[Surface stress analysis of distal extension removable partial denture retained with two types of semi-precision attachments]

Abstract

Objective: The aims of this study are to analyze the surface stress of the periodontal supporting bone of the bilateral distol extension removable partial denture which is retained by using intra-coronal or extra-coronal semi-precision attachment, and to characterize the biomechanics of these two designs by using a strain gauge.

Methods: A fresh human mandible specimen with 76|67 missing and six bilateral partial removable denture retained with six semi-precision attachments were made, including three attachments with intra-coronal studs and three attachments with extra-coronal vertical bars. A total of six 45 degrees rosette strain gauges were bonded at six prepared points on the surface of the mandible to measure the surface stress, including the middle point between 76 of the buccal edentulous alveolar crest area under the denture base verge(point 1), the distal buccal cervix of 5 (point 2), the buccal apical area of 5 (point 3), the buccal middle area of 34 roots (point 4, 5), the lingual middle area of 5 root (point 6). The static loads of 14N, 28N and 42N were applied vertically, buccally 45 degrees, lingually 45 degrees at the middle point of the 6|6 occlusal surface. The micro-strain was recorded, and the maximal/minimal principle stresses were calculated for each RPD and each point. The stress characteristics of these two types of attachments were compared and analyzed.

Results: In most situations, the stress of these two semi-precision attachments showed significant differences. The vertical load: The stress values of these intra-coronal and extra-coronal attachments at points 1, 2, 3, 4, 6 differed significantly(P < 0.05), including points 1, 2, (sigma intra < sigma extra) and points 3, 4, 6(sigma intra > sigma extra). Buccal loads: The stress values of these intra-coronal and extra-coronal attachments at points 1, 2, 3, 4, 5 differed significantly(P < 0.05), including points 1, 2(sigma intra < sigma extra) and points 3, 4, 5(sigma intra > sigma extra). Lingual loads: The stress values of these intra-coronal and extra-coronal attachments at points 2, 3, 4, 6 differed significantly (P < 0.05, sigma intra > sigma extra). The intra-coronal attachment generally produced higher stress at the site of the alveolar bone around the abutment than the extra-coronal attachment, but extra-coronal attachment produced higher stress at the edentulous alveolar crest and the distal cervical alveolar bone of the distal abutment than the intra-coronal attachment.

Conclusion: The intra-coronal attachment is suggested to be applied in some cases that the periodontal condition of distal abutment was good, and the extra-coronal attachment is suggested to be used in some cases that the condition of the edentulous alveolar crest is fairly good, while the periodontal condition of the distal abutment was relatively weak.