Effects of splinted prosthesis supported a wide implant or two implants: a three-dimensional finite element analysis

Objectives: Three-dimensional finite element (FE) models of splinted prosthetic crowns were studied and stress analyses were evaluated with different types of implant support, including standard, wide or two implant(s) for partial, posterior edentulous restorations. Material and methods: The FE models were constructed based on a cadaver mandible containing the 2nd premolar and the 1st molar. The crowns of these two teeth were modeled as connected and disconnected to mimic the splinted and non-splinted designs, respectively. One standard implant was placed at the premolar region, while three types of implant support, one at a time (the standard implant, wide implant and two implants), were used to support the molar crown. A 100 N oblique load was applied to the buccal cusp on each crown. The FE simulation was validated experimentally via strain gauge measurement. Results: The experimental data were well correlated with the FE predictions (r(2)=0.97). When compared with the standard implant used in the molar area, the wide implant and two implants reduced the peak stress in crestal bone by 29-37% for both splinted and non-splinted cases. Inserting the standard implant into both the premolar and molar area, the bone stresses were identical for splinted and non-splinted designs. However, splinting the adjacent crowns has shown to decrease the bone stresses at the premolar region by 25%, while the wide implant or two implants were placed at the molar region. Conclusion: The biomechanical advantages of using the wide implant or two implants are almost identical. The benefit of load sharing by the splinted crowns is notable only when the implants on the premolar and molar regions have different supporting ability.