On-Bone Fixation of Free Gingival Graft Induces an Osteoinductive Effect in Human Alveolar Bone.

We examined alveolar bone samples in the area of on-bone fixation of a free gingival graft performed during surgery in patients aged 37-55 years with a diagnosis of secondary partial adentia of the upper and lower jaws. Six months after fixation of the graft in the alveolar bone, foci of neoosteogenesis were found in the contact zone. They were characterized by the appearance of appositional lines, cords of basophilic osteoblasts, and growing osteons. An immunohistochemical study revealed an increase in the number of CD44+, CD29+, and osteocalcin+ cells in the layer of the outer circumferential lamellae, primary osteons, and the lining of the Haversian canals. TGF-ß1+ cells were located in the intertrabecular reticular tissue and wall of microvessels. The results indicate activation of mesenchymal stem cells in the area of localization of the graft and differentiating osteoblasts. The observed osteoinductive effect of free gingival graft is associated with its participation in reorganization in MSC and induction of morphogenetic molecules.

Trigeminal input, pupil size and cognitive performance: From oral to brain matter.

It has been observed that, in patients affected by temporomandibular disorders (TMDs) and edentulism, a left-right asymmetry in electromyographic (EMG) activity of masseter muscles during clenching and in pupil size at rest (anisocoria) is present. Both are greatly reduced by an orthotic-prosthetic correction. In parallel, the correction significantly improves cognitive performance. These effects are possibly due to the recovery of a cortical balance, via Locus Coeruleus (LC) modulation, whose activity is powerfully affected by the sensorimotor trigeminal input. The role of this functional axis was further investigated in subjects without overt occlusal or dental problems. In these individuals, the EMG asymmetry was significantly correlated to anisocoria at rest, with the dental arches open or in contact. Also in normal subjects, both the EMG and the pupil asymmetry during clenching could be significantly reduced by an orthotic (bite) correction. Closing the arches without bite increased anisocoria and reduced performance in the Spinnler-Tognoni matrices test, as well as the mydriasis induced by a haptic task. When the bite was interposed, anisocoria was reduced, while both performance and task-related mydriasis were enhanced. Since pupil size is considered a proxy of the LC activity, these results suggest that asymmetric occlusion biases the LC discharge and the hemispheric excitability, possibly via a sensorimotor trigeminal imbalance. Removing the anisocoria through bite correction re-establishes a symmetric LC discharge, improving performance and enhancing task-related mydriasis. Therefore, occlusal balancing may represent a tool for improving subjective performance and may be exploited for training and rehabilitative purposes.

Radiographic evaluation of bone density in dentulous and edentulous patients in Riyadh, KSA.

BACKGROUND: The Cone Beam Computed Tomography (CBCT) is currently being used as the most common diagnostic method to evaluate the bone density of the maxilla and the mandible for planning dental implant. Aim: The aim of the study is to check the quantitative alveolar bone density in complete or partial edentulous and dentulous male and female patients among Riyadh sample population in Saudi Arabia. MATERIALS AND METHODS: The study involved a cross-sectional analysis of 231 consecutive CBCT images of 231 different patients (115 males and 116 females). The scans were of Saudi National patients who were partially or completely edentulous without any bone infections in the maxilla and the mandible. The findings are presented as descriptive statistics and inferential statistics: student -t-test for two group means, ANOVA for three groups, Post-hoc LSD test for multiple comparisons, Levene statistics for testing the homogeneity of variances and a statistical significance at 5% level. RESULTS: Comparison of mean alveolar bone density in maxillae of dentulous male smokers showed a statistically significant difference for bucco-cortical plate and cancellous bone among different regions. In dentulous male nonsmokers, no significant difference was observed for maxillary regions, while in mandibular areas, a statistically significant difference was seen for buccal cortex, palatal cortex, and cancellous bone among different regions. While studying the scans of female dentulous patients, a statistically significant difference was observed in alveolar bone density for all the areas. CONCLUSION: Evaluation of bone density is an important step in treatment planning and this study was aimed to provide insight into bone density patterns of population in Riyadh, Saudi Arabia. Further similar studies in different populations can help in planning for more efficient treatment outcomes.

Masticatory efficiency of shortened dental arch subjects with removable partial denture: A comparative study.

OBJECTIVE: The objective of this study was to compare the masticatory efficiency in subjects with shortened dental arch (SDA) before and after restoration with removable partial denture (RPD). MATERIALS AND METHODS: This was a prospective study carried out on 36 consecutive patients. The subjects were asked to chew 5 g of a measured portion of fresh raw carrot for 20 specified numbers of strokes. The raw carrot was recovered into a cup and strained through a standard mesh sieve of 5 mm by 1 mm, it was air dried for 30 min and weighed with FEM digital series weighing scale. The masticatory performance ratio was then determined. RESULT: The age range of the subjects was 34-64 years with the mean age being 52.2 ± 8.2 years. The difference between the total masticatory performance score at the post- and pre-treatment phases was statistically significant (P = 0.001). The improvement in masticatory performance was marked among the younger age groups (P = 0.001), unilateral free end saddle subjects (P = 0.001), and among the male gender (P < 0.05). CONCLUSION: Masticatory performance improved with the provision of RPD. However, the improvement was marked among the younger age groups, unilateral free end saddle subjects, and the male gender; thereby supporting the need for RPDs in patients with SDA.

Mandibular movements in older people with rheumatoid arthritis.

OBJECTIVE: The aim of this study was to compare the mandibular movements in older people with and without temporomandibular disorder (TMD) associated with rheumatoid arthritis (RA). STUDY DESIGN: Thirty partially or completely edentulous older adults (65.33 ± 4.7 years) were assigned to 2 groups: (1) with RA and TMD and (2) without RA and TMD. Chewing movements of the jaws during mastication of the test material (Optocal) and the range of mandibular movements were evaluated by using the JT-3-D kinesiographic device before and after new removable prosthesis insertion. Multiple comparisons were made with analysis of variance (ANOVA) and the Tukey-Kramer test. RESULTS: Comparisons between the 2 groups before and after new prosthesis insertion revealed that the RA and TMD group had reduced opening angles (P < .05) during chewing. After insertion of new prostheses, both groups showed increased opening and closing angles during chewing (P < .05). The mandibular range of motion results showed that patients with RA and TMD exhibited lower aperture and laterality movements (P < .05) compared with controls before and after new prosthesis insertion. However, there was an increase in aperture, lefty laterality, and protrusion values after new prosthesis insertion in both groups. CONCLUSIONS: TMD associated with RA may impair mandibular movements. Well-fitted prostheses may improve mandibular movements in older adults, especially those with RA.

Radiographic Evaluation of Crestal Bone Level in Split-Crest and Immediate Implant Placement: Minimum 5-Year Follow-up.

PURPOSE: This study aimed to evaluate the radiographic bone level changes of implants positioned via the split-crest procedure both in the maxilla and mandible at a long-term follow-up. MATERIALS AND METHODS: Seventy-one patients were retrospectively enrolled in the study. The placement of 137 dental implants was performed in the edentulous premolar or molar region after a split-crest ridge expansion procedure. Implants followed a delayed loading protocol. Intraoral digital radiographs were performed at baseline, upon implant placement, at 70 days (following placement of the provisional prosthesis), and on a yearly basis during followup. Crestal bone levels were evaluated at the baseline, upon provisional prosthesis placement, at 12, 36, and 60 months, and at the long-term follow-up of healing from implant placement. RESULTS: The patients underwent a mean follow-up of 6.54 ± 1.32 years, from which the implant survival rate was reported at 98.54%. Within the first year from implant placement, a bone loss resulted at a mean value of -1.11 ± 0.44 mm. After almost 3 years from implant placement, a mean bone gain of +0.89 ± 0.39 mm was reported, which was statistically significant compared with 12-month values (P < .05). From this point, bone levels remained stable, reporting similar values over time, with no significant differences (P > .05). CONCLUSION: A mean vertical bone gain of +0.89 ± 0.39 mm was observed after almost 36 months after implant positioning.

Masticatory function and oral health-related quality of life in patients after partial maxillectomies with closed or open defects.

STATEMENT OF PROBLEM: The healing pattern after surgical resection of tumors of the oral cavity involving the maxilla may vary from one patient to another. The result may be open communication between the oral and nasal cavities (open defect) or complete oronasal separation after healing of the defect area (closed defect). PURPOSE: The purpose of this clinical study was to compare masticatory function and oral health-related quality of life (OHRQoL) between patients with closed and open defects who had undergone a partial maxillectomy and were wearing dentomaxillary prostheses. MATERIAL AND METHODS: Thirty-eight participants who had undergone a partial maxillectomy and who were wearing dentomaxillary prostheses were enrolled between September 2014 and April 2016. Participants were assigned to 2 groups according to the type of defect after healing: 19 participants had a closed defect, and 19 participants had an open defect. Masticatory function was evaluated objectively and subjectively. The objective measurement was food-mixing ability, which was assessed using color-changeable chewing gum. The subjective measurement was perceived mastication ability, rated as a masticatory score based on the patient's responses to a 35-item food intake questionnaire. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). The GOHAI questionnaire consists of 12 items reflecting 3 hypothesized domains of the impact of oral disease: physical function, psychosocial function, and pain or discomfort. Differences in the scores obtained by the 3 measurements were compared between the 2 groups, using the Wilcoxon rank-sum test (α=.05). RESULTS: No significant differences were seen between the 2 groups in objective mixing ability, subjective masticatory score, or GOHAI (P>.05). Regarding the GOHAI physical function domain, only the swallowing item was significantly lower (P=.025) in participants with an open defect than in participants with a closed defect. Regarding the GOHAI psychological function domain, the item related to patients' psychological worries or concerns about their teeth, gingival tissue, or dentures was significantly lower (P=.045) in patients with an open defect than in those with a closed defect. Other items related to physical function, psychological function, and pain or discomfort were not significantly different (P>.05) between the 2 groups. CONCLUSIONS: The closed or open defect in patients who had undergone a partial maxillectomy may not influence patients' masticatory function and overall OHRQoL if they have adequate prosthetic rehabilitation. However, special consideration should be given to patients with an open defect with regard to swallowing function and psychological concerns in order to improve their OHRQoL.

Influence of Healing Period Upon Bone Turn Over on Maxillary Sinus Floor Augmentation Grafted Solely with Deproteinized Bovine Bone Mineral: A Prospective Human Histological and Clinical Trial.

PURPOSE: To investigate the influence of maturation timing upon histological, histomorphometric and clinical outcomes when deproteinized bovine bone mineral (DBBM) was used as a sole biomaterial for staged maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS: Patients with a posterior edentulous maxillary situation and a vertical bone height ≤ 4 mm were included in this study. A staged MSFA was carried out. After MSFA with DBBM as a sole grafting material, biopsy cores were harvested with simultaneous implant placement followed by a healing period of 5, 8, and 11 months, respectively. Micro-CT, histologic and histomorphometric analyses were performed. RESULTS: Forty-one patients were enrolled and 38 bone core biopsies were harvested. Significantly greater BV/TV was observed between 5- and 8-month healing from micro-CT analysis. Histomorphometric analyses showed the ratio of mineralized newly formed bone increased slightly from 5 to 11 months; however, no statistically significant difference was reached (p = .409). Residual bone substitute decreased from 37.3 ± 5.04% to 20.6 ± 7.45%, achieving a statistical significant difference from of 5 up to 11 months (p < .01). Moreover, no implant failure, biological or technical complication occurred after 12-month follow-up of functional loading. CONCLUSION: DBBM utilized as sole grafting material in staged MSFA demonstrated to be clinically effective regardless of the healing period. Histomorphometrical and micro-CT assessments revealed that at later stages of healing (8 and 11 months) there is a higher proportion of newly-bone formation compared to earlier stages (5 months). Moreover, the longer the maturation period, the substantially lesser remaining biomaterial could be expected. Even though, these facts did not seem to negatively impact on the implant prognosis 1-year after loading.

Association between posterior teeth occlusion and functional dependence among older adults in nursing homes in Japan.

AIM: To examine whether posterior teeth occlusion is associated with functional dependence regardless of the number of natural teeth among Japanese nursing home residents. METHODS: The present cross-sectional study included 234 residents aged >60 years from eight nursing homes in Aso City, Japan. Functional dependence in basic activities of daily living was measured using the Barthel Index, and the primary outcome was independence for essential personal care (Barthel Index ≥ 60 points). Posterior teeth occlusion was assessed by a dentist using the total number of functional tooth units, depending on the number and location of the remaining natural and artificial teeth on implant-supported, fixed, and removable prostheses. Logistic regression models were used to assess univariate and multivariate associations between the total number of functional tooth units and independence for essential personal care. Models were sequentially adjusted for the number of natural teeth, demographic characteristics, socioeconomic status, health behaviors and comorbidities. RESULTS: Independence for essential personal care was found in 14.1% of participants. Greater total numbers of functional tooth units were significantly associated with greater odds of independence for essential personal care (odds ratio 1.12; 95% confidence interval 1.01-1.24). The association remained significant after adjustment for the number of natural teeth and other possible confounders (odds ratio 1.14, 95% confidence interval 1.01-1.29). CONCLUSIONS: Posterior teeth occlusion was independently associated with functional dependence among nursing home older residents in Japan. The maintenance and restoration of posterior teeth occlusion might be preventive factors against late-life functional decline. Geriatr Gerontol Int 2017; 17: 622-627.

Correlation of cognitive and masticatory function in Alzheimer's disease.

OBJECTIVES: This study investigated chewing function in elderly individuals with Alzheimer's disease (AD) and correlated chewing function with cognitive status. MATERIALS AND METHODS: Sixteen elderly individuals with mild AD (mean age 76.7 ± 6.3 years; 8 men, 8 women) and 16 age and gender-matched healthy controls (mean age 75.23 ± 4.4 years; 8 men, 8 women) were included in this study. All volunteers wore removable prostheses: 11 were totally edentulous and five were partially edentulous in each group. Chewing function was evaluated via masticatory performance (MP) using Optocal chewable test material and a sieve fractionation method. Cognitive functioning was assessed by the Mini Mental State Exam (MMSE), administered by a trained examiner. Data were analyzed by non-paired t test and Pearson's correlation with α = 0.05. RESULTS: Compared to controls, mild AD patients had decreased MP (P < 0.01) and MMSE (P = 0.01). MP showed a moderate negative correlation with MMSE (r = -0.69). CONCLUSIONS: Mild AD was associated with impaired chewing function. CLINICAL RELEVANCE: Knowledge that mild AD has an impact on chewing is important for dental professionals in decision-making related to prosthetics and general dental treatment.

Oral physiology, nutrition and quality of life in diabetic patients associated or not with hypertension and beta-blockers therapy.

The relationship between type 2 diabetes oral physiology, nutritional intake and quality of life has not been fully elucidated. We assessed the impact of type 2 diabetes - exclusive or associated with hypertension with beta-blockers treatment - on oral physiology, mastication, nutrition and quality of life. This cross-sectional study was performed with 78 complete dentate subjects (15 natural teeth and six masticatory units minimum; without removable or fixed prostheses), divided into three groups: diabetics (DM) (n = 20; 45·4 ± 9·5 years), diabetics with hypertension and receiving beta-blockers treatment (DMH) (n = 19; 41·1 ± 5·1 years) and controls (n = 39; 44·5 ± 11·7 years) matched for gender, age and socioeconomic status. Blood glucose, masticatory performance, swallowing threshold, taste, food intake, stimulated and unstimulated salivary flow, pH and buffering capacity of saliva were assessed. Glycemia was higher in DM than in controls (P < 0·01). No differences were observed between DM and controls for nutrition and quality of life. Both stimulated and unstimulated salivary flow rate were lower in DMH (P < 0·01), which also presented the lowest number of teeth and masticatory units (P < 0·0001), and reduction in the number of chewing cycles (P < 0·01). Controls showed lower Decayed Missing Filled Teeth index (DMFT) scores in comparison with DMH (P = 0·021). Masticatory performance and saliva buffering capacity were similar among groups. Exclusive type 2 diabetes did not alter oral physiology, nutrition or quality of life. However, when hypertension and beta-blockers treatment were associated with diabetes, the salivary flow rate, chewing cycles and number of teeth decreased.

Objective assessment of mastication predominance in healthy dentate subjects and patients with unilateral posterior missing teeth.

We aimed to investigate mastication predominance in healthy dentate individuals and patients with unilateral posterior missing teeth using objective and subjective methods. The sample comprised 50 healthy dentate individuals (healthy dentate group) and 30 patients with unilateral posterior missing teeth (partially edentulous group). Subjects were asked to freely chew three kinds of test foods (peanuts, beef jerky and chewing gum). Electromyographic activity of the bilateral masseter muscles was recorded. The chewing side (right side or left side) was judged by the level of root mean square electromyographic amplitude. Mastication predominance was then objectively assessed using the mastication predominant score and the mastication predominant index. Self-awareness of mastication predominance was evaluated using a modified visual analogue scale. Mastication predominance scores of the healthy dentate and partially edentulous groups for each test food were analysed. There was a significant difference in the distribution of the mastication predominant index between the two groups (P < 0·05). The mastication predominant score was weakly correlated with self-awareness of mastication predominance in the healthy dentate group, whereas strong correlation was observed in the partially edentulous group (P < 0·05). The results suggest that the individuals with missing unilateral posterior teeth exhibited greater mastication predominance and were more aware of mastication predominance than healthy dentate individuals. Our findings suggest that an objective evaluation of mastication predominance is more precise than a subjective method.

[Occlusal evaluation and design of dental implant therapy in defect dentition].

Implant prosthesis of dentition defect is characteristic of remaining teeth and implants exist at the same time, so the remaining teeth occlusal conditions related to the final occlusal design is to maintain, adjust or re-establish the original dentition occlusion. Therefore, full evaluation of remaining teeth occlusion before restoration, clear prognosis, balancing the occlusal force distribution of natural teeth and implants, and carrying out the predictable occlusal design in the entire process of implant prosthesis can minimize the adverse events after implant prosthesis. Based on the typical cases in this paper, three occlusal design types of occlusal maintain-implant restoration, occlusal adjustment-implant restoration and occlusal reconstruction-implant restoration will be expounded respectively.

Effect of prosthetic restoration on masticatory function in patients with shortened dental arches: a multicentre study.

The aim of this multicentre study was to investigate the effect of prosthetic restoration for missing posterior teeth on mastication in patients with shortened dental arches (SDAs). Partially dentate patients who had an intact teeth in anterior region and missed distal molar(s) (2-12 missing occlusal units) classified as Kennedy Class I or Class II were recruited from seven university-based dental hospitals in Japan. Of the 125 subjects who underwent baseline (pre-treatment) and follow-up/post-treatment evaluation, 53 chose no replacement of missing teeth and 72 chose treatment with removable partial dentures (n = 53) or implant-supported fixed partial dentures (n = 19). Objective masticatory performance (MP) was evaluated using a gummy jelly test. Perception of chewing ability (CA) was rated using a food intake questionnaire. In the no-treatment group, mean MP and CA scores at baseline were similar to those at follow-up evaluation (P > 0·05). In the treatment group, mean MP after treatment was significantly greater than the pre-treatment mean MP (P < 0·05). However, the mean perceived CA in the treatment groups was similar at pre- and post-treatment (P > 0·05). In a subgroup analysis of subjects in the treatment group, subjects with lower pre-treatment CA showed a significant CA increase after treatment (P = 0·004), but those with higher pre-treatment CA showed a significant decrease in CA (P = 0·001). These results suggest that prosthetic restoration for SDAs may benefit objective masticatory performance in patients needing replacement of missing posterior teeth, but the benefit in subjective chewing ability seems to be limited in subjects with perceived impairment in chewing ability before treatment.

A multifactorial model of masticatory performance: the Suita study.

Previous studies have identified various factors related to masticatory performance. This study was aimed to investigate variations and impacts of factors related to masticatory performance among different occlusal support areas in general urban population in Japan. A total of 1875 Japanese subjects (mean age: 66·7 years) were included in the Suita study. Periodontal status was evaluated using the Community Periodontal Index (CPI). The number of functional teeth and occlusal support areas (OSA) were recorded, and the latter divided into three categories of perfect, decreased and lost OSA based on the Eichner Index. Masticatory performance was determined by means of test gummy jelly. For denture wearers, masticatory performance was measured with the dentures in place. The multiple linear regression analysis showed that, when controlling for other variables, masticatory performance was significantly associated with sex, number of functional teeth, maximum bite force and periodontal status in perfect OSA. Masticatory performance was significantly associated with number of functional teeth, maximum bite force and periodontal status in decreased OSA. In lost OSA, masticatory performance was significantly associated with maximum bite force. Maximum bite force was a factor significantly influencing masticatory performance that was common to all OSA groups. After controlling for possible confounding factors, the number of functional teeth and periodontal status were common factors in the perfect and decreased OSA groups, and only sex was significant in the perfect OSA group. These findings may help in providing dietary guidance to elderly people with tooth loss or periodontal disease.

Association between dental status and food diversity among older Japanese.

OBJECTIVE: To investigate the relationship of dental status to food diversity among older Japanese. DESIGN AND SETTING: A community-based cross-sectional study conducted in the town of Tosa, Kochi Prefecture, Japan. METHODS: The study participants were 252 Japanese (84 men and 168 women, average age 81.2 years) and dentate participants were classified into three groups: 1-9 teeth, 10-19 teeth and 20 or more teeth. Food diversity was assessed as a validated measure of dietary quality using the 11-item Food Diversity Score Kyoto (FDSK-11), which evaluates frequency of consumption of 11 main food groups. Multivariable analysis of the differences in FDSK-11 score ranging from 0 to 11, with a higher score indicating greater food diversity, among the three dental status groups was conducted using general linear models. All the performed analyses were stratified by gender. RESULTS: There was no association between dental status and food diversity score in models for men. In contrast, women with ≤ 9 teeth and with 10-19 teeth had significantly lower FDSK-11 scores than women with ≥ 20 teeth after adjusting for confounders (p < 0.001 and p = 0.009, respectively). Additionally, there was a trend toward lower scores for FDSK-11 with fewer teeth (p = 0.001). CONCLUSION: A less varied diet, as indicated by low FDSK-11 score, was observed in female participants with fewer teeth. Tooth loss was associated with poor diet quality among older Japanese women.

Connection of functional quality of partial removable dentures and the degree of patients' phonetic adaptation.

INTRODUCTION: Phonetic adaptation is a complex biological phenomenon with a highly individual course, depending on the patient's motivation to use prosthesis, on the functional quality of removable dentures. The aim of the study was to estimate phonetic adaptation in patients with partial dentures, connecting it to alteration in speech quality and dentures functional value. MATERIALS AND METHODS: We examined some peculiarities of phonetic adaptation in 50 patients with removable dentures (50 patients with natural dentition were invited for the control group). The standardized evaluation protocols (12 speech quality determining parameters) were developed separately for Latvian and Russian native speakers. 500 speech video samples were recorded and analysed according to pre-established guidelines. The connection of speech quality and the functional quality of the dentures was assessed. Statistical analysis was performed using SPSS 20.0. P values equal to or less than 0.05 were considered to be statistically significant. RESULTS: In patients with appropriate functional quality of removable dentures distorted speech production was detected in 25% (pk=0.008) cases and in patients with inappropriate functional quality of the prosthesis - in 40% (pk<0.001). Patients with appropriate dentures functional value were satisfied with their speech performance in 96% (pk=0.674), in the group with inappropriate dentures functional value only 59% (p<0.001) rated their speech quality positively. CONCLUSION: Phonetic adaptation to removable dentures depends on the patient's individual adaptation capacity, prosthetic design and functional value. Thus statistically significant correlation between removable partial dentures functional value, duration of usage and the degree of patients' phonetic adaptation (p<0.001) may be considered to be confirmed.

Theoretical role of adjunctive implant positional support in stress distribution of distal-extension mandibular removable partial dentures.

This preliminary study evaluated the adjunctive supporting role of diverse implant positions on stress distribution in a Class I removable partial denture (RPD) design. Nine three-dimensional finite element models were prepared to simulate mandibular RPD designs with three different loading conditions applied. Implant supported designs demonstrated lower stress value concentrations and mucosal displacement.

Finite element analysis of an implant-assisted removable partial denture during bilateral loading: occlusal rests position.

STATEMENT OF PROBLEM: When implants are incorporated into an existing partial removable dental prosthesis, the acrylic resin base can fracture. It is therefore essential to study the mechanical behavior of partial removable dental prostheses by using stress and deformation analysis. PURPOSE: The purpose of this study was to analyze the effect of the occlusal rest position on the implant-assisted partial removable dental prosthesis by finite element analysis. MATERIAL AND METHODS: A Faro Arm scan was used to extract the geometrical data of a human partially edentulous mandible. A standard plus regular neck (4.8×12 mm) implant and titanium matrix, tooth roots, and periodontal ligaments were modeled by using a combination of reverse engineering in Rapidform XOR2 and solid modeling with the Solid Works CAD program. The model incorporated a partial removable dental prosthesis and was loaded with standard bilateral forces. A uniform pressure was applied on the occlusal surface so as to generate an equivalent net force of 120 N for both the left and right prosthesis. The finite element analysis program ANSYS Workbench was used to analyze the stress and strain distributions in the implant-assisted partial removable dental prosthesis. RESULTS: Maximum stresses were significantly high for the metal framework compared to the acrylic resin surface, and these stresses were different for the mesial and distal arm designs. The maximum stress in the metal framework for the mesial arm design was 614.9 MPa, and it was 796.4 MPa for the distal arm design. The corresponding stresses in the acrylic resin surface were 10.6 and 8.6 MPa. CONCLUSIONS: Within the limitation of this study, it was found that moving the position of the occlusal rest from the mesial to distal side of the abutment teeth improved the stress distribution in the metal framework and acrylic resin denture base structures.