title: Pressure distribution of implant-supported removable partial dentures with stress-breaking attachments.
abstract: OBJECTIVE
  This in vitro study investigated the pressure distribution of the implant-supported removable partial dentures (RPDs) with the stress-breaking attachments under the occlusal force.
  
  
  METHODS
  The experimental model of bilateral missing premolars and molars was modified from a commercial simulation model. Five pressure sensors were embedded near the bilateral first molars, first premolars, and medio-lingual alveolar crest. Two implants were placed near the second molars, and they were connected to the denture base using the following conditions: complete separation between the denture base and implant with cover screws (CRPD), flexible connection with a stress-breaking ball (SBB) attachment, and rigid connection without stress breaking with healing caps (HC). The pressure at five different areas of the soft tissue and the displacement of the RPDs were simultaneously measured, loading up to 50 N. The coefficient of variation (CV) for each connection was calculated from all data of the pressure at five areas to evaluate the pressure distribution.
  
  
  RESULTS
  The pressure on medio-lingual alveolar crest and molars of the HC was less than SBB and CRPD. In contrast, the pressure on premolars of SBB was greater than for the HC and CRPD. The CV of SBB was less than that of HC and CRPD. Denture displacement of HC and SBB was less than for CRPD.
  
  
  CONCLUSIONS
  Within the in vitro limitations, precise denture settlements and pressure distribution under the denture base could be controlled using an SBB attachment. An SBB attachment might be able to protect the implant from harmful force.
authors.affiliation: Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, Japan. Electronic address: kono-kentaro@tsurumi-u.ac.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kono
authors.affiliation: Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kurihara
authors.affiliation: Division of Oral Maxillofacial Implantology, Tsurumi University School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, Japan.
authors.forename: Chikahiro
authors.initials: C
authors.lastname: Ohkubo
mesh_terms: D001696:Biomechanical Phenomena; D001732:Bite Force; D015921:Dental Implants; D003834:Denture Precision Attachment; D003832:Denture, Partial, Removable; D066298:In Vitro Techniques; D008963:Molar / Q000502:physiology*; D011312:Pressure
chemical_list: D015921:Dental Implants
keywords: Implant; Implant-supported removable partial denture; Pressure distribution; Stress-breaking ball (SBB) attachment