterior edentulous ridge, the cantilevered anchorage systems generated the highest stresses, under load, to the ipsilateral terminal implant and the solitary anchor design transferred the least. With simulated intimate extension base contact, all anchorage systems transferred low stress to the distal implant region. For all conditions and designs, low stress was transferred to the contralateral side of the arch.
Sadowsky
S J
SJ
University of Southern California, and University of California at Los Angeles, Los Angeles, CA, USA. sadow333@aol.com
Caputo
A A
AA
D000539:Alveolar Process / Q000502:physiology; D001718:Birefringence; D000044:Dental Abutments; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention / Q000295:instrumentation / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported; D003799:Dental Stress Analysis / Q000379:methods; D003828:Denture, Overlay; D006801:Humans; D008334:Mandible; D003765:Models, Dental; D008961:Models, Structural