Mandibular Flexure and Its Significance on Implant Fixed Prostheses: A Review

Purpose: The aims of this review are to determine the effect of mandibular flexure on the implant-framework system, and analyze the existing literature on the topic. Materials and Methods: A MEDLINE and PubMed search was conducted to identify any articles in English related to the topic published up to May 2010 using the search words "mandible," "dental implants," "dental impression technique," "jaw movement," "dental stress analysis," and "mechanical stress." Results: The search identified 40 and 36 articles from MEDLINE and PubMed, respectively. Twenty articles met the inclusion criteria. Conclusions: Mandibular flexure is a multifactorial phenomenon, and the effect of the implant-framework system in this is unclear. Studies have focused mainly on the fully edentulous mandible. These have found that mandibular flexure should be taken into consideration when designing a prosthesis and have suggested that dividing the prosthesis at the symphysis region, or into multiple implant fixed dental prostheses, may minimize the effect of mandibular flexure on the implant prosthesis. At this time, no studies have investigated the effect of mandibular flexure on long-span, unilateral, implant fixed prostheses. The clinical significance of mandibular flexure on the success of dental implant treatment is at this time unclear, and further research is needed.