Non-linear 3D finite element analysis of full-arch implant-supported fixed dentures

Despite the necessity for faster clinical protocols for immediate loading of implant-supported dentures, there is a lack of biomechanical studies to confirm the rigid splinting effectiveness. We compared the stress in mandibular full-arch implant-supported fixed dentures under immediate loading through three-dimensional finite element analysis. Edentulous human mandible models were restored with a 4-implant fixed denture. Implants were splinted with a metallic framework and submitted to conventional loading (group A-control), with acrylic resin and submitted to immediate loading (group B), with a metallic framework and submitted to immediate loading (group C), and with acrylic resin and a prefabricated distal bar and submitted to immediate loading (group D). Models were supported by masticatory muscles. A 100-N oblique load was applied on the first molar. Group A presented the lowest stress and implant displacement values, whereas group D showed the highest values. In bone, groups under immediate loading exhibited the highest stress, whereas the group experiencing conventional loading showed an approximately 50% reduction. All groups submitted to immediate loading presented similar stress values in peri-implant bone. The loading protocol influenced the stress and implant displacement, but the design of the fixed denture did not affect the stress in the peri-implant bone. Rigid splinting of implants submitted to immediate loading is not essential for treatment success.