An In Vivo Study on Load Distribution in Different Implant Configurations for Supporting Fixed Partial Dentures

Purpose: The aims of this study were to develop a device for in vivo measurement of three-dimensional (3D) loads on implants and to investigate the effects of implant configuration on the load distribution under a three-unit fixed partial denture (FPD). Materials and Methods: A 67-year-old female patient with three implants (in the mandibular left second premolar, first molar, and second molar regions) was recruited. Four implant configurations for a three-unit FPD depending on the number and position of the implants were considered in this study. They included a three-implant prosthesis and three types of two-implant prosthesis: a central pontic, posterior cantilever, and anterior cantilever, with the same superstructure (splinted three crowns) for the same occlusal contact. Customized abutments and 3D piezoelectric force transducers were fixed to the implants of the four configurations with the superstructure. The loads on the implants were recorded during maximum voluntary clenching (MVC-test) and when chewing a piece of chewing gum (GUMtest). Results: The occlusal forces on the dental arch during MVC-test with the four implant configurations did not exhibit significant differences. In the three-implant prosthesis, there were no significant differences in the mean maximum resultant load on each implant in both tests. In the central pontic, the load on the second premolar was significantly greater than that on the second molar in the MVC-test but there were no significant differences in the GUM-test. High loads were detected on the first molar in both the posterior cantilever and anterior cantilever. The highest load was detected on the first molar in the posterior cantilever during the GUMtest. Conclusion: The in vivo 3D load-measuring device using the piezoelectric force transducers enabled the measurement of the functional load on implants supporting a FPD. The results suggested, within the limitations of this study, that a three-implant prosthesis and central pontic provide biomechanically beneficial designs compared with the posterior cantilever and anterior cantilever in terms of the equal distribution of loads on supporting implants. Keywords: dental implant, fixed partial denture, occlusal force, transducers