title: Should oral implants be splinted in a mandibular implant-supported fixed complete denture? A 3-dimensional-model finite element analysis.
abstract: BACKGROUND
  The design of a mandibular fixed complete denture can influence periimplant bone loss. However, the design that transfers the greatest stress to the periimplant bone is not well documented.
  
  
  OBJECTIVE
  The purpose of this study was to assess the stress distribution associated with splinted and nonsplinted implant-supported mandibular fixed complete denture designs.
  
  
  METHODS
  Three-dimensional finite element models simulating 6 osseointegrated implants were created in the mandible to support a cobalt-chromium alloy and feldspathic porcelain veneering framework. One model simulated a 1-piece framework, and the other models simulated 2-piece and 3-piece frameworks. Axial and oblique loads were applied to the frameworks.
  
  
  RESULTS
  For all the models, the greatest stress values were recorded in the periimplant bone of posterior implants, with differences between the left and right sides. The axial load transferred greater stress values to the periimplant bone than did the oblique load. The lowest periimplant bone stress values were observed in the 3-piece framework model at all implant locations, with the exception of implants placed in the canine region.
  
  
  CONCLUSIONS
  A framework separated into 3 pieces transfers the least stress to the periimplant bone.
authors.affiliation: Professor and Head, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain. Electronic address: arenal@uniovi.es.
authors.forename: Angel
authors.initials: A
authors.lastname: Alvarez-Arenal
authors.affiliation: Clinical Assistant Professor, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain.
authors.forename: Aritza
authors.initials: A
authors.lastname: Brizuela-Velasco
authors.affiliation: Clinical Assistant Professor, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain.
authors.forename: Hector
authors.initials: H
authors.lastname: DeLlanos-Lanchares
authors.affiliation: Associate Professor, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Gonzalez-Gonzalez
mesh_terms: D000538:Aluminum Silicates / Q000737:chemistry; D001696:Biomechanical Phenomena; D001732:Bite Force; D002858:Chromium Alloys / Q000737:chemistry; D003198:Computer Simulation; D003481:Cuspid; D003724:Dental Arch / Q000503:physiopathology; D015921:Dental Implants; D003776:Dental Porcelain / Q000737:chemistry; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003801:Dental Veneers; D003779:Denture Design; D003826:Denture, Complete, Lower; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007575:Jaw, Edentulous / Q000503:physiopathology; D008334:Mandible / Q000503:physiopathology; D008954:Models, Biological; D016348:Osseointegration / Q000502:physiology; D017680:Potassium Compounds / Q000737:chemistry; D013314:Stress, Mechanical
chemical_list: D000538:Aluminum Silicates; D002858:Chromium Alloys; D015921:Dental Implants; D017680:Potassium Compounds; D003776:Dental Porcelain; C016447:feldspar