Heng-Li Huang

Jehn-Shyun Huang
Ching-Chang Ko
Jui-Ting Hsu
Chih-Han Chang
Michael Y. C. Chen

Effects of splinted prosthesis supported

a wide implant or two implants:
a three-dimensional finite
element analysis

Authors affiliations:
Heng-Li Huang, Jui-Ting Hsu, Chih-Han Chang,
Institute of Biomedical Engineering, National
Cheng Kung University, Tainan, Taiwan
Ching-Chang Ko, Department of Oral Science,
University of Minnesota School of Dentistry,
Minneapolis, MN, USA
Jehn-Shyun Huang, Institute of Oral Medicine,
National Cheng Kung University, Tainan, Taiwan
Michael Y. C. Chen, Department of Oral &
Maxillofacial Surgery, China Medical University
Hospital, Taichuang, Taiwan

Key words: finite element analysis, oral implants, splinted crowns

Correspondence to:
Chih-Han Chang
Institute of Biomedical Engineering
National Cheng Kung University
No. 1 Ta-Hsueh Road
Tainan 701
Taiwan
Tel.: 88-66-2757575-63427
Fax: 88-66-2343270
e-mail: cchang@mail.bme.ncku.edu.tw

respectively. One standard implant was placed at the premolar region, while three types of

Abstract
Objectives: Three-dimensional finite element (FE) models of splinted prosthetic crowns
were studied and stress analyses were evaluated with different types of implant support,
including standard, wide or two implant(s) for partial, posterior edentulous restorations.
Material and methods: The FE models were constructed based on a cadaver mandible
containing the 2nd premolar and the 1st molar. The crowns of these two teeth were
modeled as connected and disconnected to mimic the splinted and non-splinted designs,
implant support, one at a time (the standard implant, wide implant and two implants),
were used to support the molar crown. A 100 N oblique load was applied to the buccal cusp
on each crown. The FE simulation was validated experimentally via strain gauge
measurement.
Results: The experimental data were well correlated with the FE predictions (r2 0.97).
When compared with the standard implant used in the molar area, the wide implant and
two implants reduced the peak stress in crestal bone by 2937% for both splinted and nonsplinted cases. Inserting the standard implant into both the premolar and molar area, the
bone stresses were identical for splinted and non-splinted designs. However, splinting the
adjacent crowns has shown to decrease the bone stresses at the premolar region by 25%,
while the wide implant or two implants were placed at the molar region.
Conclusion: The biomechanical advantages of using the wide implant or two implants are
almost identical. The benefit of load sharing by the splinted crowns is notable only when
the implants on the premolar and molar regions have different supporting ability.

Date:
Accepted 7 July 2004
To cite this article:
Huang H-L, Huang J-S, Ko C-C, Hsu J-T, Chang C-H,
Chen MYC. Effects of splinted prosthesis supported a
wide implant or two implants: a three-dimensional
finite element analysis.
Clin. Oral Impl. Res. 16, 2005; 466472
doi: 10.1111/j.1600-0501.2005.01124.x

Copyright r Blackwell Munksgaard 2005

466

Implant-based restorations for molar teeth

present a challenging area in biomechanical
research. This is primarily due to the complicated implant-prosthetic structures and
the complexity of stress-related bone adaptation. In the molar region, large chewing
forces occur that can be detrimental to the
prostheses and alveolar bone (Rangert et al.
1995; Ishigaki et al. 2003). This may induce marginal bone loss and decrease implant stability, thus imperiling the implant
and its supra-structures (Brunski 1999;
Miyata et al. 2000).

Three designs widening the diameter of

implant, using two implants or splinting the
crowns have been suggested to improve the
biomechanical performance of implant-supported molar restorations. Studies reported
that using wider implants could decrease the
percentage of failures (van Steenberghe et al.
1990; Davarpanah et al. 2001) and increase
the removal torque (Ivanoff et al. 1997).
Likewise, using two implants to support a
single crown could reduce the rotational
moment (Bahat & Handelsman 1996) and
decrease implant mobility (Balshi et al.

Huang et al . Stress analysis of implant & prostheses designs

1996). Splinting the adjacent prosthetic

crowns was also used to decrease peak stresses by load sharing (Guichet et al. 2002).
Each of these three designs has its own
advantages. However, the biomechanical
criteria for choosing one design over the
others have not been defined. It has been
stipulated that using a large diameter of
implants and two implants can increase
stiffness of the implant(s) and bone-to-implant contact surfaces (Langer et al. 1993;
Balshi & Wolfinger 1997). Nevertheless,
the use of wide-diameter implants could
lead to bone loss when narrow posterior
ridges exist (Davarpanah et al. 2001).
Higher failure rates for wide implant have
been found in clinical reports (Ivanoff et al.
1999; Attard & Zarb 2003). Furthermore,
the stress states in the narrow space of bone
between the two implants are unclear.
Studies on the crown splinting showed
controversial results, which require further
investigation. (Herbst et al. 2000; Guichet
et al. 2002; Naert et al. 2002).
The aim of this study was to compare the
biomechanics between standard implants,
wide implants and two implants supports
with and without splinting the prosthetic
crowns for posterior, fixed, partial dentures
using three-dimensional (3D) finite element
(FE) analyses. The experimental strain
gauge analysis (ESGA) was also performed
to validate the FE simulation.

Table 1. Design parameters of dental implant and prostheses on posterior partial edentulous (2nd premolar and 1st molar) restoration
Model

Layouts of implants

Spl-S

2nd premolar

Types of prostheses
1st molar

Splinting prosthetic crowns

Non-splinting prosthetic crowns

nSpl-S

3.75 mm
Splinting prosthetic crowns

Spl-T
nSpl-T
Spl-W

6.25 mm
5.0 mm

nSpl-W

Non-splinting prosthetic crowns

Splinting prosthetic crowns
Non-splinting prosthetic crowns

Spl, splinted crown; nSpl, non-splinted crown; S, standard implant; T, two implants; W, wide implant.

images) of the above-mentioned human

mandible were obtained. An in-house image processing program was used to detect
the boundaries of various materials, i.e.,
the crown, cortex, as well as cancellous
bone, from each CT image. This program
uses various thresholds in CT number and
gradient values to separate different materials. A depth-first search algorithm (Huang
et al. 2002) is used to detect the contours of
each material. The mandible model was
rendered using ANSYS (Swanson Analysis
Inc., Huston, PA, USA) in which cylinder
holes were removed for the incorporation
of implants as described below. Clinically,
because of the limited buccolingual mandibular width in the premolar region, the
standard size implant was selected for this
area.

To investigate the effects of crown

splinting and various molar implant supports, three implant support conditions
(standard implant, wide implant and two
implants) combined with two crown states
(splinted and non-splinted crown) were
modeled. In total, six FE models constructed with 10-node tetrahedral p-element (ANSYS solid 148) were generated.
To label these models, two sets of symbols
were used. The first set of the symbol
indicates the splint factor: Spl for splinted
and nSpl for non-splinted. The second set
of the symbol represents the implants
configurations, i.e., S for standard implant,
W for wide implant and T for two implants. Table 1 summarizes the notations
of these six models. The FE models of SplS, Spl-T and nSpl-W are shown in Fig. 1.

Material and methods

A posterior portion of a human cadaver
mandible containing the second premolar
and the first molar was used to construct
the FE model of alveolar bone. This mandible segment was approximately 32 mm
mesiodistally, 12 mm buccolingually at the
premolar site and 15 mm buccolingually at
the molar site. The bone height was 36 mm.
Cylindrical implants were used IMZ (FRIADENT AG, Manheim, Germany). This is
3.75 mm in diameter for the standard implant and 5 mm in diameter for the wide
implant. The length of the implant was fixed
at 12 mm. The detailed geometry and components of the implant were omitted and the
cylindrical root was modeled.
3D FE analyses

Computer tomography (CT) images of

frontal plane (1 mm interval between

Fig. 1. Illustrations of (a) Model Spl-S, the splinted crown were supported by one standard implant at the 1st
molar site and one standard implant at the 2nd premolar site. The oblique loads (100 N each) were applied on
the buccal functional cusps. (b) Model Spl-T, the splinted crown were supported by two standard implants at
the 1st molar site and one standard implant at the 2nd premolar site. (c) Model nSpl-W, the non-splinted crowns
were supported by one wide implant at the 1st molar site and one standard implant 2nd at the premolar site. Spl,
splinted crown; nSpl, non-splinted crown; S, standard implant; T, two implants; W, wide implant.

467 |

Clin. Oral Impl. Res. 16, 2005 / 466472

Huang et al . Stress analysis of implant & prostheses designs

To examine the convergence level, the

p-value of the p-element was set to be
bounded between 2 (initial value) and 8
until the convergence was accomplished.
The p-level tolerance for convergence criteria was set as the global strain energy
change less than 5%.
Material properties of the cortical and the
cancellous bone of the six models were
applied as transversely isotropic and linearly elastic (OMahony et al. 2001) while
the materials of implant and prosthetic
crown were assumed to be isotropic, and
linearly elastic (Sertgoz & Guvener 1996;
Ciftci & Canay 2000). All materials properties are listed in Table 2. The bite forces
were applied to buccal cusps of two prosthetic crowns with 451 bucccal inclination
(Fig 1). The load magnitudes were 100 N
for each site. The boundary condition
was constrained at the bottom surface of
the mandibular bone in all directions. The
boneimplant interface was identified as
bonded in all models to simulate osseointegration.
The mesh model Spl-S was further used
for the experimental validation. In this
model, the material properties, loading
and boundary conditions were re-assigned
based on the experimental setup described
in the next paragraph. The principal strains
of this validation model were compared
with those measured from the experiments. The surface nodes on the lingual
mandible near the implant, corresponding
to the measured areas of experimental
strain gauges, were selected to calculate the mean principal strains for the
comparison.
ESGA

Using the acrylic resin (Tempron, GC,

Kasugai, Japan), a posterior mandibular
sample was duplicated from the same mandibular cadaver used in the FE modeling.
The splinted second premolar and first
molar crown (crown type of Model Spl-S)
was also replicated with another acrylic
resin (Luxatemp, DMG, Hamburg, Germany). The material properties of these
two resins were measured by the uni-axial
compressive test on cube specimens that
were plastered with bi-axial strain gauges.
The Youngs modulus was calculated from
the slope of the stress-strain curve within
the elastic region. The Poissons ratios
were obtained from the quotient of the

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Clin. Oral Impl. Res. 16, 2005 / 466472

Table 2. Material properties of the finite element models

Material

Youngs modulus
E (MPa)

Poissons
ratio n

Shear modulus
G (MPa)

Cortical bone

Ex 12,600

nxy 0.3
nyz 0.253
nxz 0.253
nyx 0.3
nzy 0.39
nzx 0.39
nxy 0.055
nyz 0.01
nxz 0.322
nyx 0.01
nzy 0.055
nzx 0.322
0.35
0.19

Gxy 4850

Ey 12,600
Ez 19,400
Cancellous bone

Ex 1148
Ey 210
Ez 1148

Titanium
Porcelain

110,000
70,000

Gyz 5700
Gxz 5700
Gxy 68
Gyz 68
Gxz 434

The vectors of x, y and z indicate the buccolingual, infero-superior and mesiodistal direction,
respectively.

Table 3. Youngs Modulus and Poissons ratio of each material of the experimental model
was assigned to the validation finite element model
Material

Youngs modulus E (MPa)

Poissons ratio n

Resin (temporon)
Resin (Luxa temp)
Steel (ASTM-A242)

2979
6880
200,000

0.4
0.4
0.3

transverse (et) and axial (ea) strains, that

is, n et/ea. These material properties are
listed in Table 3 and were used in the
validation FE model mentioned above.
Two stainless steel cylinders (diameter
3.75 mm, length 12 mm), mimicking the
implants, were embedded in the mandibular model with the splinted crown. Two
single-axis strain gauges (KFG-1-120-C111L1M2R, KYOWA, Tokyo, Japan) were
cemented on the lingual side of mandibular
model near the implant with cyano-acrylate cement (CC-33A, KYOWA), oriented
toward the directions of the minimal principal strain obtained from the validation FE
model (Fig. 2).
In order to evaluate various loading effects, a clamping jig was designed with an
adjustable screw-system so that the vertical load could be transferred into an oblique
load on the implant/mandible construct.
On the premolar crown and the molar
crown, a force was applied either at the
center fossa with vertical direction or at the
buccal cusp with 451 buccal inclination;
hence, in total, there were four loading
conditions (Table 4). For each of these
four loading cases, two force magnitudes,
100 and 200 N, were applied. The strain
values were recorded through the data ac-

Fig. 2. The strain gauges were attached on the lingual side of the experimental mandibular mold. The
resistors of each strain gauge were set along the
direction of minimum principal strains obtained
from the finite element model. Arrows indicate
the four loading points (dimples) located on the
central fossa and functional cusps.

quisition system (instruNet Hardware,

GW instruments, Inc., Somerville, MA,
USA). Each measurement was repeated
three times.

Results
Table 4 shows the minimum (compressive)
principal strains in the experimental model
and the validation FE model under the four
loading conditions. In general, the experi-

Huang et al . Stress analysis of implant & prostheses designs

Loaded position

Implant no.

100
100
100
100
100
100
100
100
200
200
200
200
200
200
200
200

Pre-BC
Pre-BC
M-BC
M-BC
Pre-CF
Pre-CF
M-CF
M-CF
Pre-BC
Pre-BC
M-BC
M-BC
Pre-CF
Pre-CF
M-CF
M-CF

1
2
1
2
1
2
1
2
1
2
1
2
1
2
1
2

Experiment (me)
MS

SE

759
387
219
729
164
25
27
211
1527
792
488
1393
335
53
43
377

49
4
10
11
7
7
3
7
32
4
3
12
7
14
6
7

FEM (me) strains

610
415
240
606
128
46
33
120
1219
829
479
1325
255
91
66
240

Pre-BC, buccal cusp of the 2nd premolar; M-BC, buccal cusp of the 1st molar; Pre-CF, central fossa of
the 2nd premolar; M-CF, central fossa of the 1st molar.

mental strains were higher than the simulated strains and the differences were 10%
to 50%. However, comparing within all
loadings, the experimental and simulated
results did show a consistent relationship.
This indicated a high correlation between
the experimental and the FE approaches
(r2 0.97). Moreover, the experimentally measured compressive strains were
doubled when the loading increased from
100 to 200 N, which indicated the linear
status of this model.
Figure 3 shows the von Mises stress
distributions on the cortical bone of the six
FE models. High stresses were located at the
alveolar crest around the implants, which
matched the clinical observations of crestal
bone loss (Rangert et al. 1995). In addition,
no stress was concentrated at the space
between the two implants of two-implant
models (Models Spl-T and nSpl-T).
The peak von Mises stresses on the
cortical bone around each implant of the
six models are shown in Fig. 4. With
the splinted prosthesis, the peak stresses
of bone at the first molar region decreased
by 29% in Model Spl-T and 31% in Model
Spl-W, respectively, as compared with
Model Spl-S. Likewise, with non-splinted
prosthetic crowns, the peak stresses of
bone at the first molar region were reduced
by 37% in Model nSpl-T and 35% in
Model nSpl-W, respectively, as compared
with Model nSpl-S. However, the peak
stress difference between the wide implant

Maximum EQV (Mpa)

Load (N)

Implant 1
120
100
80
60
40
20
0

b
Maximum EQV (Mpa)

Table 4. The mean microstrains (MS) and standard error (SE) measured form the experimental in vitro test, which were compared with strains of the validation finite element
model (FEM)

Spl-S
Implant 1

Implant 2

Spl-T
Implant 2

Implant 3

Spl-W
Implant 3

120
100
80
60
40
20
0
nSpl-S

nSpl-T

nSpl-W

Fig. 4. The peak von Mises stress of cortical bone

around each implant for (a) the splinted crown and
(b) the non-splinted crown. Implant 1 is placed in
the 2nd premolar region while Implant 2 and Implant 3 are placed in the 1st molar region. Spl,
splinted crown; n-Spl, non-splinted crown; S, standard implant; T, two implants; W, wide implant.

Spl-T) decreased by 25% as compared with

non-splinted crown (Model nSpl-T). In the
wide implant models, the peak stress at
premolar region decreased by 36% on comparing Model Spl-W with Model nSpl-W.
This demonstrated that the splinted factor is
vital only if the support of the implant at the
first molar region is stronger than that at
the premolar region.

Discussion

Fig. 3. The von Mises stress distributions on the

crest bone for the models with (a) splinted crowns
and (b) non-splinted crowns. Spl, splinted crown; nSpl, non-splinted crown; S, standard implant; T, two
implants; W, wide implant.

and two implants, for both splinted and

non-splinted groups, was not significant.
As for the splinting effect, with a standard
implant under molar crown, the differences
of peak bone stresses between Model Spl-S
and Model nSpl-S were not significant at
both premolar and molar regions. However,
in two-implant models, the peak stress at
premolar region for splinted crown (Model

The predicted principal strains by the validation FE model had a trend similar to
those measured from ESGA among all
loadings. The deviations in strain values
between the ESGA and the FE simulation
may be attributed to the measuring error
in material properties, loading locations
and directions between two approaches.
The orientation of the strain gauge, which
does not align perfectly with the direction of
principal strains, may also contribute to the
deviations in strain. However, these deviations proportionally change in response to
the alternation of biomechanical parameters
in the models. For the purpose of comparing
different implant designs, the FE simulation
in this study was, therefore, verified.
The anatomic accuracy of the present FE
models was assured by the computed tomography images. In general, the simu-

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Huang et al . Stress analysis of implant & prostheses designs

lated results of FE modeling depend considerably on the geometric structures of the

models. In previous FE studies, the mandibular model was either simplified as a
rectangular configuration (Stegaroiu et al.
1998; Wang et al. 2002) or constructed by
a digital laser scanner (Ciftci & Canay
2000; Akca & Iplikciogiu 2001). The latter
approach provides accurate surface topography but lacks the cortical shell information, which may over/underpredict stress/
strain distribution of bone around the implant. Further, by introducing the transversely isotropic model (OMahony et al.
2001), the characteristic of bone material
was better reflected.
The use of the wide implant or two
implants in the molar region can provide
the advantage of reducing stress in the
surrounding bone as shown in this study.
This is because of the increased structural
capacity and the enlarged boneimplant
contact area offered by these implants.
Balshi et al. (1996) indicated that a molar
crown supported by a standard size implant
can easily introduce large bending moments to bone because the dimension of
the crown is usually greater than the diameter of the implant. Therefore, the wide
implant or two implants are suggested for
placement at the molar region to reduce
the possibility of overload, which may lead
to implant failure associated with the marginal bone loss (Rangert et al. 1995).
However, whether the wide-diameter implant (D 5 mm) or two implants (D
3.75 mm) is preferred for the edentulous
molar restoration is still an issue. Based on
the outcomes of this study, differences
between these two treatments are not significant. Therefore, with sufficient posterior mandibular bone width (buccallingual
direction), the wide implant is suggested to
reduce the surrounding bone stress due
to the simplicity of its surgical procedures.
However, according to the report of Davarpanah et al. (2001), placing the wide implants in narrow posterior ridges can lead to
marginal bone loss that may raise the risk
of implant failure. Therefore, in the cases
of insufficient posterior mandibular bone
width, two implants are preferred because
the stress reduction by two implants is
about the same as that induced by the
wide implant. Further, the narrow distance
(2.5 mm in this study) between the two
implants of the two-implant treatment

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Clin. Oral Impl. Res. 16, 2005 / 466472

would not increase the bone stress. Nevertheless, it is necessary to note that recent
clinic reports (Ivanoff et al. 1999; Attard &
Zarb 2003) showed that using wide implants could result in higher failure rates
than that of the standard implant. However, the authors pointed out that the failure might be associated with the surface
treatment and shape of the implant and
patients bone quality rather than the usage
of wide implants.
Some scientific data suggested that prosthetic crown splinting had biomechanical
advantage and could raise the success rate
because occlusal force could be shared
through splinted crowns, thus decreasing
the peak-stresses (Guichet et al. 2002;
Wang et al. 2002). However, there is insufficient quantitative evidence to support
this hypothesis. Wang et al. (2002) had
developed simplified FE models to evaluate
this splinting effect and demonstrated that
splinting the prosthetic crowns could reduce stresses in bone. Similar observations
were presented in the study of Guichet
et al. (2002) using photoelastic models.
However, in their simulations the implant
structures were loaded on the premolar
only. When loading is applied to a single
crown and, by splinting the crowns, the
loading would redistribute itself through
the implant under the unloaded crown,
and then the peak stress of bone is decreased certainly. In the present research,
the bite forces were exerted at both functional cusps of two crowns to mimic full
contacts of normal occlusion. The results
of the present study showed that there is no
significant difference between Model Spl-S
and Model nSpl-S; that is, with standard
implants for both premolar and molar, the
splinting effect is minimal. Our result
appears to support clinical observations of
Herbst et al. (2000), who showed a similar
survival rate for the splinted prosthetic
crown and non-splinted prosthetic crowns.
However, we cannot explain why some
clinicians observed higher implant failure
in the splinted cases than in non-splinted
cases (Naert et al. 2002). Further investigations such as crown misfit as proposed by Jemt & Book (1996) may provide some clues and help answer this
question.
However, the combination of one wide
implant or two implants at the molar
region and one standard implant at pre-

molar region provided a notable stresssharing effect when prosthetic crowns

were splinted. By sharing, stresses in premolar regions decreased more than 25%,
which may protect overload damage if
patients have an inadequate bone quality
in their premolar ridge. Therefore, the
splinted prostheses should only be considered when two crowns are held by different
implant supports.
There are limitations associated with the
current simulations. First, only one oblique
force was applied to the models. In reality,
the occlusal force can be multi-directional,
which may complicate the stress situations. However, it has been demonstrated
in this study that using a vertical force, the
trend in stress comparison between different designs remains the same. With a
linear, elastic model used in this study, it
is unlikely that other loading conditions
will yield a different result with regard to
implant designs. Second, the material properties of the mandible were assumed to
be regionally homogenous, which may primarily affect the stress values rather than
the general trends.

Conclusions
FE studies cannot reliably be transferred to
the clinic without clinical trials or further
evidence. However, the FE analysis reflects the underlying mechanical aspect of
a bio-structure. Therefore, the conclusions
of this study should be regarded as a general
principle and useful information to clinicians.
(1)

(2)

Employing wide implant or two implants for posterior partial prostheses

could provide a benefit to reduce stresses in bone. The percentage of stress
reduction is almost identical for both
designs. The narrow space of bone
between the two implants of the
two-implant treatment does not provoke stress concentration. The selection between these two treatments
can be based on the anatomic conditions rather than their biomechanical
effects.
The advantage of load sharing by the
splinted prosthetic crowns is not absolute. It is notable only when the supporting implants of the two crowns
have a significant difference in biome-

Huang et al . Stress analysis of implant & prostheses designs

chanics, such as using the standard

implant on premolar region and the
wide or two implants on the molar
region.

Acknowledgement: This research was

supported by Grant NSC 92-2320-B-006058 from National Science Council,
Taiwan, Republic of China.

Resume
Des mode`les delements finis (FE) tridimensionnels
de couronnes prothetiques attaches ont ete etudies et
les analyses de stress ont ete evalues avec differents
types de support dimplants comprenant le standard,
le large ou deux implants pour des restaurations
posterieures partielles. Les mode`les FE ont ete construits sur base de mandibule de cadavre contenant
deux premolaires et une molaire. Les couronnes de
ces deux dents ont ete modelees comme connectees
et non-connectees pour mimer respectivement les
mode`les avec attache ou sans. Un implant standard a
ete place dans la region premolaire tandis que trois
types dimplants supportaient en un temps (limplant standard, limplant large et deux implants) ont
ete utilises pour porter la couronne molaire. Une
charge oblique de 100 N a ete appliquee sur la
cuspide vestibulaire de chaque couronne. La simulation FE a ete validee experimentalement via une
mesure par jauge de force. Les donnees experimentales etaient en bonne correlation avec les previsions
FE (r2 0,97). Compares a` limplant standard utilise
dans la zone molaire, limplant large et la combinaison de deux implants reduisait le pic de stress dans
los crestal de 29 a` 37% tant dans les cas attaches
que non-attaches. En inserant limplant standard
dans la zone premolaire et molaire, le stress osseux
etait identique pour les mode`les attaches et nonattaches. Cependant, lattache reliant les couronnes
adjacentes saccompagnait dune dimininution des
stress osseux dans la region premolaire de 25%,
tandis que limplant large ou les deux implants
etaient places dans la region molaire. Les avantages
biomecaniques de lutilisation dun implant large ou
de deux implants sont quasi identiques. Le benefice
dune charge partagee par les couronnes solidarisees
nest visible que lorsque les implants des regions
premolaires et molaires ont des capacites de support
differentes.

Zusammenfassung
Ziel: Bei der Rekonstruktion von Lucken im hinteren Seitenzahnbereich untersuchte man in einem

dreidimensionalen Finiteelement-Modell (FE) zementierte Kronen und wertete in Belastungs-Analysen verschiedene Implantatabstutzungen aus, namlich auf Standardimplantaten, Wide neck-Implantaten
oder auf zwei Implantaten.
Material und Methoden: Das FE-Modell basierte
auf den Werten eines Leichenunterkiefers in der
Region des zweiten Pramolaren und ersten Molaren.
Die Kronen auf diesen beiden Zahne wurden jeweils
zusammenhangend und einzeln modelliert, so dass
man die verblockte und unverblockte Situation
nachempfinden konnte. In der Pramolarenregion
implantierte man ein Standartimplantat. In der
Molarenregion wahlte man jeweils eine von drei
verschiedenen Varianten der Abstutzung fur die
Kronen: ein Standardimplantat, ein Wide neck-Implantat oder zwei Implantate. Auf den buccalen
Hocker jeder Krone liess man schrag eine Kraft
von 100 N auftreffen. Die FE-Simulation eichte
man experimentell mit Hilfe von Dehnmessstreifen.
Resultate: Die experimentellen Daten korrelierten
sehr gut mit den FE-Voraussagen (r2 0.97). Verglich man die in der Molarenregion verwendeten
Standartimplantate mit den Wide neck-Implantaten
und zwei Implantaten, so reduzierte sich die Spitzenbelastung im crestalen Knochen um 2937%,
bei den verblockten wie auch bei den unverblockten
Versionen. Setzte man sowohl im Pramolaren wie
auch im Molarengebiet Standardimplantate, so war
die Knochenbelastung fur die verblockte wie auch
fur die unverblockte Version gleich gross. Wenn aber
das Wide neck-Implantat oder zwei Implantate in
der Molarenregion gesetzt worden waren, so vermochte die Verblockung der Implantat-Kronen die
Knochenbelastung in der Pramolarenregion um
25% zu senken.
Zusammenfassung: Ob man das Wide neck-Implantat oder zwei Implantate verwendet, die biomechanischen Vorteile sind beinahe identisch. Man
erreicht durch das Verblocken von Kronen erst
dann einen spurbaren Vorteil bezuglich Lastenverteilung, wenn die Implantate in der Pramolarenund Molarenregion verschiedene Tragfahigkeiten
aufweisen.

soportar la corona molar se colocaron tres tipos de

implantes, uno a la vez, (un implante estandar, un
implante ancho y dos implantes). Se aplico una carga
oblicua de 100N en la cuspide bucal de cada corona.
La simulacion de elementos finitos se valido experimentalmente por medio de medicion de tension.
Resultados: Los datos experimentales se correlacionaron bien con las predicciones FE (r2 0.97). Al
comparase a los implantes estandar usados en el area
molar, el implante ancho y dos implantes redujeron
el pico de estres en el hueso crestal en un 2937%
tanto para los caso ferulizados como para los no
ferulizados. Al insertar el implante estandar tanto en
la region premolar como en la molar, los estres oseos
fueron identicos para los disenos ferulizados como
para los no ferulizados. De todos modos, la ferulizacion de las coronas adyacentes mostro un descenso
del estres oseo en un 25%, mientras el implante
ancho o los dos implantes se colocaron en la region
molar.
Conclusion: Las ventajas biomecanicas de usar el
implante ancho o dos implantes fueron casi identicas. El beneficio de compartir la carga al ferulizar las
coronas es notable solo cuando los implantes en las
regiones premolar y molar tienen diferente capacidad
de soporte.

Resumen
Objetivos: Se estudiaron modelos tridimensionales
de elementos finitos (FE) de coronas protesicas y se
evaluo el analisis de estres con diferentes tipos de
soporte implantario, incluyendo implantes estandar,
anchos o dos implantes, para restauraciones parciales en posteriores edentulos.
Material y metodos: Se construyeron dos modelos
FE basados en mandbula de cadaver conteniendo el
21 premolar y el 1er molar. Las coronas de estos dos
dientes se modelaron como conectadas y desconectadas para imitar los disenos conectados y desconectados, respectivamente. Se coloco un implante
estandar en la region premolar, mientras que para

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