A photoelastic stress analysis of fixed partial dentures with endopore implants according to splinting, contact tightness, and crown length

Jeong, Hoe Yeol; Choi, Min Ho; Kim, Yu Lee; Cho, Hye Won

Abstract

STATEMENT OF PROBLEM: A difficulty in achieving a passive-fitting prosthesis can be overcome by individual crown restoation of multiple implants. But individualized crown has another difficulty in control of contact tightness and stress distribution. PURPOSE: This in vitro study is to evaluate the stress distribution and the magnitude in the supporting tissues around Endopore implants with different crown lengths, interproximal contact tightness, and the splinting effects. MATERIAL & METHODS: Three Endopore implants(4.1*9 mm) were placed in the mandibular posterior edentulous area distal to the canine and photoelastic model was made with PL-2 resin(Measurements Group, Raleigh, USA). Restorations were fabricated in two crown lengths: 9, 13 mm. For non-splinted restorations, individual crowns were fabricated on three custom-milled titanium abutments. After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal(8 micrometershim stock drags without tearing), medium(40 micrometer), and heavy(80 micrometer). For splinted restorations, 3-unit fixed partial dentures were fabricated. This study was examined under simulated non-loaded and loaded conditions(6.8 kg). Photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure. RESULTS: 1. When restorations were not splinted, the more interproximal contact tightness was increased among the three implants, the more stress was shown in the cervical region of each implant. When crown length was increased, stresses tended to increase in the apex of implants but there were little differences in stress fringes. 2. When nonsplinted restorations were loaded on the first or third implant, stresses were increased in the apex and cervical region of loaded implant. Regardless of interproximal contact tightness level, stresses were not distributed among the three implants. But with tighter interproximal contact, stresses were increased in the cervical region of loaded first or third implant. 3. When the nonsplinted restorations were not loaded, there were little stresses on the supporting structure of implants, but low level stresses were shown in the splinted restorations even after sectioning and soldering. 4. With splinted restorations, there were little differences in stresses between different crown lengths. When splinted restorations were loaded, stresses were increased slightly on the loaded implant, but relatively even stress distribution occurred among the three implants. CONCLUSIONS: Splinting the crowns of adjacent implants is recommended for Endopore implants under the overloading situation.