Evaluation of stress induced by implant type, number of splinted teeth, and variations in periodontal support in tooth-implant-supported fixed partial dentures: a non-linear finite element analysis.

ABSTRACT

BACKGROUND: This study investigated the biomechanical interactions in tooth-implant-supported fixed partial dentures (FPDs) with variations in periodontal support, implant system, number of splinted teeth, and load type using the non-linear finite element (FE) approach. METHODS: The section contours of the alveolar bone, abutment teeth, and prosthesis were acquired using computed tomography (CT) and micro-CT to construct the FE models with normal periodontal support (NPS) and compromised periodontal support (CPS) containing one- and two-piece implants splinted to the first and second premolars. Realistic interface conditions within the implant system were simulated using frictional contact elements. The main effects for each level of investigated factors in terms of stress values and dissimilar mobility of natural teeth and the implant were computed for all models. RESULTS: Analytic results indicated that the load condition was the predominant factor affecting stress developed in the implant, bone, and prosthesis. Additionally, the oblique occlusal forces increased the stress values relative to that of axial analogs. A splinted system with a two-piece implant increased stress on the bone and decreased stress on the prosthesis compared to that of the one-piece implant. The splinted system with a CPS only slightly increased implant stress on the bone compared to that of the splint system with NPS. Splinting an additional tooth did not significantly impact stress values for the tooth-implant-supported FPD. CONCLUSIONS: A one-piece structure implant may be better than that of a two-piece structure implant in decreasing bone stress when a natural tooth is planned to connect with an implant. The factors of periodontal support and number of splinted teeth only slightly influenced stress in tooth-implant-supported FPDs.