Human ex vivo bone tissue strains around immediately-loaded implants supporting mandibular fixed prostheses

The purpose of this study was to qualify and quantify bone strains around immediately-loaded implants supporting mandibular fixed prostheses with regard to number of implant support. Linear strain gauges were bonded on the labial bone of 5 Straumann dental implants placed in the mandibular symphysis region of 2 completely edentulous mandibles of fresh human cadavers. Installation torque value of each implant was measured by a custom-made torque wrench and resonance frequency analyses were undertaken. A one-piece full-arch fixed prosthesis was fabricated for each cadaver and 2 miniature load cells were integrated in the cantilever region of the prostheses for controlled loading experiments. 5-, 4-, and 3-implant support designs were consecutively tested. Strain measurements were performed at a sample rate of 10 KHz and under a maximum load of 100 N, simultaneously monitored from a computer connected to data acquisition system. The installation torque values and implant stability quotient values of the implants ranged between 42.12 to 145.67 N cm and 61 to 80, respectively. Between-group comparisons revealed that the highest strain magnitudes were recorded for the 3-implant design followed by the 4- and 5-implant designs, although there was a tendency toward similar load partitioning between 4- and 5-implant designs (P < 0.05). Bone strains around 3-implant supported mandibular fixed prostheses is significantly higher than those around 4- and 5-implant designs, and this may lead to failure of supporting implants. Four- and 5-implant designs might have similar clinical outcome.