Sm. Heckmann et al., Overdenture attachment selection and the loading of implant and denture-bearing area. Part 2: A methodical study using five types of attachment, CLIN OR IMP, 12(6), 2001, pp. 640-647
In general, an implant is loaded via axial and horizontal forces. Besides t
his, moment loading can also occur. The aim of this study was to investigat
e how different prosthetic connectors with overdentures develop force trans
fer to implant and bone as well as to the denture-bearing alveolar ridge. F
ive connectors were investigated on a stereolithographic model fabricated a
ccording to a real patient situation. The model was fitted with strain gaug
es on the "bone" distal and medial to the implants and with vertical force
transducers in the alveolar "bone" under the denture-bearing area. The para
llel-sided rigid telescopic connector developed the highest moment loading
of the implant (P <0.001), which would suggest restraint in the use of this
connector. The bar construction also showed somewhat high moments but thes
e may have been at least partly exaggerated by the individual patient situa
tion. Loading results through the non-rigid telescopic copings, single sphe
rical attachments and magnet overdentures demonstrated a low level of impla
nt moment loading which would in part result from horizontal forces caused
by denture forward shift during force application. The denture-bearing area
loading was different with all attachments (P <0.001) and was related to t
he rigidity of the connector and reached the highest values with the non-ri
gid telescopic coping. The clinical implications of the various findings ar
e discussed.