Effects of attachment clips on occlusal force transmission in removable implant-supported overdentures and cantilevered superstructures

Attachment clips are commonly used to provide retention for removable implant-supported overdentures. In this study, the effects of attachment clips on occlusal force transmission in four implant-supported overdentures with cantilever extensions were investigated using beam theory. Distributions of moments and of forces in overdenture, clips, cantilevered superstructure, and implants were calculated as functions of position, number, and stiffness of attachment clips. Three-, four-, and five-attachment clip configurations were analyzed. Results showed that maximum bending moments and forces in all components are strong functions of position, number, and retention of attachment clips, while the effects of attachment clip stiffness are negligible. Increasing the number of attachment clips from three to five results in a significant decrease of maximum bending moments in the superstructure and implant. For a nide range of attachment clip positioning, the maximum tensile force on the implants is as high as half the applied load. At least one attachment clip for all configurations is also subjected to tensile force, which can cause it to slip out from the superstructure and increase maximum bending moment in the superstructure and implants.