Keywords: bar attachment, implant configuration, maxillary implant overdenture, palateless denture, splinted implants, strain
Purpose: Implant overdentures with splinted attachments have been used in clinical practice, and the effect of splinting on implants has been reported frequently. However, the effect of implant configuration of more than four implants and covering the palate with an overdenture has not been sufficiently examined. The purpose of this study was to reveal the effects of implant configuration and palatal coverage on both implant and denture strain in maxillary implant overdentures using splinted implants.
Materials and methods: Six implants were placed in the anterior, premolar, and molar areas in a maxillary edentulous model. Four strain gauges were attached to the implant surface, and Dolder bar attachments were used to splint implants distributed in various configurations. Two types of maxillary experimental dentures (with/without palatal coverage) were fabricated, and two strain gauges were attached at the midline. A vertical load of 98 N was applied, and the strains on the dentures and implants were measured. The strain measurements were compared using one-way analysis of variance and t test (P = .05).
Results: When comparing the implant strains, the strain was significantly smaller on the anterior and premolar implants when six implants were used, but there was no significant difference among the different implant configurations in the strain on the molar implants. Strains on anterior implants of the palateless overdenture were significantly greater than those of the overdenture with palatal coverage. When four implants were used, the strain on the palatal side of dentures without palate was significantly greater than that on those with palatal coverage. When six implants were used, there was no significant difference in the strain on either side between two types of dentures.
Conclusion: When implants were splinted to each other using a denture without palatal coverage, the strain of dentures when six or two anterior and two posterior implants were used was lower. The difference of denture strains between two types of dentures was not significant when six implants were used, but was significant for all other configurations. Also, the difference of implant strains between two dentures was significant in anterior implants regardless of implant configuration.