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EFFECT OF ANCHORAGE SYSTEMS ON LOAD TRANSFER WITH MANDIBULAR IMPLANT OVERDENTURES : A THREE-DIMENSIONAL PHOTOELASTIC STRESS ANALYSIS  

Kim Jin-Yeol (Department of Prosthodontics, College of Dentistry, Pusan National University)
Jeon Young-Chan (Department of Prosthodontics, College of Dentistry, Pusan National University)
Jeong Chang-Mo (Department of Prosthodontics, College of Dentistry, Pusan National University)
Publication Information
The Journal of Korean Academy of Prosthodontics / v.40, no.5, 2002 , pp. 507-524 More about this Journal
Abstract
Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study, 1. In all experimental models. the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows: type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems. more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread. selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.
Keywords
Anchorage system; Photoelastic stress analysis; Mandibular implant overdenture;
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1 Adell R, Eriksson BO, Lekholm U, et al. A long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990:5:347-59
2 Haraldson T, Jemt T. Stalblad PA Lekholm U. Oral function in subjects with overdentures supported by osseointegrated implants. Scand J Dent Res 1988:96:235-42
3 Allen PF, McMillan AS, Smith DG. Complications and maintenance requirements of implant-supported prostheses provided in a UK dental hospital. Br Dent J 1997; 182: 298-302   DOI   PUBMED   ScienceOn
4 Branernark P-I. Svensson B, van Steenberghe D. Ten-year survival rates of fixed prostheses on four or six implants ad modum Bra-nemark in full edentulism. Clin Oral Impl Res 1995:6:227-31
5 Carlsson GE, Haraldson T. Functional response. In: Branemark P-I, Zarb GA, Albrektsson T eds., Tissue integrated prostheses: Osseointegration in clinical dentistry. Chicago: Quintessence: 1985. p.155-63
6 Osterberg T, Carlsson GE. Symptoms and signs of mandibular dysfunstion in 70-year old men and women in Gothenburg, Sweden. Community Dent Oral Epidermiol 1979: 7: 315-21
7 Bergman B, Carlsson GE. Clinical long-term study of complete denture wearers. J Prosthet Dent 1985: 53 :56-61
8 Melas F, Marcenes W, Wright PS. Oral health impact on daily performance in patients with implant-stabillized overdentures and patients with convetional complete dentures. Int J Oral Maxillofac Implants 2001:16:700-12
9 Engquist B, Bergendal T, Kallus T, Linden U. A retrospective multicenter evaluation of osseointegrated implants supporting overdentures. Int J Oral Maxillofac Implants 1988: 3: 129-34
10 Jemt T, Carlsson L, Boss A. In vivo load measurements on osseointegrated implants supporting fixed or removable prostheses: A comparative pilot study. Int J Oral Maxillofac Implants 1991:6:413-7
11 Naert I, De Clercq M. Theuniers G. Schepers E. Overdentures supported by osseointegrated fixtures for the edentulous mandible: A 2.5-Year Report, Int J Oral Maxillofac Implants 1988:3: 191-6
12 Leimola-Virtanen R, Peltola J, Oksala E, et al. ITI titanium plasma-sprayed screw implants in the teatment of edentulous mandibles: a follow-up study of 39 patients. Int J Oral Maxillofac Implants 1995: 10: 373-8
13 Wismeyer D. van Waas MA. Vermeeren JI. Overdentures supported by ITI implants: a 6.5-year evaluation of patient satisfaction and prosthetic aftercare. Int J Oral' Maxillofac Implants 1995:10:744-9
14 Jemt T. Chai J. Harnett J. et al. A 5-year prospective multicenter follow-up report on overdentures supported by osseointegrated implants. Int J Oral Maxillofac Implans 1996: 11: 291-8
15 Smedberg JI. Lothigius E. Bodin I, Frykholm A. Nilner K. A clinical and radiological two-year follow-up study of maxillary overdentures on oseeointegrated implants. Clin Oral Implants Res 1993:4:39-46
16 Naert I, Quirynen M. Hooghe M. van Steenberghe D. A comparative prospective study of splinted and unsplinted Bra nemark implants in mandibular overdenture therapy: a preliminary report. J Prosthet Dent 1994: 71 :486-92
17 Sadowsky SJ. Caputo AA. Effect of anchorage systems and extension base contact on load transfer with mandibular implant-retained overdentures. J Prosthet Dent 2000:84:327-34
18 Jemt T, Book K, Karlsson S. Occlusal force and mandibular movements in patients with removable overdentures and fixed prostheses supported by implants in the maxilla. Int J Oral Maxillofac Implants 1993;8:301-8   PUBMED
19 Cho HW, Kwon JH. Lee WY. A stress analysis of the implant supported overdenture using strain gauge. J Korean Acad Prosthodont 1999: 37: 93-103
20 Kirsch A. Funf Jahre IMZ-Implantat-System. Grundlagen, Methodik. Erfahrungen. In: Franke J ed.. Der heutige Stand der Implantologie. Munchen. Hansler: 1980
21 Davodi A, Nishimura R, Beumer J. An implant-supported fixed-removable prosthesis with milled tissue bar and Hader clip retention as a restorative option for the edentulous maxilla. J Prosthet Dent 1997:78:212-7
22 Brunski JB. Forces on dental implants and interfacial stress transfer. In: Laney WR. Tolman DE. editors. Tissue integration in oral. orthopedic. and maxillofacial reconstruction. Chicago: Quintessence: 1992. p.108-24
23 Dally JW, Riley WF. Experimental stress analysis. New york: McGraw-Hill Inc; 1991. p.479-502
24 Cune MS, de Putter C, Hoogstraten J. Treatment outcome with implant- retained overdentures. Part I-Clinical findings and predictability of clinical treatment outcome. J Prosthet Dent 1994: 72: 144-51
25 Mericske-Stern R, Geering AH, Buergin WB, Graf H. Three dimensional force measurements on mandibular implants supporting overdentures. Int J Oral Maxillofac Implants 1992; 7: 185-94   PUBMED
26 Gunne H, Bergman B, Enbom L, Hogstrom J. Masticatory efficiency of complete denture patients. Acta Odontol Scand 1982:40:289-97
27 Johns RB, Jemt T, Heath MR, et al. A multicenter study of overdentures supported by Bra nemark implants. Int J Oral Maxillofac Implants 1992:7: 513-22
28 Kenney R, Richards M. Photoelastic stress patterns produced by implant- retained overdentures. J Prosthet Dent 1998;80:559-64   DOI   ScienceOn
29 Skalak R. Aspects of biomechanical considerations. In: Branernark P-I, Zarb GA. Albrektsson T. editors. Tissue integrated prostheses: Osseointegration in clinical dentistry. Chicago: Quintessence: 1985. p.117-28
30 Meijer HJA, Starmans FJM, Steen WHA, Bosman F. Locations of implants in interforaminal region of the mandible and consequences for the design of the superstructure. J Oral Rehabil 1994;21:47-56.   DOI   ScienceOn
31 Hutton JE, Heath MR, Chai JY. et al. Factors related to success and failure rates at 3-year follow-up in a multicenter study of overdentures supported by Bra nemark implants. Int J Oral Maxillofac Implants 1995:10:33-42
32 Adell R, Lekholm B, RockIer B, Br nemark P-I. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981: 10:387-416
33 Ericsson I, Lekholm U, Branemark P-I. A clinical evaluation of teeth and osseointegrated titanium implants. J Clin Periodontol 1986: 13: 307-12
34 Meijer HJA, Kuiper JH. Starmans FJM, Bosman F. Stress distribution around dental implants: Influence of superstructure, length of implants, and height of mandible. J Prosthet Dent 1992: 68: 96-102
35 Menicucci G, Lorenzetti M, Pera P, Preti G. Mandibular implant-retained overdenture: finite element analysis of two anchorage systems. Int J Oral Maxillofac Implants 1998: 13: 369-76
36 Kinni ME. Hokama SN, Caputo AA. Force transfer by osseointgrated implants devices. Int J Oral Maxillofac Implants 1987: 2: 11-4
37 Parel SM. Implants and ovsdentures: The osseointegrated approach with conventional and compromised applications. Int J Oral Maxillofac Implants 1986:1:93-9
38 Hemmings KW, Schmit A, Zarb GA. Complications and maintenance require ments for fixed prostheses and overdentures in the edentulous mandible: a 5-year report. Int J Oral Maxillofac Implants 1994: 9: 191-96
39 Shin KH. Jeong CM. Jeon YC. Hwang HS. A Three dimensional photoelastic stress analysis of implant supporting bone tissue according to design of attachments used for mandibular overdenture using two osseointegrated implants. J Korean Acad Prosthodont 1996: 34: 31-69
40 Batenburg RHK, Meijer HJA, Raghoebar GM, Vissink A. Treatment concept for mandibular overdentures supported by endosseous implants: A literature review. Int J Oral Maxillofac Implants 1998: 13: 539-45
41 Adell R, Long-term treatment results. In: Branemark P-I, Zarb GA, Albrektsson T, editors. Tissue integrated prostheses: Osseointegration in clinical dentistry. Chicago: Quintessence: 1985. p.175-86
42 Zarb GA. Schmitt A. The edentulous predicament. I: a prospective study of the effectiveness of implant supported fixed prostheses. J Am Dent Assoc 1996: 127: 59-65
43 Helkimo E, Carlsson GE, Helkimo M. Bite force and state of dentition Acta Odontol Scand 1977:35:297-303
44 Goodacre CJ. Kan JYK, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999:81 :537-52
45 Ichikawa T, Horiuchi M, Wigianto R, Matsumoto N. In vitro study of mandibular implant-retained overdentures The influence of stud attachments on load transfer to the implant and soft tissue. Int J Prosthodontol 1996:9:394-9
46 Albrektsson T, Dahl E, Enbom L, et al. Osseointegrated oral implants: A Swedish multicenter study of 8139 consecutively inserted Novelpharma implants. J PeriodontoI 1988:59:287-96
47 van Steenberghe D, Calberson L, Verbist D. A two and a half year follow-up study on the rehabilitation in edentulous lower jaws with osseointegrated fixtures, supported bridges and dentures. J Head Neck Pathol 1985:4: 108-10
48 Quirynen M. Naert I, van Steenberghe D. Fixture design and overload influence marginal bone loss and fixture success in the Bra-nemark system. Clin Oral Implants Res 1992:3:104-11
49 Mericske-Stern R, Piotti M, Sirtes G. 3D in vivo force measurements on mandibular implants supporting overdentures. A comparative study. Clin oral Implants Res 1996: 7: 387-96
50 French AA, Bowlers CQ, Parharm PL, et al. Comparison of peri-implant stresses transmitted by four commercially available osseointegrated implants. Int J Periodontics Restorative Dent 1989: 9: 2219
51 Albrektsson T. A multicenter report on osseointegrated oral implants. J Prosthet Dent 1988:60:75-84
52 Albrektsson T, Zarb GA, Worthington P, Eriksson AR. The long term efficiency of currently used dental implant : A review and proposed criteria of success. Int J Oral Maxillofac Implants 1986: 1: 11-25
53 Naert I, Quirynen M, Theuniers G. van Steenberghe D. Prosthetic aspects of osseointegrated fixtures supporting overdentures. A 4-year report. J Prosthet Dent 1991:65:671-80
54 Lekholm U. Zarb GA. Patient selection and preparation. In: Branernark P-I. Zarb GA. Albrektsson T. editors. Tissue integrated prostheses: Osseointegration in clinical dentistry. Chicago: Quintessence: 1985. p.199-209
55 Meijer HJA, Starmans FJM, Steen WHA. A three-dimensional finite element study on two versus four implants in an edentulous mandible. Int J Prosthodont 1994:7:271-9
56 Carr A, Laney WR : Maximum occlusal force levels in patients with osseointegrated oral implant prostheses and patients with complete dentures. Int J Oral Maxillofac Implants 1987:2:101-10
57 Jemt T, Book K, Linden. Urde G. Failures and complications in 92 consecutively inserted overdentures supported by Bra nemark implants in severely resorbed edentulous maxillae: a study from prosthetic treatment to first annual check-up. Int J Oral Maxillofac Implants 1992: 7: 162-7
58 Jeong CM, Caputo AA, Wylie S. Sohn SS. Effect of cortical engagement on implant load transfer. [abstract 41) J Dent Res 1995: 74(special issue)
59 Zitzmann NU, Sch rer P. Oral rehabilitation with dental implants: Clinical compendium. Vol III. Zurich: KBM; 1997. p.25. 97
60 Misch CE. Prosthetic options in implant dentistry. In: Misch CE. Contemporary implant dentistry. 2nd ed., Missouri: CV Mosby: 1999. p.67-72
61 Mericske-Stern R, Venetz E. Fahrlander F. Burgin W. In vivo force measurements on maxillary implants supporting a fixed prosthesis or an over denture: A pilot study. J Prosthet Dent 2000; 84: 535-47   DOI   ScienceOn
62 Kim JH, Jeong CM, Jeon YC, Lim OK. Effect of development of supporting bone and mechanical property of implant abutment on stress distribution at osseointegrated interface in mandibular posterior fixed prostheses using implant : A finite element analysis. J Korean Acad Stomat Occ 1998; 14: 199-212
63 Zarb GA, Jansson T, Jemt T. Other prosthodontic applications. In: Branemark P-I, Zarb GA, Albrektsson T, editors. Tissue integrated prostheses: Osseointegration in clinical dentistry. Chicago: Quintessence: 1985, p. 283-92
64 Kang JM, Yang MS. Photoelastic stress analysis on the mandible caused by implant overdenture. J Korean Acad Prosthodont 1994:32:327-53
65 Tolman DE. Laney WR. Tissue-integrated dental prosthesis: the first 78 months of experience at the Mayo Clinic. Mayo Clinic Proc 1993:68:323-31
66 Federick D. Caputo AA. Effects of overdenture retention designs and implant orientations on load transfer characteristics. J Prosthet Dent 1996:76:624-32
67 Sutherland JK, Holland GA, Sluder TB, White JT. A photoelastic analysis of the stress distribution in bone supporting fixed partial dentures of rigid and nonrigid design. J Prosthet Dent 1980:44:616-23
68 Haraldson T, Karlsson D, Carlsson GE. Bite force and oral function in completedenture wearers. J Oral Rehabil 1979: 6: 41-8
69 Versteegh PA van Beek GJ, Slagter AP, Ottervanger JP. Clinical evaluation of mandibular overdentures supported by multiple-bar fabrication: a follow-up study of two implant systems. Int J Oral Maxillofac Implants 1995: 10: 595-603
70 Mericske-Stern R. Clinical evaluation of overdenture rstorations supported by osseointegrated titanium implants: A retrospective study. Int J Oral Maxillifac Implants 1990:5:375-83
71 Jeong CM, Lee HY. A finite element stress analysis of the stress distribution and the short absorption in an osseointegrated implant-natural teeth supported fixed partial denture. J Korean Acad Prosthodont 1992;30:582-606
72 van Steenberghe D, Quirijnen M, Calberson L, Demanet M. A prospective evaluation of the fate of 697 consecutive intraoral fixtures modum Branemark in the rehabilitation of edentulism. J Head Neck Pathol 1987:6:53-8
73 Schroeder A, Maeglin B, Sutter F. Das ITI-Hohlzylinderimplantat Typ F zur Prothesenretention beim zahnlosen Kiefer. Schweiz Mschr Zahnheilk 983:93: 720-33