Stress Analysis on Equator Attachment with Palatal and Palatless Maxillary Implant Overdenture designs

Abstract

This study aimed to compare the amount of stress generated on two versus four implants with equator attachments in maxillary implant overdentures with palatal coverage and palateless designs. Four standardized educational edentulous maxillary models simulating bone type II were used. The models were divided into two main groups according to palatal design (palatal coverage and palateless), and each group was further subdivided based on the number of implants (two or four implants). In the two-implant subgroup, implants were placed bilaterally in the canine regions perpendicular to the residual ridge using a surgical stent, whereas in the four-implant subgroup, implants were installed bilaterally in the canine and second premolar regions. Equator attachments with appropriate cuff heights were selected, and framework patterns were constructed. Four strain gauges were cemented to each fixture using strain gauge cement. A LLOYD digital loading device was used to apply compressive loads to measure the resulting stresses around the implants for each attachment configuration. The results demonstrated a statistically significant difference between stresses on two implants with equator attachments (74.53 ± 35.9 N/m × 10²) and four implants with equator attachments (10.85 ± 10.81 N/m × 10²) within the same palatal coverage design. Similarly, a statistically significant difference was found between stresses on two implants with equator attachments (123.75 ± 44.60 N/m × 10²) and four implants with equator attachments (14.51 ± 14.60 N/m × 10²) within the same palateless design. It was concluded that stress on two implants with equator attachments was markedly greater in the palateless design compared with the palatal coverage design, whereas stress on four implants with equator attachments was slightly greater in the palateless design than in the palatal coverage design, with no statistically significant difference.