Photoelastic analysis of the effect of palatal support on various implant-supported overdenture designs.

Abstract

The effect of palatal support on various types of implant-supported maxillary overdenture designs has not been sufficiently assessed. The purpose of this study was to photoelastically evaluate the palatal support of 3 designs of maxillary implant-supported overdentures. A photoelastic model of an edentulous maxilla was fabricated with four 3.75 x 13-mm 3i implants. Three maxillary overdenture designs were fabricated: a splinted Hader bar incorporating 2 distal ERA attachments with anterior clips; non-splinted Zaag 4-mm direct abutments and attachments; and nonsplinted Locator 2-mm direct abutments and attachments. All restorative components and attachments were fitted and observed for passivity of fit and alignment. The overdentures were first tested with complete palatal coverage. Unilateral 25-lb loads were applied at the left and right first molars and the incisive papilla area. The photoelastic effects were monitored and recorded photographically. The palatal area was removed from the 3 overdentures and the loading regimens were repeated. The highest stresses under central loading were seen with the splinted Hader bar and complete palatal coverage, followed by similar levels of stress with either Zaag or Locator attachments. After removal of the palate, the center load demonstrated greater differences between designs. The highest stresses were observed with the Hader bar, followed by the Zaag and then Locator attachments. Lack of palatal coverage demonstrated higher levels of stress around implants and visible supporting tissues. The unilateral load produced the highest stress for the splinted Hader bar, followed by Locator, and then Zaag. Removal of the palatal support produced a greater effect and more concentrated stress difference for maxillary overdentures than differences between the attachment designs tested.